Skin health kōrero at kura draws many in Rāhui Pōkeka
Our Whānau Voice kaimahi attended a community hui at Te Wharekura o Rakaumanga, hosted by Matawhaanui Trust to kōrero about common health challenges affecting tamariki and whānau, with a special focus on skin conditions.
It was a packed and uplifting session, bringing together whānau, nurses, paediatricians, rongoā practitioners and other health professionals who shared their knowledge and practical advice. Among those present were Nurse Practitioner Justina Leaf, CEO of Matawhaanui Trust Joyce Maipi and her whānau, Julia from Sexual Health Waikato, and three paediatricians from the ARROW childhood wheeze trial, Dr Cameron Bennett, Dr Owen Sinclair, and Dr Te Aro Moxon.
The kōrero centred on simple, practical ways to support whānau managing skin issues like eczema and scabies. Dr Owen Sinclair reminded those gathered not to be too hard on themselves, saying the problem is the eczema, not the child. He emphasised that mindset matters, and that parents should not feel blame but instead focus on gentle, consistent care.
Dr Cameron Bennett spoke about the importance of rest, as sleep gives the body time to fight infection, and also shared tips around salt baths, soaked dressings, and managing infections that can complicate skin conditions. Others suggested checking whether soaps or food such as cow’s milk might be contributing to irritation.
For some whānau, cost can be a barrier, and affordable options like adding a teaspoon of Janola to the bath were discussed as simple ways to disinfect the skin when used safely. Parents were also encouraged to make sure that kōhanga or preschools are aware if tamariki have hot or red skin, so early help can be found.
Dr Te Aro Moxon, who works both as a community paediatrician and general physician, spoke about the need to strengthen the link between hospital-based care and the support available in communities. The hui also highlighted the barriers that many whānau face in accessing healthcare, from the cost of travel to Hamilton, to issues of trust, affordability, and feeling heard.
Joyce Maipi, shared a heartfelt story about a young wahine from the community who passed away at just 38 years old from breast cancer that was detected too late. She spoke of her legacy as a reminder to all wāhine to get screened early, noting that the Breast Screening Aotearoa mobile unit is currently parked outside Huntly Woolworths.
Justina Leaf acknowledged that this was the first face-to-face forum held in some time and thanked those who travelled down from Auckland to attend. She shared examples of the manaaki shown by Matawhaanui’s team, from staying on late to help a koro with heart issues, to supporting another with nicotine patches that helped him give up smoking and improve his health. These small but powerful acts of care, she said, are what make the difference for whānau.
Rongoā healers from Te Puna Ora also attended, sharing their mirimiri and natural health knowledge. Julia from Sexual Health Services (formerly Family Planning) spoke about the importance of HPV vaccination and the rising rates of syphilis, encouraging whānau to get checked and treated, especially for the health of unborn pēpi. Rangatahi were also present including nieces and nephews brought along by their aunties and uncles and their participation was warmly acknowledged as a positive sign of intergenerational learning in action.
The hui ended with Ursula from the Electoral Commission encouraging everyone to make their voices count in the upcoming election. For whānau wanting trusted information and support, the KidsHealth website was recommended as a valuable resource for parents, alongside the ARROW study site and the Paediatric Society’s equity commitment page.
It was a powerful and timely reminder that hauora begins at home with aroha, rest, and simple, practical care. By bringing together community voices, health professionals and researchers, gatherings like this help bridge the space between hospitals and homes, between science and rongoā, and between whānau and wellbeing.
Kāwhia whānau lead kōrero on more support
This morning in Kāwhia, a close-knit community of just 378 people, we joined the latest Community Health Forum to kōrero, listen, and offer tautoko. Te Tiratū acknowledges the vital work of Te Whatu Ora kaimahi, who coordinate these hui across the rohe to connect with whānau, share updates, and ensure their voices are heard.
Whānau travelled from across the West Coast Harbours to share their stories, experiences, and priorities for the wellbeing of their whānau and community.
A key priority was funding awareness and support. Whānau highlighted the need for proactive guidance from Te Whatu Ora staff to help them understand and access available funding opportunities. Clear advice, they said, empowers whānau to improve wellbeing, build resilience, and strengthen independence.
Another strong theme was community connection. Whānau spoke about the importance of small, humble events, from karaoke nights to kaumatua creative workshops, which lift spirits and reduce isolation, especially for those living alone.
The forum also highlighted kaumātua support needs. Many kaumātua are struggling with everyday tasks and require consistent, daily support. Whānau spoke about the need for a kaumatua bus, tailored services, and culturally appropriate care to help uphold their dignity and independence.
