Te Hauora O Te Hiku O Te Ika Trust – Te Tai Tokerau
posted by Alastair McLean on 4 April 2012
In 2006 Te Hauora O Te Hiku O Te Ika embraced PHARMAC’s One Heart Many Lives and developed Hauora Tāne, ‘One Heart, Many Lives’.
This hugely successful programme won the trust a Whānau Ora Award in 2008.
Te Hauora O Te Hiku O Te Ika Whānau Ora Clinical Nurse Manager, Angee Keung described the achievement as a reward that acknowledged the trust could bring the community together, empower people and make a difference for their tāne.
‘Until this project came along we were working in silos. But Hauora Tāne, ‘One Heart, Many Lives’ gave health promoters and clinicians alike, the opportunity to really work together to engage the community and successfully deliver the programme.’
Early and effective community engagement was crucial to its success. This began in 2007 with a series of tāne dinners.
‘The opportunity for a free dinner worked I suppose,’ said kaumātua Hohepa Stephens. ‘But when we got them there, we gave them dinner and then asked them to stand and say why they’d come. A lot of them had genuine reasons, like ‘I came because my wife made me come’. Others came because they had whānau who had died of heart attacks and they’d had problems themselves in their younger years, so they thought they’d better do something about their health. A lot of them said ‘I’m doing it for my kids and mokopuna’.’
After dinner, local general practitioner Dr Lance O’Sullivan would cover the clinical aspects of cardiovascular disease in laymen’s terms before question time, when the kōrero really started.
Little was left to chance when it came to making sure the tāne dinner contributed to the design and delivery of the programme. The health promotion team ensured in advance that the questions were pertinent, the kōrero focused and that the ideas of all the tāne contributing to the kōrero were captured to inform the programme.
Project manager Callie Corrigan said it was a privilege to be a wahine in the room, listening to the kōrero.
‘We were sitting in the back hearing some extremely valuable comments like, ‘I’ve gone and got all of the tests, but I haven’t gone and got the test results’; ‘I don’t want to go and have the doctor tell me what needs to be done’; ‘I want to maybe go to a doctor who will help me on the path, not just tell me the kōrero’.
Health Promotion team manager Lisa McNab said it was through this early harnessing of ideas that they began to see what effective resources might look like.
‘When we started discussions with PHARMAC, the District Health Board and the Primary Health Organisation about implementing the programme, we took our tāne with us,’ she said.
‘From then on the basis for everything we developed, presented and delivered came from the tāne who attended those tāne dinners. Our role was to take the ideas and make them work.’
Also critical to the success of the programme was the way in which it was delivered. The issue of access came up early in the tāne dinners.
‘Why would I go to the doctor for a 10am appointment if I’m working up in the forestry and have to take a whole day off?,’ asked one attendee. The response was to have the nursing team go bush.
‘For every barrier, we’d find a solution,’ said Callie. ‘For every question like “what would it take to get you going to a screening?” we’d find the answer.’
The style of communication was also exceptionally important to the tāne, who would grumble if their precise words were not used or their thoughts interpreted in a way they did not believe made sense.
Lisa said the Bro-Files started at the dinners as well. ‘Men would agree to become a Bro and we would record their kōrero, their own words about their health. The Bros’ stories circulated in press and on radio and some of the Bros went on to become the Poster Boys.’
The Warrant of Fitness Health Heart Card with red, yellow and green lights indicating cardiovascular disease risk was another success. General practice clinics throughout Te Tai Tokerau knew if a tāne produced a Warrant of Fitness card, they were signalling a desire to take heart health seriously.
One of the Poster Boys, Manuera Riwai, believes families are closer as a result of the programme.
‘Our men have been able to communicate and be with each other,’ he said. ‘We’re not insular anymore because we’ve taken the opportunity to network with each other.’
Lisa agrees the programme strengthened relationships, especially among the men.
‘We had all this intense support in the whare. There were groups of bros supporting each other around their health. There was a bro supporting another bro who had depression. There were all kinds of support systems that grew from this.’
Lance O’Sullivan said the programme gave space for men to talk. ‘The guy who did an article on heart health was hit up in the tea room at the mill because all of a sudden, he was an expert in his peers’ eyes.’
Lisa agrees with Lance about their men becoming megaphones for heart health. ‘Our tāne did become the experts. One of the current Bros is still on the back of a Toll transport truck that travels up and down State Highway 1 and 10 twice a day, seven days a week. He’s become the expert and his whānau are still contacting him “oh, bro, I saw you sitting ten feet high… What’s it all about, what do I need to do? Where do I go?’
Lance also points out that a lot of people involved in the programme gave their time, stories and photos free.
‘The programme relied on the passion of our community and that passion really wasn’t valued. If I had a wish list now, it would be funding to properly support what we did at the time and funding to properly evaluate.’
Callie Corrigan is aware she is sitting on mountains of valuable data and material.
‘Collating the evaluation is the part that’s missing; we currently do not have the time or capacity. We have a wealth of learning here and it deserves to be published.’
In Northland, Te Hauora O Te Hiku O Te Ika is the largest Māori provider of general practice services and second largest Māori provider overall of health services.
For more information, go to: www.hauora.net.nz