FIRST FOUNDATION YOUNG MAORI LEADERS CONFERENCE 2005

TĀIA TE KAWA

HEALTH AND FITNESS WITHIN THE CONTEXT OF A WHARE WĀNANGA  

Meihana K. Durie Te Wānanga o Raukawa 

INTRODUCTION

The Young Māori Leaders Conference 2005 represents an opportunity for young Māori to discuss, shape and advocate ideas that contribute to Māori advancement for the future.  The question of leadership within the areas of education, health, and fitness is one that will become increasingly important to Māori over the next decade if gains in health are to accompany gains in other areas including education and economic growth.   

Despite the high levels of participation that many Māori currently enjoy in sporting pursuits such as touch rugby, netball, basketball, rugby league, tennis, golf and kapa haka, recent statistics indicate that levels of Māori participation in physical activity are uneven, and twenty percent of Māori are sedentary.[i]  Māori rates of obesity are relatively high: [ii] 28 percent of adult Māori females; 27 percent of adult Māori males; 17 percent of Māori girls; and 16 percent of Māori boys. The growing number of Māori succumbing to preventable diseases such as type 2 diabetes and obesity at increasingly young ages[iii] suggests that Māori must exert a greater level of control over their own environment and ultimately their own destinies.   

While the leadership provided by health and education experts is important, leadership within the household is also required.  Parents must be able to provide children with models for healthy living while collectively Māori must look for effective ways of promoting the benefits of healthy lifestyles and encouraging the assumption of active leadership roles at household, whānau and community levels.    

At the 2001 Hui Taumata Mātauranga, three educational goals for Māori were advanced: to live as Māori, to actively participate as citizens of the world, and to enjoy good health and a high standard of living.[iv]  This paper describes an initiative that has the potential to contribute to all three goals.  Tāia Te Kawa is being developed at Te Wānanga-o-Raukawa as an educational programme that introduces both theoretical and practical aspects of health and fitness.  It also forms part of the major case study for a doctoral research dissertation currently being undertaken through Massey University.  Tāia Te Kawa draws on two key aspects of Māori health promotion:  first, it utilises Māori health perspectives to endorse health and wellbeing as integral to everyday living; second, it highlights key Māori cultural components including kawa, tikanga and te reo, as vehicles for promotion of health, fitness and wellbeing amongst the target population.  The underlying emphasis of the initiative is on successful and regular engagement in health and fitness programmes. 

The role of health and fitness within a wānanga context has been insufficiently realised despite the fact that increasing numbers of Māori are enrolling at wānanga, as well as other tertiary education institutions.[v]  There is a clear relationship between successful schooling and health[vi] and if, along with educational achievement, students are provided with opportunities to increase levels of health, fitness and wellbeing, there is greater chance of addressing the four domains of health and wellbeing that make up Te Whare Tapawhā: hinengaro, wairua, whānau and tinana.  These four domains were introduced to Ngāti Raukawa at a Hui Rangatahi in 1983[vii] and have been incorporated into the iwi health services and existing Wānanga courses.  

Māori health research indicates that as a matter of relative urgency, attention to taha tinana is necessary to avoid further serious health consequences.  To a greater degree than ever, Māori are leading sedentary lifestyles characterised by little or no exercise, and aggravated by eating foods high in sugar and fat.[viii]  This explosive combination provides the critical drivers for the accelerated onset of preventable diseases such as diabetes and heart disease.  In part, the high-risk situation is attributable to a failure by many Māori to adapt to changes in the modern environment.  The shift from rural to urban-based communities often meant changes in the work environment.  Active lifestyles were replaced by sedentary lifestyles.  Scarcity of food was replaced by an over-abundance of food, the nutritional standards of which were often dictated by economic factors.  Moreover, whereas the guiding principles of kawa, tapu and noa were often applied in rural settings where food gathering was closely aligned to customary practices, in urban environments, practice is more likely to be determined by principles associated with consumerism. 

Given the high number of Māori currently enrolled in programmes of academic study[ix], fresh opportunities have arisen to promote a culture of healthy lifestyles within tertiary educational settings – lifestyles based around the application of key Māori cultural perspectives to modern environments and strengthened by engagement in health and fitness programmes, as well as a curriculum that integrates academic study with skills and knowledge for healthy living.  

BACKGROUND

As the New Zealand tertiary landscape has evolved over the past decade, Māori have enjoyed increased opportunities for study in Māori tertiary institutions.  Te Wānanga-o-Raukawa is privileged to play host to students from a diverse range of iwi, hapū and whānau affiliations, all of whom seek qualifications and knowledge that will enable a fuller and more active participation at various levels of modern Māori society and in the wider New Zealand society.   

