Transcript
ANNEKA ANDERSON: They were quite willing to share with us some of their experiences, as sad as they may be, including those of being called names such as 'coconuts' or being treated differently than say non-Pacific or non-Maori patients in hospitals.
KORO VAKA'UTA: What effect or impact is this likely to have in terms of people going to get treatment?
AA: It creates another barrier to people wanting to utilise health services. Knowing that you are going to go and encounter sub-standard treatment or being treated differently doesn't help so there is a barrier for accessing and experiencing. What it also does is that for health care to be effective you need a very good relationship between a health care provider and the patient or the patient and their family and having these racist encounters erodes those relationships. So that means that providing health information is disrupted so people may not understand the full extent of their illness or treatment of their illness or management of their illness as well as they could. For rheumatic fever we do have to have ongoing injections with particular antibiotics to prevent further infections of sore throats. These may not happen if you don't understand the importance of it or if you don't have a relationship with someone who has to give it to you so it has multiple flow on effects.
KV: And there is also, I guess, the cultural considerations which you have cited, things in terms of tapu in regards to Maori and Pasifika.
AA: Very much so for our Pacific, so for some of the examples we had were young Pacific girls in hospitals asked to expose their bare chests for an examination to male doctors but with no family or support in the room, which made them feel very scared, quite vulnerable. Another example we have with rheumatic fever was for one of the older married Pacific women having a male nurse come to her home without her husband or family there to deliver the injections in her buttocks. For her that was very unsettling and she said very insensitive and inappropriate.
KV: You have obviously looked and Maori and Pasifika experiences and we are always told in terms of the campaigns and the messages that Maori and Pasifika are at higher risk or have higher rates, but it is not actually a genetic thing is it when it comes to rheumatic fever?
AA: Absolutely not. So it looks there is genetic susceptibility from getting sore throats and developing rheumatic fever, but that doesn't seem to differ across any populations. If we look at Pakeha in terms of genetic susceptibility and Maori and Pacific and other groups, we have about the same proportion of every population who are susceptible so there is absolutely no genetic basis in which Maori or Pacific, from current research, are more susceptible to rheumatic fever.
KV: There are recommendations that this report has to improve the situation, what are some of those?
AA: Really if we are serious about eliminating rheumatic fever and recurrent rheumatic fever in Aotearoa, we need to look at primordial prevention, so we need to look at structural inequities. Look at the housing situation for a start, homeless situation, poverty for our whanau. Within the health care system itself we need more flexible models of care, where health providers come to families and provide them treatment. Where health care providers form good relationships with families and we also need to work more I think in eliminating bias and institutionalised racism.
