Giving Wairoa back its autonomy by returning basic services is key to a happy, healthy community, according to a local social worker.

Hine is a 64-year-old Māori wahine who is married with children. She has lived in Wairoa for 45 years and has always felt Wairoa was treated like the second cousins.

While she describes pockets of the Wairoa community as resilient, she also says resilience is not an ointment you put all over and say, “we’re resilient.”

“Because we aren’t. It’s untrue.”

She believes Wairoa’s small, connected community is its strength — but that needs to be supported with more services.

“We would love to have a scan here. It’s over a million dollars, but then our mummies wouldn’t have to go out of town. We’d love our own enhanced and expanded diabetic clinics and dialysis. We had it — it’s gone.
Those sorts of things, for health, they need to come back so they can assist the community.
People will take control of their own health if they know we’ve got the services here.
The District Health Board might have had a name change, but that doesn’t mean nothing to me, because at the end of the day, it doesn’t change what my whānau wants or needs. It’s just a name. The systems are still the same. They’re still not bloody coming here.
And, quite frankly, 80% goes into all that — getting it started — and 10% maybe for the whānau or for the community.
We want to be in charge of our own. And we could do that here in Wairoa, monitor our own health and wellbeing, if we had the resources to do it.”

Hine believes whānau need to be given knowledge and skills to ensure their health and wellbeing are taken care of — and that health, social work, and education are a package.

“To implement change, education is needed. That should have started 10 years ago at college, or even primary school — to get students to think about being a social worker, or nurse, or doctor, and supporting them.”

With a background in adult teaching, Hine recalls the impact of social issues on learning.

“People didn’t know how to fill in forms — they couldn’t even read the damn forms. They had relationship problems, communication breakdowns, whānau were a dysfunction.
Even now we have some training happening, but it takes four to five years, and these kids are not seeing the full picture — they don’t see the future.
It’s an instant generation. So, for now, we’ve got a gap, and us oldies have to stay here a little bit longer to train the younger ones.”

Hine says having only one health care centre and one GP practice catering to nearly 8,000 people puts a lot of strain on services.

“Some whānau don’t like going to the doctor. Whether it’s financial or just scary — they don’t come.
There is an age bracket, around my age, who leave it too late. So, I’m finding that the happy is not happening.
Human nature gets in the road of wellbeing and common sense — we procrastinate right till the end.
Wellbeing is a mindset. If you feel good within yourself, you’re not going to go to the doctor.
And then suddenly something will happen, and you haven’t seen a doctor for 10 years — and you’ve got to build that file up, build that relationship with whatever doctor.
Back in the days, we had one doctor. And that doctor knew your history. Now, you could be telling your story so many times.
And, when you see the doctor, it is 10 minutes, 15 tops, to give your story, and then walk out.
Are they happy because they’ve got their prescription? Or not happy because they don’t think the doctor understood?
Do they understand what the doctor is showing them in a space of 10–15 minutes?
Do they need a person who can check in after a doctor’s appointment and just ask if they actually understood? Or maybe they need to bring a support person who sits and listens?”

From a family perspective, Hine says they try to eat well and exercise to keep healthy — but the most important thing is communication and staying connected.

“You’ve got to have those laugh times, those good times.
Well, sad times too — but that also helps health.
Connectedness is about being open, not being so isolated.”

Over the last few years, Hine says she feels like all she is doing is putting the elderly into some sort of rest home.

“It’s ongoing every week. Whānau who think they can look after each other — and then all of a sudden, they can’t.
There are always going to be barriers because of the system. Everything has to go down the Bay. And so, we wait for them…
And I know they’ve got a lot of things to do, but the process is so frustrating.
And it’s not just because we’ve now got no roads out — this process was frustrating before then.
Now it’s escalated.
Now whānau are going to Gisborne and we are depleting their resources by filling their beds.
You’ve got two DHBs that are not the same, not talking the same, and you’ve got to get permission from this one to send a patient to that one.
Bureaucracy.
It doesn’t make my life as a social worker very happy.
And then, I take it on as my personal life and think, ‘Oh, my god.’”

“And we’ve got whānau who are mentally unwell — or become mentally unwell — because they’re worried about putting their mother and their father somewhere.
We have no respite care, so there are a lot of dynamics going on.
Whānau have parents with dementia and the health issues that go with that.
Our hospital ward is an acute ward — it’s not a care facility — so we try not to keep people in there.
But I’ve insisted, because if you send that person home alone, that person’s going to be back the next day.”

Hine wants a Wairoa-based consultant assessor so needs assessments can be done straight away, rather than having delays from referrals to Hastings. The closure of SH2 saw the first local assessment conducted via Zoom, which Hine says worked well and should be made permanent.

“This is about giving us the autonomy to do that service.
It’s complementing the service — it doesn’t take anything away from Te Whatu Ora.
The referral process just needs to be faster.”

Hine says assessments can take two weeks to complete, and there are often communication breakdowns with Hawke’s Bay-based staff coming into town and not liaising with the Wairoa staff who requested the referral.