Te Wānanga-o-Raukawa was formally founded in 1981, primarily as an institute for teaching and research in kaupapa Māori related fields.  Particular importance was placed on the promotion of te reo Māori and iwi and hapū studies as key tools for survival into the next twenty-five years.  At a time when there were relatively few if any, tertiary Māori institutions in existence, Te Wānanga-o-Raukawa arose, largely as a result of a cultural renaissance strategy implemented by members of Ngāti Raukawa, Te Ati Awa and Ngati Toarangatira in 1975. Whakatupuranga Rua Mano, a twenty-five year positive action plan was formulated to increase levels of understanding, awareness and knowledge amongst younger tribal members, in particularly the areas of te reo Māori and tikanga-ā-iwi.  The project enjoyed a high level of support from associated hapū and whānau, and since it was first mooted in 1975, has been responsible for a marked increase in the number of fluent speakers and cultural practitioners.  Whakatupuranga Rua Mano provided the initial impetus for the establishment of Te Wānanga-o-Raukawa and continues to play an important part in defining its present role as a centre for kaupapa Māori teaching and research.   

More recently, the Wānanga has defined a set of guiding principles or tikanga that serve to provide both an ethical and philosophical framework for all wānanga related activities.  There are ten guiding principles, each of which incorporates a uniquely Māori aspect of cultural practice that can be applied in modern times.[x]  The principles of Rangatiratanga and Manaakitanga have particular relevance for Tāia Te Kawa.  Rangatiratanga refers to the obligations on the Wānanga to respect the rangatiratanga of individuals, whānau, hapū and iwi in all its activities.  Manaakitanga refers to the way in which mutuality between students and staff is maintained in order to enhance the standing of each. 

Te Wānanga-o-Raukawa has continued to grow both in numbers and profile and as a consequence, has had to accommodate changes in several areas including increased student numbers, additional academic programmes of study, changes to the learning environment, and compliance with an increasing array of government regulations.  To a large extent the Wānanga efforts have contributed to securing a place for te reo and tikanga in the long-term future of the iwi and in that sense have nurtured a significant cultural survival.  

Another key determinant for assuring the survival of Māori into the future and beyond is health status.   Taking ownership of personal health and fitness levels will provide greater collective synergies in the drive towards promoting good health and fitness among Māori.   By embracing healthy lifestyles as integral to everyday living, there is further potential to improve the current Māori health status.  

DEFINING THE PROBLEM

Current research and analysis provides some hard-hitting statistics in respect of the health and wellbeing of Māori.  For example, the number of reported cases of Type 2 diabetes has increased to a point that the disease, previously acquired by an adult only population, is now affecting children and young people.[xi]  This is a direct result of obesity, diets high in fat and sugar, lack of exercise, and smoking.[xii]  The lifestyle factors that serve as a precursor to type 2 diabetes have flourished in modern Māori society, and the attrition rates show no signs of waning.  Other preventable lifestyle illnesses are also major causes of poor health and premature death.  For example, although there is some evidence that smoking rates among adult Māori have declined, the number of cases of smoking related diseases among Māori is still disproportionately high and are twice those of non-Māori.[xiii]  Despite the increasing profile that the Auahi Kore message has enjoyed in recent years, there remains a comparatively high number of Māori, especially women, who succumb to smoking related deaths each year.[xiv]   Recent statistics show a slight decline in levels of daily smoking among young Māori females, but also point to an increase in the prevalence of smoking among this group.[xv] Heart related illnesses are another major cause of mortality among Māori and often attributable to a combination of sedentary lifestyles, inadequate nutrition and obesity.  Moreover, a failure to wear seat belts in the face of public education, has increased preventable Māori death rates due to motor vehicle accidents.  In light of these trends, the efficacy of conventional health promotion programmes and public health measures as they apply to Māori are open to question. 

So what then can be done to improve the situation?  Of the two broad approaches used to address lifestyle health problems, personal treatment for established cases and preventative interventions aimed at a wider population, most effort has focussed on finding more effective methods of treatment and then encouraging ongoing rehabilitative procedures.  A rehabilitative approach however is only part of a comprehensive remedy.  Māori must be prepared to take a proactive stance in ensuring that poor health will be reduced for future generations and the need for medical interventions minimised.  In short, prevention offers a greater measure of control and a higher level of independent life expectancy.  The fact that Māori continue to die at a younger age than others in the population, and have higher rates of hospitalisation than non-Māori, suggests that there has been a tendency to pay insufficient credence to health promotion messages and important health issues.   

Many Māori health promotion teams are already utilising Māori cultural paradigms to reinforce health messages, and the health curriculum in primary and secondary schools has similarly adopted Māori perspectives.[xvi]  Te Wānanga-o-Raukawa is attempting to actively promote healthy lifestyles for its staff and students by utilising some of those approaches but is also reconfiguring health promotion as an active process with a distinctive kawa, shaped largely by the Wānanga guiding principles.   Te Wānanga-o-Raukawa has previously accepted a role in health promotion.  Te Ōhākī for example is a programme that targets tobacco smoking and contains a clear expectation that a smoke free environment will be guaranteed and opportunities to quit tobacco smoking will be offered.  Similarly, Te Kawa o Te Ako prescribes a safe learning and teaching environment that is free from alcohol and drug consumption.[xvii] 

TĀIA TE KAWA

Tāia Te Kawa is a Māori health promotion initiative, particular to Te Wānanga-o-Raukawa, that aims to engage the wider Wānanga population in customised programmes of health and fitness by utilising both new and existing kaupapa Māori approaches to health promotion.  While it draws on the best available scientific evidence for health and fitness, it is shaped by Māori perspectives on health and by the guiding principles of Te Wānanga-o-Raukawa.  Underlying Tāia Te Kawa is the proposition that the application of a kawa to healthy living will more readily enable Māori to achieve best outcomes in health and fitness.      

