Working 'by Ōtaki for Ōtaki' brings GPs to community in need

An Ōtaki kaupapa Māori health care facility is set to branch into primary health after recruiting three general practitioners.

What was the old bank at 51 Main Street is now a health hub for Te Puna Oranga o Ōtaki, who start their new GP service from 4 November.

Kaiwhakahaere (General Manager) Heniti Buick said it has always been a plan to own or become shareholders in a medical centre.

"In recent times, we've pivoted what we want for our people and the development of a new GP practice that is kaupapa-led with reo-speaking or Māori GPs to drive this initiative for us."

Of the three GPs, two are Māori, and one is coming from overseas but can speak te reo.

"It being kaupapa-led or [by] having Māori GPs come in, it means that whānau Māori can be seen, can be heard, and they can be understood in a way that also uplifts their mana - in a way that allows them to be Māori or culturally safe in a primary care setting."

The Mauri Ora GP clinic will compliment the Ōtaki Medical centre and provide health care to both Māori and non-Māori patients.

Ōtaki Medical has been struggling with staffing after losing three doctors in May.

"They've contributed massively to the health landscape of Ōtaki, but with the loss of some key doctors back to their home countries, it's creating more of a gap," Buick said.

Te Puna Oranga has been in the community since 2012, starting with just one board member and no kaimahi. Now there are nearly 40 kaimahi providing kaupapa-led support.

The GP clinic will become the fifth arm running alongside their programmes: Tamariki Ora / Well-Child, Māori nursing, smoking cessation, kaumātua support, food sovereignty and youth mentoring programme.

There are also health navigators who understand inequities Māori face and help improve health outcomes for everyone.

The youth programme runs in and next to The Barbershop they own on Aotaki Street to accommodate for the rangatahi who like fresh cuts.

Buick said their 'by Ōtaki for Ōtaki' approach works for the town where 40 percent of the population are Māori.

"No one knows Ōtaki like we know Ōtaki. So when you get a provider that's for Ōtaki, within Ōtaki, you get someone who's fighting for sustainability, something to keep services here.

"And like Tariana Turia and Mason Durie have always advocated for - what works for Māori works for everybody. But you can't have your whare tapa whā focused on your tīnana, or focused on your hīnengaro. You've got to have all four components looked after for health and wellness to come from that."

The disestablishment of Te Aka Whai Ora (Māori Health Authority) has left one of their contracts to fall through, therefore relying on short-stinted contracts for some services.

Buick said it really disrupts their stability to be able to provide some services.

"As unsettling as that is for our kaimahi, it's also really unsettling for people who have just transitioned to use our services, only to be told, in six months it's no longer a service you can access.

"So it's really hard. Short-natured contracts are really hard. But also having that leadership through Te Aka Whai Ora or the Māori Health Directorate, they really see value in hauora Māori providers."

As a result, a kōhanga reo they work with will fall back into a central system that failed them in the first place, she said.

While the GP practice itself is not funded, the board has invested equity funds to keep the clinic ticking along until there are enough enrolments for capitation to be introduced.

Within the first 24 hours of enrolments opening, 150 people requested to be on their books.

The kaupapa-driven clinic also has their 'waka' mobile clinic, as well as the Raukawa marae to work from.

Board member and kaumātua Rawiri Rikihana said, "Ōtaki has just come alive" since the announcement.

And having clinics on the marae is special for the iwi.

"We've got the resources here, we've got a couple of rooms, plus we've got the waka that we can bring on site. So we're set we're ready to go."

Rikihana said the big push for the younger generations is te reo Māori, which drives kauapapa like this.

"With the reo, it's the tikanga that a lot of our kids are picking up, and so just having a service like this, you're picking up everything,

Barb Rudd has been on the board since 2011 and joked that it was time for her to step away to let the younger ones take over.

"We've come a long way and a lot of our rangatahi are part of it. Who would have thought that we'd come to this?"

Rudd said there are many issues with attracting international GPs to New Zealand, and wants to see more Māori look into a medical career.

"I don't know what the attrition is at Otago, but maybe we need to get more of our Māori people in there and have them as doctors - that would be wonderful."

She puts the organisations gain down to Buick's persistence.

"She has worked really hard to build networks, she's sat on a lot of tables where it's important for her to be, and I think through that she's attracted people to her because of who she is, the drive that she has, and passion for us here in Ōtaki."

And what they have is a dream come true, she said.

"My dream was to be here with all our older people, so that's why we're here. We come back to help look after our own, to be with our own, and to be here on the marae."

"[The marae] is where they'll feel more comfortable and more at ease to talk to their GP."