Turanga Health chief executive Reweti Ropiha has thanked the Tairāwhiti community for putting its trust and confidence in local iwi health providers to vaccinate the public during the Covid-19 outbreak. “Whānau turned up and when they did, they brought their trust and confidence in us to help keep them safe and well. That was a privilege, and here at Turanga Health, we accepted the challenge.” Mr Ropiha’s comments follow the release of Turanga Health’s annual report for the year ended 2022. It shows Turanga Health staff administered 18,187 vaccinations including boosters and tamariki doses in the 12 months to June 2022. Mr Ropiha says the arrival of the Covid-19 Delta variant and then the Omicron strain, changed the way health organisations vaccinated almost overnight. In the midst of a nationwide health response, Turanga Health vaccinated the community at rotating rural and urban drive-through locations including schools, carparks, and streets. It was an all-staff approach as clinics relied on set-up and breakdown crews, vaccinators, administration staff, and manaaki support (hospitality) crews. Despite the urgency, Turanga Health’s drive-through vaccination events always had a relaxed come-as-you-are fun whānau vibe. There was often a DJ on site, hot drinks, cold beverages, and snackpacks available for delivery to each vehicle. Everything was contactless apart from the vaccination itself. “Sitting behind that fun front-of-house vibe we had to implement complex tech infrastructure that would work in places without electricity and wifi,” says Mr Ropiha. To help prevent spread of the disease in their own workplace Turanga Health staff were divided into two teams, each working seven-day rosters. Mr Ropiha says the goal was to achieve high vaccination rates across the rohe. He says Turanga Health staff provided straightforward information and weren’t there to judge. “Our local faces in local spaces approach to vaccination meant we succeeded in reaching previously under-served communities and those with vaccine hesitancy concerns.” In total, Turanga Health created 270 vaccination clinics across 79 community locations including 21 workplaces and 13 schools. In the busy days during the nationwide lockdown of August 2021, staff regularly vaccinated over 200 people at the three-hour vaccination events. On 16 October 2021 staff administered a record 321 vaccines at a Harry Barker Reserve vaccine drive-through event. Local vaccine figures illustrate the community’s well-placed trust. In July 2021 just 11,230 of the total Tairāwhiti population including 3,799 Māori, had received their first dose. 12 months later by June 2022, 34,339 of the total Tairāwhiti population including 17,073 Māori, had received their first dose. “We knew where to target, which streets, to set up in, and who we should work with. And in doing so, we earned the public’s trust and confidence.” Mr Ropiha adds that for much of the past 12 months, staff working at Turanga Health had to balance their vaccination mahi alongside community PCR testing and RAT distribution. Other essential Turanga Health services including nursing, mental health support, and Well Child Tamariki Ora, also continued during this time. “It has been an unpredictable and incredible past 12 months and so I sincerely acknowledge the achievements of Turanga Health staff, but also those of the Tairāwhiti community and beyond.” Turanga Health Faces, Spaces, Voices: Annual Report July 2021-June 2022
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Trusted Turanga Health kaiāwhina Rhonda Pohatu, Mere Waihi, and Memory Taylor are helping whānau overcome any concerns associated with participating in the national bowel screening programme. The screening programme aims to save lives by finding bowel cancer at an early stage when it can often be successfully treated. Aotearoa New Zealand has one of the highest rates of bowel cancer in the world. Annually more than 3,000 people are diagnosed with bowel cancer every year and more than 1,200 die. Health providers in Te Tairāwhiti and Waikato are piloting a kanohi-ki-te-kanohi approach to the bowel screening programme. Rhonda, Mere, and Memory visit eligible whānau aged between 55 and 74 at their home and talk to them about the importance of doing the test and how to do it. Around the rest of the motu people eligible to participate in the programme receive their testing kit in the post. Turanga Health chief executive Reweti Ropiha says talking about topics related to the bowel can make some people feel embarrassed and so the role of the kaiāwhina is to help whānau overcome any feelings of awkwardness or discomfort. “Talking about bowel cancer, tiko, and testing, might be considered tapu kaupapa but that’s where Rhonda, Mere and Memory’s close connections with whānau and kinship make a