THE challenging days of the Covid-19 pandemic have changed how Turanga Health delivers care forever, chief executive Reweti Ropiha told directors at the company’s annual general meeting last month.

Mr Ropiha says the disruption of Covid-19 turned out to be an accelerator of change as the Māori health organisation offered more care in real time like influenza vaccinations on a Saturday, doctor and nurse telephone consultations, and virtual exercise sessions during lockdown.

“Whānau who previously considered the only way of receiving health services was by meeting their nurse or kaiāwhina face-to-face, found other ways to receive their care,” he says.

“Whānau could interact with staff on the phone, use apps, online tools and video conferences. And in many cases, they found we could offer a far more responsive approach.”

Mr Ropiha says many whānau now see and understand this to be an okay way to receive some of their health care. “We’ve had feedback on the new complementary ways of service delivery and in the process also discovered more about their needs. Who has wifi? Who has a shower over the bath? And who has support over the weekend? All this information helps us provide a more responsive service.”

Mr Ropiha says If Covid-19 has taught the organisation one thing “it’s that no health system can stay stagnant. While existing health care methods won’t ever be replaced - new health care delivery models will certainly be retained to complement them.”

Turanga Health board chairman Pene Brown says he and the other hauora directors were impressed with Turanga Health’s response to the challenging year and the leadership shown by chief executive Reweti Ropiha and the wider team.

“Reweti’s sensible leadership in the past meant Turanga Health was ready to hit the ground running when it needed. Covid-19 was new to all of us but Turanga Health didn’t start from ground zero. With some subtle changes the organisation leapt into action providing care and services to enrolled whānau and others.”

Turanga Health offers a range of wraparound community health services for all ages. It’s services such as fitness programmes, classes for new mums, and support for older people, are accessed by around 3,000 Māori and non-Māori living within the tribal boundaries of Rongowhakaata, Ngāi Tāmanuhiri, and Te Aitanga a Māhaki.

The health organisation operates from a campus in Derby St and a general practice in Te Karaka which has just under 1600 patients enrolled. Turanga Health has one general practitioner, 10 nurses, and 30 community workers and kaiāwhina.

Successful Turanga Health programmes include the Tū Mahi workplace wellness programme. In the year ended June 2020 mobile health staff provided wellness checks for 203 workers at 15 workplaces from its state-of-the-art mobile clinic. Twenty-three individuals were referred for nurse follow up.

In the same time period 377 pēpi (babies) were referred to Turanga Health’s Well Child Tamariki Ora service. Forty-three percent of Māori babies were fully breastfed at six weeks with 40% reported to be still being breastfed at six months.

During the company’s annual general meeting last month Mr Ropiha thanked the dedicated workers “that kept Turanga Health’s heart beating this year”.

“Early and deserved praise must go to the nurses and kaiāwhina working in the community during the lockdowns.”

He also thanked all Turanga Health funders and governance kaitiaki for the part they played during a most extraordinary 2020 year.

Board chairman Pene Brown also paid tribute to health, social, and iwi organisations across the region that worked collaboratively with each other for the health and wellbeing of everyone in the region during the Covid-19 response.

Turanga Health’s easily digestible annual report created as a concise way to learn about the company’s accomplishments.

E ngā mana, e ngā reo, e ngā hau e whā. Tenā koutou, tēnā koutou katoa.

Taku pepeha.

Ki te taha o toku papa

Ko Whiria te maunga
Ko Hokianga te moana
Ko Ngātokimatawhaoroa te waka
Ko Rāhiri te tupuna
Ko Pakanae te marae
Ko Maraeroa te wharenui
Ko Ngati Korokoro te hapu
Ko Ngāpuhi te iwi

Ki te taha o toku whaea

Ko Putahi te maunga
Ko Wairoro te awa
Ko Ngātokimatawhaoroa te waka
Ko Nukutawhiti te ariki
Ko Parahirahi te pa
Ko Te Kiore te tupuna
Ko Kohewhata te marae
Ko Puhimoana ariki te whare
Ko Te Takatoke te hapu
Ko Ngāpuhi te iwi

Haumi ē! Hui ē! Tāiki ē!

HIGHLY respected Vanessa Lowndes Centre tutor Guy Moetara has spent the past 20 years sharing his love of building and the outdoors with people managing intellectual, physical, and mental health disabilities.

Before arriving at Turanga Health, Guy, Ngāpuhi, was a carpenter for over 30 years. He helped build the former Gisborne Post Office building on Grey St, and Tairāwhiti museum, as well as his own home and many other houses.