“We have a case now where the patient is waiting and is unsafe in their home.
The whānau looking after him is unwell — to the point where it’s a safety issue, where his father might not be good, because it’s just not good for him.
He’s not in the space to look after his dad.
So, we have a bed waiting, but we are waiting for NES (Te Whatu Ora’s National Enrolment Service) and a geriatrician — and meanwhile, the whānau are stressed.
We put him in the hospital just for his son to have some respite.
He’s a lovely old man. He does wander a bit, but he’s not aggressive.”

Hine says Wairoa’s providers connect well together. The greatest need for local whānau is a roof over their head — so they feel safe, warm, and functional. And if they’re needing services, they should have a choice.

“Maybe you just need to break them into it with the right services and right people.
It’s that communication, it’s that connection — showing that you care.
Because I tell you what, my job sometimes can be a misery.
There are good sides to it too.
Sometimes my empathy just goes out the window, but I have to pull myself back in because I’m thinking, ‘It’s not about you, it’s about the community.’
It’s about growth.
It’s about education.
It’s about them being happy and then moving forward.”

Roberta’s whānau have used sport as a vehicle to connect with each other and the wider hapori. They make a deliberate effort to create safe spaces for whānau to come along, hang out, learn a new skill or sport, and get active.

Roberta is a 23-year-old Māori woman who describes getting together and communicating as the foundations of a happy and healthy whānau.

“Our whānau get out and about and exercise together. Sometimes it looks like getting around a table and having a kai and sharing how our days are going, what we’ve got coming up, being able to communicate in a healthy way about how we’re actually feeling — because it can be hard. That’s what my whānau like to do, and we’re slowly doing it more often, and we recognise we need to.”

Three generations are involved in supporting the hapori.

“We meet up at least once or twice a week. Usually, on a Sunday, we’ll get together and have a big kai, and talk about how our week was, what we’ve got coming up, or if we’ve got a community event — who’s available to do it? And just having that kind of clear communication with each other.”

Roberta says Wairoa people have natural sporting ability, skill, drive, and passion — but they weren’t actually playing.

“We’ve got all the sporting talent, but we were lacking sport. We saw there was a need for that, and because my whānau are very heavily involved in sport and we love being out in our community, we thought, why not?”

Community engagement has come through netball, softball, and now touch is starting up.

“We do walk awareness, stuff for autism, and Relay for Life, and we’ve got a concert coming up. We do quite a lot of things that are for hapori, by our hapori.”

Roberta says her family are naturally very whānau-orientated and driven by their hapori.

“That’s what makes us, us — the things that we do. Even though sometimes it can be a real big burden on us, we don’t mind doing it because we know our whānau want it. We know they’re going to appreciate it. And we have other whānau who help, and it’s kind of just made this one big whānau with the hapori.”

She says the drive comes from knowing what you’re doing is working and helping.

“Because man, some days, doing some of this work, it’s like — why are we here? Why are we doing this? Why are we stressing about this at 11:30 at night? And then all those things from people are just like — oh, this is why we do it. It’s because people want it. People love it.”

Roberta is mindful that not everyone is like her whānau.

“That’s how we are, that’s how we’ve been raised, but some whānau aren’t like that — which is fine. You can lead a horse to water, but you can’t make it drink. We could show all these whānau all these things, but if they’re not going to take it on… and that sucks, because that ends up being a whānau that slips through the cracks. But you’ve done all you can. You can only do so much for whānau. It’s that fine line of ‘I want to help so much,’ but then you don’t want to burn yourself out. And if you burn yourself out, then you’re not going to be able to help the other people, yeah.”

Before last season, Wairoa netball was being run by the Hawke’s Bay Netball Association. Roberta’s whānau could see that travelling to Napier and the pressure on time and money wasn’t working for Wairoa.

“We want whānau to come and watch their kids, to be involved — so we saw that need.”

The first local season saw nine women’s teams entered and more than 20 school teams playing in the local competition.

“We have so much natural skill and talent. You can’t teach that anywhere, but we need local access to sport.”

Roberta admits that what her whānau is trying to achieve can be challenging.

“Sometimes different entities see us as a challenge to them — which we’re not. At the end of the day, we’re not here for ourselves. We’re here for the hapori. And if entities saw us that way, then we’d be able to work hand in hand, because we don’t mind working with everyone. We’re not trying to take things away from people. We can work together to provide better kaupapa or better programmes for our hapori.”

Another challenge is Wairoa’s infrastructure. Roberta would like to see improved netball court surfaces, rugby fields, and tennis courts.

“We need money and time put into those improvements, because better resources mean we can provide something for our whānau and our hapori that doesn’t have drugs or alcohol.”

Roberta says that living in a low-income place like Wairoa means it’s not easy for whānau.

“A lot of our kids do want to do sport. You can see it when you’re playing with them, when you’re coaching them — they genuinely want to do it. But because of the lack of money, it’s harder for whānau to support them. The solution is bringing sports back here and keeping it alive. Because again, the passion, the drive — it’s all here. And once they go from here, they’ll be able to go into the world and showcase what they have.”

Roberta has also lived in Auckland and described the health service in Wairoa as much better than the big city.

