KOROWAI ECEIV. Toiora Whanau. Our Mission Whakapumau. Motiva ting People to Prioritise Healthcare

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1 Our Vision KOROWAI Health Centre Toiora Whanau ECEIV ED 2 8 JAN 2010 MAORI AFFAIRS SELECT COMMITTEE Genera tional Wellbeing Our Mission Whakapumau I te ora Motiva ting People to Prioritise Healthcare Our Values Manaakitanga Rangatira tanga Whanaunga tanga Kotahitanga Ukaipotanga Kaitiakitanga

2 2 Submission on the Maori Mfairs inquiry into the Tobacco Industry in Aotearoa and the Consequences of Tobacco Use for Maori To the Maori Affairs Select committee Chair Tau Henare MP Introduction: This submission is from Ngaroma Grant Chief Executive Officer Korowai Aroha Health Centre 1292 Hinemoa St Rotorua Ph Fax Date 26.~ anuary 2010 x~/~ ~ ~/~/ Signature d'a Position ( /~ ~ We wish to appear to the committee to speak to our submission. We wish that the following also appear in support of our submission. Ngaroma Grant: Dr Michael Tustin: Turoro/Whanau Chief Executive Officer MB, ChB, BSc, Dip Paeds, FRNZCGP. Korowai Aroha Trust: Tupara Morrison: Chairman Pare Aratema: Deputy Chairperson Tina Ngatai Trustee Dr Michael Tustin Trustee. Chief Executive Officer Ngaroma Grant Management Team Rose Whetu Boldarin (Clinical Manager) Hariata Vercoe (Corporate Services Manager) Mike Tustin (I/C Clinical Governance) Kay Marie Turuta (Community Team representative) Korowai Aroha is a kaupapamaori service and this determines who we are, how we treat each other and most importantly, how we treat our patients and whanau.

3 Kaupapa The following are the kaupapa identified by Korowai Aroha Health Centre as the drivers of all policies and practises. In addition, examples of tikanga consistent with the kaupapa are suggested... These kaupapa are consistent with the Maori world view and will assist us in developing and maintaining Korowai aroha as a kaupapa Maori institution Manaakitanga Rangatiratanga Whanaungatanga Kotahitanga Wairuatanga Ukaipotanga Kaitiakitanga Objectives: To deliver an efficient, effective, comprehensive health service to Maori in order to raise the standards of Maori health to those of non Maori or better. To market ourselves by improving the accessibility and affordability of health services to Maori and through role modelling behaviour. To develop and strengthen the infrastructure of Korowai Aroha Health Centre to ensure ongoing professional, economic and culturally focused viability. To conduct business within the bounds of legislative requirements and Korowai Aroha's policies and procedures. Korowai Aroha currently has a strong market orientation with a focus on the various stakeholders with whom it interacts. Stakeholders include clients (Turoro) customers (funders, businesses) and networks (Iwi, health providers and other services including education and social services. The GP clinic is Korowai Aroha's core business which is staffed by 6 doctors and seven practise nurses in addition we have 24 community health contracts with a staff of approximately 80. Korowai Aroha has delivered primary health care and a range of community health services within the Lakes District of Rotorua for 18 years. Enrolled population: Maori 5860, Pakeha 517, Pacific Islander 266 Other 281 Korowai Aroha has a responsibility for the future ofmaori health in Te Ara wa and Aotearoa, New Zealand. Consultations: Te Arawa Lakes Trust Chairman Toby Curtis. Trustees and Management Korowai Aroha Staff Turoro/ Whanau. 3

4 Summary We wish to make the following comments. It is timely and of urgency that an inquiry is being held into the tobacco industry in Aotearoa and the consequences of tobacco use for Maori. Korowai Aroha as a Health Centre has seen and experienced over the years the devastating effects that tobacco smoking has had on Maori patients and their whanau within Te Arawa. We are a clinic offering low cost fees and as such most of our enrolled population are Maori suffering from chronic health much of which smoking is related. This is why we are concerned about the high rates of smoking in Maori and effective change needs to be done especially in addressing the Tobacco industry. We wish to raise the following matters under Terms of reference: Just under half of our enrolled Maori patients are smokers. Korowai Aroha has had an Aukati kaipaipa service since 2001 and assisted hundreds of Maori clients and their whanau to try to become Auahi kore. It has been difficult as we do not have the resources to lift up the quit rates as Maori have become so entrenched in tobacco smoking causing generations of ill health, early death and social instability. The tobacco industry is responsible for the annual death toll of 600 Maori (4400 non Maori) imports of tobacco need to be stopped. Maori addicition to tobacco especially women, young hapu women and those with a mental health disability is prevalent and they fred it difficult to quit. The 2006 census shows that 40% of Te Arawa age 15 and over were regular smokers. (45% for women.)that has an impact on the health, economic, social and cultural wellbeing of Maori within Te Arawa. Clients who come to our Aukati Kaipaipa service are motivated to quit smoking. They find it difficult to quit and experience the loss of self esteem and negativity. As staff and whanau we have attended many tangi over the years for turoro who have died of a smoking related illness. As Aukati Kaipaipa quit coaches we have gone into homes of dying whanau who are still asking for patches and gum with the hope of staying alive longer. Chronic illness from smoking has had an impact on the health, economic, social and cultural wellbeing of Maori here. Recommendation 1 Korowai Aroha would like to see an increase in the number of kaupapa based smoking cessation programmes ( Aukati Kaipaipa) and for them to be resourced to the same level as the National Quit Group.

5 The impact of tobacco use on Maori has deprived whanau and the wider Iwi of opportunities to play an important part in the development potential of the tribe. There is a history of Maori suffering from discrimination and marginalisation Currently smoking is looked upon by society in a negative way and as Maori are the highest users of tobacco this is another area of prejudice. There have been no benefits to Maori from the use of tobacco. Today it has impacted on the loss of potential and in the colonial past, tobacco was one of the commodities traded for land and the beginnings of a smoking culture in Maori. Recommendation 2 Korowai Aroha would like to see the supply of tobacco more difficult to obtain by increasing taxes and removing tobacco displays from licensing retailers and to reduce retail outlets and to hold the tobacco industry accountable for the 600 Maori (4400 non Maori) deaths each year. 3. Korowai Aroha would like to support the Wai 844 Mate Pungarehu/ Tobacco Claim submitted by our late Ruahine/ Kuia, Guide Huhana Mihinui and supported by the New Zealand Maori Council The General Functions of the New Zealand Maori Council under the Maori Community Development Act 1962 at section 18 shall be: To consider and discuss such matters as appear relevant to the social and economic advancement of the Maori race: The NZMC is mandated to act in respect of ah the Maori people of New Zealand in this capacity it is claimed: That the Maori people of New Zealand are and have been prejudicially affected by the omission of the Crown to provide equitably for Maori health in the elimination or reduction of Maori smoking. Recommendation 3 To address the deaths from smoking in Te Arawa and the motu Korowai Aroha would like to recommend that this claim be progressed within the office of Treaty Settlements. Conclusion. In conclusion Korowai Aroha is dedicated to alleviating the health disparities within Te Arawa If the inquiry into the tobacco industry in Aotearoa finds that tobacco has no place here, it would give quality of life and raise the health, social, economic status of our people so we have the potential to participate fully not only at a whanau, hapu, Iwi level but to be part of the wider global peoples of the world. Kia Ora Ano Tatou.