THREE months after funding for the HPV vaccine was extended to cover males, a Gisborne health provider has asked eligible boys if they want it and the answer has been a near-unanimous “yes”.
Turanga Health community nurses offer cover at 11 rural schools in Tairawhiti which between them have about 45 year-eight boys on their rolls.
Of those, 41 boys have consent from their caregivers to be vaccinated against the cancer-causing human papillomavirus (HPV).
That's an uptake rate of around 91 percent – well up on the 66 percent average coverage for girls across the country. It’s also considerably higher than the 72 percent average recorded in the wider Tairawhiti region, and the 75 percent target the Ministry of Health hopes to reach for HPV vaccinations in New Zealand.
Turanga Health community nurses Aimee Milne and Reena Rivera believe straight-talking has been key to getting parents and caregivers on board.
They don't talk as much about growths-on-genitals as they do about heading off life-threatening diseases, says Aimee.
“We talk to the kids about the vaccine, show them a video about how it works then give them information to take home to their parents so they can decide if it is for them,” she says.
“There are lots of benefits we can talk about but, for us, the emphasis is really on those potentially fatal diseases. We think that's massive.”
Not all of the boys have had their first shots – for reasons such as forgetting their consent forms – but Reena says they do a catch-up visit to ensure the boys are ready for their second shot (and last) shot around September.
“That's why we like to approach them early in the school year, so we can make sure they get both shots for full cover.”
The nurses say that immunisation before the age of 15 means young people need only two doses of the vaccine, rather than three. It also ensures they have full cover well before they consider becoming sexually active and therefore coming into contact with the various forms of HPV.
Since its introduction in 2008 the vaccine has been free for girls (though available to others for $500-$800) because of HPV's relationship with cervical cancer.
Since the start of this year, however, it has also been offered free to boys and University of Auckland senior lecturer Dr Helen Petousis-Harris says that's a matter of equity.
“The HPV virus causes cancers that affect them, too, and boys also get genital warts, just like girls,” she says. “Offering this vaccine to all our population makes it much fairer.”
Members of a Manutuke kapa haka team find a fitness programme that helps keep them on top of their game.
THE swell of voices rising in waiata gives way to the bulge of biceps when a Manutuke kapa haka team swaps rehearsing for training in the great outdoors.
“Stay in it whānau,” Tū Te Manawa Maurea kaiāwhina Bruce Amai urges as team members realise just how many press-ups and kettle bell lifts they have let themselves in for. “It will be so worth it.”
As part of their build up for the 2017 Te Matatini kapa haka nationals, members of TTMM (Rongowhakaata) have taken part in weekly sessions known as Tū Haa – an outdoor training initiative run by Turanga Health.
“Being fit is important for the performers but this is also a way for them to strengthen their bond away from the performance arena,” says Turanga Health kaiāwhina Bernie Semau.
Bernie has a background in health science and personal training. “Taking the activities outside means we can use and enjoy our natural resources. People like being out and about and appreciating where they live.”
Bruce Amai's role as kaiāwhina with TTMM sees him working behind the scenes, but he joins the team front and centre at their Thursday night Tū Haa sessions.
“I like to stay active and I like to get behind the whānau and this is a way of bringing the two together,” he says. “It builds on and enhances what we already have as a whānau and as a team.”
It is also a way of making sure TTMM is always on its game.
“Te Matatini is over for another four years but we always take part in the Tairāwhiti Tamararo regionals so, by continuing to work together, we stay focused.”
With Tū Haa (the breath), anyone can take part and TTMM kai haka Alex Ria says that suits her perfectly.
Alex has been member of the team for 10 years and in 2010 added a further string to her bow by training for Iron Māori.
Tū Haa sessions help her maintain fitness for kapa haka and the myriad of other sporting commitments she and her whānau enjoy.
And, as she says, the whānau that plays together, stays together . . . for Te Matatini 2017, son Kereopa (17) played guitar and joined in on the Tū Haa circuit.
“When you step up a level to do something like Iron Māori it’s worth maintaining that fitness and these sessions really help,” Alex says.
“It helps us continue those important connections we have within the team, plus it's great to go somewhere after work where you can really have a blow-out.”
Story by Kristine Walsh
Images by Strike Photography
A CHANCE meeting has given the Te Miha, Casey, and Kepa whānau a new lease of life
It was a hot January night and milk delivery man Kelly Te Miha had left exercise instructions at his cousin’s place so she and others could do a workout. The instructions said they should jog up and down the street.