“It’s not as judgemental here. I am comfortable, no matter who the doctor is — there’s a connection. The health service here — it’s getting there. They are a bit slow from what I’ve experienced, and it’s kind of stopped me from wanting to go to the doctors half the time. But I see that they are still trying, and with the lack of doctors that we have, it makes it a bit harder.”

Roberta’s job means she answers a lot of queries from the public, and she says people often ask about what Wairoa lacks — like a dentist or banks.

“You can see that people really need all these health services — not just the doctors — but we actually need the dentist.”

She also sees a need for more mental health support — counsellors and therapists.

“Living here, our mental health is shockingly high, and not having a lot of services to cater for that really sucks. And it’s worse with our rangatahi — they’re just going to suffer more.”

Roberta has seen rangatahi missing school or not wanting to go.

“I see them not even wanting to be around or exist or be alive. And we say, ‘Oh, we’ve got this, and I know that you can do this — come along.’ And then they do, and you kind of just see that change in them where they’re like, ‘Oh, I love this. Thanks for letting us come.’ And I’m like, ‘Anytime. Come back.’ Yeah, it’s quite amazing to see the development of the person when you know where they’ve been. It’s something different — gives them a sense that they are actually good at something and helps them believe in themselves.”

Roberta has met kids who were unwell who came to their whānau netball clinics and really got into it.

“I just see the confidence in them when they grow. ‘Oh, I love that you’re coming here. I love that you’re doing this. I love that you’re getting into this.’ And I never would’ve known if we hadn’t sat down and they told me, ‘Oh, I was real shit. I was in a real shit space, and thank you for letting me come.’ And I’m like, ‘Oh, how did I… I did not even know that. This is so good that you are enjoying this.’ And it’s all about just sitting there, having a conversation with them at the end of the day, eh.”

Support and self-sustainability, both within whānau and the Wairoa community, are key to helping whānau thrive.

Hendrix is a 23-year-old Māori man, born and bred in Raupunga, and says that if you have no support, you have nowhere to go.

Hendrix does not believe there is enough support in the Wairoa district.

“We are told there is enough support, but I personally don’t believe there is — especially in the whānau stuff, because a lot of people have been brought up to be hard enough, get over it, ka pai.
That’s a good structure, but there are also other structures that could work well.
Support is the number one that needs to be established from the start — from your family, your friends, to the community, to our teachers, our council members.”

Hendrix is part of the Rainbow community and works as a rangatahi coordinator, creating services from health to education for rangatahi aged 12 to 24. He holds a bachelor’s degree and has worked in multiple jobs to upskill himself.

His parents and whānau are self-managing. They live off the grid and have no plumbing in their house — by choice.

“We’ve consciously taken a step back to get down to basics again. And I believe that’s the healthiest way because everyone’s too materialistic.
We’re self-sustaining — we grow our veggies, we don’t need to rely on shopping.”

Hendrix shares his own experiences with the rangatahi he works with, and created a gardening programme to help people understand seasonal kai and develop the knowledge needed to sustain it.

“The programme is around self-management but is on hold because of Cyclone Gabrielle.
A lot of whānau think just putting it in the ground is enough — which, ka pai, that’s the start.
But the whole reasoning behind why gardening was created was to be self-sustainable.
Because if we’re self-sustainable, we don’t need to rely on others or outside help.
The programme was so they can learn the knowledge of how to grow, when to grow, and how to sustain it — through a te ao Māori kind of vision, but also upholding our tikanga as well.”

For Hendrix and his broader whānau, support is automatic.

“Whānau support is the number one in our whānau. If we can’t support our own, we can’t support anyone else.
If we can’t support ourselves, we can’t support our whānau.
My whānau is always sick. My mum has diabetes, my dad has cholesterol problems, and just checking up — that’s what we do.
Support could be helping them mentally and making sure they’re okay.
If anything’s needed, we help — without any questions, we just help. But a lot of people don’t do that because they don’t know anything else.”

Hendrix doesn’t believe Wairoa’s health providers or services engage enough with the community.

“A lot of our community don’t know because they have limited knowledge.
And a lot of them just end up doing it themselves — and end up worse.”

Hendrix is in hospital every year due to health conditions. He was misdiagnosed around 10 times through Wairoa, Hawke’s Bay, and Hamilton health services. It took four weeks to get a correct diagnosis — by which time his lungs had significantly deteriorated. He now has regular check-ups, but says a challenge is local staff not having the knowledge to manage his condition.

“A lot of our community doesn’t have the right resources to ensure they’re getting the right care.
A doctor appointment lasts, say, 20 minutes max — really, it should be longer so they can carry out proper testing.
In Wairoa, if they can’t get the proper testing because they don’t have the right equipment, then they just send us somewhere else.
And that’s the biggest thing — because a lot of us, we don’t have cars, and then we are displaced and we’re away from our whānau.”

“We need more specialists here in Wairoa working in the certain fields that we know are bad here.
Diabetes is a number one here. And a lot of whānau have cholesterol problems.
And yes, it is a way of eating as well, but if we had specialists coming in and telling you exactly how it is…
Just making sure that we have the right people that we’re talking to — targeted services and education.”

Hendrix also believes sending rangatahi directly into the workforce with no life experience is not the right approach.

