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Wai 2575, #B25 •••• •• •••• ••••••••••••••• ••• ••••••••••••••••••••••••••••••• ••••••••••••••••••••••••••••••••• ••••••••••••••••••••••••••••••• •••••••••••••••••••••••••••••••• ••••••••••••••••••••••••••••• ••••••••••••••••••••••••••• ••• •••••••••••••••••••••••••••• •••••••••••••••••••••••••••• •••••••••••••••••••••• •••••••••••••••••••••• ••••••••••••••••••••• ••••••••••• • ••••••••••••••••••••••• ••••••• • ••••••••••••••••• •••••• •••••••••• ORANGA AND ••••••••••• •••• ••••• ••• ••••••••••••• • • • MĀORI HEALTH •••••••• •••••••••••••••••••••• INEQUITIES, • • ••••••••••••••••••••••••••• ••••••••••••••••••• 1769–1992 ••••••••••••••••••••••••••••••••• ••••••••••••••••• ••••••••••••••••••••••••••••••••• •••• • ••••••••• 20 AUGUST 2019 •••• • ••••••••••••• •••••• •••••• •• ••••••• • ••••• •• DR. FIONA CRAM • • ••• BEVERLY TE HUIA ••••••••••• TRACEE TE HUIA •••••• DR. MELISSA MATUTINA WILLIAMS •••••• NATHAN WILLIAMS ••••••••• • PREPARED FOR THE MINISTRY OF HEALTH •• Oranga and Māori Health inequities, 1769–-1992 page ii Organisation Details Full name Katoa Ltd Postal address PO Box 105611 Auckland City Auckland 1143 Contact person Fiona Cram Email: [email protected] Mobile: 021 774 690 GST number 84-975-168 Management Structure Director (1). Fiona Cram Director (2). David Wignall Services, including staff, are contracted or employed on a project-by-project basis Personnel This scoping report has been prepared by our research team: Fiona Cram, PhD, Māori health researcher Melissa Matutina Williams, PhD, Māori historian Tracee Te Huia, Māori health strategy and policy Beverly Te Huia, Midwife, Māori health policy and practice Nathan Williams, Research Assistant Website www.katoa.net.nz Oranga and Māori Health Inequities, 1769–1992 page iii Mihi Koinei te mihi ake a te rōpū rangahau o te kerēme WAI 2575 ki ngā Manukura o te Ao Māori i tautoko mai i tēnei kaupapa. Tākuta Tā Tīmoti Kāretu o Ngāi Tūhoe me Ngāti Kahungunu, Tā Kevin Prime o Ngāti Hine me Ngāti Whātua, Trevor Moeke o ngā waka o Horouta, Mataatua me Takitimu, Ngahiwi Tomoana o Ngāti Kahungunu me Ngāti Hāmoa, Tākuta Rangimarie Turuki Pere o Ngāti Kahungunu, Ngāi Tūhoe me Ngāti Ruapani, Kahurangi Naida Glavish o Ngāti Whātua, Kahurangi Tariana Turia o Ngā Waiariki, Ngāti Apa, Whanganui, Ngā Rauru, Ngāti Tūwharetoa, Moe Milne o Ngāti Hine me Jean Te Huia o Ngāti Kahungunu. Me i kore ake tā koutou hora mai i ō koutou mōhiotanga i eke ai ngā whāinga o tēnei kaupapa. E rere tonu nei ā mātau mihi mō koutou e tautoko tonu mai nei, e ārahi tonu mai nei, e arataki tonu mai nei ki tā te tohunga mahi rangatira. I taumaha hoki te kaupapa i ōna anō wā, ā, i kumea ai ko ngā tauwharewharenga o te ngākau, heoi i mauru ai nā tā koutou whakakākahu ki te korowai manaaki. Kia tahuri ināinei ki te tini o te Māori i pēhia i roto i ngā whakatipuranga maha. I rangona tō koutou mamae, i takahia e mātau te ara i takahi ai koutou, ā, mamae ana hoki mātau. Inā kē ngā papatoiaketanga o tēnei rangahau, e kī nei hoki te haka rongonui a Ngāti Kahungunu: “He hiki aha tō hiki! He hiki roa tō hiki, i āhaha! E tama te uaua nā, e tama te mārō!”. Heoi nā koutou, nā tātau i tutuki ai, mō tātau me ā tātau mokopuna i roto i ngā reanga ka whai mai i a tātau. E mihi ana mātau i tō koutou kaha, i tō koutou manawaroa me tā koutou piki i ēnei whakapātaritari. E poho kererū ana mātau, ā, e rangatira ana hoki i tā mātau noho hai waha mō koutou ki te whakatakoto i ngā nawe o tēnā whakatipuranga, o tēnā whakatipuranga, me te hora i tō koutou mamae nui. Ka whawhai tonu tātau kia pae rā anō te waka ki uta. Ahakoa te whenewhene o te moana, ngā piki me ngā heke, me hoe tonu tātau i te waka me kore e ū ki te pae tawhiti, ki te wawata roa, arā, ko te tauritenga o te noho a te Māori me ngā iwi katoa e noho mai nei ki Aotearoa. Kia hoki anō tātau ki ngā kōrero a te hunga kua ngaro, kei te haka rongonui a Ngāti Kahungunu e mau ana: “Inā hoki rā te tohe o te uaua nā, e tau nei! Ana, ana, ana, auē!” Oranga and Māori Health Inequities, 1769–1992 page v Contents Mihi ................................................................................................................ iii Preface ............................................................................................................. ix Chapter 1. Introduction ...................................................................................... 1 Oranga: Whakapapa, Whenua and Whānau ................................................................ 1 Whakapapa ................................................................................................................................. 1 Whenua—Land ........................................................................................................................... 