difference.” And it is making a difference. Reweti confirms that the kanohi-ki-te-kanohi approach means more people are taking part. In the 12 months between July 2021 and June 2022, 673 whānau out of 815 (or 83 percent) visited by a Turanga Health kaiāwhina agreed to participate. In other places around Aotearoa New Zealand, where whānau receive the kit in the mail, uptake is much lower. Rhonda and the other kaiāwhina hand deliver the test kit, have a korero, and then leave the kit with whānau. Rhonda says whānau will sometimes invite kaiāwhina off the doorstep and into their home to talk about bowel cancer and the test. It’s not unusual to have a cup of tea with whānau allowing more time to korero about the importance of the test. The kaiāwhina return a few days later to pick it up the test and then they arrange for it to be sent to the laboratory for checking. Rhonda, Mere, and Memory are hand delivering bowel screening testing kits to eligible whānau who live to the west of the Tūranganui River. They’re also visiting whānau in rural areas including Motu, Matawai, Whatatutu, Te Karaka, Patutahi, Tiniroto, Manutuke and Muriwai. AFTER months of working out in their own bubble Vanessa Lowndes Centre (VLC) whānau living with mental, physical, and intellectual disabilities are relishing the chance to exercise further afield. VLC whānau have resumed their tai chi classes at Waikanae Beach and the Botanical Gardens now that Covid-19 restrictions have lifted and it’s easier to gather in groups around the rohe. “It’s so good for the VLC whānau, they love it,” says Turanga Health instructor Walter ‘The Wiz’ Walsh, who opens each class with a karakia. “Getting out into the fresh air is so good for everyone’s wairua.” Tai chi is a type of martial art that has evolved over thousands of years as an effective means of alleviating stress and anxiety. It is considered a form of meditation in motion which promotes serenity and inner peace. Practitioners all over the world often gather in public places to do the exercises. Walter has always incorporated te reo Māori into his classes and this year he looks forward to increasing the links between the tai chi movements and te ao Māori. He says by taking the class outside whānau can more easily connect their movements with the environment, Tāwhirimātea, God of Wind and Storms, Papatūānuku Earth Mother, Tāne Mahuta, God of Forests and Birds, and Tangaroa, God of the Sea. “We can incorporate a kaupapa Māori centred programme by drawing on key themes and whenua.” Walter says it’s not unusual for members of the public to observe the class with interest. Some join in and he’s occasionally seen Waikanae Beach Top 10 staff try out some of the movements. As for the whānau, they love it, he says. “It’s all about whanaungatanga. We used to have two male members of the class who wouldn’t move much at the start. Now they’re keen to move through all the movements. It’s a work in progress for those with disabilities and while their movements aren’t perfect it’s helping their mind.” Initially set up by ACC as part of an injury and falls prevention programme for the elderly, tai chi was first adopted by Turanga Health (managers of VLC) in 1996. Before Covid, tai chi was also taught as part of the wraparound support programme Eke Tu for whānau managing chronic conditions. “When someone loves tai chi they always want more,” says Walter. Fears that whānau living in Tairawhiti’s rural west might make up high numbers of people hospitalised with Omicron thankfully never came to pass, says Te Karaka Health Care GP Dr Mark Devcich. “While it spread quickly and everyone knew someone who had or has COVID, as far as I know only one person from our practice was hospitalised during March,” says Dr Devcich. Dr Devcich has been the GP at the Turanga Health-owned general practice for 11 years. Alongside nurse practitioner Kylie Moressey, the pair care for 1700 enrolled patients four days a week. They are supported by nurses Tara Collins, Jocelyn Arahunga and Jo Cranefield. Receptionist and administrator Tess Trafford makes up the regular rural primary health care team. General practice interns and training doctors join the crew periodically. During Omicron’s march through the district in late summer the Te Karaka nurses triaged patients with potential COVID-19. Patients were asked to phone ahead, says nurse Tara Collins. If their issue couldn’t be managed via a nurse practitioner, GP, or nurse telephone consult, they were given a time to come to the Station Rd practice. The carpark was the waiting room and patients were screened again. “We saw patients sick with respiratory illness in our external cabin thereby reducing the chance of other patients and our senior medical staff becoming infected,” says Ms Collins. The process left Dr Devcich free to take care of patients