“We shouldn’t be forcing rangatahi to move straight into work when they have no experience — they have nothing.
They’re just going straight into a career, and that’s all they know.
So, my vision is to help them get multiple experiences in multiple fields of work.
Because if you know everything within the different ranges of work in the workforce, you can pick and choose what suits you best.
I’m over seeing my community walk around with their heads down, doing nothing with their lives.
I’d rather get them into a workforce where they are needed, wanted, and their worth is accepted as well — and even following their dreams, following their passions, and upholding that.”

If Hendrix could change anything, he would bring in a whole lot of specialists in different fields.

“Create something that’s needed here.
Take our kids off the roll at Affco, off the roading, and give them options.
Having that massive option could help us thrive as a community.
We won’t need to go anywhere. But having those specialties come in and teach, give us knowledge, give us an opportunity — that’s what I believe needs to be done.
Because without knowledge, you can’t do nothing.”

Claire was born on Taveuni, the third-largest island in the Fiji group. Her husband, also from Fiji, has worked in forestry in Hawke’s Bay for the past 10 years. Claire, along with her daughter, moved to Wairoa seven months ago because she felt the need to support her husband through the hardships he was facing.

They chose Wairoa to be their home, saying they love the town, fitted in straight away, and can see a lot of similarities between Wairoa and Fiji in terms of community and family.

Claire was raised in a village and described herself as a happy girl growing up because they had food on the table and good clothes, even though there were seven of them.

“My parents worked, my dad was a full-time farmer. We were happy — it was basic, but we had everything we needed — contentment.
For me, going to the mainland, into Suva, that’s a city life, and years later, being there and bringing up the kids, it’s stressful. It’s like living overseas.
Every step of the way costs money, and you have to have money in order to have those needs met.
But being in the village, everybody was looking out for one another — even in terms of health and traditional medicines.”

Claire says in New Zealand, everything is also financial, whereas in her village, you grow your own garden, and if you don’t have anything, you barter with other family members.

Claire will be 48 this year and works as a social worker. She and her husband have six children. Claire was a flight attendant, but her priority was looking after her extended family — particularly after her dad became sick.

“In Fiji, it’s all about family. It’s not nuclear family — it’s extended family as well.”

Claire is a Roman Catholic and also worked at the church with elderly people and with St. Vincent, which looks after the abandoned, the poor, the old.

“I used to love working with those people — just visiting them and knowing they’re not alone in their daily lives.”

Claire has a love of people, describing helping people as the place she belongs — looking after people and keeping traditions and culture alive.

Claire and her husband are waiting for his visa variation to come through so he can start work at Affco. Claire is in New Zealand on an open work visa under her husband and has been able to complete some free courses through Pacifica Health — something she is grateful for. She was prompted to do the health papers because she saw a need through the forestry boys.

“It was an opportunity to be a voice for them. One day I was at home, and one of the forestry boys came knocking on my door. He was sick and needed to go to the doctor. But he had no money for the doctor or medication because he sends his wages back home to his family in Fiji. I knew then I had to do something.”

A lot of the people Claire works with are elderly, kaumātua. She thinks nurse-led clinics with resources to meet people’s basic needs — set up as satellite hubs throughout the district — would meet a great need.

“Many of the elderly are alone — their families are busy or have moved to the cities. Most of them live by themselves.
I think it’s the feeling of just being alone. They just welcome seeing you coming to see them — big smiles on their faces, they are filled with joy.”

Claire describes a happy, healthy, and safe family as well-rounded — having all your needs met in terms of health, finances, and social wellbeing, and how we interact with other people.

Their daughter has started as a Year 8 student at Wairoa College and is fitting in well.

“That’s why I said that by being well-rounded, our needs are met — because when I see her being happy, it makes our little family happy.
This is what I call wellbeing. She’s learning and she’s enjoying it. My heart is content.”

Claire says New Zealand’s health response is better than Fiji’s, with more access and the ability to be seen and have any health problems identified.

“In Fiji, I always say you just need to look after yourself. Exercise, eat right.
I’m grateful we are here because I know in terms of health my needs will be met.”

Claire is happy to be working and contributing, as she does not feel you can live on one income in New Zealand. She says her work energises her during the day, and when she is not working, she and her husband have a garden with plots of taro — which reminds her of home.

The couple’s biggest worry is their visas and awaiting residency. They want to buy a home in Wairoa, and waiting for her husband’s variation to be able to work at Affco instead of the forestry company is unsettling.

“We need some security. My husband has been here for 10 years.
There is a lot of opportunity for the Fijian workforce to use their skills in Wairoa, but they were all bonded to the forestry companies for their employment, so need visa variations or residency to be able to work elsewhere.”

Claire has been part of a drive to support the Pacifica community, particularly around the impact Cyclone Gabrielle has had on the forestry industry. She said iwi have supported the Fijian/Pacifica community — and they also support each other.

A wānanga organised by Te Iwi o Rakaipaaka drew 126 Fijians together.

“People were just so ready to come together and be part of a community.
I know Gabrielle did a lot of devastation here in Wairoa, but it was a blessing in disguise for us, the Pacifica community, because it brought us together.”

