Māori Responsiveness – HRC 2010 Papaarangi Reid February 2010.
Super-Māori or Super-Doctor - future indigenous medical graduates Papaarangi Reid LIME Connection...
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Super-Māori or Super-Doctor - future indigenous medical graduates Papaarangi Reid LIME Connection II September 2007
Transcript of Super-Māori or Super-Doctor - future indigenous medical graduates Papaarangi Reid LIME Connection...
Super-Māori or Super-Doctor - future indigenous medical graduates
Papaarangi Reid
LIME Connection II
September 2007
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
Super-Doctor or Super-Māori?
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
Super-Doctor or Super-Māori?
Or do we expect them to be both?
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
Super-Doctor or Super-Māori?Or do we expect them to be both?
Who qualifies as indigenous in our affirmative action admissions programmes?
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
Super-Doctor or Super-Māori?Or do we expect them to be both?
Who qualifies as indigenous in our affirmative action admissions programmes?
Are the pathways into our programmes decolonised or liberated from our baggage?
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
clinically safe
Super-Māori or Super-Doctor
What do we mean by clinically safe?
Do grades matter? “C”s get degrees
Grades and engagement
What do our communities need/deserve?Practice or practise.
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
clinically safe culturally safe
Super-Māori or Super-Doctor
What do we mean by culturally safe?
• Noted a variety of words used• Noted a variety of definitions• How are we going to move forward?
• Cultural safety from kawa whakaruruhau
Super-Māori or Super-Doctor
What do we mean by culturally safe?• Recognises cultures – including the medical or
nursing culture • Acknowledges who has power• Therefore who is the “agent of change”• What needs to change?• “Negotiate a space for the indigenous patient
to heal or die peacefully”• Communicate with patient, establish
relationship, ask, listen, negotiate.
Super-Māori or Super-Doctor
What do we mean by culturally safe?• “Negotiate a space where the indigenous
patient can heal or die peacefully”• Communicate with patient, establish
relationship, ask, listen, negotiate, act • Depends on mature sense of self,
understanding of power & professionalism• Depends on ability to be reflexive
Super-Māori or Super-Doctor
However in a system• An agent of change is perceived as very
powerful and potentially very dangerous• Especially one working to reduce systemic
inequalities acting out on indigenous peoples• That is, a health worker who intentionally
intervenes in the accrual of white privilege
Super-Māori or Super-Doctor
Therefore a system that is designed and finely tuned to create and maintain white privilege, will not welcome cultural safety.
Understandably cultural safety is being colonised and sanitised by health systems [including those we work for] to neutralise its ability to shift power.
Colonised by name [competence, sensitivity], nature [self-reflexive] and intent
Super-Māori or Super-Doctor
Therefore it remains important to hold fast to the vision of cultural safety and
• define only what our institution can cope with • [rather than re-defining cultural safety]• And ….
Super-Māori or Super-Doctor
And ….. train graduates to• Negotiate a space for their indigenous patients
to heal or die peacefully• Communicate with patient, establish
relationship, ask, listen, negotiate, act • Develop a mature sense of self, an
understanding of power & professionalism• Develop the ability to be reflexive
Super-Māori or Super-Doctor
When we envisage future indigenous doctors, who do we see?
clinically safe culturally safe
Cultural competency has raised the expectation that indigenous doctors be capable of leading and responding appropriately in a variety of indigenous cultural settings.
Is this reasonable?
Super-Māori or Super-Doctor
It will be difficult to achieve:1. Student pathways into medical science2. Difficult to do a conjoint degree
Is there evidence of better health outcomes?
[warm fuzzies are not enough]
Super-Māori or Super-Doctor
Why do we want this outcome?- are we credentialing?- is it a hang-up from “real-Māori” racism?- are we being romantic – time-warped?
Try to understand individual histories within colonial histories, judge the histories not individuals, promote rights and provide supportive pathways to re-engage
Changing entry criteria at FMHS UoA
Super-Māori or Super-Doctor
Finally• Indigenous graduate, or• Indigenous graduates
Thinking beyond [super] individuals to cohorts of indigenous graduates who will have travelled important roads together, who will network through different regions and different specialities. Differences will be good.
Super-Māori or Super-Doctor
So – of course it’s both [if possible]
Otherwise a committed indigenous person who is fascinated with science, passionate about learning, engaged with their community and their own personal development, can reflect constructively on colonial events [macro and micro] and cope with stress.
Commitment not involvement.
