L-R: Alex Neil, health care assistant; Rachel King, member of the Parihaka Papakinga Trust and Kiri Wicksteed, lead doctor for the clinic.
Every fortnight inside a whare at Parihaka Papakāinga in Taranaki, people can be found laughing and catching up with whānau in the Wakaihu Taiora clinic waiting room. They’re there because of a new health initiative designed to respond to community need.
Whakaihu Taiora is a marae-based medical clinic offering free services to Parihaka residents and the wider community. Launched in November 2020, it’s the result of a responsive co-design process between the Parihaka Papakāinga Trust, doctors from local Opunake Medical Centre, Taranaki DHB and Pinnacle.
The kaupapa of Whakaihu Taiora is to provide healthcare centred in Māori culture, based in a place whānau know well and can easily access. Traditional 15-minute appointments common in Western medicine don’t feature here. Instead, whānau might see the GP and nurse from Opunake Medical Centre for an hour or more, an organic approach that is responsive to the needs of the remote community it serves.
Originally a large, vibrant and prosperous papakāinga known for its non-violent resistance to European land confiscations, Parihaka was devastated in 1881 during a military assault by colonial troops. The kāinga was occupied for several years and people imprisoned.
Today, the community still exists and although the events of 1881 reverberate, Parihaka is focused on once again creating a thriving, resilient community that meets the needs of its people.
The name Whakaihu Taiora is an in-depth reference to the wellbeing aspirations of Parihaka. Whakaihu connects to the location in the ships where men were held while being taken to be imprisoned in the South Island in the 1880’s. It symbolises the demanding journey needed for their descendants to return to their former health and security. Taiora creates an image of being carried on the tides of wellbeing.
Parihaka Papakāinga Trust Pouhautū, Mitchell Ritai, says the creation of Whakaihu Taiora supports the Trust’s ongoing kaupapa to rebuild a sustainable, healthy community.
“We have kaumātua and tamariki living at the papakāinga who need access to health services,” says Mitchell. “To be able to have a doctor and nurse visiting every fortnight is really beneficial.”
The idea for Whakaihu Taiora began with conversations between the Parihaka Papakāinga Trust and local doctors. A hauora survey of Parihaka residents highlighted the need for accessible healthcare, and doctors at Opunake Medical Centre could see the impact of well-known barriers and health inequities experienced by Māori in the community. The thinking was, creating a medical clinic at Parihaka would be a positive thing.
Further support for the idea came from Pinnacle with the allocation of flexible funding to get the clinic up and running. Deputy CEO, Justin Butcher, says Pinnacle immediately loved the idea and jumped at the opportunity to make the Parihaka clinic happen.
“Whakaihu Taiora is a ground-up initiative based on connections and partnership between Māori and local GPs,” says Justin. “They’ve invested time to co-design and get it right. We absolutely want to be an enabler for that.”
The Parihaka Papakāinga Trust provided rooms in a whare for the clinic and undertook building work to make them fit for purpose. Pinnacle funding ensured the clinic had all the equipment it needed and that patient visits are fully funded, while Opunake Medical Centre approached GP and Māori health practitioner, Dr Kiri Wicksteed, to work at Whakaihu Taiora every fortnight.
An important part of the setup process included kōrero with papakāinga members at monthly Rā gatherings, which have taken place at Parihaka every month since the 1800s. During this time, suggestions for naming the clinic were made by Te Paepae o Te Raukura, Takitūtū Marae Chairperson and Parihaka Papakāinga Trustee, Dr Ruakere Hond.
The service received a hesitant response from the community at first, driven by people’s previous experience of short-term services setting up in Parihaka and then withdrawing.
Dr Kiri Wicksteed says the first question people ask is often ‘How long will you be here for? When are you leaving?’
“The answer is that we will continue to be here and continue to provide this service,” says Kiri. “Whakaihu Taiora is important to the community, it’s still evolving, and we want to find ways to provide people with what they need.”
The clinic takes a flexible approach to enrolments, with patients able to stay enrolled with their own GP, or enrol with Opunake Medical Centre.
“People have sometimes spent years building a relationship with their own GP and don’t want to leave that,” says Kiri. “It’s totally understandable. But getting out to town can be difficult, so being able to come to the Parihaka clinic and easily get something checked is great.”
“We’ve seen quite a few people that way, along with their friends from the wider farming community. Some are here for hui and become unwell so come to see us – lots of times they are people who whakapapa to Parihaka, which is really special.”
Kiri highlights the support of the Parihaka Papakāinga Trust in growing suport for the clinic. “The Trust office is based on the marae, they are there every fortnight helping us with everything we need and communicating with the community. They send out a text message to remind people we’ll be there the next day.”
For Mitchell Ritai, the support received from Opunake Medical Centre and Pinnacle to meet the needs of the community prompts similar appreciation. “The fact that we have a service and it’s a regular service now, means quite a few members of the community are starting to turn up,” says Mitchell. “The flexibility in this arrangment has suited the needs of our community, it’s very beneficial and I can definitely see it growing.”
Justin Butcher agrees and says Whakaihu Taiora is a model that Pinnacle wants to try and replicate in the future. “Integrating a Māori health model in all we do means having strong partnerships and relationships with Māori. It’s about identifying needs and working with communities to really provide them with the right kind of services.”