A barrier had been the lack of connection between the Pacifica community — but that is no longer a problem. Claire sees opportunities for Pacifica people to become enmeshed in the Wairoa community and actively participate in work and volunteering.

For Claire, her faith as a Roman Catholic is what keeps her rooted and supporting her husband.

“Faith is an essence of my basis — of being an active, contributing member of the community.”

Rangatiratanga — the ability to self-determine what is right for you and your whānau — is the biggest measure of whānau health and wellbeing, according to Wairoa-born academic Professor Suzanne Pitama.

Professor Pitama (née Meihana) is a Professor and the Dean and Head of Campus at the University of Otago in Christchurch. With her Ngāti Kahungunu roots still firmly placed in Wairoa, she says whānau need the right information to have choices, access to the right assessments, and to receive the same level of care and choice that would be offered to someone living in Hastings or Christchurch.

Educated at Wairoa College, Professor Pitama qualified as a child psychologist before moving into academic roles. She has returned to Wairoa to conduct research into cardiovascular disease and gout and has investigated inequities in Māori health and how rurality is a risk factor.

She describes Wairoa as one of the most impoverished communities in Aotearoa.

Professor Pitama is on the Ngāi Tahu Iwi-Māori Partnership Board and believes that looking at data is an important way to tell the whānau story.

“Te Whatu Ora tells us to talk to people and hear their story, but there is so much other data out there, and so many points that tell our whānau story in a way that shows how disadvantaged Wairoa is, and what services people are getting.
Determining hauora is not just about aspirations — it’s understanding the baseline and knowing where to prioritise. We can do that with data.
Because if it’s just based on customer service or feedback, we’ll never ever reach hauora. That won’t give a good indication of hauora — it just gives a good perception of people being polite.
If Wairoa really wants to advocate as a locality, and not be stuck where it was as a rural hub of the Hawke’s Bay District Health Board, it needs rangatiratanga over its own data. It needs to dictate to Te Whatu Ora what services it wants to purchase, and where those services come from.”

Professor Pitama says it’s crazy that it’s easier for people in Nūhaka and Māhia to go to Gisborne, but they are expected to travel all the way to Hastings.

“That is not a benefit to Wairoa. There needs to be more choices.
Wairoa needs to pivot — and the secondary and tertiary services around it need to pivot too. That’s how you get quality.
These fake boundary issues have disadvantaged the Wairoa district.
Wairoa people don’t complain. They’re really gorgeous around being thankful for what they’ve been given.
They are resilient.
Resiliency is developed when you come across opposition — and Wairoa people have been forced to be resilient.
We don’t want to keep building resilience because that’s just a personal response to structural inadequacies.
Wairoa people are tired because they have to be so resilient all the freaking time — and that’s exhausting.”

She also says it’s difficult for whānau to know what to ask for.

“People are informed by their experiences.
So, it’s like being in a restaurant and it’s à la carte — and you haven’t been shown the menu, but you’re asked to order.
My concern for Wairoa is that when you gather people’s aspirations, they don’t know what’s on offer — say, what I’m getting in Christchurch.
Based on my experience in reviewing the Wairoa health system through our research projects, those in Wairoa are offered fewer choices.
Ultimately, people should have access to health care that is aligned with best practice guidelines.
But unless you know those best practice guidelines, you can’t advocate for it.
I think that holistically, people know what they need to keep themselves well — but it’s really impacted by what you can afford.”

She says the locality needs to be asking:

“Based on the levels of poverty, how are we going to advocate so people can get resources even though they’re impoverished?”

“The structural things that would support better health are less stress, warm housing, good nutrition, opportunities to exercise, and choices — those things cost money.
I’m less willing to put that burden back on whānau.
The biggest role of the Wairoa locality will be to tackle the structural issues — to make visible what’s on the à la carte menu so our whānau know what they can ask for.”

Preventative measures are great, she says, but they’re based on the false pretence that everybody can make choices — and that doesn’t align well with Wairoa, where most families don’t have options.

“The holistic stuff comes from quite a privileged lens.
I worry because it uses Māori health as a buffer and Māori health models as a bit of a guise — by saying your spirituality is just as important, which it is — but it distracts from where mainstream is actually putting their funds.
This is a health reform.
Localities are about health reform.
The problems lie in primary and secondary care, where governments have not invested time or money into fixing the system they’ve helped corrupt.
I totally get the determinants of health — but they’re pushing responsibility onto the other determinants of health, which are not getting additional funding, rather than the actual health system itself.”

Professor Pitama’s dream for Wairoa is a Community Health Hub, with integrated services that reflect Wairoa’s values — a mixture of traditional Māori medicine (rongoā, rākau, mirimiri), herbal remedies, allied health professionals, talk therapies — all sitting alongside primary and secondary care.

“Everyone working together — with MSD, with housing, with educational opportunities — and having hauora embraced, as opposed to having to navigate hauora within the silos that exist.”

She says rural health in Australia is far more developed, with rural and remote models that could work for Wairoa. She experienced a federally funded community hub run by an Aboriginal provider.