who didn’t have respiratory illness but were presenting with more regular concerns such as skin disorders, joint pain, back problems, mental health challenges and high blood pressure. “In some ways it was business as usual. Our inboxes were full of patients with COVID-19 but I was relatively free to see patients and provide normal community care to those who needed it.” While in his clinic room patients remained socially distanced from Dr Devcich for as much as the appointment as practically possible. Both patient and doctor would wear a mask. Despite the smooth process for all involved there were some extra challenges for staff. “The masks meant I didn’t have the facial cues from people that I normally would,” says Dr Devcich. “If I can see someone’s full face it can help me discern emotion, or pain for example.” In late March Dr Devcich caught COVID-19 from a family member. Once he recovered from his mild case he felt more at ease when seeing his patients. “There was always that fear around the hospitalisations, knowing a lot of things about our patients, many of whom have pre-existing conditions, meant I was worried in the beginning. It's certainly not what we wanted but it was expected - and thankfully the scenario didn’t arrive.” Receptionist Tess Trafford says the clinic does its utmost to be flexible and adapt to the constant COVID-19 changes. Right now, staff are encouraging patients to have their influenza vaccination at one of Turanga Health’s rural vaccination drive-throughs. “We’re always here for patients and always looking for ways to provide more of our services directly into people’s homes and community settings in conjunction with Turanga Health staff.” RURAL residents aged nine and older will be able to get their influenza vaccination this month at a Tūranga Health drive-through clinic. COVID-19 vaccinations, boosters, and COVID-19 paediatric vaccinations will also be available at the rural drive-through clinics. This year Māori health organisation Tūranga Health in te Tairāwhiti has opted to make the vaccination available to people aged nine and older in rural settings. Chief executive Reweti Ropiha says in an ordinary year anyone can become seriously ill from the influenza virus. “But this is not an ordinary year which is why we have decided to deliver the vaccine to rural whānau aged nine and older.” “Influenza rates have been very low in the past two years due to lockdowns and border closures. While we cannot predict how mild or severe a winter flu season will be, with the international borders now reopened Aotearoa is again connected to the rest of the world.” “With more Kiwis returning home and tourism increasing, rates of flu are expected to rise.” Tūranga Health’s rural influenza drive-through vaccination clinics have been modelled on the successful COVID-19 drive-through vaccination clinics held across the rohe for the past two years. Mr Ropiha says the drive-through model makes sense for a number of reasons. “In the drive-through model members of the public go through the end-to-end vaccination process while in their vehicles. It’s a safe and efficient way to deliver the influenza vaccination without putting everyone at risk of infection from any of the respiratory illnesses circulating in the community right now.” Mr Ropiha says anyone who wants to be protected from influenza this year can come through a rural clinic. Tūranga Health’s Dr Patrick McHugh says the influenza vaccine can be safely administered at the same time as the COVID-19 vaccine - whether that be a booster shot or paediatric vaccine. “You can have a COVID-19 vaccine or booster at the same time as your flu vaccine. There’s no need to leave a gap between these vaccines.” Dr McHugh says COVID-19 is still prevalent in Tairāwhiti with multiple cases being reported daily. He warns that the local prevalence of respiratory disease, along with international borders opening, means “we’ll see new and re-occurring strains of flu spreading in our community.” “The flu can be serious and make people very unwell. It affects the whole body and can last up to a week or more. For best protection it's best to get the flu jab before winter.” In some cases, the flu can put people in hospital – particularly if you are 65 or older or are Māori or Pacific. In severe cases, the flu can be fatal. The rural influenza drive-through vaccination clinics will be in Te Karaka, Waihirere, Manutuke, Patutahi, Muriwai, Matawai and Waerenga-o-Kuri. Keep an eye on the turangahealth.co.nz home page for locations and times. Original story written by Meriana Johnson of The Spinoff: Read here Most mandates may be about to be dropped, but with omicron sweeping the country, many unvaccinated Māori are making the decision to get protected for their whānau – even some who were once vehemently opposed. Every