At another house on the street Tūranga Health school health and fitness kaiāwhina Daiminn Kemp was sitting on his veranda thinking about what his boss had said that day. It was the school holidays and he had to find other whānau to work with until the kids came back.
And that’s when some of the Te Miha, Kepa and Casey whānau jogged past.
“I remember thinking ‘is this really happening?’” says Daiminn.
He spent the next 10 minutes watching the group walk and jog around the street. Deciding this was the project he’d been looking for he wandered over to the house they’d come out of. “Kia ora, I’m Daiminn, and I’m pretty sure Tūranga Health could help you.”
KELLY Te Miha, Ngati Porou, is a 33-year-old man on a mission. Having successfully ditched his heavy drinking and rediscovering his love of exercise, the former under-16 Poverty Bay winger, has been the catalyst for nearly 40 whānau to lose weight and stay healthy.
He has a full time job delivering milk, is a husband, and father to four busy sporty kids. Despite his own commitments Kelly began helping some cousins and nieces with some easy at-home exercises earlier this year. He says they were motivated - they just didn’t have the money for a gym membership.
“So I thought this was a good way to help. You don’t need money, there are still ways to work out.”
He’d go to their house every second night and guide them through a workout.
Kelly’s homestyle exercise sessions were a hit and more whānau kept turning up. They were beginning to outgrow the small Daphne St house they’d started in. So Kelly moved the sessions to Anzac Park and started a Whānaufit 2017 Facebook page to better keep in touch with everyone.
Cousins told aunties about the workouts. Nieces told brothers and sisters they were feeling great. And the whānau fitness group swelled from seven, to 12, to 40 at last count.
“They want more every day,” says Kelly who now works out with them six days a week doing a mix of cross training and Kaiti Hill runs. “Exercise doesn’t have to cost a lot. It just has to be fun and with other people.”
THE group includes cancer survivors, diabetes sufferers, and someone with gout. Some are overweight and others are just there because it makes them feel good and they want to support the kaupapa.
Now, with Tūranga Health’s help the fitness sessions also include circuits with equipment like kettle bells and weights. Tūranga Health has held short nutritional education sessions with the group and many of them have now seen a Tūranga Health nurse. Some whānau are considering a smoking cessation programme. And the YMCA Gisborne, where Kelly is studying to become a personal trainer, has provided spin classes.
“I think it’s amazing,” says Daiminn who expected attendance to drop off. “Kelly is 100 percent behind his whānau and they are 100 percent behind him. Everyone keeps coming back.”
Kelly says it’s an honour. As a young man he survived rheumatic fever, used to weigh 100kg, and once got expelled from school.
“My family used to be a sick family, but now I’m helping keep them get fit and healthy. The kids come along too and that’s great because their mums and dads are role models now.”
Just this month the whānau helped raise hundreds of dollars for cancer awareness by taking part in the Relay for Life. Some members walked through the entire night – something they would not have been able to do before Kelly and his inspirational idea.
Tūranga Health congratulates Kelly Te Miha and the whole whānau fit team.
TWO Turanga Health staffers have started this year as new graduates – and they recommend the experience to others.
Population Health Coordinator Dallas Poi completed a postgraduate diploma in business studies and Corporate Services Manager Lisa Tamatea has done a bachelor of business with a double major in accounting and management.
Lisa studied extramurally through Open Polytechnic New Zealand so it would fit around work and home life.
“I hadn’t done any tertiary study prior to starting at Vanessa Lowndes Centre in 1997. I joined the airforce after school and studied accounting but it wasn’t recognised outside of the forces.
“When I started at Vanessa Lowndes Reweti encouraged me to study so initially I did a diploma in business with an accounting focus.”
After she completed that, Reweti encouraged her to do more so in 2010 Lisa started part time study for her degree.
“For me, the flexibility was huge. It’s definitely an achievement finally finishing, knowing I am a role model for my kids. They had to sacrifice as well,putting up with a grumpy mum from time to time. Finishing was more about them than me.”
“It’s a bit of a relief and a bit surreal to be honest, because I have just been doing a paper here or there as work and family demands allowed.”
For Dallas the process was quicker, but just as rewarding.
“I completed my diploma part time over two years, travelling every fortnight to Waikato University for Saturday classes. I had to make sacrifices but it still allowed me to work full time.”
Dallas already holds a bachelor of health science and a postgraduate diploma in public health, so last year’s qualification was mainly about upskilling.