Transport challenges were another key concern. Funding and reliable transport to Waikato Hospital and nearby towns remain a significant barrier, especially for those requiring regular appointments, specialist care, or after-hours help.
Accessing home help is difficult in isolated areas. Limited carer training and high travel costs make services unaffordable for many whānau. Investment in workforce development and travel support is urgently needed to ensure everyone receives the care they need.
Rangatahi mental health was a serious topic of discussion. Suicide among rangatahi is a concern in isolated communities. Whānau want more clinical expertise, suicide prevention support, and culturally responsive mental health services available close to home.
Primary care workforce shortages were raised as a pressing issue. Dr John Burton, the local GP, has been a lifeline for Kāwhia whānau, but there is uncertainty about future care provision once he retires. Succession planning and investment in rural healthcare are critical to maintaining services.
Whānau also spoke about the need for Disability Allowance awareness. Clear communication and outreach regarding support available through WINZ and ACC will ensure that entitlements are accessed and whānau can receive the help they need.
After-hours care is available through Ka Ora Telecare and 24/7 telehealth services, but these user-pays services can be costly for those without a Community Service Card. Affordable options are needed to ensure whānau can access care at any time.
Public health preparedness was another focus. The Waikato Immunisation and Public Health Teams are coordinating plans in case of measles or other outbreaks. Community awareness and readiness are key to keeping whānau safe.
Finally, whānau highlighted the urgent need for affordable dental services for adults in rural areas, to ensure everyone has access to essential care.
It was clear that the Health Forum shone a light on the power of connection. It reminded everyone that strong kōrero, listening, and care can make a real difference in whānau wellbeing.
Frontline voices on state of rural health in Thames
Associate Health Minister with responsibility for Rural Health, Matt Doocey and Minister for Rural Communities, Mark Patterson came to Thames today, to hear directly from the frontline about the challenges facing rural communities.
Doocey set out the five priorities of the Rural Health Strategy; recognising rural communities as a priority group, focusing on prevention for a healthier future, ensuring services are available closer to home, supporting access to services at a distance, and building a valued and flexible rural health workforce.
He also noted the review underway of the travel assistance programme, ongoing workforce pressures, and the rollout of one of six prototype digital telehealth services, with Thames chosen as a pilot site for 24/7 support.
While government priorities were outlined, much of the kōrero centred on the lived realities of staff, communities and a Māori provider of affordable health and wellness services across the Hauraki rohe for over 25 years.
Attendees described severe burnout among doctors and nurses, with calls for immediate workforce relief in Hauraki. Many emphasised that the bulk of the health workforce are women, yet parity in pay remains unresolved, creating inequity and undermining retention.
CEO of Te Korowai Hauora o Hauraki, Tammy Dehar, stood to share whakaaro about what integrated services might look like if they included the social determinants of health. She urged government to design solutions with communities rather than impose top-down targets, especially to support rangatahi. Similar calls were made for better training pathways, with regulated health body training and youth development identified as vital to the future of the rural health workforce.
Rural GP Alex McLeod also spoke out, saying good primary care services are not being given enough regard in government health design and resourcing. He said kaupapa Māori providers already deliver effective, whānau-focused care but are undermined by fragmentation and competition for funding. He urged government to consider local governance for primary care, rather than allowing secondary services to dominate leadership and decision-making.
In response, Doocey said immigration and skilled migration could help to address workforce shortages but were “not a silver bullet,” with policy settings needing to shift. He confirmed that a new mental health crisis response service is being developed with Police over the next three years and acknowledged the importance of building equity into workforce planning. A senior nurse and a nurse practitioner have also just been approved for the Thames Hospital ED.
Housing emerged as another barrier, with limited supply making it difficult for staff to stay and live locally. Safety was also raised, with communities dealing with domestic and sexual violence, drugs and alcohol, and the resulting rise in mental distress. Without adequate supports, attendees said, these pressures compound the crisis for both whānau and frontline services.
Transport and access challenges were highlighted, especially for elderly residents. After-hours services remain very limited. A short-term transport option provided by Thames Hospital earlier this year was welcomed but is not permanently funded. Seasonal pressures also weigh heavily, with the summer population in Coromandel surging from around 1,400 residents to 30,000 visitors, stretching an already fragile system.
In Waihi, residents face a three-day wait for telehealth services, with no permanent local health professionals and reliance on Thames Hospital ED. While Te Whatu Ora has committed to changes, attendees said stronger support for rural health practitioners is essential.