day, families across the country are losing loved ones to the virus. This hit a peak on Tuesday of 34 deaths. The numbers of Māori hospitalised is on the rise, as reported by the director general of health Ashley Bloomfield on March 24. In that same week, Māori also made up the majority of community cases, with the highest number of cases per capita for Māori in Tairāwhiti. But there is a much smaller, but by no means less significant, number being reported daily. The number of first doses administered. Over a year on from the start of vaccination rollout (although only eight months on from when everyone eligible could receive it), some are now making the decision to get vaccinated – the majority of those Māori. In fact, tangata whenua made up two-thirds of all the first doses administered in the two-week period of March 14-30 (3,022 in total), with 2,043 Māori receiving their first vaccine. Māori health providers, such as Te Hau Ora o Ngāpuhi in Kaikohe and Tūranga Health in Gisborne, are a big part of driving this uptake. In Tairāwahiti, where first-dose vaccination coverage has reached 91%, Gisborne Māori health provider Tūranga Heath is continuing to run community clinics. Tūranga Health chief executive Reweti Ropiha says they largely get whānau and rangatahi coming in for their second vaccine, but 15-20 people have come in for their first dose in the last fortnight. He says most of them are coming through as couples, and he says their driver for finally getting vaccinated is the anxiety. One couple he spoke with were originally strongly anti-vax but they’d seen the impacts on their whānau, and were concerned about their mokopuna with asthma contracting the virus. “It put a smile on my dial that even over the duration of this hīkoi, this journey, their consideration was still about stepping forth [to get vaccinated], ” Ropiha says. At this stage in the rollout, Ropiha is focused on going to people, literally bringing the vaccine to their doorstep, as he says whānau feel more comfortable doing it in their own backyard. “A lot of the whānau enjoyed having a Māori kaimahi there so they can also have a kōrero, particularly around the timeframes, like the stand-down times [for their second dose] if they get Covid”. Māori health providers continue to be innovative in getting their people vaccinated. Through whānau networks, they are continuing to push to get as many Māori vaccinated as possible. A recent success for Te Hau Ora o Ngā Puhi was vaccinating 100 people through the Whakaoranga Whānau Recovery Hub, a methamphetamine rehabilitation programme. Following a hui held with those recovering through the programme and their whānau, 70% of those who attended decided to get the vaccine. The mandates might be dropping, but for Reweti Ropiha at Tūranga Health that doesn’t mean he’ll be ending community vaccination clinics. He says the focus now is lifting rangatahi Covid-19 vaccination rates, and then, getting people vaccinated against the flu. Te Hau Ora o Ngāpuhi Covid response lead Tia Ashby says in the town of Kaikohe, there is increased anxiety because of the current outbreak in the community. “They’ve witnessed some of their own family having severe symptoms and ending up in hospital, and now because it is something they can see, it’s tangible, it’s encouraged them to go and get vaccinated to protect those who are most vulnerable, like their kuia and kaumātua that they want to go visit at the marae, and their children,” says Ashby. “For others, it’s about finally getting the right information because they had a lot of information overload and they said the anti-mandate, anti-vax stuff was starting to confuse them… they already have a lot of distrust of the government surrounding their experiences of Oranga Tamariki, with MSD, [and] some of the information coming in – they didn’t know who to listen to.” In the last fortnight, Ashby says roughly 80-100 whānau have come through for their first dose of the vaccine. It’s a tough pill to swallow for some who’ve been fervently against the vaccine, and Ashby has received a handful of phone calls from whānau who’ve asked if she’ll go directly to the house of one of their loved ones who is too whakamā to go in after speaking out so vocally. One of these people, Ashby says, was someone who had abused her and her team, including throwing things at them, when they were out doing a vaccination drive. Charges could have been laid but Ashby says “they aren’t like that”, and when they finally asked her for the vaccine she was happy for them. “We knew that health literacy hadn’t been addressed, and it would have been unfair to put our own bias onto their thinking. “We just wanted a chance to be able to sit down and have a kōrero with them like this, but I think at the time they were heavily influenced by information around them and