“A family comes in and goes to a room which is set up for multiple types of consultations — dentistry chair, consultation bed, comfortable seats.
If I was meeting with them as a psychologist and I read they had low abdominal pain, then I would leave the room and say, ‘Hey, I need a nurse or doctor in here.’
And then they might go, ‘Oh my gosh, this person hasn’t eaten for a week.’
Then they’d get the social worker to go into the room.
It really is whānau-centred.
The whānau owns the room — that’s the space for healing.
The people who contribute and support their healing go in and out of the room, as opposed to the whānau moving around — totally whānau-centred holistic health care.
It might be green prescriptions or a Year 13 student mentoring a Year 8 student who’s having some troubles.
We need somewhere that has the capacity to provide all those things.”

Professor Pitama believes Wairoa should also have far more access to tele-med and tele-health services.

“And if you need a physical exam, there are people who could be there who the surgeon or medical registrar could talk through with — to ensure it is completed, e.g. a nurse.”

She also supports mobile community services for areas outside of Wairoa, where hubs might be based in schools and set up to normalise hauora.

“They don’t have to be manned 24/7 — they just have to be supported.”

Relating to Professor Pitama’s Hauora Manawa heart health study (2007–13), which compared cardiovascular risk factors in rural Māori, urban Māori, and non-Māori communities in New Zealand, 254 Wairoa participants were randomly selected from the electoral roll and had their health checked.

“We found Wairoa people were going to the GP at the same rate as Christchurch people.
So, there wasn’t a delay in treatment or trying to access care — and people were prepared to pay when they were concerned.
But when they were getting to the GP, the access to quality service was not in line with what we’d expect according to best practice guidelines.
There was a lack of access to quality care, and a lack of the old DHB investing in Wairoa the way it should have.
A lot of attention was being given to Hastings/Napier because it’s easier.”

“The study showed there wasn’t a lot of difference between the health of 20-year-olds and the health of 65-year-olds.
The health of the 20-year-olds was terrible.
We saw 23-year-old men with left ventricular hypertrophy — which is where you’ve had high blood pressure for so long that it’s enlarged the left ventricle of the heart.
Then too, when these young men drop dead at 30 or 40 on the rugby field and we don’t know why — actually, we do kind of know why.
But it’s not being diagnosed.”

Participants ranked relationships with GPs or primary care providers as super important — but this did not align with actually receiving the healthcare they needed.

“The good relationships with healthcare did not transfer to good health outcomes — with high levels of undiagnosed hypertension, hyperlipidaemia, even diabetes — and also those who were diagnosed but undertreated.”

Professor Pitama says the government and the health system should be responsive to people — not blame them.

“Localities deflect responsibility of a billion-dollar industry away from the government.
How did the health reforms and trying to change the way we spend millions and millions of dollars end up with me being told to think about my health more holistically?
To me, it’s a scam — because the reforms are supposed to be about how we more effectively and efficiently use the resources given to health.”

Suffering in silence with limited access to local respite care or a disability facility is how a Wairoa family has lived for the past 26 years.

Meeting their disabled son’s needs is a battle and has defined their whānau way of life. And while the parents have never considered not looking after their son, they admit it is hard — especially being isolated from specialised services and support.

Heta and Jane are whānau-focused and have six children living with them, all either working or at school. Maaka, their third oldest, is 26 and was born at 24 weeks’ gestation. He is a paraplegic, diabetic, and has seizures.

Maaka spent the first year of his life in Wellington Hospital, and the whānau relocated from Wairoa to stay at McDonald House. Heta worked in the hospital kitchen, and their oldest son went to the hospital school. Heta says they were lucky to keep him.

“The fourth day he just about died — he’s a strong fellow. And from then on, it’s just been us.
He came with some problems, but we just treat him like a kid — not a disability, not special needs — just part of the kids.”

Jane echoes her husband’s comments:

“Like every mother, we forget about ourselves when it comes to our families.”

Maaka came home on an oxygen tank and five or six syringes of medicine. Heta returned to work at Affco, and Jane looked after the kids.

“We really only had us — our support group was just my family. It was full on.
We didn’t know what we were dealing with when it came to his health. We just took him day by day.
We weren’t looking for support because we didn’t know whether we needed it.
We just knew he was ours, and we had to deal with him — so we did.
We were young, we were adjusting and dealing with the moment. At the start, we didn’t know about the other complications and the cognitive and motor skill side.”

The first time they had any support was when Maaka was two.

“We didn’t even know who they were or what they wanted.
We were just bringing him up like we were the rest of the kids.
Then a lot of people started coming into the house and telling us what to do — and then leaving.
And we’re going, ‘Hey, hang on. You’re telling us what to do — you go home, we’re still here with him.’
We had to do what worked for us, and the agencies didn’t like that because it didn’t fit their curriculum.”

Heta describes the disabled community as silent sufferers.

“They don’t have a voice to express how they are going through life.
Do we really know what we are doing is for his benefit?
Do we know what he’s going through?
We can think, ‘Oh, okay he wants that,’ and hope we make the best decisions for him.”

Maaka was supported through education until he turned 21 — but now there is nothing. The family has no respite or anyone coming in to help, and there is nowhere locally for Maaka to go.