“The work that we do at Turanga Health is ever changing, so you have to keep up with whatever new knowledge is coming out. I totally recommend it otherwise you can get too stagnant and comfortable around your knowledge base.”
Lisa agrees.“Staff should definitely take the opportunity. Turanga Health is big on internal upskilling. It’s an organisation that’s willing to invest in you. You just have to commit to it,” says Lisa.
In 2016, 15 staff members also completed Te Wananga o Aotearoa Whirikoka campus’s tikanga marae course, committing two hours every Friday afternoon.
This year Turanga Health has secured scholarship funding through Hauora Tairāwhiti to support seven clinical and nonclinical individuals develop through tertiary level studies.
TWENTY-EIGHT year-old Jess Kirwan has faced many challenges but continues to overcome them at every turn.
Tireless and cheerful Jess works part time in administration and cleaning at Tūranga Health – a job she came to through her involvement with Tūranga Health’s Vanessa Lowndes Centre.
She works half an hour every morning and has learned a lot in her first year. “It’s been good doing things like learning how to work the scanner - when it doesn't die on me - and meeting new people through customer service.”
The Vanessa Lowndes Centre, on Derby St is a melting pot of people each experiencing various levels of intellectual, physical and or sensory disabilities.
Every day people arrive at the Centre to take part in programmes and classes helping them learn skills to live in society and make progress towards their own independence. At VLC the students are known as “whānau”.
Vanessa Lowndes Service Manager Laura Biddle says a lot of work goes into building confidence and preparing people for employment.
“Jess is pretty independent now. I have seen huge growth in her. Once she sets her mind to something she puts in 100 percent. Her achievements are worth celebrating.”
Last year Jess completed the Taupō Great Lakes Relay as part of a team. “I always wanted to achieve something like that and now I have. I did the Weet-Bix TRYathlon in Auckland every year when I was younger, so I am pretty proud of myself.” Just last week Jess helped out as a marshal at this year’s Weet-Bix Tryathlon in Gisborne.
She has some other exciting new year’s resolutions.
“I really want to get my restricted. I got my learner's license last year which was exciting because my nana’s husband promised me $100 if I passed.”
Getting Jess through her learners license took some effort. She studied at Adult Literacy Tūranga and took AA website practice tests at Tūranga Health. “I’ve been learning to drive but mum says I have a bit of a hot-foot.”
It’s hard to imagine when Jess will find the time to practice driving in preparation for her restricted license test with her packed schedule. She takes spin and sprint cycle classes on Mondays and Wednesdays, and Taekwondo classes with Te Karaka Taekwondo on Fridays and Tuesdays. She’s a green belt going for her blue stripes this year. “I enjoy it. I like learning self defense. I’m getting better and better.”
Taekwondo has an added challenge with much of the class spoken in Korean. “I can get nervous when the master asks me a question,” she says. Not so nervous that she hasn’t helped out as an instructor in Taekwondo classes for people with their own challenges. “I was scared at first but then I got my confidence up and really enjoyed it. I also learned about other special needs.”
Jess takes part in courses at the Tairāwhiti Environment Centre and she likes to draw. She’s saving for a car, wants to go to Australia later this year, and is keen to complete the bike leg of IronMāori.
“I like to keep busy, it keeps me out of mischief,” says the amazing Jess Kirwan in her understated way!
FORTY contractors working with New Zealand’s fourth largest forest owner Ernslaw One, were the first to benefit from Turanga Health’s mobile forestry health checks yesterday [Tuesday 21 February].
The onsite workplace wellness programmes for forestry staff is making it easier for them to seek medical help while also taking better care of themselves, says Turanga Health coordinator Dallas Poi.
“The health checks are tailored to meet the needs of men and women working in an industry where it’s not always easy to slip away to see a nurse in the middle of the day.”
Ernslaw One Gisborne regional manager Iain McInnes said the health checks carried out at the Mangatu forest headquarters yesterday were well received by those who passed through. “We were really keen to have Turanga Health offer the service to our contracting staff. People are the most valuable asset in any company and so investing in the health of our workforce makes good business sense as well as being the right thing to do.”
Mr McInnes says a healthy and happy workforce is just as important as investing in maintaining buildings and equipment. “We’re working with some talented people and we want to make sure they are well. The onsite health check was a unique opportunity for our staff and we’re thrilled it’s going to be available to others working in the forestry industry.”
