The Asthma FoundationNew Zealand Respiratory Conference 2013
Te Hā o Te TangataBreathing Easy in Aotearoa
Mason DurieMassey University
The Main Points
1. Māori understandings of health and sickness place importance on context
2. The health context is shaped by four Pou Ora, key markers that underly the health-sickness continuum: Hauora - Compatible environments Toi Ora – Knowledge transfers Whānau Ora Empowering relationships Mauri Ora - Enhanced potential
3. Breathing will be easier when all four Pou are aligned and the human mauri is flourishing.
Pou Ora 1: Hauora Compatible Environments
Rangi and Papa
Locked into an embrace that excluded light
and life
Ki te Ao Mārama
Rangi and Papa
Forced apart by the offspring
• Forests & birds• The elements• The seas and waters, fish• Crops• Ferns• Humankind
Separation enabled
Light and Life
Whanaungatanga Environmental relationships, the common bonds
Rangi & Papa Environmental Impacts
The Whanaunga principle‘While each species is unique, there is nonetheless a relationship between all species within the natural world. They are linked by time, inter-dependency and common needs.’
The Ahiowhio principle:‘meaning comes from an outward (centrifugal) flow of energy; life is best understood by the relationships that exist between people and their environments.’
Hauora as a Centrifugal Spiral Ahiowhio Wharite
Building relationships
An Outward flow of energy
People, land, flora, fauna,water, air, cosmos
Centrifugal direction
Relationships and context are a basis for health
Smaller entitiesmake sense when viewedin relationship tolarger entities
Hauora & Health
‘Health’ is widely used as a synonym for sickness
‘Hauora’ has been a common translation for ‘Health’
BUT
Hau = wind, air, human breath, the security of home (hau kainga), fame, and vitality
Ora = safety, satiation, survival, life
Hauora as an ecological concept
Hauora positions people within a broad ecological context environments are drivers of health.
The Hauora focus is on: associations between people with
surroundings reducing risk from external natural and
human threats identifying new and emerging
environments
Hauora & Connectedness
A Māori world view of connectedness and inter-dependence provides a framework within which Hauora can be understood and its significance to modern times appreciated
The implication is that health is essentially about ‘living in the world’
Human health cannot be fully understood without taking into account impacts from the wider
environment
Complex Environments - easy and not-so- easy breathing for Kiwis Global environments The natural environment Urban environments Metropolitan
environments Marae environments Home environments Work environments On-line environments Whānau environments Pastoral environments Horticultural
environments School environments Roading environments
Pou Ora 2 Toi Ora Knowledge Transfers
Toi = knowledgearthuman originsbirthplace
Ora = wellnessalivesaferecovery
Toi Ora
Wellbeing associated with Indigeneity a sense of home knowledge and
information Creativity
Toi Ora
Health is enhanced by old knowledge, heritage, and remembered ties to an ancestral home
Health is linked to artistic expression, the use of symbols and metaphor derived from cultural experience, and the transfer of knowledge between generations
Toi Ora is about
Knowledge that is based on past journeys
Knowledge that recalls longstanding world views
Knowledge that can be used for ‘living well’ in
the world Knowledge as a
platform for health and wellbeing
Pou Ora 3: Whānau Ora Empowering Relationships
Whānau
Kaupapa whānau –group with a common interest
Whakapapa whānau –group who share a common genealogy
Māori families – two-generational household
Ora safety life wellness
Whānau capacities Manaakitanga
the capacity to care Pupuri Taonga
capacity for guardianship Whakamana:
capacity to empower whanau Whakatakato tikanga:
capacity for planning Whakapumau tikanga:
capacity to transmit culture, knowledge, between
& within generations
Whakawhanaungatanga: capacity for reaching
consensus
Whānau interventions
Interventions can be aimed at:
changing the external impacts on relationships – an ecological approach
(e.g. improving housing)
building whānau capacities
(e.g. building manaakitanga: capacity to care)
Whānau Outcome Goals
Whanau self management Healthy whānau lifestyles Full whānau participation in society
Confident whānau participation in te ao Māori