The hui also heard about local innovations such as the Colville Project, promoted and led by Dr Katie Armstrong, which integrates housing solutions, youth trainee pathways, and visiting specialist support. With $1.29 million already raised, the project demonstrates the ability of rural communities to design and deliver their own solutions when adequately supported.
The meeting showed that rural health cannot be transformed without resourcing the workforce, addressing housing and pay equity, and empowering local solutions that reflect the realities of rural communities. As Minister Doocey acknowledged, co-design and localism must sit at the heart of the Rural Health Strategy if it is to deliver for Hauraki and beyond.
Standing together for hauora – “Unity is what gives us mana”
Today, Te Tiratū Iwi Māori Partnership Board and Ngaa Pou Hauora oo Taamaki Makaurau Iwi Māori Partnership Board, representing over 210,000 whānau Māori, and partners in Rangitāmiro Whānau Ora Commissioning Agency gathered in Kirikiriroa for their first Board-to-Board hui to discuss the future of Māori health.
The kōrero focused on how the two IMPBs can work more closely together on hauora priorities and create future opportunities for Māori communities across Tainui waka rohe and Tāmaki Makaurau. One Board member reminded the rōpū, “The issues our whānau face don’t stop at regional boundaries. When we move together, our people are impossible to ignore.”
Legislative changes under the Pae Ora Bill and the statutory role of IMPBs were a major theme. There was strong consensus on charting an independent path forward that puts Māori voice and priorities at the centre of decision-making.
A key theme of the afternoon was mana motuhake, the power of designing health systems that reflect Māori realities. “We need to design systems for delivery that are inherently rooted in kaupapa Māori rather than being adjuncts to a system that was never built with the Māori experience of health in mind,” said one Board member. Another added, “We can’t wait for the system to decide what matters. We need to set the direction ourselves.”
The hui also highlighted the importance of joint advocacy and a stronger Māori voice. By working together with other Iwi Māori Partnership Boards, especially in high-population regions like Tāmaki Makaurau and Waikato, the collective scale of IMPBs strengthens national influence.
Aligning positions, sharing data, and producing joint communications ensures that both media and decision-makers cannot ignore the weight of Māori voices. As one participant noted, “Fragmentation weakens. Unity is what gives us mana.”
A significant discussion focused on how local priorities feed into national frameworks. Members explored the intersection between their Community Health Plans, the Hauora Ministerial Advisory Committee (HMAC), and the Government Policy Statement set by the Minister of Health.
As one board member explained, “Ideally, IMPBs set the final priorities through our Community Health Plans, HMAC puts those to the Minister, and those priorities become the Government’s priorities too.” This underscores the crucial role IMPBs play in ensuring whānau voices are not sidelined in policy and planning.
Both Boards also emphasised the need to move beyond deficit narratives. While inequities remain stark, the hui highlighted the importance of celebrating whānau successes and showcasing kaupapa Māori solutions already making a difference. “We are not just a story of struggle,” said one voice around the table. “We are innovators, we are resilient, and we already have answers that work.”
By the end of the hui, both Boards affirmed their commitment to Māori health priorities and keeping Whānau Voice at the centre. The message was clear, by staying strategic and united, the IMPBs will ensure Māori health priorities are carried strongly into national decision-making, with whānau voices shaping a system designed for them, not imposed upon them.
Rural Health Roadshow: Te Kūiti Speaks
Yesterday, the Les Munro Centre in Te Kūiti was packed as Te Tiratū Iwi Māori Partnership Board attended the Rural Roadshow. Mental Health Minister Matt Doocey and Minister for Rural Communities Mark Patterson listened as the community spoke directly about the real issues affecting them so both ministers and bureaucrats heard their voices firsthand.
Minister Doocey admitted that while national targets for health services may appear strong, performance in rural areas, particularly for rangatahi Māori mental health, lags significantly behind.
“Nationally we might be hitting 80 percent, but in rural Māori communities, the figures drop sharply,” he said. He praised the importance of local decision-making, stressing that community knowledge is essential to design effective services, and shared that the government is prioritising investment in underperforming areas, with $2.8 billion committed to mental health services this year, aiming to resource local providers and lift access and outcomes.
Key Questions from the Community
Local doctors, Kaimahi, and hauora Māori providers raised concerns that included access to care, noting that in some rural areas travel times to a hospital can exceed three hours, meaning urgent care is often delayed. Workforce shortages were another pressing issue, with providers asking what strategies will be implemented to retain doctors, nurses, and Māori health practitioners in rural areas. Digital health limitations also surfaced, with communities highlighting the challenges of telehealth in areas without reliable internet. Sustainable funding and integration of services were other priorities, with providers questioning why many community services still receive only one-year contracts and how mental health, primary care, social services, and housing can be coordinated locally.