2 Whānau ...................................................................................................................................... 2 Thinking about Terminology—Oranga and Wellbeing ................................................. 3 Writing One History, Telling Two Stories: Oranga and Māori Health Inequities, 1769– 1992 ........................................................................................................................ 4 The Narrative of Oranga ............................................................................................................... 4 The Narrative of Māori Health Inequality ....................................................................................... 5 The Overarching Framework—Colonization ............................................................... 5 Colonization, Trauma and Whakamā ............................................................................................ 7 The Historiography ....................................................................................................................... 7 Māori Health Historiography ......................................................................................................... 8 The Question of ‘Balanced’ History ................................................................................................ 9 Writing Oranga—A Word From the Research Team ....................................................................... 9 The Dynamics of Oranga, pre 1769 ............................................................................ 9 Tohunga and Rongoā .................................................................................................................. 10 Kai Ora ..................................................................................................................................... 11 Mana Wāhine ........................................................................................................................... 12 Oranga Through the Eyes of Pākehā ............................................................................................. 13 Chapter Summary .................................................................................................... 14 Chapter 2: Disease, Faith and the Politics of Health Care (1769–1859) ........................................ 15 Chapter 3: Decline and Survival (1860–1900) ............................................................................. 15 Chapter 4: He Aha te Mate? The Scars of Recovery (1900–1945) ................................................. 15 Chapter 5: A Healthy Equality? (1945 to 1975) .......................................................................... 15 Chapter 6: Healthy Partnerships? (1976 to 1992) ........................................................................ 16 Chapter 2. Diseases, Faith and the Politics of Health Care (1769–1859) ................. 19 Infectious Diseases .................................................................................................... 20 Maintaining Faiths ................................................................................................... 25 Missionaries and Informal Health Care to 1840 ........................................................................... 26 Oranga and the Politics of Health, 1840–1859 ............................................................ 27 Te Tiriti—The Treaty and Politics of Health, 1840 ..................................................................... 27 Early Erosion of Oranga—The Whenua ...................................................................................... 32 The Kingitanga ........................................................................................................ 33 Nourishing Oranga—Building Economies .................................................................. 33 Conclusion .............................................................................................................. 34 Chapter 3. Decline and Survival (1860–1900) ...................................................... 37 Warfare ................................................................................................................... 37 War, Alliances and Strategies for Survival ..................................................................................... 38 The Impacts of War on Oranga ................................................................................. 39 Population Decline ...................................................................................................................... 39 Land Loss—Raupatu ................................................................................................................. 40 Oranga and Māori Health Inequities,
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