By the time he was 50 he was due a break from scrambling up scaffolding and swinging a hammer in Gisborne’s heat. After a short stint at the freezing works he joined Tautoko Work Trust (as it was known back then) as a tutor. The trust was managed by Faye McMillan.

Now known as Tautoko Support Services, the organisation helps people work towards a more fufulling life. It was a big change for Guy...and he loved it.

“I enjoyed working with whānau. They make my life interesting and I love seeing how much they enjoy the opportunties we can offer.”

Guy worked at the Trust for 10 years before the organisation had to reduce staff. Knowing he could probably find work again as a builder Guy stepped away from the Trust. But life has a funny way of working out and rather than becoming a tradesman again, he found himself at Turanga Health.

“I walked in off the road and met Reweti Ropiha and told him I was looking for a job. He said bring me your CV on Monday...so I quickly created my first CV and handed it in!”

Initially Guy worked with staff helping secure respite homes for people  with mental health issues. During this time he observed the work going on next door at the Vanessa Lowndes Centre (VLC) which had recently come under the wing of Turanga Health.

VLC programmes build confidence and prepare people with mental, physical or intellectual disabilities for employment. ​Programmes on offer include fitness and health, cooking and meal preparation, horticulture and gardening, numeracy and literacy.

The centre has caring staff from a range of backgrounds and Guy was drawn to the work. He knew the satisfaction and pride that came from using your hands to build things and so very early on he wanted to share that passion with VLC whānau.

Guy was supported to create a marae maintenance work programme. He and whānau carried out repair and maintenance work at marae around the rohe. Amid the speed and chaos of the modern world activities such as carpentry, farm work, and time spent outdoors “gave whānau a place where they could learn to do things for themselves”.

“I could see that whānau felt a new sense of self worth, self-esteem, and a new-found confidence while doing this kind of work. They wanted to be out there and it opened their eyes up to their own abilities.”

A highlight of Guy’s 20 years with VLC was teaching whānau how to save money for a special occasion. He helped whānau budget for an overseas holiday to Australia, set financial targets, and created fundraising opportunities. A year later he and other staff took groups to see the Lion King musical in Sydney and then Melbourne. They were trips of a lifetime and over the next few years other trips followed.

“The point of it was that they had to put together a savings plan for over a year. We wanted their learning to be about the figures and about them individually taking charge. We taught them how to make money last and how to save.”

Guy says he’s always enjoyed passing on his life skills and experiences to whānau, and people should never underestimate how much they can learn in return.

“They have taught me patience. They have taught me that anything is possible,” he says, citing VLC superstars Jury Houkamau, Rita Cuthers, Aaron Harding, Jessica Kirwan, and Stacey Hohapata, who between them have achieved many study credits through the Eastern Institute of Technology. Some now hold down jobs in the community.

“There are many others, too many to name, who have also achieved their goals and whom I want to acknowledge. They are all superstars in my eyes. They have revealed more to me about the need for community than I could ever have imagined, that we all have something important to bring to the world.”

Turanga Health chief executive Reweti Ropiha has known Guy for years and remembers his leadership at Manutuke Marae running activities for kids. “We were lucky to have someone like him around.”

Reweti says Guy started at VLC at a time when someone with outdoor experience and a passion for music and te ao Māori was the perfect fit.

“He’s a deep thinker and a man of formidable patience. From fishing in the sea to the wise counsel he offers to those around him, Turanga Health and Vanessa Lowndes Centre have been very priviliged to have him on board. Congratulations on your 20 years.”

Guy’s world changed this year when New Zealand went into lockdown. Aged 70 he had to stand down from work.  While he was disappointed not to be contributing to Turanga Health’s mahi, he enjoyed the time at home with wife Raiha, his children and grandchildren.

When asked what he will remember the most from lockdown, he becomes emotional, and searches for words to express his gratitude to those around him.

​“I want to particularly acknowledge Rongowhakaata Iwi Trust, Manutuke Marae and Turanga Health for their support of food and health packs delivered over the lockdown period. And I especially want to acknowledge all those essential workers who continued to work during March and April including Turanga Health staff who delivered so much help, health care and support to our whānau during that time.”

A small act of kindness by a Gisborne builder unleashed a community festival at Cobham School this week celebrating new sports equipment, a garden, and easier access to pharmacy services.

“I just can’t believe what’s happened at this school and the way everyone has pulled together for the children,” exclaimed emotional principal Gina Holmes during the fun day.

The Hakinkina, Hauhake, Hauora festival was an idea pulled together by Turanga Health and community stakeholders after a chance act of kindness by a builder earlier in the year got everyone thinking.