Various locals raised the broader determinants of health, including alcohol accessibility, youth vaping, housing, and poverty, noting that these factors directly influence mental health outcomes. A story was shared about intergenerational trauma, the lingering impact of war, and how past experiences of discrimination and stigma continue to shape the mental health landscape for whanau living rurally and remotely in the rohe today.
Ministers’ Responses
Minister Doocey spoke about targeted investment to underperforming regions and the importance of enabling local providers to design solutions from the ground up. Relational commissioning was highlighted as a key approach, allowing communities to develop services that meet their own needs rather than relying solely on top-down directives. He spoke about ambitious mental health targets, including one-week access for primary mental health services and three-week access for specialist services, among the fastest internationally.
Ministers discussed workforce development as a critical piece of the solution, encouraging rural students to pursue healthcare careers and return to their communities. Initiatives such as mobile health screening units, and integrated care prototypes currently on the drawing board as innovative ways to improve equity and access. Ministers also recognised the importance of preventative and early intervention services, stressing that timely support is vital to prevent minor health issues from escalating into serious conditions.
The meeting underlined that improving rural health requires both cross-agency government support and local leadership.
“Health isn’t just about seeing a doctor. It’s about housing, food security, education, and the broader environment. The government can pull a few levers, but ultimately communities drive what works,” said Minister Doocey.
On the ground in Piopio: Health access struggles exposed at Te Nehenehenui Hui-ā-Tau
Photo: Whānau Voice kaimahi Raven Torea with kaumātua at Te Nehenehenui Hui-a-Tau
Whānau from Te Kūiti, Taumarunui, and surrounding areas came together at the Te Nehenehenui Hui-a-Tau, held at Napinapi Marae in Te Mapara, Piopio, to share their experiences with local health services, highlighting both the strengths of providers and the pressing gaps in care.
The hui, held on a clear and sunny day, provided an opportunity for kaumātua and whānau to discuss their needs and challenges with our Whānau Voice team. They reported using a mix of mainstream health services, including GP clinics, hospitals, dentists, midwives, physiotherapists, and optometrists, alongside traditional rongoā practices such as kawakawa teas, mirimiri, and herbal remedies. For many, GPs are a last resort, accessed only when traditional methods are insufficient.
Despite these resources, whānau emphasised the need for expanded services. Requests for more GPs, dentists, Māori-led health providers, mental health and counselling support, dieticians, and specialist services were consistent. Many whānau continue to travel to Waikato for care, often relying on friends or shuttles for transport, adding additional strain for elderly community members.
Access challenges were a recurring theme. Long wait times for GP and specialist appointments, lack of after-hours care, high costs for dental and optometry services, and limited information about available services all create barriers. Some whānau reported preferring to travel to Hamilton for glasses or dental care due to affordability and better service, highlighting inequities in local provision.
Despite these challenges, trusted providers received strong praise. Dr Rose Harris of the Maniapoto Whānau Ora Centre, which is part of the Taumarunui Community Kokiri Trust in Te Kūiti was highlighted as a Hauora Māori provider who delivers exceptional care, earning widespread respect from the community.
When asked about government health targets, whānau were unanimous in their assessment: the targets are not being met. “The government don’t see the struggles whānau have on the ground. They should walk in our shoes,” one wahine said. Another noted the higher rates of diabetes among Māori and Pasifika, adding, “No way. They’re not meeting them, and they need to go.”
Whānau also shared what supports their wellbeing. Engagement in marae and iwi activities, speaking te reo Māori, participating in physical activity, and spending time in nature were identified as key to maintaining health.
The hui underscored the importance of whānau voices in shaping health services. Whānau called for care that is accessible, culturally grounded, and delivered by Māori providers close to home. Their message was clear: health systems must meet the needs of the people they serve.
Our nationwide stand with all IMPBs against proposed Pae Ora Bill changes
Photo: Board member Maxine Ketu and e Tiratū Tumu Whakarae, Brandi Hudson attend the National IMPB Hui in New Plymouth
Te Tiratū Iwi Māori Partnership Board (IMPB), as part of a national alliance of 15 IMPBs, opposes the proposed amendments to the Pae Ora Act, warning that the changes would weaken Te Tiriti-based partnerships and undermine progress in Māori health equity.
At a recent National IMPB Hui in New Plymouth, 15 IMPBs representing 914,400 Māori from 82 iwi aligned in opposition to the Bill. The discussions highlighted the critical importance of maintaining partnerships that are rooted in trust, respect, and intergenerational thinking, ensuring solutions are anchored in mātauranga Māori and the realities of whānau.
