Precontact Public Health systems of Māori population
The Indigenous populations have long shared the burden of colonisation that has had an impact on the social, cultural, and mental aspects of health as well as social, cultural, and economic wellbeing (Moewaka Barnes & McCreanor 2019). The M?ori population of New Zealand is an Indigenous community and is estimated to have an ethnic population of about 16.7 per cent of the national population of the country (Government of New Zealand, 2020). The impact of colonisation on the community is of high importance (McIntosh et al., 2019). The Indigenous communities had their own set of beliefs and understanding of health and community that was eroded and was significantly impacted by the colonisation in the country (Came & Tudor, 2017). In the 1700s, the population was identified to have gathered a range of customary knowledge with an understanding of the concept of health and also had the context of developing an understanding of the importance of healthy communities. This reflected the values and relationships in the individuals and also with their environments (Government of New Zealand, 2020). This essay will highlight the importance of the M?ori population in the context of the development of the healthcare systems. The first part of this essay will provide a detailed analysis focusing on the precontact public health systems that were prevalent in the community. This will help in the analysis of the public health systems of the population in the times of 1700s. This paper will discuss this in context with three cultural imperatives, which are, R?hui, Wai, Rongo?. This will be used to discuss and analyse how societies are transformed to be healthy and inclusive. The benefits and the challenges of these cultural imperatives will also be taken into consideration. The second part of this paper will highlight and examine the M?ori responses against the impact of colonisation. This will be done with a discussion as well as on rationale based on Hauora M?ori, 1975 Land march, and the Ng? Tamatoa. This paper will follow an evidence-based approach and on how it has impacted the contemporary society.
The first contact with the Maori population was based on the introduction of Abel Tasman and the East India Company in the year 1642 (Government of New Zealand, 2021). The community lived in small hunting bands and believed in holistic perspectives (McIntosh et al., 2019). In the context of the traditional Maori terms, health is associated with embracing all the aspects that include the family, spiritual and the mental health wellbeing (Moewaka Barnes et al., 2019). This model is now considered holistic but was initially very different from the considerations of what was regarded health as per the traditional aspects of modern medicine. Thus, M?ori health is associated with the concept of health that includes holistic care inclusive of psychological, spiritual, physical care, and the care associated with the family (Came & Tudor, 2017). Health is not a universal concept, and health specialists are not always the best persons to determine people’s health objectives (McIntosh et al., 2019). The health of Maori people, like other important goals, is determined by their elders during traditional tribal gatherings. Traditionally, four different models of health are present in the Maori tradition include the models of Te Whare Tapa Wh?, Te Wheke – Rose Pere, Te Pae Mahutonga – Mason Durie. The four cornerstones of this model of health include the family health of the community, physical health of the community, mental health of the community, and the spiritual health. The Te Wheke – Rose Pere model of health is associated with the understanding of eight core dimensions of health that are included in the process of care and individual developments of health components (Barton, 2018). Te Pae Mahutonga – Mason Durie model of health is also included in the process of health. This model of health in the Maori community is included only in the later stages and is not the health system that was prevalent before first contact (Moewaka Barnes et al., 2019). In this approach, the healthcare components are associated with the factors associated modern health information that is distinct from the traditional approaches (Hill, 2021). Through evidence in history, it is clear that the Maori population was healthy and was not under a major implication on health in the pre-European times (McIntosh et al., 2019). Even when some epidemic diseases were Indigenous to the population, the spread of these diseases was systematically controlled through the policies associated with the sanitation and isolation protocols that were followed by the community that included isolation and frequent cleaning of the surroundings (Hill, 2019).
Traditional concepts of Māori health
The M?ori population is identified to be a generally fit population before the colonisers’ settlement in the region (Mark et al., 2017). Many illnesses in the community were associated with the introduction of the Europeans in the community who brought in a range of diseases and illnesses (Government of New Zealand, 2020). Some illnesses were present in the population but it was after first contact that a range of illnesses was transferred from the Europeans to the indigenous populations. The illnesses that were present in the population before the contact included diseases such as arthritis, pneumonia, and rheumatism (McIntosh et al., 2019). The idea of health illness was strongly associated with the spirituality of the community. The population had a strong belief that they were sick and unhealthy as they did not believe or obey the rules of Tapu (Barton, 2018). To get over this, the population engaged with the Tohunga that was native doctors who had a strong knowledge and understanding of the plant medications (Came et al., 2020). Many diseases like measles, influenza, typhoid fever, etc. were introduced in the population based on these illnesses. This resulted in a massive fall in the Maori population that fell in number by the factor of thirty per cent since first contact till the year of 1840 (Came et al., 2021).