a lot of that turned to hate and anger because of the mandates.” Kuini Daniels is a Kaikohe nurse who says while she knew of the benefits of vaccination, and had received child vaccines like meningococcal, she was still hesitant about getting the Covid-19 vaccine. She says she felt torn between her professional judgement and her Māori side; her culture, beliefs, kawa and tikanga, and the strong resistance from her people to Crown-imposed action. However, there was a lot of guilt in not being able to support her kaimahi on the frontline, she says, so she finally decided to get vaccinated a couple of days after the mandate for health workers came in. She says while there were options for doing administrative work, working on the frontline was what she loved, and getting vaccinated allowed her to get back out there. DESPITE the march of Omicron through the rohe, Manutuke Vegetable Garden continues to thrive under the nurturing care of Vanessa Lowndes Centre whānau. The Vanessa Lowndes Centre (VLC), which is part of Turanga Health, helps people with mental, physical and intellectual disabilities live fulfilling lives and prepare for the workplace. The gardens behind Manutuke Memorial Hall have been cared for by whānau for about 20 years. Long-time VLC kaiāwhina Chris Miller says it’s a great way for whānau to safely spend time outside and connect with nature during these strange times. He adds “it’s also about whānau taking their learnings and creating their own gardens at home.” Chris drives whānau to Manutuke a couple of times a week and they do everything from preparing, planting and weeding the crop right the way through to harvesting. Right now, to help keep whānau safe, the group is broken into smaller teams thereby reducing the chance for the spread of Covid-19. “We’re a bit down on numbers,” explains Chris. “On any given day some of them get stuck in and lend a hand and then there are others that tend to hold back. But we try to get them all to do something to help.” The full VLC team developed raised gardens four years ago and have been successfully growing silverbeet, cauliflower, and broccoli. This year they ran a ‘spud in a bucket challenge’ which “wasn’t very successful” laughs Chris. “They just didn’t grow! I think it was the soil we used, it was lacking something.” The same could not be said of the kamokamo which have proliferated on the vine! Gardener Riki Brooking says he enjoys being in the garden. He’s very quick to point out the ancestor Hinehākirirangi whose likeness oversees proceedings. Hine was the sister of Pāoa, captain of the Horouta canoe. “Papa John [Pomana] taught us how she brought the kumara down,” explains Riki. Chris says some of the vegetables harvested during March have been used by Turanga Health to help feed staff working in the vaccination and RATS distribution clinics. “But mainly the produce is for whanau. They learn to cook them onsite in the Tūranga health catering kitchen with help from our other kaiāwhina.” Propagation and harvesting is set to increase later this year now that a new nursery at Matawhero has been added to the VLC operation. BLAKE Crosby has pivoted from managing sports programmes for children to caring for the community at vaccine clinics - and he loves it! A Gisborne Boys' High School old boy, Blake, Ngāti Porou, completed a degree in Sports and Recreation, with a double major in exercise science/physical activity and nutrition. He graduated in 2019 and worked on sport and movement programmes for kids, before heading back to Tairāwhiti to finalise his post-graduate studies in sports management. By June 2021 Blake, 24, was Tūranga Health’s newest lifestyle coach and health promoter. His early work involved working in kohanga and kura around the rohe, using play and sport to guide tamariki towards active, healthy lifestyles. But then COVID-19 returned to Aotearoa and like the rest of Tūranga Health, Blake was part of the all-of-service vaccination effort. As a kaiāwhina at dozens of vaccination clinics Blake is a cheerful caring member of the team. He prefers working at the small clinics helping awhi whānau who may be vaccine hesitant. “We receive a lot of gratitude from people, especially when we create smaller more personal and discrete local pop-up clinics.” He says Tūranga Health staff are close, dedicated, and the support within the organisation for new staff like himself, and whānau they care for “has been amazing.” A LACK of good gear is seen as being a big barrier to participation in sport, so a Tairawhiti health organisation is helping to bust those barriers down. Turanga Health in December oversaw the unveiling of new basketball hoops and backboards at Te Karaka Area, Gisborne Girls' High and Gisborne Boys' High schools, adding to those already installed at the city's Cobham and Elgin schools. They