Setting the Health Scene for Iwi

Establishment of Turanga Health

In 1985, Te Runanga o Turanganui-a-Kiwa (TROTAK) was established with the support and mandate of Rongowhakaata, Ngai Tamanuhiri and Te Aitanga-a-Mahaki Iwi.

It was their vision and still is, to acquire:

• tino rangatiratanga or total control by the year 2010;
• social, welfare and economic prosperity; and
• recognition of the Treaty of Waitangi by the Crown and the local community

TROTAK maintained the responsibility for providing a range of services, including health services, to the people of Turanganui-a-Kiwa.

Changes in the mid 90's saw the introduction of new health policy from Government which required that the purchasing of health services became distinct and separate to the provision of health services. Regional Health Authorities were established to fulfil the purchasing role. TROTAK became active participants by entering into an arrangement with the then Midland RHA to assist in the process of purchasing health services for Iwi and Maori in the Tairawhiti region.

With TROTAK already providing health services, the new purchasing role appeared to be in conflict with their new role. What then followed was the setting up of a separate health company by TROTAK to provide health services in Turanganui-a-Kiwa. Hence, Te Hauora o Turanganui-a-Kiwa Ltd or Turanga Health was established.

Turanga Health Directors

Turanga Health is a limited liability health company with charitable trust status. The three Iwi of Turanganui-a-Kiwa are the principal shareholders of the company. Each shareholder or Iwi Trust elects one Director to be represented on the Board of Turanga Health. Shareholders also decide on two independent Directors to make the balance of five skilled and committed Directors charged with the responsibility of governing the delivery of health services to the people of Turanganui-a-Kiwa.

	Pene Brown Chairman		Erena Nepe Director
	Charlie Pera Kaumatua		Jackie Jones Director
	Tui Ferris Director		Tangiwai Ria Director

Turanganui-A-Kiwa

Traditional boundaries of Turanganui-a-Kiwa encompass Te Toka-a-Ahuru in the northeast, Paritu in the south, to Matawai in the west.

"… Ko Makauri anake i mahue atu I waho i Toka-a-Ahuru…"
(Enoka Te Pakaru - extract from the oriori "Po Po")

There are over twenty active Marae within the rohe of Turanganui-a-Kiwa, each of which play a key role in the development and provision of health services in this region.

In the 2001 Census 46.2% of people (19,362) in the Gisborne District said that they belong to the Maori ethnic group.

In 2001, 3822 people identified themselves as members of the three Iwi shareholders of Turanga Health and live within the Gisborne area.

Approximately 14,754 Maori live within the Turanganui-A-Kiwa area, 2,220 have been identified as living within the Turanganui-A-Kiwa rural communities and 12,534 live within the Gisborne urban communities.

5.4% of Maori in the Gisborne District are aged 65 and over, 36.1% are aged 15 and under. The median age of Maori in the Gisborne District is 23.9.

It is projected that there will be an increase in the 45 years and over age group over the next ten years.

Maori Health Environment

Historically, Maori have been disadvantaged and over represented in negative statistics of most social areas. The health environment to Turanganui-a-Kiwa is no different.

In fact, research reveals that many Maori in Turanganui-a-Kiwa are more likely to suffer than non-Maori from diabetes, oral hygiene, heart disease, asthma, smoking, alcohol, drugs, mental health, and the list goes on.

The picture of Iwi and Maori health in Turanganui-a-Kiwa poses significant challenges. The task set down for providers of health services such as Turanga Health, is to ensure that improvements in the health status of Iwi and Maori in Turanganui-a-Kiwa, is achieved. Improving the general health status of our Iwi and Maori regionally, is a small but valued contribution nationally in terms of all Iwi and Maori.

The current health status of our people and Maori in general must certainly raise questions about the effectiveness of past government health initiatives. However, we note that there is goodwill on the part of government to assist in reversing the negative Iwi and Maori health statistics.

With that goodwill in mind, supplemented with the principles of partnership, protection and participation, both Turanga Health and Government can look forward to some significant health gains for the future.

STRATEGIC DIRECTION

Vision

"Kia Whai Oranga-a-Whanau Mo Nga Whakatipuranga"

"Building family wellness for future generations"

Mission

Achieving Mauri Ora by working with and building healthy whanau.

Delivering high quality primary healthcare through strategic partnering and best practice clinical service delivery.

Strategic Goals

Goal 1: Make measurable improvements in whanau wellbeing.

Goal 2: Extend our Primary Healthcare capability.

Goal 3: Strengthen our relationships in health.

Goal 4: Build our internal capacity and capability.

Kaupapa

"To increase participation in health services for Whanau, Hapu, Iwi of Turanganui A Kiwa and others residing in the rohe"

Turanga Health will ensure that whanau become the primary focus and not social indicators of failing Maori health.

By focusing on Whanau and their wellbeing Turanga Health removes the silo delivery approach to health services.

Our mission provides and allows for collaboration or integration of other services outside the core business of health, eg. housing, social services, employment, education and training.

We will continue to find ways to "do what the others don't" for Whanau.

Values

The difference between good providers and better providers can sometimes hinge on the way we carry ourselves in the eyes of those receiving services, and who are potential receivers of our service.

Turanga Health's values are an integral part of its make-up. It ensures that our behaviour in whatever we do, whether it be promoting healthy lifestyles, giving healthy advice, attending health meetings or simply answering the phone, our behaviour will be consistent with the implicit teachings of our tipuna.

Turanga Health has accepted three core values to guide its behaviour:

TURANGA HEALTH ORGANISATIONAL CHART