The public health perceptive also involved the inclusion of a R?hui. R?hui was a form of tapu that can restrict the access and use of areas of the kaitikitanga of the area or the guardianship of the area (Government of New Zealand, 2020). The imposition of R?hui can be associated with different reasons in the community. These can include the inclusion of the need for conservation of different natural resources along with the management and restriction due to a recent death in the area (Came et al., 2020). This R?hui could be placed on land or any water sources. The authority of R?hui is given by mana, who is the person who imposes it. The R?hui is still applied today in the community in different regions that are inhabited by the community (Came et al., 2021).
Another cultural aspect that was included in the cultural care and health management and monitoring of the Maori population is the Wai care (Selak et al., 2020). Wai Care is the approach to water quality monitoring that was associated with the process of education and action programs (Blakey et al., 200). The process of Wai care is an approach that is involved in the process of caring for the waterways and for the catchments. Historically, its primary purpose was based on the on ensuring a community action for water management and prevention. This can be associated with the fact that the presence of healthy communities is associated with the healthy waterways (Blakey et al., 2020). The process is also concerned with involving the individuals in the process of care as well as in the process of health management. This is associated with the inclusion of the waterways as one of the primary sources of risk of contamination and also impacting the health and well being of the community (Hill et al., 2019). Therefore, in the past, The conferment of tapu was essentially a safety measure developed with a premise to invoke caution and to warn of any form of danger (Durie, 1985).
Impact of colonisation on Māori population healthcare systems
Rongo? is also an essential component of healthcare and is one of the critical aspects associated with the healthcare of the Maori population. This is regarded as a tradition of Maori healing and is inclusive of plant based medications and remedies (Brockie et al., 2020). The practitioner of this tradition is regarded as Tohunga in the Maori tradition and culture. The core of this approach lies in ensuring the establishment of a strong relationship between the Maori patients and focusing on enabling them to improve their healthcare perspectives (Hunter et al., 2020). This approach is included with a perspective of traditional healing and is associated with the transmission of knowledge. This is associated with an approach where the focus is on traditional healing and the practice is ensured through oral transmission of knowledge (Came et al., 2020). The process is inclusive of herbal medicines, physical therapies, and herbal healing. A suppression act was also passed against the Tohungas as the Tohunga suppression Act (Government of New Zealand, 2020). This act was developed to stop people from using spiritual practices of traditional M?ori medicine as medical interventions. Finally, the act was repealed by the M?ori Welfare Act passed in the year 1962 (Government of New Zealand, 2020). These approaches are based on a more holistic perspective and include a systematic identification of health and its impact which was lacking in then developed modern sciences. Plant remedies were thus one of the core aspects included in the health perspectives of the M?ori population this included the use of native plant species that were used for the treatment of a variety of plant species (Brockie et al., 2020). Many plants are used in the process of medicine and care. In this medicinal approach, the culture used trained individuals. This was associated with the use of plants with specific collection and preparation (Hill et al., 2019). Further, the plant material that was used in the process of care has to be taken into consideration with the collection of plant material, crushing or drying procedure where the plant material is converted in a usable form. It was also ensured in the Maori culture that the focus was on prevention and in holistic care to avoid the incidence of the disease. It was then later applied to ensure treatment and care (Came et al., 2020).
