Principles of Te Tiriti O Waitangi in Healthcare

Submitted by coleen.yan@edd… on Mon, 05/22/2023 - 13:29
Sub Topics

You learned about Te Tiriti O Waitangi earlier in the course. Here, we will explore three of the principles that are relevant to health and wellbeing settings in New Zealand today, and that respect the status of tangata whenua:

  • partnership
  • participation
  • protection

These 3Ps, or operating principles, are tools that help give us a better understanding of Te Tiriti and how it can be used as a framework for support work in a way that is inclusive and culturally safe.

Relationships with a person being supported and their whānau can be established where:

  • The values that are important to tangata are included.
  • The 3Ps are used.
  • The spiritual and social aspects of a person’s health and well-being are included.

Both organisations and individuals all play their part in ensuring that Te Tiriti is an integral part of support work.

Partnership

Partnership is about working together with tangata, their whānau, hapū and iwi so that they are all involved in the tangata‘s health and well-being support. It means valuing the person and their support networks, having empathy, and sharing decision-making and resources. Partnership is about working with tangata, sharing skills, sharing power and treating tangata equally in relationships.

Working in partnership requires people to:

  • respect and value differences
  • show empathy
  • share knowledge and empower others
  • share decision-making processes

Partnership relates to article 1 of Te Tiriti o Waitangi: kāwanatanga.

Applying partnership in support work

An organisation’s functions, policies and procedures will aim to ensure that services are provided in an atmosphere that respects and values everyone’s input into decision-making processes.

Support workers need to:

  • Act in good faith based on Te Tiriti principles.
  • Work alongside the person they support and their whānau, including them as equals in the working relationship.
  • Recognise that partnership involves support workers and other members of a multidisciplinary team working together and alongside the tangata and their whānau.

Whakawhānaungatanga

Whakawhānaungatanga is the process of establishing relationships and relating well to others. It is about building connections and working together. In healthcare, it equates to getting to know the tangata and their whānau that you are supporting and having honest, respectful interactions and relationships with them.

Participation

Participation is about allowing time for people, their whānau, hapū and iwi to be part of discussions and decision-making about their needs, for example, when the personal plan is designed or reviewed. Participation requires everyone to be inclusive of the person and their whānau.

Participation occurs when there is:

  • open discussion and genuine consultation
  • good faith
  • support for tangata to share their ideas and have their ideas supported

Participation relates to article 2 of Te Tiriti o Waitangi: tino rangatiratanga.

Applying participation in support work

An organisation’s functions, policies and procedures will enable tangata and their whānau to have the opportunity to participate in all decision-making, such as the development and review of personal plans. The organisation must ensure that support clients and their whānau have access to services and activities in the community.

Support workers need to:

  • Ensure the tangata they support and their whānau are included in their assessments, goal setting, decision-making and creation of personal plans.
  • Ensure support services are geographically accessible, culturally responsive and financially affordable and that tangata can use available transportation options.
  • Recognise Māori rights to equitable access to services, enabling them to attain optimal health and well-being outcomes.

Protection

Protection is about ensuring tangata are supported and protected from inequality in the health system. It involves ensuring they have access to services that meet their needs. It also involves safeguarding Māori elements, including taha Māori (culture) and te reo Māori (language), and protecting tangata from threats to their wellbeing and quality of life. A threat to someone’s cultural practices and values can directly impact their wellbeing. Protection requires:

  • advocacy and honesty
  • knowledge and awareness
  • protecting the things that are important to the person

Protection relates to article 3 of Te Tiriti o Waitangi: oritetanga.

A traditional maori carving

Applying protection in support work

An organisation’s functions, policies and procedures show they expect support workers will meet the requirements of all relevant health and safety regulations and New Zealand Standards to protect the health, safety and well-being of tangata being supported and their whānau.

Support workers should:

  • Safeguard Māori health.
  • Ensure their clients have access to all services available and appropriate for them. Advocate for your client if you think they are missing out on support.
  • Ensure the support they provide is culturally, spiritually, and emotionally safe, in addition to being physically appropriate.
  • Seek feedback from the person and their whānau to ensure the support aligns with their needs. Avoid making assumptions about what's best for them.
  • Acknowledge that health and well-being are precious taonga (treasures) and collaborate with the individual to protect and enhance them.
Case Study

You support Kuini with home-based care, visiting every evening to help with her bedtime routine. Kuini has mobility issues due to diabetic neuropathy, which has led to chronic foot pain. Her whānau are concerned that Kuini is reluctant to leave the house and is becoming isolated. Although family visit her regularly, they feel that if she could attend other whānau events more easily, this would benefit her greatly. The whānau have recently purchased her a mobility scooter; however, Kuini says she is concerned that she cannot use the mobility scooter on public transport. Although she would like to do aqua exercises at the local pool, the transport issues and the cost are prohibitive. The whānau are also concerned that Kuini is not receiving podiatry support, which they think could help with the foot pain.