The hui included rangatahi voices emphasising the deep connections between hauora, whakapapa, and whenua. Their presentations stressed the need for health approaches that integrate ancestral knowledge with modern, data-driven health systems. This interweaving of the old and the new highlighted the value of locally led solutions that resonate with whānau and communities.
Te Tiratū IMPB asserts that the proposed changes would remove direct iwi accountability, replacing kanohi ki te kanohi relationships with a centralised, Minister-appointed process. This approach risks tokenistic consultation rather than genuine Māori leadership, and threatens the hard-won equity gains achieved by IMPBs over the past decade.
The Board’s position is clear: local accountability through IMPBs must remain, regional advice to Te Whatu Ora must be strengthened, and health strategies must include specific Māori equity actions. Any amendments that weaken or replace Te Tiriti principles are opposed.
Te Tiratū IMPB submitted its formal response to the Health Committee on 18 August 2025, supporting a unified IMPB call to:
- Retain HMAC accountability to iwi through IMPBs
- Strengthen IMPB roles for local and regional advice to Te Whatu Ora
- Develop health strategies with targeted Māori equity actions
- Oppose amendments that undermine Te Tiriti principles
Our Board emphasises that this is about safeguarding the right to lead local solutions for Māori communities. Analysis shows the proposed changes are unlikely to improve Māori health outcomes, reinforcing the need to maintain systems that are already showing results.
Te Tiratū IMPB remains committed to advocating for whānau-centred health solutions and ensuring Māori voices remain central in shaping Aotearoa’s health system.
What whaanau told us at Tainui Hui-aa-Tau
Photo: Whaaea Audrey Wildermott, Ngaati Koroki Kahukura with Whaanau Voice kaimahi
Te Tiratū Iwi Māori Partnership Board was honoured to attend Tainui Hui-aa-Tau 2025, hosted by Tainui iwi walking in the steps of their visionary Koiora strategy. This aspirational kaupapa brought together thousands of uri and providers across the motu to connect, share, and strengthen collective oranga.
We were there by invitation to support Whaanau Voice and deepen our understanding of how the Koiora Collective and Te Tiratū fit within the wider ecosystem of Māori health and wellbeing. While our original focus was on promoting our Oranga Survey the day quickly turned into something more — a space for heartfelt koorero and deep listening.
What we heard was despite government targets focused on faster cancer treatment, shorter ED stays, improved immunisation, and reduced wait times for specialist and elective care, whaanau at Tainui Hu-a-Tau described a system that remains slow, hard to access, is culturally disconnected, and difficult to navigate — especially for whaanau seeking kaupapa Maaori services and timely, affordable care.
Whaanau Voice Leads the Way
Our space at Hui-aa-Tau was a hive of activity, filled with whānau keen to share their experiences and insights about accessing healthcare. Many whaanau wanted to koorero at length, reflecting a widespread desire to be heard. Primary care was a consistent topic. Whānau spoke about long GP wait times, often up to four weeks, difficulty enrolling at kaupapa Maaori clinics due to capped rolls, and the frustration of not being able to see the same doctor for continuity of care. Many whaanau living rurally shared feelings of isolation from healthcare, relying on transport support from whaanau, iwi or local services. For those who could afford it, urgent care was preferred over long waits at emergency departments, but even this came with financial strain.
The Strain of Financial Pressure
Cost was a major barrier. Whaanau shared stories of having to choose between kai and seeing a doctor. Prescriptions added another burden. Even if a whaanau member managed to secure an appointment, the costs didn’t end there. Some spoke of giving up altogether — delaying care or avoiding it until it became urgent. Many whaanau weren’t enrolled with a GP at all. Some had been trying to enrol with kaupapa Maaori services but were turned away due to capacity limits. Several questioned why non-Maaori were enrolled in Maaori-specific services when they, as tangata whenua, were being declined. There was deep mamae in these koorero, and a desire for a fairer, more culturally grounded system.
The Challenge of Health Literacy for Kaumatua
Kaumatua shared personal journeys of navigating health conditions and the system without proper explanations or support. One kaumatua described an 18-month journey to get assistance to help manage his diabetes to get it under control which is a long time to be mauiui. Others expressed confusion around medication or what services were available to them. Many didn’t know where to go or how to ask for help, and several mentioned feeling whakamaa about not understanding their conditions. The language barrier was another big one, where whaanau are not able to understand a lot of different accents by non-Maaori health practitioners, they feel there is a lack of cultural safety too. For kaumatua living rurally, transport remains another major barrier. Many said that it was much easier for them to go to their local marae that was close. Many rely on once-a-week iwi transport or local hauora hubs that have now been scaled back due to funding cuts. In some areas, services that once operated five days a week now open for just one — creating high demand and limiting access.