“It’s hard. The other siblings help out, but we don’t want to put it on them because they’ve got their own lives.”

There is funding available to hire someone to help with Maaka, but the family haven’t found anyone suitably qualified who they can trust.

“He has complex needs — it can’t just be a walk-in person. This is about relationships, trust, and becoming emotionally attached.”

They do have a cousin who was a stand-in teacher and has known Maaka since he was a baby.

“She played a big role in his life anyway and was someone we could call on if we suddenly had to go somewhere — but we don’t use her as relief care.”

Wairoa has no other special needs or disability support. There was a residential house, but that is now gone. Maaka was once referred to Glengarry aged care — which was not appropriate and is now closed.

Jane knows that if they lived in Napier, Hastings, or Gisborne, services would be more accessible.

“We would have more access — things like Hohepa Home. But why can’t we have a Hohepa Home here? Why can’t we employ our own?
What I’d want for him is somewhere where he can belong in the community. Somewhere where he can go — for himself.
All the kids go to work and school, and he doesn’t. Our day is him saying to me in the morning, ‘Oh Mum, we clean up?’
And he’s got his own vacuum, so he’s got our routine. But that’s a home routine — and that’s all he knows.
That’s what we are living every day.
He needs somewhere to go. Somewhere that looks after him as a person.
Somewhere, so that if we do need some respite — because we’re all getting a bit older now — we have an option.”

Jane says if Maaka were looked after by the state, the cost would be huge.

“CCS in Gisborne worked it out — if they had him, they’d need his van to pick him up, take him to Gisborne, have someone qualified to take care of him.
And based on current funding, he would only be able to go for two or three months — and that was only once or twice a month.”

Maaka can’t stand or walk, and it’s getting harder for Heta to lift him into their van, which has a hoist.

“He’s getting too big for us to lift — and that’s not beneficial for him because he can’t go anywhere now.
We try to spend time together as a whānau, but that means everyone being involved.”

Heta recalls a time, about five years ago, when Maaka had an abscess. He took him to Wairoa Hospital, but they wouldn’t admit him and told them to see a GP.

“We couldn’t get an appointment until the next day, so in the end, I rang Hastings and got a referral.
And we knew he was hurting — he’s strong, and he can’t tell you how much he’s hurting.
So, I drove him to Hastings — two hours — and he was in a coma for 12 days.
He ended up being transferred to Wellington for eight weeks before coming back to Hawke’s Bay Hospital.”

Jane’s biggest worry is her husband’s health.

“He’s my biggest worry — because my kids are strong, so they got my back.
We are all able to work together as a unit because that’s what we are. Our whole family makes it work.
But my husband — he’s the one I look to as we do that strength.
Since he’s had his heart attack — he’s had quite a few. He’s had an operation on the valves, and then he had a stroke about two and a half years ago.
And that’s when I really felt it.”

She recalls saying to him while he was in hospital:

“You know what? I realised how much I value you.
We don’t acknowledge what one another does — because it’s just become part of our lives.”

Heta, now 60, says he and Jane, 54, have not had time together — as a couple — away from Maaka.

“Because we felt one of us needed to be there when the other one was going somewhere.
It’s the only way we can do it. Our life is organised around him.
We don’t want to put that on anyone else either, because it is a big job — and we know how to deal with him.
We do often think too — how patient he is to put up with us for 26 years.”

Jane says a happy, healthy, and safe whānau is keeping everyone well.

“A healthy, dry, clean home for our family.
I try to give all my kids an equal share of me — the way we were brought up.
We weren’t rushed to leave. So, for me, that’s how I look at my own children.
I don’t have no worries if they’re here — I know they’re home, they’re safe.”

Even from a housing perspective, Jane says there hasn’t been enough listening.

“We were in a two-bedroom house and there were six of us.
So, we got offered a three-bedroom — and I’m saying that is not big enough. Maaka needs a room to himself.
We were standing on the road with all the agencies — they are talking about how they can modify the three-bedroom.
I’m thinking this is a waste of time. No one is listening — and I’m staring across the road at a much bigger house that had one person living in it.
Eventually, they did listen — and we moved into that house 15 years ago.
And it’s taken us that long to get carpet in the living room and a heat pump.
It’s been a long haul.
We breathed steam in the winter and needed insulation.
Maaka can’t walk — so he’s on the ground. We needed support for him.”

Jane has other Wairoa-based friends looking after their disabled children. One in particular has a son of similar age to Maaka but has never received a diagnosis.

“Why do you need to be diagnosed when you know there’s something wrong with your child?
So, she gets no support — because there is no diagnosis. She has just given up on the system.”

Jane is doing what she can to advocate.

“We formed a parent group to support us. We meet once a month and just vent how we are feeling.
Have a cup of tea. Some would come in really angry — but it was soul-healing for us because we understood one another.
All our kids had different diagnoses and different disabilities — but we all had one thing in common.
And we all had teacher aide issues, school issues, educational issues, health issues, even housing issues.
So, we could support one another — because we are also suffering in silence.
How can our community help our kids if they don’t even know what kids are in the community?
We can’t get out and about — we are not seen — and there is nowhere for us to go.
And that’s the reality of what all our kids go through.
We are six families that have come together — but where is the other data telling us how many other parents are out there?
We couldn’t get that information.
How can we help them and tell them that we’re here?”

