25 Jun 2018

Breast cancer: Health institutions 'still racist' towards Māori

3:10 pm on 25 June 2018

A legal consultant has spoken out about offensive and ignorant comments from hospital staff while she was being treated for breast cancer.

Irene Kereama Royal

Irene Kereama Royal Photo: Supplied

Irene Kereama Royal was 52-years-old when she found two lumps in her breast - and a year later, another more aggressive cancer was found.

"I asked the Breast Care Centre when do I get the talk about reconstruction, and the Breast Care clinical nurse said to me, 'oh, I did not think that Māori women want reconstruction'," she said.

"I kind of went to a weird place... and was confused about that way of looking at me."

She said it was suggested to her during her treatment that it would be better not to give Māori women the full research about breast cancer, because it would scare them.

About 600 women die each year of breast cancer in New Zealand and thousands more are diagnosed with it.

A new report from the University of Waikato shows Māori women get diagnosed too late and are 79 percent more likely to die from it than Pākehā.

Lead researcher Professor Ross Lawrenson said there were several inequalities between Māori, Pasifika and Pākehā women.

The study found Māori women were less likely to get chemotherapy and take the treatment Herceptin.

He said that was particularly concerning, because women have a 40 percent greater chance of surviving if they get those treatments.

"Our information will challenge the services to make sure Māori and Pasifika are getting access to the same rates of chemotherapy as well as Herceptin."

Ms Kereama Royal said there is a perception out there that Māori women did not care about their health, but there was more at play.

"That institution that diagnoses you, that treats you, that reconstructs you after you have had your mastectomies - that institution still is racist towards Māori women."

Breast Cancer Aotearoa Coalition chair Libby Burgess said the figures were unacceptable and more needed to be done.

"It is really important that awareness campaigns are rolled out by the government," she said.

"It would be incredibly more effective if those campaigns were designed in conjunction with iwi and with communities ... I do not think that is really happening."

Māori rates for breast screening were the lowest at 65 percent, falling short of the national target of 70 percent.

Whakatāne health worker Sonia Stewart said she supported calls for more iwi involvement.

She worked alongside Te Whanau a Apanui to do breast screening on the East Coast, and the rates for Māori there more than doubled.

"All of the key players down here were involved, the schools, the marae," she said.

"Everyone knew where aunty and nanny were if they didn't show up to their mammography and we were a lot more flexible down there"

Previously, people would be turned away if they showed up to their appointments late, she said.

Ms Stewart works for Te Puna Ora o Mataatua health service, which held a contract for breast screening until last year.

Now it sits with public health, but she said Māori organisations were expected to do all the leg-work.

"They just kind of drip feed us Māori providers on crumbs and expect us to do this magnificent job to get our women there."

Ms Burgess said they had told past Health Ministers to consult with iwi, but nobody was listening.

They were keen to discuss the problem with Health Minister David Clark, but they have been referred to Associate Minister Julie Anne Genter.

A spokesperson for Mr Clark said women's health was her delegation, and she has been approached by RNZ for comment.

However, the government is undertaking a broad review into health care, with Mr Clark acknowledging that complexities in the current system were getting in the way of people accessing the care they need.

The review aims to identify who is missing out in the health system and how it can be fixed.

"We need to face up to the fact that our health system does not deliver equally well for all," Mr Clark has said.

"We know our Māori and Pacific peoples have worse health outcomes and shorter lives. That is something we simply cannot accept."

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