Mental Health in Crisis
Mental health was another area of concern. Many who spoke were supporting a sibling, cousin or other whaanau member. The main issue raised was the lack of support available before a person reaches crisis or hospitalisation. Henry Bennett Centre came up repeatedly — described as difficult to deal with, lacking cultural safety, and disconnected from whaanau. Whaanau described not being informed about loved ones’ care, feeling shut out of the process, and being left to advocate for their whaanau without support.
There was a strong call for mental health services that are proactive, culturally safe, and easy to navigate. Many felt stuck trying to get help for their whaanau and repeatedly faced barriers in the process.
The Hidden Gaps in Women’s Health
A number of wahine raised concerns about the lack of accessible information around menopause. They described debilitating symptoms and feeling unsupported or dismissed. Some were surprised to learn just how little was publicly available in terms of education and care. The koorero made it clear that more kaupapa Maaori women’s health services are needed — both in delivery and in design.
Hearing Loss, Delayed Care and Advocacy
Hearing support was another unexpected but prominent theme. Many whaanau attending the hui wore hearing aids, yet no hearing-focused service was present. One kaumatua, a veteran of the New Zealand Army, shared that it took years to realise the extent of his hearing loss. Another wahine described the two-year process of trying to get care for her daughter — eventually only made possible with the help of a Maaori advocate. For these whaanau, accessing support required determination, energy, and navigating complex systems. Funding options, eligibility, and appointment access created further layers of stress. Even for tamariki, care was delayed — sometimes for years. While support grants like the kaumatua hearing aid fund exist, awareness and accessibility remain major gaps.
The Need for Rongoaa and Kaupapa Maaori Options
Throughout the day, whaanau called for more access to mirimiri and rongoaa Maaori. There was a hunger for services that reflect maatauranga Māori and are grounded in whakapapa and whaanau values. One whaanau member, supporting a younger relative who had experienced a stroke, spoke of the lack of Maaori-led recovery options. Others expressed interest in alternatives to mainstream medication but didn’t know where to start. The desire for Maaori-led, whaanau-centric, culturally affirming care was one of the strongest themes to emerge. It aligns closely with the aspirations of Tainui’s Koiora strategy and the values Te Tiratū holds as we walk alongside whaanau and providers.
A Call to Honour Whaanau Voice in System Change
Tainui Hu-aa-Tau 2025 was more than an event — it was a collective pulse check on how the health system is serving our people. Whaanau were open, honest, and generous with their koorero. Their insights paint a clear picture of a system that needs to evolve, one that genuinely centres Whaanau Voice, upholds Te Tiriti o Waitangi, and recognises hauora as a right, not a privilege. We are committed to carrying these voices forward — into our planning, our advocacy, and our partnership with Te Whatu Ora. We also mihi to Tainui iwi for their bold leadership and vision, and for the opportunity to stand together in kaupapa Maaori-led transformation. Te Tiratū will continue to listen and act — because when whaanau speak, the system must listen and respond.
“How do I fix this?” Terereawai’s journey from kura teacher to future nurse practitioner
Photo: Terereawai Kipa-Kearns with whānau
When Terereawai Kipa-Kearns (Waikato, Tainui, Ngāti Mahanga, Te Papa o Rotu Marae) asked herself “How do I fix this?”, it wasn’t a casual question—it was the turning point of her life, and a spark that’s now transforming how hauora care is delivered for Māori whānau. Raised in a typical Māori whānau in Ngāruawāhia, Terereawai grew up with reo Māori and from generations on the benefit. She was the first in her whānau to pursue tertiary education, breaking cycles and building new pathways not just for herself, but for generations to come.
She didn’t start her working life in health. In fact, she was a kura kaupapa Māori teacher for more than a decade—after graduating directly from high school into teacher training, then working with both tamariki and adults to uplift reo Māori. But it was the experience of becoming a māmā—specifically her sixth baby—that changed everything.
When her pēpi became seriously ill with bronchiolitis, she found herself in hospital for weeks, grieving the lack of cultural care. “They said I couldn’t breastfeed, couldn’t sleep with my baby, couldn’t make choices that were part of who I am as a Māori māmā. My baby cried. I cried. We just cried together.”
In the middle of one of those long nights in the hospital, she googled: how to become a nurse. The next morning, she told her husband her plan. He said, “Okay.”