Through the assessment of the cultural aspects of understanding of health in the M?ori population, it can be identified that the focus of the population was on ensuring holistic care of the community by focus on social, psychological and physical wellbeing (Villamayor-Tomas et al., 2018). Doctor’s appointments, drugs, and treatment plans are only a small part of what healthcare entails. Nonetheless, healthcare professionals ignored or misread the personal and culturally appropriate ways in which they controlled their health (e.g. Rongo, listening to their bodies, and being with whanau) (Hamley et al., 2021). Furthermore, prior bad experiences made Maori patients feel unwilling to speak openly with health care providers, especially when it came to Tikanga Maori-based approaches to wellness and holistic care (Tikanga Maori: the customary system of values and practises). Since the focus was on individual aspects as well as prevention of the communities for health development (Moewaka Barnes et al., 2019). It is also critical to understand that the focus of communities was therefore to have a systematic approach that was based on community health and for better building of a cohesive society (Villamayor-Tomas et al., 2018). A shared working of the community was thus present in a pre-contact of the Maori population. Maori elders have advocated traditional approaches with less reliance on biological parents and more on tribe parents due to a lack of trust in Western child-rearing techniques. Any large-scale initiative aiming at improving Maori health must engage elders and may need acceptance of alternative aims and approaches, which are relevant to present Maori thought but maybe unrelated to established Western health issues (Hamley et al., 2020).
Rūhui, Wai, Rongo – Māori cultural imperatives
Maori are also more likely to have poorer earnings, less desirable employment, and limited housing and educational opportunities (Villamayor-Tomas et al., 2018). Maori people have limited access to health care that meet their most basic requirements, which is a serious problem (Government of New Zealand, 2020). The health status of the Indigenous population has been significantly impacted by the historical, cultural, and social contexts of care for masses. The impact is also evident in consideration of the health of the Maori as well as the non-Maori populations of New Zealand (Manukau, 2020). This impact is visible in terms of the current health status of the population with impact on the life expectancies of the population and with impact on their lifestyle factors, association with the socioeconomic factors, availability of healthcare and access to services, and poor inclusion in the societies. The population has asserted and has expressed their disputes in the societies through various ways (O’Toole, 2020). In the post contact scenario, it is important to understand that the Maori community was significantly impacted by the history of colonisation with the erosion of their culture as well as social wealth and also of their natural resources and agencies (Government of New Zealand, 2021). Therefore, in the post-contact scenario, the most common aspect of the Maori cultural development can be associated with the individual developments of resistance, collective actions for conservation and preservation of social and cultural identities and development of an approach for combating the post-colonial trauma and response to the trauma in the process of care (Manukau, 2020).
One of the key movements of protest by the Maori population was the protest that was led by a Maori group of New Zealand, the Te R?p? Matakite. This was a land march that was a protest done in the year 1975 (Manukau, 2020). This protest was of key significance and was associated with the passing of the Maori Affairs Act by the government of New Zealand. The amendments in this Act were associated with the impact on the land and its ownership. It would have led to the development of the building of dispute and could lead to further alienation of the community (Government of New Zealand, 2021; O’Toole, 2020). The importance of this entire movement is reflected in this approach that there is a need to develop an understanding as well as the growth and understanding of the land of the Maori (Villamayor-Tomas et al., 2018). This would be an essential aspect of their historical and cultural developments. This entire march was highly supported by different individuals and was based on acknowledging the primary aspect of Maori culture, that is, their land (Government of New Zealand, 2021). This march was also highly successful as it led to the signing of a petition that asserted an end to the monocultural land laws in the country. This thus focussed on the development of communal ownership (Government of New Zealand, 2020). This was also essential as it helped in understanding and establishing a voice by the population for the injustices that were implicated through the land loss as well as cultural loss (Came et al., 2020).
Māori responses against colonisation
Another essential aspect of the community where the Maori population fought for their rights and their wellbeing was through the inclusion of the Ng? Tamatoa. The Ng? Tamatoa is one of the warrior activist groups that focussed on the vocation and conservation of Maori rights. The purpose of this activist group was to fight against discrimination and to prevent incidences of injustices that were present in the New Zealand government. The group is associated with a range of activities. These include the fight for the Maori language (Government of New Zealand, 2021). The group had fought for the petition against the Maori language that is included in the process of Maori language (O’Toole, 2020). The group was also involved in the land march of the Maori population. The He Tuaua of 1979 was also done in association with and support the community (Villamayor-Tomas et al., 2018). The activist group also played a major role in the Treaty of Waitangi which was the first founding document that aimed for conservation of the M?ori culture on the native land (Manukau, 2021). The emergence of this group was in association with the Auckland University in 1969. Ng? Tamatoa is thus one of the essential factors that are associated with the development of understanding the cultural, social, and linguistic developments of Ng? Tamatoa (Villamayor-Tomas et al., 2018). The need and justification of the presence of this activist group and its overall working are also associated with the systematic alienation of the community and vindication of their rights with the history of colonisation (Mark et al., 2017). The purpose of these activist groups is to ensure the development of the marginalised communities to ensure that discrimination is prevented and the communities are involved in the processes of social and political decision making with adequate representation along with a just approach (Manukau, 2021). Therefore, the role of Ng? Tamatoa was crucial for the advancement of the Maori community of New Zealand and for the conservation of their rights and resources through the periods of systematic exploitation (Government of New Zealand, 2021).
