The boot that is held on the throat of Māori and Pacific people is stubbornly resistant to attempts to shift it.’
– Professor Peter Crampton
I understood very little about the root causes of bad health before starting work in the Department of Public Health at the University of Otago’s Wellington School of Medicine. I had managed to complete a small clinical trial examining the impact of diabetes on lower-limb function for my doctoral thesis, without ever having to consider why I was spending most of my time recruiting patients in clinics around South Auckland, or why nearly all the recruits were either Māori or Pasifika.
My first weeks in the Department were heady. I had moved from a laboratory that studied diseases and their causes in silo, to an environment that considered most diseases as symptoms of one underlying cause: the social determinants of health. Coming to grips with this link was crucial to my acceptance in my new public health world. I needed to learn quickly. [Read more…] about Tangata Tiriti
Dr G. M. Smith: “a cross between an Arab Chieftan and an Archbishop.”
Soon after the war, my intrepid mother Margot Wood (later Ross) set off on the long, dusty journey from Dunedin, in the south of New Zealand’s South Island, to the Hokianga, in the far north of the North Island, in her little Ford Anglia car. My father, Captain Win Wood, had died in Egypt, and medical student Janet Smith, daughter of Dr. Smith of Rawene, was then our boarder. She would prove a life-long friend to Margot and a second mother to me. We were both run-down and thin, so Janet recommended a holiday with her parents, George and Lucy Smith. George was the well-known Rawene-based doctor George Marshall McCall Smith (1882–1958), described by the poet A. R. D. Fairburn as “a cross between an Arab Chieftain and an Archbishop.” To a small child, he seemed almost as awe-inspiring as Tāne Mahuta, for he was a tall man-tree with fierce, penetrating blue eyes, big hooked nose, white eldritch locks, open-necked white shirt, loose flannel jacket and trousers, flapping oilskin coat, old grey felt hat with a sagging brim, Roman sandals, and curved Cherrywood pipe. He and Lucy immediately set about stuffing us with fresh eggs, cream, and butter. Alas, I’ve never looked back.
I remember waka racing on the harbour, and Māori children, blinded in a measles outbreak, singing in a choir. Rooms opening off the verandah were filled with flowers; sofas were strewn with books and journals; paintings by Olivia Spencer-Bowers and Eric Lee-Smith hung on the walls. We began to heal.
Many people think of the hospice as a place where people with cancer go to die. Back in 2014, when I frequently walked past the Otago Community Hospice building in Dunedin’s North East Valley on my way home, that was my impression. What a sad place that must be to work, I thought. Although I practically lived on its doorstep, I had only ventured into this daunting place once. My partner had asked me to drop off a gift to a friend who was a hospice inpatient. I agreed, but only to leave it at reception. I didn’t want to go any further, in case I encountered dying people.
Like most people, despite ‘bearing witness’ to thousands upon thousands of deaths (both real and imagined) through images in the news and in film and television, my exposure to the reality of death and the dying process was minimal. When I went to the funeral home to view my father’s body in 2003, I was so uncomfortable about real death that I could only manage to look at him for a matter of seconds. When my mother had a serious stroke a few years later, I spent time with her as she slowly deteriorated, surrounded by her children, grandchildren and extended family. I was not present when she died, but when asked if I wanted to see her body, I declined, remembering how traumatic I had found trying to view my father’s body years earlier.
Patience (n.): the calm endurance of pain of any provocation; perseverance; forbearance; quiet and self-possessed waiting for something.”
Year of the houseplant: this variegated minima recently sold for NZ$8,150. (Photo: Trade me/ hurley88)
Okay, that’s nice, but are we there yet?
Patience is a virtue, so the saying goes, but I disagree. Yes, it’s possible to have the patience of a saint, but it’s also possible to have the patience of the devil. Many crimes and abuses have been committed by people patient enough to wait, preparing all the while to strike. Aggressors against others are often very, very patient. For the victims of those aggressive or oppressive acts there is more wisdom than virtue in ensuring your survival by keeping your head below the parapet and biding your time. Patience is a strategy, a behaviour, a matter of judgement, of choice-in-circumstance. Just as courage is called out only in the existence of fear, patience comes into existence in the presence of, and in response to, impatience. It requires the exercise of personal restraint and impulse control in the service of a greater end goal, and it may feel entirely counter-intuitive in the moment. I hesitate to disagree with my trusty Collins Dictionary, but it may not feel anything like “calm endurance” or “quiet and self-possessed waiting.” Yes, the patient person waits, but it’s an active state involving paying attention, reflecting, planning. Patience isn’t a thing. It’s a capacity, an attitude. It’s an ongoing recallibration of approach rather than a one-size-fits-all solution. It’s a work in progress, a practice, an art.
The 2020 Covid-19 pandemic has been described, perhaps accurately, as a one-in-one-hundred-years event, but during its history New Zealand has a number of “scares” and lockdowns because of infectious diseases that have had detrimental impacts on Māori. In 2020, the memory of these epidemics has led some Māori communities to attempt to keep the coronavirus away from their own communities.
Historically, Pākehā were more concerned that Māori would spread disease to them. Māori were sometimes seen by Pākehā as a weak link in New Zealand’s chain of health defences, with poor, overcrowded and unsanitary housing and customs that could potentially spread disease. Māori, often due to poverty or lack of access, were also less likely to seek medical treatment, and epidemics could hit their communities hard.
Red Cross volunteers during the Spanish flu epidemic, USA, 1918.
How do you protect yourself against a pandemic virus? The current debate about the efficacy of wearing face masks in public as protection against Covid-19 echoes the difference of opinion during the ‘Spanish flu’ pandemic a century ago. And while we all now pay attention to handwashing and social distancing, in 1918 people followed government advice to breathe deeply in public inhalation chambers filled with a zinc sulphate mist or where a machine sprayed it directly into their mouth. Responsibility for their own health meant they also shared their own preventive measures for warding off influenza.
To mask or not to mask? According to the 1919 commission of inquiry which considered the best ways to deal with any future pandemic, there was complete agreement that doctors, nurses and other attendants in close contact with influenza patients should wear masks. This was probably prompted by the shock that in less than eight weeks, three quarters of hospital nurses had contracted the disease from pandemic patients. The question was whether citizens should wear masks in public.
Many people think of the hospice as a place where people with cancer go to die. Back in 2014, when I frequently walked past the Otago Community Hospice building in Dunedin’s North East Valley on my way home, that was my impression. What a sad place that must be to work, I thought. Although I practically lived on its doorstep, I had only ventured into this daunting place once. My partner had asked me to drop off a gift to a friend who was a hospice inpatient. I agreed, but only to leave it at reception. I didn’t want to go any further, in case I encountered dying people.
The 2020 Covid-19 pandemic has been described, perhaps accurately, as a one-in-one-hundred-years event, but during its history New Zealand has a number of “scares” and lockdowns because of infectious diseases that have had detrimental impacts on Māori. In 2020, the memory of these epidemics has led some Māori communities to attempt to 
