"Ko Au te Whenua, Ko te Whenua Ko Au: I Am the Land, and the Land Is Me": Healer/Patient Views on the Role of Rongoa Maori (Traditional Maori Healing) in Healing the Land.

In Rongoa Maori (traditional Maori healing), the connection with the land stems from seeing Papatuanuku/Mother Earth as a part of our identity/whakapapa (genealogy), our culture, and our wellbeing. This qualitative study aimed to explore the holistic nature and meaning of Rongoa Maori. There were 49 practitioner and patient participants who participated in semi-structured interviews and focus groups across Aotearoa/New Zealand. The findings showed four themes: land as an intrinsic part of identity; land as a site and source of healing; reciprocity of the healing relationship; and the importance of kaitiakitanga/conservation to Rongoa Maori. Participants shared narratives of connections between the people and the land that showed that when the land is well, the people are well. Implications of these themes for Indigenous wellbeing and the conservation and protection of our natural environments led to three recommendations to reconnect with the land, support Rongoa Maori healing, and to participate in the conservation and preservation of local land and waterways. It is hoped that in learning more about the connection between the land and Rongoa Maori healing, we begin to place greater value on the need to conserve and preserve both the land and our connections to her through traditional healing practices.

Exploring indigenous perspectives on tobacco tax: how some Maori families are responding in Aotearoa New Zealand.

OBJECTIVE: High smoking prevalence rates, combined with a steep tax on tobacco and lower household income, mean that 5% of Maori (indigenous) whanau (family unit) expenditure in New Zealand is on tobacco. This paper outlines whanau perceptions of, and behavioural responses to, increasing tobacco tax. METHODS: This qualitative study was informed by the Kaupapa Maori theory and used a simplified interpretive phenomenological analysis thematic hybrid methodology. A semistructured, open-ended interview guide was designed and used in one-off focus group interviews. SETTING AND PARTICIPANTS: Interviews were separately conducted with each of 15 whanau units. A total of 72 participants, most of whom were smokers, took part in the interviews carried out in two geographical regions: one rural/provincial and one urban. RESULTS: Whanau were concerned about the rising cost of tobacco. However, this concern had not generally translated into quit attempts. Whanau had instead developed innovative tobacco-related practices. Working collectively within their whanau, they were able to continue to smoke, although in a modified fashion, despite the rising costs of tobacco. Whanau thereby resisted the intended outcome of the government's tobacco tax which is to reduce rates of smoking prevalence. CONCLUSION: In the face of significant government disinvestment in New Zealand tobacco control over the last 10 years, hypothecated taxes should be used to scale up Maori-specific cessation and uptake prevention programmes, supporting authentic Maori partnerships for endgame solutions including restricting the availability and appeal of tobacco.

Strategies to support culturally safe health and wellbeing evaluations in Indigenous settings in Australia and New Zealand: a concept mapping study.

BACKGROUND: In recent decades, financial investment has been made in health-related programs and services to overcome inequities and improve Indigenous people's wellbeing in Australia and New Zealand. Despite policies aiming to 'close the gap', limited evaluation evidence has informed evidence-based policy and practice. Indigenous leaders have called for evaluation stakeholders to align their practices with Indigenous approaches. METHODS: This study aimed to strengthen culturally safe evaluation practice in Indigenous settings by engaging evaluation stakeholders, in both countries, in a participatory concept mapping study. Concept maps for each country were generated from multi-dimensional scaling and hierarchical cluster analysis. RESULTS: The 12-cluster Australia map identifies four cluster regions: An Evaluation Approach that Honours Community; Respect and Reciprocity; Core Heart of the Evaluation; and Cultural Integrity of the Evaluation. The 11-cluster New Zealand map identifies four cluster regions: Authentic Evaluation Practice; Building Maori Evaluation Expertise; Integrity in Maori Evaluation; and Putting Community First. Both maps highlight the importance of cultural integrity in evaluation. Differences include the distinctiveness of the 'Respecting Language Protocols' concept in the Australia map in contrast to language being embedded within the cluster of 'Knowing Yourself as an Evaluator in a Maori Evaluation Context' in the New Zealand map. Participant ratings highlight the importance of all clusters with some relatively more difficult to achieve, in practice. Notably, the 'Funding Responsive to Community Needs and Priorities' and 'Translating Evaluation Findings to Benefit Community' clusters were rated the least achievable, in Australia. The 'Conduct of the Evaluation' and the 'Prioritising Maori Interests' clusters were rated as least achievable in New Zealand. In both countries, clusters of strategies related to commissioning were deemed least achievable. CONCLUSIONS: The results suggest that the commissioning of evaluation is crucial as it sets the stage for whether evaluations: reflect Indigenous interests, are planned in ways that align with Indigenous ways of working and are translated to benefit Indigenous communities Identified strategies align with health promotion principles and relational accountability values of Indigenous approaches to research. These findings may be relevant to the commissioning and conduct of Indigenous health program evaluations in developed nations.

Ma mahi, ka ora: by work, we prosper--traditional healers and workforce development.

AIM: Rongoa Maori practitioners make a valuable contribution towards Maori health outcomes, albeit with limited resourcing or formal training. This paper reports on a survey of healers/healing practices-specifically healers' aspirations for professional development and training-and considers the implications for healing practice and future training undertakings. METHODS: Healers in seven districts around the country were surveyed about rongoa practice and service delivery during 2013. Consenting healers completed surveys either in person, via phone, or returned them via post, according to their preference and convenience. Resulting data were analysed and reported according to frequency of responses. RESULTS: Thirty-eight healers/rongoa clinics completed the survey--a 79% response rate. Respondents were primarily Maori (88%), female (69%), aged 50 years or older (60%), and worked as volunteers. Informal training modes focused on te reo, matauranga and tikanga were the most common means of skill/ knowledge acquisition, and preferred modes for further training. CONCLUSIONS: The survey highlights the pressing need for expansion of the rongoa Maori workforce and training/service funding, to sustain rongoa practice. The findings add to what little is known about the training pathways and aspirations of practising healers, identified targets of the Maori Health Workforce Development Plan 2006.