One hundred days of harsh lessons for Māori as calls for help go largely unanswered

Wednesday, 24 November 2021

Papakura Marae delivers food parcels and medical support to Covid-positive whānau. (First published November 2021.)

The only lessons that have been learned since Auckland’s lockdown began 100 days ago reinforce that Māori are in this alone, Māori experts say.

For 100 days and then some, Māori leaders in health, data, and science have called on the Government for help and partnership as Auckland slips further into a Covid-19 nightmare.

Calls for resources. Calls for stronger restrictions. Calls for equity.

But those calls went mostly unheeded, and any trickle of support which did arrive was weeks too late and created competition for resources.

Dr Rawiri McKree Jansen has been travelling the North Island trying to help Māori protect themselves against Covid-19.

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Co-leader of Te Rōpū Whakakaupapa Urutā and Papakura Marae general practitioner Dr Rawiri McKree Jansen has been at the coalface of the pandemic response.

He says lessons have been learned in the past 100 days, but not by the Government.

Dr Rawiri McKree Jansen consults with a patient at Papakura Marae.

“One of the things I learned was the assertion that health resources was limited, turns out that’s not true.

“When the majority population needed it, they have had unlimited resources, that’s not true for Māori communities.

“Māori communities are never well protected or well resourced.”

Time and time again the Government has ignored his calls for an equity-based response to the Delta outbreak.

Data researcher Dr Rawiri Taonui says Māori booster and child vaccination rates are not yet high enough.

“It didn’t have to be this way,” he says.

Roxie Mohebbi leads a discussion about the Covid-19 vaccine with immunologist Dr Maia Brewerton and general practitioner Dr Api Talemaitoga as part of Stuff's Whole Truth project.

“The Government has deliberately heard certain voices in alignment with certain pressures on them to ease restrictions.

“Māori deaths due to Covid are going to become normal, and a lot of the deaths we’re going to see were preventable.”

On Sunday, Māori made up 42.9 per cent of deaths due to the Delta variant, according to data researcher Dr Rawiri Taonui’s calculations.

Associate Health Minister Peeni Henare gives an update on Māori vaccination efforts.

Māori were 51.7 per cent of new cases and 31.8 per cent of hospitalisations.

Of the national population, Māori make up just 16.7 per cent.

Mistakes have been made time and again as Māori experts screamed through the media for change, Jansen said.

If the Government had listened to their advice, Auckland wouldn’t have dropped from alert level 4 to 3, then to 3 step 1 or 3 step 2.

If it had listened, Māori health providers wouldn’t be scrambling for resources to take the vaccine on wheels to their people across the region, the virus wouldn’t have spread through Māori communities leading to deaths, and there wouldn’t be people isolating in homes without face-to-face help, supported only by a daily phone call.

Auckland, along with the rest of Aotearoa, wouldn’t be going into the traffic light system next week, Māori would have been vaccinated earlier, and their vaccination rate wouldn’t be 20 per cent below the general population’s, he said.

“Failure to follow the science will cost us dearly. It’s going to cost us in lives in Māori whānau.”

In a statement on behalf of the Ministry of Health, Associate Health Minister (Māori Health) Peeni Henare and Covid-19 Response Minster Chris Hipkins, a spokeswoman said a lot had been learned in the past 100 days.

Indigenous data researcher Andrew Sporle says Māori won't reach 90 per cent vaccination status until after Christmas.

“We’ve learned a lot about the Delta variant in our response to this latest outbreak,” she said.

“We’ve also been reminded of the resilience of whānau, and the determination of our Māori health providers and other organisations to support Māori communities.”

Insights from Māori health providers had helped to inform the Māori Covid-19 response, she said, which – by working with the ministry’s Māori Reference Group, the Māori Monitoring Group, Tumu whakarae (DHB general managers, Māori Health) and iwi – had ensured an equitable and fit-for-purpose response and vaccine roll-out.

Alongside DHB and public heath unit support, $158 million in funding had been made available to support Māori communities and prepare for the traffic light system, she said.

“While much of the work we’ve done through our Māori response has been successful in keeping whānau Māori safe and increasing Māori vaccination rates, there is always room for improvement, and this Government is committed to continuing the good work in partnership with iwi, Māori health and disability experts, and Māori organisations.”

“Room for improvement” is a sentiment Jansen and his colleagues at the coalface can agree with.