The principles of Te Tiriti o Waitangi are important to the cultural, legal, and support sectors of New Zealanders. Various tools and approaches can be used to uphold and promote the principles to foster partnerships, recognise Māori rights, and address any historical injustices that may have occurred.

The Treaty/Te Tiriti documents

The Treaty (in English) and Te Tiriti (in te reo Māori) are critical tools for understanding and interpreting the principles. They outline the agreement between the British Crown and Māori chiefs, establishing a partnership and guaranteeing Māori rights and authority. Studying both texts highlights the differences between them and how they would have been interpreted differently by both parties at the time of signing.

Legislation

Several pieces of legislation have been enacted to give effect to the principles of Te Tiriti o Waitangi. These include the Treaty of Waitangi Act 1975, which established the Waitangi Tribunal, and subsequent amendments to various laws to ensure compliance with the treaty.

Waitangi Tribunal

The Waitangi Tribunal is a key tool for addressing treaty-related issues. It is an independent judicial body that hears claims and grievances related to breaches of the principles of the treaty. The tribunal investigates historical and contemporary issues, makes recommendations, and facilitates the settlement of grievances.

Cultural competency and training

To promote understanding and application of the principles of Te Tiriti, various cultural competency programs and training initiatives have been developed. These programs help individuals and organisations to build awareness, knowledge, and skills to engage effectively with Māori communities and uphold the principles of the treaty in their work.

Māori language and cultural practices

The revitalisation of the Māori language (Te Reo Māori) and cultural practices is crucial for honouring the principles of Te Tiriti. Language and cultural initiatives, such as Māori language immersion schools (kura kaupapa), Māori language revitalisation programs, and the incorporation of Māori cultural elements in public institutions, help preserve and promote Māori identity and values.

Consultation and participation forums

The principles of partnership and active participation are vital to the implementation of Te Tiriti. Tools such as consultation processes, engagement forums, and inclusive decision-making frameworks ensure Māori participation in policy development, resource management, and other areas that impact Māori communities.

Activity

Complete the following quiz to test your knowledge.

Review the following case studies. For each, reflect on how you as a support worker could demonstrate respectful application of Te Tiriti principles and values. Complete the activity that follows.

Case Study A

Fatima is a 22-year-old woman who was born in Lebanon and came to New Zealand with her family when she was six years old. She has been diagnosed with bipolar disorder and is undergoing treatment at her local mental health clinic. Fatima attends her appointments accompanied by her family, which includes her mother, father, and older brother. In her culture, the value of family involvement in her treatment and other aspects of her life is high. She consults her parents before she makes any significant decision and does not wish to engage with community workers unless her family is present. The mental health workers accommodate Fatima’s wishes by ensuring that there are always enough seats for each of Fatima’s family members to attend any meetings. They also make eye contact with everyone in the room and demonstrate inclusive practice in relation to Fatima’s family.

Case Study B

Maria is a young single mother with a five-year-old child. She has been diagnosed with depression and sees her support worker, Louise, regularly. Louise provides Maria with support, encourages her to take her medication, and helps her find social outlets in the community to develop friendships.

Maria has a part-time job at a local supermarket. She drops her son off at school in the morning and goes to her job from 10am until 2pm. The job suits her schedule perfectly as it allows her to work around her son’s schedule. However, this morning, Maria’s manager has told her that due to a downturn in the business, her position is being made redundant.

Maria is very upset and worried about how she will support herself and her son. Louise realised that Maria requires support in finding an alternative source of income. Initially, this means referring Maria to the work and income office to apply for unemployment benefits. Louise is also mindful that if Maria doesn’t find a new job soon, she may have to find alternative accommodation as her current rent is too high for Maria to afford on unemployment benefits alone. Louise makes a mental note that Maria may also need support in applying for social housing. With Maria’s permission, after the session, Louise contacts Maria’s case manager to advise him of Maria’s altered circumstances and schedules a case management meeting to address these changed needs. This meeting aims to address Maria’s changed needs and explore potential solutions for her financial stability and housing situation.

Case Study C

Carl and Nan have both just started working at the same organisation. Carl is originally from South Africa, and Nan is originally from Thailand. In South African culture, it is quite common to stand close to someone and look them directly in the eyes while talking, whereas in Thai culture, it is more appropriate to maintain physical distance and maintain lower levels of eye contact.

One day, Carl and Nan are talking about a new organisational policy. As Carl is making his point, he leans in close to Nan and looks at her intensely in the eyes. This makes Nan feel uncomfortable because this behaviour is at odds with her own cultural style of conversation.

As Carl continues to talk, Nan steps backwards and averts her eyes (consistent with her cultural communication practices). However, Carl perceives this behaviour to indicate that Nan does not understand the point he is trying to make, which results in him continuing to move closer to her and making his point more forcefully. This makes Nan feel quite intimidated and eventually results in her fleeing the conversation. Afterwards, both Nan and Carl have quite negative feelings towards each other.

Module Linking
Main Topic Image
Treaty of Waitangi
Is Study Guide?
Off
Is Assessment Consultation?
Off