Whānau economic security Whānau cohesion
Whānau Ora Approach focus on the whānau as a whole builds on whānau strengths and increases whānau
capacity six key operational elements:
1. whānau-centred methodologies shaped by the values, protocols and knowledge contained within te ao Maori
2. Intersectoral contributions
3. a primary focus on best outcomes for whānau, through integrated and comprehensive delivery
4. skilled whanau practitioners
5. expertise in whanau dynamics, relationships, aspirations
6. practices that increase whanau skills, knowledge, financial status, and self management (e.g. Online health records)
Towards Flourishing
Hauora Compatible environments
Toi Ora Knowledge environments
Whānau Ora Nurturing environments
Pou Ora 4Mauri Ora Enhanced Potential
Mauri = a force for life human integrity human spirit
human vitality individual uniqueness
Ora = alert responsive
lively
Spiritually robust Culturally engaged Emotional vitality Positive thinking Energetic Able to participate
in activities, events Sustainable &
rewarding relationships
Mauri Oho A Flourishing Mauri
Spiritually robust Culturally engaged Emotional vitality Positive thinking Energetic Able to participate
in activities, events Sustainable &
rewarding relationships
Mauri Oho Flourishing
Mauri OhoIndicators
Inspired Inspirational Optimism Clear thinking Outward thinking Moving easy Breathing easy Liked Likeable
Spiritually robust Culturally engaged Emotional vitality Positive thinking Energetic Able to participate
in activities, events Sustainable &
rewarding relationships
Mauri Oho Flourishing
Cultural & spiritual alienation
Negative emotions Knowledge gaps
Listlessness Slow moving Laboured btreathing
Negative relationships
Social isolation
Mauri Noho Languishing
Spiritually robust Culturally engaged
Emotional vitality Positive thinking Energetic Able to participate
in activities, events Sustainable &
rewarding relationships
Mauri Oho Flourishing
Cultural & spiritual alienation
Negative emotions Knowledge gaps
Listlessness slow moving laboured breathing
Negative relationships
Social isolation
Mauri Noho Languishing
Wairua
Hinengaro
Tinana
Whānau
The Challenge
Creating environments where: the mauri can flourish and
breathing is easy
Toi OraKnowledge transfers
Intellectual environmen
ts
HauoraCompatible
environments
Natural & man-made
environments
Whānau OraEmpowering relationships
Social environments
(home, work, leisure)
Some implications for prevention of disease & the management of disease
HauoraEnvirons
Toi OraKnowledg
e
Whānau Ora
Family
Mauri Ora Individual
sFactors that prevent poor health, disease, sickness
Green fieldsOrganic farmingSafe & nurturing environs School environsOccupational Health & safety
Access to old knowledgeMarae experienceExposure to matauranga Turangawaewae
Food –Housing –Income Parenting Whānau inclusion Whānau wealthWhānau cohesionWhānau modelling
EducationEmploymentPersonal resilience & social skillsSelf determinationExercise, sport, recreation
Risk Factors that can lead to disease, sickness
Alcohol Housing Ag.-Hort spraysTraffic densityNatural & man made disastersFood standards
Alienation from heritage, culture,old knowledge.
Detached from a past
Discrimination, racism, stigmaFamily dysfunction, child neglectPovertyViolence
Cultural alienationEducational failurePhysical inactivityUnemploymentLifestyles – tobacco, drugs, alcoholWork stress
‘Breathing Easy’ Environments
Personal Environments
Natural & Man-made
Environments
Whānau Ora Toi Ora Hauora
Internal‘inner’
environments
Family, work, &
socialenvironments
Heritage & culture
Knowledgeenvironments
Natural &man-made
environments
Mauri Ora
Family & Social Environments
Heritage &cultural environments
The overall challenge for preventing and
managing sickness and disease is to
create environments where ‘breathing
can be easy’
Stay well
Kia Ora
The Asthma FoundationNew Zealand Respiratory
Conference 2013
The Main Points
1. Māori understandings of health and sickness place as much importance on context as on individual experience
2. The health context is shaped by four Pou Ora, key markers that underly the health-sickness continuum: Hauora - Compatible environments Toi Ora – Knowledge transfers Whānau Ora - Empowering relationships Mauri Ora - Enhanced potential
3. Breathing will be easier when all four Pou are aligned and the human mauri is flourishing.
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