Following Jansen’s resignation from the Immunisation Implementation Advisory Group in April after his advice fell on deaf ears, he has tried to highlight to Government the hefty toll Māori will face as Covid-19 infects their communities.

Papakura Marae will be calling all unvaccinated patients enrolled at its GP clinic to have a conversation with them about getting the Covid-19 jab.

But it’s a lesson, he says, the Government will learn the hard way.

Auckland University senior researcher Andrew Sporle has been creating models of how the outbreak will impact Māori communities since 2020.

Based on his calculations it will take Māori at least four weeks to get up to 90 per cent first doses – based on the Ministry of Health’s Health Service User population estimates which undercounts Māori – if the current vaccination rates continue, which he says is highly unlikely.

It will be well beyond Christmas before they get to 90 per cent fully vaccinated, and well after that before 90 per cent of the population, based on Stats New Zealand figures – is actually reached.

Across Auckland, Waitematā, and Counties Manukau, Māori double-dose vaccinations are 76 per cent, 73 per cent and 67 per cent respectively, according to Ministry of Health figures.

Nationally that figure is 65 per cent.

“This is what happens when equity is not in the forefront,” Sporle said.

“Wellington still isn’t listening to Māori on the ground. If you put a population out there with 70 per cent [vaccination] coverage, a lot of people are going to get the virus and die, and it’s going to happen a lot quicker.”

D'Angelo Martin explains why so many Māori and Pasifika people are at the head of the Covid-19 vaccine queue.

Papakura Marae Health Clinic chief executive Tony Kake says the MÄori organisations have shown their strength over the past 100 days of Aucklandâs lockdown.

The writing was on the wall, the experts were calling for help, and the Government ignored them, he said.

“It’s going to be brutal. It’s only when communities are screaming that they get the resources they need.”

However, in the past 100 days Sporle has seen Māori leaders and healthcare professionals take the hits in their stride – “Māori community-led approaches that are recognising this is a crisis, and it’s all hands on the pump.”

At Papakura Marae Health Clinic, chief executive Tony Kake and his team have been tirelessly supporting the vaccination effort, as well as helping whānau survive the lockdown and now home isolation.

Around him, Māori health providers and organisations have come together to provide the greatest protections they can, something he hasn’t seen reflected in the Government’s response.

“Competition went out the window 100 days ago. We’ve worked with a higher level of collaboration.

“I’ve seen Māori organisations step up. They understand how the game is played down here, and they’ve stood up to the challenge.

“As the Government announces the opening up of boundaries and the loosening of the belts, we have to keep our communities safe.”

Kake says the past 100 days have been hard. His kaimahi (staff) were fatigued weeks ago, it’s been “extremely tough” to keep up with the demand on their resources, but they can’t stop.

Covid-19 is out there and is getting worse, and to get the best outcomes for whānau and families there must be equity in the response and the advice the Government listens to, he said.

“How long do we have to be subservient? We want to be a partner.

“That’s what we’re after, we will decide when we feel like a partner. There are pockets of hope here and there, but we’ve got a long way to go.”

Further north at Turuki Healthcare in Māngere, Dr Lily Fraser is facing the same battle.

She was infected with Covid-19 two weeks ago and has been isolating at home, but her condition is stable because she’s double-vaxxed.

For some whānau in her area, they haven’t had one dose yet and, as the end of lockdown nears, she knows they will be hit the hardest.

“There have been decisions made at the national level that haven't been made to protect Māori.

“I’m disappointed that we are dropping levels before Māori have caught up. The result of that will be a high number of Māori who will have Covid.”

Healthcare workers, experts and the Government knew Covid-19 would return after it was successfully eliminated in 2020, Fraser said.

She expected there would have been better planning to ensure Māori were protected, but that responsibility has fallen on the shoulders of Māori health providers.

“As frustrating as it is, I’m still really proud of the vaccine uptake and I think we’ve achieved something really incredible, but I just want it to be incredible for Māori as well.

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“I’d like to see Māori vaccination rate up at the same level as non-Māori, and I would like to see them being taken care of by their own GPs.”

But now it’s about the long game, she said. The work isn’t over, vaccinations need to increase, and as the 100-day milestone of lockdown passes, the need remains.

“You get disappointed, but then you just keep doing the mahi.”