Turanga Health had its state-of-the-art mobile clinic in the Whatatutu hills all Tuesday afternoon. It was staffed by four nurses, a smoking cessation coach, and a kaiāwhina (community health worker).
Forestry crew warratah drivers, fallers, break out staff, machinery operators, and digger and truck drivers, all came through the health check clinic. The comprehensive health check was about more than just eating habits and exercise, says Ms Poi.
“The initial assessments, which take up to half an hour, looked at a forester’s age, gender, ethnicity, weight, family history, blood pressure, glucose and cholesterol levels, and diabetic and smoking status.” A person’s risk of developing heart problems in the next five years was also assessed. “People can be told they have a risk ranging from mild to very high and where appropriate were directed to their GP or given education.”
Medication, alcohol, anxiety and depression were also discussed during the private consultations. Female staff had the chance to talk about women’s health issues such as smears and breast checks.
Ms Poi says yesterday when the forestry workers stepped inside Turanga Health’s four-wheel-drive truck and saw it was a fully functional clinic room they were pleasantly surprised. “Turanga Health does whatever it takes” to get health care and support to workers. “Health services offered Monday to Friday, 9am to 5pm, don’t work for most primary industry staff which is why we take the services to the people on the roadside, or into the forest, any time of the day.”
Eastland Wood Council chief executive Prue Younger said the health checks are the result of a joint partnership between the wood council and Turanga Health which “aims to build a culture of health in the forestry industry.”
Ngati Porou Hauora nurses and support staff will help provide the mobile service when it’s taken to Ernslaw One contractors at Tokomaru Bay in March.
For more information contact: Dallas Poi, Turanga Health, (06) 869 0457.
A revolutionary way to get help from a doctor using iPads in schools was been introduced at five Tairāwhiti kohanga last week by 2014 New Zealander of the Year Dr Lance O’Sullivan.
The popular Kaitaia doctor was in Gisborne promoting a recently developed iPad application that can be used by trained adults in schools to assess a child's general health.
Known as iMOKO the assessments are sent via the internet to GPs in Kaitaia where they are reviewed and advice on any treatment needed is sent directly to whānau - saving them the cost of a trip to the doctor.
Like Uber, the world’s largest taxi firm that owns no cars, and Airbnb, the accommodation provider which owns no property, iMOKO is revolutionary. The technology enables existing infrastructure to be used more efficiently.
“We’re just using every day technology to put health care into the hands of the people,” Dr O’Sullivan told local health providers during presentations at Turanga Health on Thursday.
“Out of anger I have developed courage to change things and the vehicle is iMOKO.”
Dr O’Sullivan’s says his anger was directed at the inability of vulnerable whānau to access health care. As well as geographical isolation, cultural, social and financial isolation was preventing families in the Far North from getting help.
“Too many times the current system gets an F-grade. While this new way may meet some resistance from traditional health care providers the reality is, we are targeting unmet need. It’s disruptive innovation. It saves time, it saves money, and it’s enhancing primary care.”
As well as being used in schools and early education, Dr O’Sullivan says he’d helped introduce it into a Kaitaia gang pad, and will soon be doing the same in Hastings.
Turanga Health Chief Executive Reweti Ropiha applauds the notion of bringing technology to whānau so they have the ability to connect to health care and good decision making. And he’s pleased the iMOKO team is looking at ways to have GPs from around the country, including Tairāwhiti, involved. “It’s not just about bricks and mortar anymore”.
iMoko is funded by Māori health innovation fund Te Ao Auahatanga Hauora Māori, and is a Whānau Ora initiative.
Dr O’Sullivan was hosted by Midlands Health Network and Hauora Tairawhiti while in Gisborne.
Daiminn Kemp is putting his teaching degree and love of sports to good use, as one of Turanga Health’s newest health and sports providers.
Daiminn (Ngai Tāmanuhiri) studied primary school teaching through Te Wānanga o Raukawa and has spent the past three years as a Lytton High School relief teacher. Now with Turanga Health he works in schools and kohangas teaching ki o rahi, league and physical skills.
“At the start of the year I started postgraduate health and sports studies extramurally through Waikato University. When the [Turanga Health] position came up, everything I was studying matched the job description, so I asked my tutor what she thought and she said to go for it.”
Daiminn still has a year of study to complete but is already putting his knowledge to good use.
“I always wanted to focus more on physical education as a teacher. Most of my strengths and experiences were listed in the job description and I’ve always wanted to work with children in sports. I’m so glad I’m finally getting that experience here at Turanga Health.”
