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The Treaty of Waitangi and Healthcare

Realities and Maori Models of Health

New Zealanders has major ethnicities than any other areas of the world, comprising over 213 ethnic categories. Five major cultural groups in New Zealand comprise New Zealand Western european, Maori, Chinese, Samoan and Indian (NZ Herald, 2013). And of most ethnic communities, Maori has been noted as getting the poorest health status in New Zealand even following the rules of factors like income, house and education. This health status is the effect using their negative experiences from colonization techniques that resulted in the loss of their cultural values, practices and even their Maori terminology. As Ramsden, Irihapiti has stated:

Maori have until been recently passive consumers of the health service they have had little source into. As yet Maori have little control over funding, policy and delivery of health service in the state of hawaii sector.

Many Maori would dispute that situation is at contravention of the guarantee of the second article to safeguard the "unqualified exercise of Maori chieftainship. . . over lands, villages, and all their treasures". [1]

Tino rangatiratanga warrant has not been realised while Maori cannot gain autonomy in health service and be accountable to Maori. [2]

The Ministry of Health documents [3]has disclosed the seriousness of the problem and the need to address the inequalities and disparities of health as what Hon. Annette Ruler has stated:

The Federal has acknowledged the value of prioritizing Maori health gain and development by figuring out a need to lessen and finally eliminate health inequalities that negatively have an impact on Maori. [4]

As healthcare providers, it is our utmost responsibility to react to Maori's health issues in respect to the diversity of worldviews which could exist in between us. To fully understand Maori health campaign, it is advisable to examine these key models that contain been developed and currently used.

Maori view health in a holistic way. Each one of these models is interlinked and shows the links among the physical, spiritual, individual & most importantly, the family.

  1. Te Whare Tapa Wha

Te Whare Tapa Wha is also called "four cornerstones or edges of Maori health". These four cornerstones includes the:

  • Taha tinana or Physical Health - from the word itself, it refers to the body and its own physical manifestation.
  • Taha Wairua or Religious Health - Maori assumed that the religious essence of the average person is their life force and therefore is vital in the id of a person all together.
  • Taha whanau or Family Health - it details the importance of family on the well-being of the average person.
  • Taha hinengaro or Mental Health - refers to the relevance of your brain and the capability to communicate, think and feel.

This model expresses the relevance of balance that if one of these elements fails can result in illness. It had been produced by Mason Durie in 1982 because the spiritual aspect of health was discarded which includes become an important in the prevailing health models.

  1. Te Pae Mahutonga or Southern Mix Star Constellation

This model brings together the components of modern Maori health promotion. These important elements highlight the linkages in between Mauriora (social individuality), Waiora (physical environment), Toiora (healthy life-style) and Te Oranga (Involvement in world). Both guidelines symbolize Ng Manukura(community command) andTe Mana Whakahaere(autonomy) which depicts the resources had a need to achieve those outcomes. It's been presently used around New Zealand to create a positive change regardless of ethnicities or culture.

  1. Te Wheke

Te Wheke or the octopus depicts family health. The octopus mind represent te whanau (the family), octopus eye as waiora (family and individual's total well-being) and the tentacles representing specific dimensions of health which are interwoven representing closeness of the tentacles. Maori acknowledges importance of interconnectedness among the mind, soul, whanau and physical and is definitely even after the introduction of American medicine.

  1. He Po Oranga Tangata Whenua

This model has been developed to ensure the traditional tangata whenua (folks of the land) prices, knowledge and corporations are named key signals of toiora: most effective health and well-being. It attempts to produce a wider connection between wider health and cultural determinants like real estate, occupation, education, resources and words. This model is now being applied in the Bay of A lot District Health Mother board.

All of the models can help reveal Maori's views of health insurance and well-being in the hope of greater understanding to them and become put into works by the professionals working in medical sector.


Loosely translated as "hospitality", manaakitanga performs an intrinsic part in Maori modern culture. It is created from the term "mana" or the person's ability to service. It derives respect that is earned and can't be forced to anybody. Being hospitable, looking after visitors and caring for them regardless of their position is of great importance to them. But manaakitanga has a much broader classification than just a word or direct translation. It can be broken down into 3 parts: mana-a-ki this means "power of the word" which motions these to be expressive and articulate in welcoming visitors. There is certainly another description with the words "mana" or prestige, "ki te tangata" or even to individuals - gives the importance of mana that contains the integrity, prestige and vitality of friends. Manaakitanga not only encompasses hospitality but also on mutual respect. It acknowledges others' mana as having equivalent or greater than their own that can be seen in the proper execution of love, generosity, as well as hospitality. In addition they believed that in virtually any gathering, small than it may look, it should be remembered with gratitude and love. They welcome settlers with wide open arms as they often trade and give foods to them. A few of them brought individuals to their marae or assembly place where they become people of whanau/family, hapu/sub-tribe and iwi/tribe.

Manaakitanga, in a nutshell sense, is about cultivating relationships, caring for each other and being careful as to how others are cared for regardless of their status in the world. It is applicable not and then the Maori but also in virtually any ethnic group. In any health care setting, it's important that people all treat each other with respect. It could enhance one's esteem knowing you are valued. In this way will we be able to build rapport and partnership not and then the patients but as well as their families, thereby, increase the health status of not only the Maori but also to the entire cultural group.


Manning, B. (2013, December 11). Census 2013: More ethnicities than the world's countries - National - NZ Herald News. Retrieved from http://www. nzherald. co. nz/nz/news/article. cfm?c_id=1&objectid=11170288

Media Resources. (n. d. ). Manaakitanga - unique New Zealand hospitality > New Zealand. Retrieved from http://www. newzealand. com/travel/en/media/features/maori-culture/maori-culture_manaakitanga-hospitality. cfm

Nursing Council of New Zealand. (2002, March). Guidelines for Cultural Basic safety, the Treaty of Waitangi, and Maori health in Medical and Midwifery Education and Practice. Retrieved from http://www. sportsouthland. co. nz/files/docs/culturalsafety nurses. pdf

Whanau Ora Media. (2013, November 11). Mori Models of Health & Wellbeing | Te Arawa Whnau Ora Collective. Retrieved from http://tearawawhanauora. org. nz/2013/11/maori-models-of-health-wellbeing/

[1] Kawharu, I. (Ed). (1989). Waitangi: Maori and Pakeha perspectives of the Treaty of Waitangi.

Auckland, NZ: Oxford School Press.

2 Ramsden, I. (1996). The Treaty of Waitangi and social security: The role of the Treaty in medical and midwifery education in Aotearoa. In Medical Council of New Zealand, Suggestions for cultural security in nursing and midwifery education. Wellington, NZ: NCNZ.


[3] Friendly Inequalities in Health, New Zealand (1999), the New Zealand Health Strategy (December 2000) and Priorities for Maori and Pacific Health: Facts from epidemiology (2001)

[4] King, A. (2001). New Zealand Health Strategy. Wellington, NZ, Ministry of Health. p. 18

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