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No. 30 (March 1960)
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HEALTH TRENDS
IN THE MAORI TODAY

by Dr G. MAAKA

Although there has been a magnificent recovery in Maori health since the beginning of the century, sickness is still a big problem. In fact, if the Maori was as healthy as the New Zealand European he would, on the average, live fifteen years longer. Maori health was discussed with much insight at the Young Maori Leaders Conference. To help delegates along, Dr Maaka supplied a most interesting paper on Maori health in the Whakatane district; part of this is reprinted here.

Whakatane is a thriving, rapidly growing town situated at the outlet of the Whakatane River on the Bay of Plenty coast. It is the centre of a rich dairy farming, timber milling and paper-making aera. The population in the district in 1956 was as follows:

Maori Pakeha Total
Whakatane Borough 660 5,440 6,100
Whakatane County 6,390 10,410 16,800
—— —— ——
7,050 15,850 22,900
—— —— ——

Within twenty-five miles of the Borough approximately 6,000 members of the Ngati-Awa and Tuhoe tribes live in scattered settlements consisting of family groups and sub-tribes centred around their own marae.

Many of the elements of the old culture are still retained, viz. Maori speech in the homes, strong kin relationships, marae activities with perpetuation of traditional ceremonies, attitude to land, and a modern variety of ‘tohungaism’. Associated with this is the modern outlook of the younger generation who, influenced by better education, the radio, press, cinema, and a freer association with pakeha friends and co-workers, become more Europeanised in their ways.

HEALTH

Although too much preventable sickness still afflicts the people, the general health pattern has shown steady improvement over the last twenty years. This latter has been due to:

(1)

Better housing conditions and sanitation with improved domestic and personal hygiene.
(2)

The untiring efforts of District Nurses and Medical Officers in the preventive field.
(3)

An increasing willingness on the part of the people to seek medical treatment.

Until recent years too many were apprehensive of modern medical methods and were reluctant to attend a nurse or doctor or enter hospital. This was due to a suspicion of pakeha methods or a fear of tapu infringements and a belief that only a tohunga could cure a ‘Maori’ disease. This attitude is slowly changing because of the dramatic results obtainable from potent anti-bacterial drugs and modern surgery and an appreciation of this fact by most of the people.

Many still prefer the empirical treatment and incantations of a tohunga—especially in mental cases or where a disease has unusual features or proves unresponsible to modern treatment. Other patients after receiving modern treatment attend a tohunga ‘just to make sure and look after the Maori side’.

I will now enumerate some of the more common ailments seen:—

INFANTS

In the first few months the general health of the new-born infant, as a rule, remains good. Arrangements are made for the odd case of congenital abnormality to undergo appropriate treatment.

LATE INFANCY — TODDLERS —
PRESCHOOL

The sickness rate in this group remains too high. In too many cases it is due to neglect or carelessness on the part of the parent. Many harassed and overworked mothers with large families naturally find it difficult to cope with everything.

(1)

Influenza with chest complications is common—bronchitis, pneumonia, bronchospasm and bronchopneumonia (many collapse suddenly and die from this condition—often despite treatment). Many keep getting recurrent attacks of

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(2)

Bowel troubles are often seen, i.e. epidemic diarrhoea with vomiting, dysentery and occasionally, typhoid fever. These conditions are due to infections from poor sanitation and also improper feeding methods. Too many children collapse and die suddenly from gastroenteritis.
(3)

Discharging ears—Otitis media is prevalent in this district and despite advice and proper medication is difficult to clear up. The germ reaches the inner side of the ear drum through the nose. Most mothers find the task of regularly cleaning the ear and instilling drops too troublesome and give up practical treatment with the result that the child reaches adulthood handicapped by being partially or totally deaf. This also retards the child's progress through school. Any infant not able to say words by the age of two years should be given a hearing test by an ear specialist.
(4)

Nutritional anaemia—this preventable blood condition is also found too often. It is caused mainly by a deficiency of iron in the diet, i.e. not enough meat, eggs and greens. It can also be controlled by giving the mother extra iron during the ante-natal period.
(5)

Unsightly skin complaints are still seen too frequently and are usually due to neglect, over-crowding and lack of cleanliness. This applies to scabies and impetigo, both of which respond to proper treatment.
(6)

Lastly I would mention the high mortality rate due to accidents in this group. It is not realised how far a small child can scramble or toddle in a short time—a moment's inattention and the child has fallen into a well or a river or pulled a pot full of boiling water over itself, or swallowed some kerosene. It therefore behoves parents to be watchful at all times when young children are around.

At this age immunisation against old killing diseases like whooping cough, diphtheria and, lately, infantile paralysis, are carried out by District Nurses and doctors.

SCHOOL CHILDREN

On the whole this group is well catered for; their general health and posture being good. Besides receiving a daily quota of pure milk, free dental treatment and enough sport and physical drill to keep them fit, they are seen regularly by medical officers and nurses and are inoculated against tuberculosis when necessary, and typhoid fever during outbreaks. The deaf, crippled, mentally retarded and under-nourished are, with the consent of the parents, admitted to the appropriate hospitals, homes or camps for proper treatment and supervision. Parent-Teacher Associations, Welfare and Vocational Guidance Officers also play their part in promoting the child's well-being.