Participants in Tāia Te Kawa will be encouraged to construct protocols for health and fitness around the concept of a kawa for healthy living.  In essence, a kawa provides guidance for behaviour, relationships, and safe practice.  In many cases, activities that involved a particular degree of risk or uncertainty customarily had a particular kawa attached.  Some examples of this include hunting and fishing, planting and harvesting food, preserving and storing food, building a whare, welcoming manuhiri, childbirth and battle.  In more modern times, the concept of kawa has found little application beyond the marae into the wider modern community environs.   

Tāia Te Kawa incorporates five central kaupapa:

1.      The utilisation of a distinctive approach to healthy living based on Māori health frameworks including tikanga, kaupapa and kawa;

2. A purpose-built health and fitness facility;

3.      Engagement in customised exercise programmes incorporating cardiovascular and resistance elements and based on pre-assessment and analysis with ongoing evaluation;

4.      Provision of lifestyle modification strategies, including promotion of healthy eating, smoking cessation strategies and support, weight management strategies and support; risk management advice;

5. Integration of both theoretical and practical aspects of the programme into an academic curriculum.

 Māori Health Frameworks

Reference to Te Whare Tapawhā has already been made.  It is central to Tāia Te Kawa insofar as it provides a context for understanding health as a balance between spiritual, emotional, physical, and family forces. Primary emphasis is placed on achieving an equitable balance between all four aspects. 

Health and Fitness Facility

A modern, on-campus purpose-built facility, incorporating a range of amenities that provide for various forms of exercise and other health related activities, will form the nucleus for Tāia Te Kawa.  The facility will include provision for a nutritional advice bureau, weight loss and maintenance advice, sports specific training, injury and illness rehabilitation, smoking cessation, and drug and alcohol intake advice.  It will also contain seminar rooms and physiological monitoring equipment to assist students with monitoring of health and fitness levels. 

Customised Exercise Programmes

All Wānanga students will have the opportunity to participate in Tāia Te Kawa and will be assisted in planning exercise programmes that are appropriate for their personal circumstances, and which might be continued beyond the Wānanga.  The aim is to introduce participants to graduated exercise routines based on pre-assessment, risk analysis and prior consultation with staff.  Programmes will incorporate both cardiovascular and resistance-training elements, with a focus on achieving key objectives incrementally.  Group activities will incorporate both indoor and outdoor elements, and will be supplemented by individual supervision. 

Nutrition and Healthy Eating

The programme will include nutritional education and under supervision, will encourage students to review their own eating patterns with a view to modifying lifestyles as appropriate.  Although the immediate context for dietary reform will be at the Wānanga, the wider aim will be to encourage all participants in Tāia Te Kawa programmes to offer nutritional leadership in their own homes and within their own whānau.  

Academic Curriculum

The fundamental kaupapa underpinning Tāia Te Kawa will be incorporated into a certificate level programme called Poupou Pakari Tinana.  The programme will be offered to Wānanga students enrolled in the full range of diploma and degree qualifications and will also be available as a stand-alone certificate.  It will include theoretical and practical components relating to lifestyle modification with a particular focus on promotion of healthy lifestyles through effective engagement in exercise and nutritional programmes.  In addition there will be discussion on the application of Te Whare Tapawhā to whānau wellbeing as well as the application of kawa to the maintenance of healthy lifestyles.  Additional qualifications in the area of Māori Health and Fitness Promotion and Sport Performance are also currently in development.  It is hoped that the qualifications will be offered at diploma, degree and post-graduate level. 

Programme Evaluation

Ongoing assessment of Tāia Te Kawa will examine three outcome areas.  First, there will be regular review of student academic progression and the relevance of the curriculum, including practical components.  Second, the impact of the programme on personal student health will be monitored on a regular basis using standard biometrics measures.  Third, the longer-term impacts on whānau wellbeing will form the basis for a longitudinal research project.  

CONCLUSION

This paper suggests that Wānanga have multiple roles as educators, agents for the development and transmission of mātauranga Māori, and leaders in the promotion of health and wellbeing.  Importantly, the integration of these three roles will be evident in Tāia Te Kawa where opportunities for new approaches to health promotion will be created.  The bi-modal nature of the certificate course, with its dual focus on theoretical and practical components will be underpinned by Māori health perspectives and the concept of kawa. It will provide students with tools for whānau lifestyle modification through nutritional change and validated fitness programmes, and has the potential to foster the development of a new wave of leaders within whānau.