are all part of the joint Hoops In Schools programme, co-run in the region by Basketball New Zealand and Turanga Health, and funded by Turanga Health. And the latest hoops got a big christening with towering Tall Blacks legend Pero Cameron and Tall Fern guard Lauryn Hippolite in town to mark the occasion, taking students through their paces while they were at it. The Tairawhiti Hoops In Schools project was founded in 2020 when Turanga Health told Basketball NZ that Cobham kids were using a bottomless bucket for a basketball hoop . . . and even that was an improvement on how they used to play “air” shots. Turanga Health events co-ordinator Dallas Poi says it is a massive addition to the promotion of wellbeing through the sport, which has long been part of Turanga Health's programme. Basketball is the second most popular sport for all secondary school-aged children, an age when participation in sport tends to drop away. Of the seven biggest sports in schools (football, netball, rugby, volleyball, hockey, cricket and basketball), it is one of only two to show growth in the last five years, and is on track to become the most popular of all secondary school sports. “Basketball is such a big sport for Maori and is a great way to get tamariki and rangatahi active,” Dallas says. Having Pero on court brought his experience not just around achieving big things in international sport, but also in making his way in the world with real mana, she added. “We've always seen basketball as a great way to engage rangatahi in particular, and you don't get any bigger than Pero Cameron!” Together with other Turanga Health kaiawhina, Luke Bradley delivers the programme to young people at kura throughout the region, as well as supporting Gisborne Basketball Association events. “There is so much benefit to be gained in everything from physical fitness to developing leadership skills, so it is really rewarding work,” Luke says. “While we do see some amazing raw talent and flair out there, we're not really looking for superstars. We're looking at improving engagement by catering for all skill levels, so all our young people can stay active and be part of the game.” Pero Cameron says basketball is a fantastic way to reconnect with young people who have missed out on so much over the nearly two years of the Covid-19 pandemic, and Luke agrees. “In recent times it has seemed that, every time we got a groove going with the young people in schools, a lockdown came and they didn't get to take part,” he says. “That's why it was so great to have Pero and Lauryn here to see the year out. Through basketball, we were able to re-engage with tamariki and rangatahi and it was nice to get out there and see their smiles again.” IF navigating Covid-19 is a journey, Pauline Gilroy has certainly been on the road! Visiting her grandson in Australia in July 2021, the state went into lockdown. Then when she started work at Tūranga Health upon her return, she was quickly immersed in working the Māori health service's vaccination centres. “Being thrown in the deep end and getting out to communities and marae has been fantastic, and showed me the scope that Tūranga Health represents.” Pauline's role is service administrator. She does everything from administration and report writing to answering Turanga Health's busy telephone lines. During her time at the vaccination clinics, however, that role expanded to replenishing vaccine supplies, disseminating the all-important vaccine clinic posters, and even making cups of tea. “It was important to make sure whanau weren't just cared for clinically, but also in terms of making them feel safe, happy and welcome,” Pauline says. “There is a real whānau feel, like being on the marae with heaps of aunties.” Pauline's own aunties are from Tuhoe and Te Aupouri descent and her papakainga is at Te Kao, about halfway up Ninety Mile Beach, and Ruatahuna, the heart of Ngai Tuhoe. “We've always been a whānau of strong wahine and that's where I get a lot of my own strength from,” Pauline says. “My grandmother was an incredible woman. She was the first Māori woman ordained in the Anglican church.” Although Pauline once trained to be a welder, she has instead worked in a range of administration and finance roles until she got caught up in the Tairawhiti Polytechnic redundancies of 2007. Pauline reckons her new job with Tūranga Health is a bit like her old job of 2001 when she worked with the Public Health Unit, which was rolling out changes to the MMR (Measles, Mumps, Rubella) vaccination programme. “Though vaccines are the focus right now, I'm excited about the variety of work to come in the future. I love that Turanga Health’s mission statement directs them to focus on better health for all whanau and I love being able to help.” |
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