“The amount of schools Turanga Health reaches out to and the amount of time and resources they give is awesome. I also like that they have an opportunity to participate and involve themselves in programmes that other companies don’t offer.”
Before teaching and study Daiminn worked in the printing industry for more than 20 years in Wellington and then at Logans Print in Gisborne.
Daiminn is father to four and grandfather to two. In his spare time he loves being at the beach with wife Kellyann and family, and staying active outdoors. “I love hunting (mainly pigs), and diving, and tramping...but the tramping happens by default if you don’t catch anything!”
Turanga Health welcomes Daiminn.
THREE months into the Tūranga Health Eke Tū programme James 'Bull' Smith has dropped 7 kgs to 160kg and is loving life.
“My energy levels are up since I started. Things that would make me tired before I can just run around and do now. My breathing is better too.”
An altercation between his knee and a dairy farm backing gate two years ago, as well as and wear and tear from rugby, meant James thought his exercising days were over.
“When the surgeon said I needed to lose 40kgs to safely have knee surgery, I laughed. I said ‘are you for real?’ His GP referred him to Eke Tū.
James who is Ngāti Kahungunu and Ngāti Porou, travels from Te Karaka to town twice a week for exercise and nutrition sessions.
James and his group take part in yoga, circuit training and swimming. They learn stress management techniques and what a healthy diet looks like. “I was an invalid doing nothing. Now the strength in my knee is improving and even though I am still limited, it is getting much better.
“Once you get that momentum going it is hard to turn back, especially if you have a goal that you want to achieve. In our team there is an excitement and enthusiasm. I love it. I’m not just doing it for myself, I’m doing it to help my Eke Tū teammates now too. I’ve not missed a session yet, I even missed a hangi one time to come into town and exercise.”
James favours the swimming sessions where he can “give 100 percent”. Being in the water takes some of the pressure off his knee. Some unexpected new passions have emerged too. “The yoga sessions are good, they teach us about mindfulness.”
He says initial shyness within the group has dissipated. “Now we’ve learned to take shyness by the horns.”
It’s a fitting metaphor for James who’s known as Bull because of his size. But with his weight loss and his new found love of exercise—tough and determined seems a more appropriate reason he’s called Bull!
Eke Tū is a wraparound Tūranga Health programme run by kaiāwhina and gym instructor Bernie Semau.
The four-month pilot programme focuses on managing and preventing chronic conditions like obesity and diabetes through exercise and healthy lifestyle education.
Bernie runs two Eke Tū groups: eight patients from Gisborne, and 14 patients from Te Karaka. Patients are referred by their GP and both groups are half way through.
“We’ve seen some good results as far as decreases in blood pressure and HBA1C levels. Things like lowering the risk of diabetes are goals,” says Bernie.
Some participants have lost nearly 10kg. “It’s humbling to see those results and cool to be a part of something so positive. The biggest thing has probably been the interactions within the groups; people from different backgrounds and experiences coming together, opening up about their conditions and supporting each other.”
Participants do circuit sessions at the beach, yoga, swimming and gym sessions at Tūranga Health. They learn about nutrition, and their overall wellbeing is monitored by a Tūranga Health nurse. “As far as participation and pilots go, it has been awesome,” says Bernie.
A LOVE of children makes being a Tamariki Ora nurse a dream job for Akesa Kavai.
Akesa has worked as a Turanga Health Tamariki Ora nurse for four months.
She studied nursing extramurally through the Universal College of Learning and has spent the past four years working at Kiri Te Kanawa Retirement Village.
Her goal has always been to work with children and babies - but not in a hospital.“I’ve always had a passion for children but I didn’t like the paediatric wards because I don’t like seeing unhealthy or sickly children.”
Being a Tamariki Ora nurse involves everything Akesa loves about health and preventative care.“Working with kids, you’re not just focusing on them, you look at the entire family as a whole. Often you can’t just fix one issue because it relates to everyone not just the children.”
Akesa loves meeting babies and in a few months will meet her own! Already mum to Carmel, 7, and Timote, 23 months, her third child is due in March.
Akesa is of Tongan descent and was born in Auckland. Her family moved to Gisborne before her first birthday and went to Te Hapara Primary School, Gisborne Intermediate and Gisborne Girls’ High School.
Away from work, Akesa and her family love spending time at the park and are heavily involved with Wesleyan Methodist Church.
Turanga Health welcomes Akesa Kavai.
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