Another cultural aspect that was developed in the post-contact era of the Maori culture was the development of Hauora. Hauora is a philosophy that was prevalent in the Maori population and was inclusive of the health and well being of the Maori community. The purpose of this philosophy is to educate and to school the individuals regarding what is expected from life (Villamayor-Tomas et al., 2018). There are four key components of the Hauora philosophy. These components include ensuring the physical well-being of the individual and of the community. This is also inclusive of the mental and emotional wellbeing of the community along with a focus on building self-confidence in the individuals and building self-esteem. In addition, the Hauora philosophy also focuses on the development of the idea of the spiritual beliefs of the individuals (Villamayor-Tomas et al., 2018). These components are regarded as the four walls of the whare tapa wha. According to the Maori culture, these components are critical for ensuring stability as well as strength in the individuals as well as in the communities (Durie, 1998). This approach is regarded as the holistic perspective of the wellbeing and health of the individuals. In the post-contact situation, the colonisation of Hauora was also observed in New Zealand. It is critical to understand that colonisation and its impact on the Indigenous populations (Manukau, 2021). In the context of the Maori population, the Hauora and its philosophy were also colonised. Therefore, there is a need for reconsideration of the health aspects and needs of the population where the trauma imposed by colonisation and its attributes are taken into consideration for the provision of care to the Maori population (Came et al., 2021). In the process of alienation of the Maori lands, there was mass destruction of forests and the native lands, this was associated with their conversion to pastures also resulted in the dislocation and isolation and alienation of the community (Moewaka Barnes et al., 2019). Therefore, the importance of such communities remains essential and is in coherence with further developments of the community (Came et al., 2020). The detrimental effects of colonialism on public health are threefold: first, the introduction of non-native illnesses; second, the facilitation of disease transmission; and third, the extraction of riches that prevented indigenous people from “growing out” of poverty and sickness (Villamayor-Tomas et al., 2018). Hence, the overall wellness of the community was impacted and is significant even in the contemporary times.
Evidence of Māori health pre-European times
Conclusion
Indigenous peoples have long been burdened by colonialism, which has had an influence on their social, cultural, and mental health, as well as their social, cultural, and economic well-being. The Maori people of New Zealand are an Indigenous group with an estimated ethnic population of 16.7% of the country’s total population. The community’s reaction to colonisation is fundamental. The colonialism of the land damaged and substantially altered Indigenous populations’ beliefs and knowledge of health and community. In the pre contact times, the people were found to have accumulated a wide variety of traditional knowledge, including a comprehension of the notion of health, as well as the framework of building and appreciating the value of healthy communities. This mirrored the people’ ideals and connections, as well as their surroundings. The relevance of the Maori people in the development of healthcare systems has been highlighted in this article. The first section of this article has presented a comprehensive review of the community’s pre-contact public health systems along with an assessment of the post-contact developments. The importance of cultural imperatives that have been discussed in this paper is also reflected through the understanding of the primary fact that these imperatives have shaped the health-related, cultural, and social aspects of the community. The relevance of culture in health is depicted in this image. Therefore, through this paper, it can be asserted that culture has a significant impact on health. It has an impact on people’s conceptions of health, sickness, and mortality, as well as their ideas about disease origins, health promotion strategies, how illness and suffering are experienced and expressed, where patients seek care, and the forms of therapy they choose. Treaty of Waitangi had a major implication on the community that was the first formal document that ensured that the M?ori community could conserve their culture live on the land with their own culture and identity .Cultural competency is critical since it is impossible to form those relationships without it. Therefore, it is important to focus on ensuring Maori care and their overall development.
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