Jane says as other families have their children come out of the special unit at the college, the care will fall back on them.

“They will be like us. It will fall back on the families — where the breadwinners will have to stop working because they’ve got nowhere to take their children.
Or they’re going to be forced to take them to Hohepa — two hours away from the family.
That’s not how Wairoa works.
It takes a whānau to raise a child — and it takes a community to raise a whānau.
Our wider whānau is our community — and if they don’t know about us, how can they help?”

Toni is of Rarotongan and Tahitian descent and has lived in Wairoa for just over 10 years. Her family moved here to be closer to whānau and because they saw potential in Wairoa — although she says that has diminished.

She is 42, married, with two children aged 23 and 21, and has five mokos, aged from four to three months.

Toni was baptised into the Jehovah’s Witness faith 16 years ago. She says her upbringing was quite religious, but they weren’t really applying Bible principles.

“It was pretty much showing your face at church, and you can do whatever you want behind the scenes.
Growing up, that didn’t gel well with me. I knew there’s got to be a better system — I wanted to better myself, and my environment wasn’t really giving me that. So, I had to do the mahi myself.
To be honest, the first 10 years of applying the Bible principles and trying to take those principles on board was hard because of my upbringing.
But I’ve learned so much in a lot of areas — how to become a better person, how to become a wife, what that involves, what it means.
And also just working outside that circle too — how to treat people, really.
I’m one of those who believes that if you treat people the way you’d like to be treated, everything will be alright.”

Toni was raised intergenerationally and says that for her, a happy, healthy, safe whānau is about going back to square one — going back to the root.

“In Rarotonga, I was brought up with grandparents, great-grandparents, etc. for 11 years.
At that point, I hated being a kid because there was a lot of ‘do this or else’.
But as a parent now, I realise what they were trying to do.
Growing up, you knew your place as a child. Now, as I look back, we’ve lost that — having those principles in life that go back to moral standards.
To me, being happy is putting our anger aside and trying to better the system, better our whānau, better our community in order to thrive — because the future doesn’t stop with us.
Our kids have mokos and so on — the next generation.
So yeah, working together as a community — and it doesn’t matter what kind of hat you’re wearing.
We have to learn to put everything aside, come together as a team, and see what we need to achieve — what are our goals, and what’s the long haul for all of us?”

Toni says it’s been hard to fit in as someone who identifies as Pacifica because her upbringing was very different.

“We had respect. As a kid, we knew our place. Everyone on the island had respect for one another.
But again, that’s the Bible principle. Back then, principles and moral standards were right there. Now, it’s like anything goes. We seem to accept everything.”

Having family time is important for Toni, as is balancing life away from mahi and giving it back to the community.

“Instilling everything that we’ve learned and passing that on to our kids.”

Toni says her whānau try to be positive and to give back and help each other out.

“We spend a lot of time together. I like to put people first — even my mokos, my kids.
So yeah, we do spend time together. I’m about giving — so that’s important to me.”

Toni describes Wairoa’s health system as “out of whack.”

“It’s hard because you don’t have a permanent doctor, so there are a lot of changes.
And when you do need assistance, it’s hard to get in there.
The doctors are not grounded here — they don’t really know the community.
I’m not after someone who’s just here to do the job — I want someone who has some feelings and is getting to know the community, someone who will help better the system, someone you have a relationship with.”

Toni also struggles with the lack of services in Wairoa.

“There’s pretty much nothing here, really. And it’s sad because it’s a community and we are trying to thrive — but it’s hard to thrive when we don’t have that help here.
We’ve turned a lot of the services down because we’re just too busy and it’s just too far to travel out of town.”

Toni previously lived in Gisborne and said most of the services she needed were available.

“I guess because we’re only a small dot on the map, no one really cares about us.
So, to me, it feels like they’re forcing us to leave our homes by not supporting us here.
We’re not getting what we need.
Not all of us can afford to travel out of town.
There are a lot of kaumātua who need help. I’ve seen on Facebook how people need a ride to get to the hospital or bring them back, or asking who’s the best dentist or doctor out of town.
It’s just hard. And the wages ain’t the greatest. So by the time you add the petrol, GP fees, whatever — and car parking — that’s pretty much your wages gone.
And then times that by how many whānau are in your household.
It’s like, come on — we need something here.
We need a system based here to look after our whānau.
I hear the whole community moaning about how whack the system is.
And that’s sad because Wairoa is such a beautiful home, and it’s a beautiful community. So why take the people out of that?”

For Toni, people having respect for one another, regardless of their background, is essential.

“It’s having empathy for one another, respecting each other, and being kind.
And I guess that’s where everyone needs to come together — to thrive, to move forward.”

She believes Wairoa could benefit from having the right people running the systems and making sure the community comes first.

“We all need to come together — iwi too — because when we’re saying it’s all about the community, we want to make sure it is about the people.
They come first. And then we look at — how do we make it work?”