The group of ailments previously mentioned are again seen—bronchitis with wheezy chests due to bronchospasm or asthma, discharging ears with, at times, impaired hearing, and, in the rural districts especially, the usual crop of scabies and impetigo due to poorer housing conditions. Heart trouble due to previous attacks of rheumatic fever is occasionally found.

Here, again, too many are injured or killed in accidental falls from horses, trees, bicycles and motor-vehicles—especially tractors—or drowned through carelessness.

To prevent all this wastage of valuable lives—

(1)

more children should be taught to swim;
(2)

more adults taught the Holger-Neilsen resuscitative method;
(3)

extra care taken when children are on tractors and also more care on the part of motorists near school buses, or where children are playing.

In passing, I would like to mention another aspect of the child's development (mental instead of physical) which concerns all responsible citizens who desire inter-personal and inter-racial harmony.

The function of education besides providing sound knowledge and understanding is the formation of decent attitudes in the child, not only to himself and his family, but to all people who comprise today's imperfect society. Many parents—pakeha and Maori alike—hand their dislikes and prejudices to their children. Failure, therefore, to inculcate wholesome attitudes in the child often leads in later life to certain social evils—to mention only delinquency at the teenage level and discourtesy and hostile racial feelings at the adult level.

ADOLESCENCE

This large exuberant group, apart from pubertal troubles like acne and growing-up pains, on the whole enjoys good physical health. The commonest disorder here is psychological in origin.

Each year many young people of both races make normal progress through the various stages to physical, intellectual and emotional maturation. They settle down in suitable employment, find healthy outlets in hobbies and group activities and become adjusted to adult life. On the other hand, through faulty upbringing, unhappy childhood experiences or some moral defect, many young people fail to make this adjustment.

JUVENILE DELINQUENCY

Regarding our own delinquents, who by their actions bring shame on their families and disrepute to the race, I consider the main causes to be:—

(1)

Free and easy upbringing and too much latitude allowed, resulting in their growing up without any decent aim in life and with no respect for authority—parental or otherwise.
(2)

Lack of guidance and supervision of those in the immediate post-school years. Many of

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  • these young people leave their familiar home environment for the strange new environment of city life, where, unless suitable board and congenial work is found, some tend to drift into trouble. Fortunately most of them settle down as they get older and become good citizens. In this district quite a number who have been on probation or returned from Borstal have taken up regular employment and become completely rehabilitated.

ADULT HEALTH

In the employable 18–50 year old group the general health remains good. Invalidism is caused mainly by the folowing condiions:—

(1)

Ginivitis and dental troubles occur as a result of too much starchy foods and lack of oral hygiene. Dental sepsis causes a lot of ill-health and increasing numbers attend the dentist for total extraction.
(2)

Obesity with all its attendant evils is still seen too often. Over-consumption of starchy foods (sugar, bread, potatoes and beer) is the main cause and the slowing down of activity aggravates the condition. In later years varicosis with ulceration, diabetes mellitus and/or degeneration of the heart and arteries (atheromatous type) take place and the sufferers' expectation of life becomes shortened.
(3)

Chronic chest trouble (especially bronchitis) with subsequent congestive heart-failure is also common.
(4)

Chronic rheumatism of the (a) articular rheumatoid arthritis and osteo arthritis) and (b) non-articular (fibrositis and gout) causes a lot of invalidism and absenteeism from work.

The following diseases are occasionally seen—cancer (of stomach and breast), tuberculosis, and hydatids, and in the young, venereal disease.

All the 80–100 years olds I have seen so far have been small, wiry people, most of whom have been attended by a doctor only at the end of their long, active lives.

ATTITUDE TO ANTENATAL,
POSTNATAL CLINICS AND
PLUNKET SOCIETY

Most pregnant women attend the nurse, doctor or maternity annexe for occasional or regular ante-natal examination. They all realise the importance of having this done so that any physical ailment or malposition may be corrected or treated.

Very few return for post-natal examination and are only seen when the infant is brought in for advice on feeding difficulties or treatment of illness.

Some of the mothers who live in town take their babies regularly to the Plunket Clinic but infants in rural areas are usually seen by the District Nurse who is Plunket-trained.

CHRONIC INVALIDISM

Many unskilled but potentially good workers, through physical deterioration (obesity, varicose veins, chronic bronchitis, rheumatism and heart trouble) become partially unemployable and qualify for Sickness Benefit. After a period of rest they recuperate but are then unable to find light work for which they are then only suited and are finally transferred to an Unemployment Benefit for an indefinite period.

Others who are only partly disabled or who have just felt the first pangs of old age also tend to give up the struggle and apply for a pension.

CONCLUSION

Darwin said ‘Adapt or perish’.

That the Maori by rapidly adopting this injunction has no intention of perishing is evident on all sides and obvious to all who are interested in him.

Improved living standards, wider education, his own racial pride and that elusive something compounded of intelligence, temperament and genius, has given him fresh confidence in his ability to carve out his own place in modern society.

The first aim is to become a well-balanced, informed, useful citizen, as exemplified by all the earnest, educated and enthusiastic young people of today. The modern young Maori is privileged in being able to accept the best from both cultures—the wonderful material benefits of the pakeha world and the enriching qualities of his own.