From Classroom to Clinic
Terereawai began nursing training a week after her pēpi turned one. Ten years later, she’s still in the thick of it—now a nurse prescriber, nearing the completion of her Master’s degree, and preparing to step into the highly specialised role of nurse practitioner, one of 66 Māori in that field across Aotearoa which is 9% out of a cohort of 703.
Her path hasn’t been typical. In fact, everything about her mahi is designed to flip the Western health system on its head.
“I started thinking I’d go into hospitals and fix things. But during my nursing training, I realised—I’m never working in a hospital. That system’s broken. I fell in love with mental health instead.”
Why mental health? Because it’s complex. Challenging. Not something that can be “solved” with a simple script. “Helping someone find their way back to wellness—that’s rewarding,” she says.
A New Model of Care, Built from the Ground Up
Seeing gaps became part of her superpower. From community mental health, to child and adolescent support, to COVID response leadership—Terereawai saw firsthand how the existing system failed whānau. “Every time I thought I’d removed a barrier, another would appear.”
This motivated her to become a community prescriber, then a designated prescriber, extending her clinical scope to treat whānau with long-term conditions like diabetes and hypertension—especially when they couldn’t afford or access a GP.
But the real shift came when she realised: she couldn’t do what was needed under someone else’s rules. “I kept getting told no—by people who weren’t clinical. They didn’t see the need.”
So, she founded her own charitable trust: Te Ngakau-aa-Kiwa. Now, she and her team deliver wraparound hauora care on whānau terms.
Whānau-First Healthcare
At Te Ngakau-aa-Kiwa, the model is simple: go to the people, not the other way around.
- Home-based care, not clinic-only appointments
- Flexible hours, including evenings and weekends
- Cultural safety, always
- Health prevention and literacy, not just treatment
- Whānau-led solutions, not system-driven ones
“Western models of care don’t work for our whānau,” Terereawai says. “Expecting someone to take time off work, find transport, and get to a GP during office hours—how is that realistic?”
As Clinical Director, she and her team adapt their hours to suit the needs of the people. Mondays, Wednesdays, and Fridays are late-night days. Tuesdays and Thursdays are dedicated to kaumātua day programmes. They see whānau when they need to be seen—early mornings, weekends, whatever it takes.
And the kaupapa works. “We’re seeing real shifts. Because this mahi honours people’s time, their lives, and their tikanga.”
Changing the System, One Whānau at a Time
Even as a nurse prescriber, she sees barriers. “I can treat a sore ear—but if I find something undiagnosed, I still can’t do anything. That’s why I’m becoming a nurse practitioner.”
As a nurse practitioner, Terereawai is the nurse equivalent to a GP. She’ll be able to assess, diagnose, treat, and prescribe—all from inside a whānau home, without them ever stepping into a clinic. That autonomy is rare. Even rarer among Māori.
“In the last three years of postgraduate papers, I’ve been the only Māori in my classes. Out of 80 students.”
That reality drives her every day—to encourage more Māori into health careers, to push for equity in training and workforce development, and to create a new generation of Māori health professionals who are community-rooted and clinically empowered.
“Fixing It” Her Way
What started with one crying mother and a baby in a hospital bed has grown into a movement. A kaupapa. A vision of hauora that centres Māori solutions, Māori leadership, and Māori care.
And she’s not finished yet.
“As soon as I walk into that whānau’s home, I want to be able to do something. Not refer them. Not wait. Just fix it. That’s what this is all about.”
Mauri ora, Terereawai. You’re exactly what our hauora system needs.
Story shared with permission for the Te Tiratū Iwi Māori Partnership Board.
He Puāwaitanga – A sacred circle of care for wāhine Māori with cancer
Photo: ĀKI Innovations Ltd (ĀKI) kaimahi with whānau
Our Whānau Voice results consistently highlight that wāhine Māori are seeking not only more Māori health professionals within the system but also greater access to rongoā Māori as they navigate healing—especially from mate pukupuku (cancer). Approaches like this one, which place cultural safety, wairua care, and whānau voice at their heart, are exactly what’s needed.
There’s a palpable sense with this kaupapa that the celestial wisdom of our tūpuna has been drawn down from Ranginui, guiding the work with deep ancestral strength and presence. He Puāwaitanga is a hauora Māori wānanga series delivered by ĀKI Innovations Ltd who deliver rehabilitation, rongoā Māori and kaitiakitanga services within the Tainui waka rohe, created by and for wāhine Māori walking the cancer journey.
For many whānau, this powerful programme of He Puāwaitanga offered a profound experience—it was the first time they felt truly seen and heard as Māori within a cancer care setting. The aim of the kaupapa is to provide a culturally responsive service that acknowledges the barriers to fundamental and systemic whānau change.
Marlana Maru, Manukura (Director) shared feedback from wāhine on why it works. One said, “This is the first space where I could speak openly and be understood.” Another told her, “I felt safe here—to be Māori, to ask my questions, and to just be myself.” And another reflected,
“It wasn’t just about having cancer. It was about being alive, and being well, right now.”
These voices reflect the need for culturally grounded care—care that honours identity, nurtures wairua, and holds space for the whole person. Grounded in manaakitanga, clinical expertise, and mātauranga Māori, He Puāwaitanga offers wraparound care that centres the whole person—not just the diagnosis. Waikato-based, the programme weaves cancer support into a broader service that includes ACC injury rehabilitation and traditional rongoā Māori healing.
Leading the programme is Renee Wood, a senior physiotherapist with over 15 years’ experience in oncology rehab and lymphedema management. Using a bioimpedance machine, she is able to monitor tinana indicators such as fluid retention and lymphatic health—especially vital for those affected by node removal or cancer-related swelling. So successful is the kaupapa, Renee presented internationally at the 2024 World Indigenous Cancer Conference in Melbourne.
Co-designed and delivered by a multidisciplinary team from ĀKI, the initiative brought together a physio, social worker, counsellor, kairongoā and kaiārahi to support wāhine in culturally grounded healing. They facilitated workshops on rongoā and rongoā rākau, shared knowledge of maramataka and movement, and held space for emotional wellbeing in a safe and supportive environment. To enable participation, petrol vouchers were offered—particularly for those travelling from outside Hamilton—and nourishing kai was provided to meet the nutritional needs of attendees.
Culturally Safe Care, Centred on Wāhine
The first He Puāwaitanga wānanga ran as an eight-week series three years ago. Each wāhine participant was at a different point in their cancer journey—some receiving active treatment, some post-treatment, and some told there were no medical options left. They came seeking information, connection, and space to be fully themselves.
What they received was a safe te ao Māori space where:
- Physical wellbeing could be tracked and understood
- Individualised nutrition plans were developed (including for those on strict diets like carnivore or keto)
- Emotional and spiritual health was honoured through kōrero, rongoā, and movement
- Deep topics like intimacy, end-of-life care, and legacy were approached with honesty and aroha
A Whānau of Experts, Chosen by the Wahine
One of the unique strengths of He Puāwaitanga was the ability for wāhine to choose their support team. A truly transdisciplinary approach involving physiotherapists, occupational therapists, counsellors, rongoā practitioners, and social workers—with a strong belief in whānau-led decision making.
Most wāhine chose Renee for follow-up physiotherapy, but a few also requested nutrition support. This included working with a non-Māori nutritionist grounded in holistic philosophy. Wāhine learned to align their nourishment to their body’s unique needs, with protocols that might include keto, high-fat, or low-sugar diets.
Others sought rongoā Māori support, including mirimiri, oro mauri (sound healing through the use of taonga pūoro). These therapies provided deep wairua release and support through vibration, rhythm, and presence.
At one-day wānanga, wāhine were introduced to poi movements paired with pao—a short song written by Renee’s cousin, in memory of her mother who passed from breast cancer. The pao spoke of anguish, transformation, and hope—offering a healing journey through sound and movement. Renee’s father even made kukau / porotiti from reclaimed rimu, which wāhine could take home.
Removing the Barriers, Making It Accessible
In most cancer care models, services like oncology rehab, physio, or mental health support are only available to those with ACC claims or private insurance—and even then, only if the right packages are in place. Most standard insurance doesn’t cover oncology rehab. He Puāwaitanga overcomes these barriers. With public funding from Te Aka Whai Ora, the programme gave wāhine access to the same care typically reserved for the insured—without the cost. It meant Māori were no longer left out of essential recovery services.
But funding only stretches so far. While some one-on-one sessions are still available thanks to a donation made to ĀKI by a private insurance company, the full group wānanga hasn’t been delivered since late 2023. The desire and need are still there—what’s missing is sustainable resourcing. He Puāwaitanga has shown what’s possible when cancer care is led by cultural safety, clinical skill, and kaupapa Māori. Wāhine left not only with new knowledge, but with strengthened relationships, tools to stay well, and restored mauri.
As we look to the future, Te Tiratū Iwi Māori Partnership Board strongly supports the vision of He Puāwaitanga to build a sustainable version of this kaupapa—one that continues to meet wāhine where they are, honours their stories, and provides the wraparound support they should have access too.