Local basketballer and builder Scott Muncaster was working at Cobham School when he noticed students were making air shots with balls because of a lack of hoops. In a spare moment he knocked together a makeshift hoop and backboard never dreaming it would lead to anything more significant.

What happened next was truly remarkable.  A basketball-mad father of a staffer, Shane McClutchie, told Basketball New Zealand about the children’s plight. Basketball New Zealand’s Hoops in Schools initiative was a perfect fit and with some added coordination from Turanga Health Cobham School is the first kura in the region to benefit from the national programme.

This week New Zealand basketball players Thomas Abercrombie and Brooke Blair surprised Cobham School children to celebrate the newly installed regulation-sized backboard hoops and give all the tamariki a basketball and some coaching.

“It’s the fastest growing sport in New Zealand,” explained Breakers captain Thomas Abercrombie, who took the kids through entertaining and inclusive on-court drills.

“We want to make sure everyone has a chance to play the game. Hoops are a meeting place for everyone. All you need is a few mates and a ball and then everyone can enjoy the game.”

Students Lata Latu (9) and Nathan Tombleson (12) were excited about the day which featured sports superstars, new equipment, and the promise of a yummy hot stir fry lunch from the mobile Turanga Health kitchen.

Nathan particularly loved the coaching and was keen to practice his “L and then R” hand motion for dunking winners. “I like bouncing the ball and dribbling it too,” says Nathan.

Holding onto her ball tightly, Lata was thrilled it had been signed by Thomas and Brooke. “I’ve learned to shoot and it’s better than when there was a bucket!”

Turanga Health has a strong relationship with decile 1 Cobham School in Elgin. As well as helping deliver Breakfast Club two mornings a week the Maori health provider linked the school with Elgin Pharmacy so whanau could better access education and resources to manage common conditions like headlice and eczema.

Pharmacist Sean Shivnan recently purchased nearby McLeans Pharmacy. “We’re part of the community and have partnered with Turanga Health to provide free treatments for head lice (kutus) and some skin conditions.

“Kody Paulson is the pharmacy manager and Linda Croskery has been a pharmacy technician at McLeans for 38 years. “Both are looking forward to helping whanau from the Elgin community.”

Pharmacist Sean Shivnan recently purchased nearby Elgin Pharmacy. “We’re part of the community and we want to help,” he says.

A Turanga Health’s Workplace Wellness partner, Riverlands, also come on board to support Cobham School this week.

Just before the festival Riverlands staff, some of whom used to go to the school, volunteered their time and resources to build a large vegetable garden.

During the festival Riverland chief executive Carl Hamlin helped children plant the last of the 200 donated seedlings.

“There’s salad greens, tomatoes, beans and sweetcorn,” says Mr Hamlin, who will also donate fruit trees to the enthusiastic school.

“’Cobham Grown’ is what we are aiming for! We’ve been amazed at how green-fingered the students and staff are. We share the same ethos and values as Turanga Health and the school, so we were thrilled to come on board.”

Principal Gina Holmes thanked everyone who attended the day and was particularly grateful to the organisations who are “throwing their weight behind a great bunch of kids and enthusiastic staff”.
​
“It was a fantastic day and we’ve got so much more planned for the children with the sports gear, garden, and pharmacy support.”  

Caption: Nine-year-old Lata Latu was thrilled when professional basketballer Brooke Blair signed her new basketball during the Hakinakina, Hauhake, Hauora festival held at Cobham School this month.

Thank you to Matai Smith and Turanga FM for this fabulous video story. 

When Turanga Health told Basketball New Zealand that Cobham School students were using a bottomless bucket for a basketball hoop - they immediately wanted to help.

“Basketball New Zealand’s Hoops in Schools initiative was a perfect fit and Cobham School is the first kura in the region to benefit,” says basketball-mad Turanga Health Service Delivery Manager Dwayne Tamatea.

The concept of the Hoops in Schools initiative is to put more fit-for-purpose hoops in primary schools.
Cobham School principal Gina Holmes says she was overwhelmed when she received the offer from Basketball New Zealand.

“Our old basketball area featured a piece of plywood with a bucket nailed to the top with it’s bottom cut out. That one was built by some builders that were working here this year. Before that the kids were playing air shots.”

“I don’t know if anyone realises just how much its going to change everything we do at Cobham School – basketball is definitely being written into the curriculum!”

On Monday [19 October] Cobham School will host New Zealand professional basketball players Thomas Abercrombie and Brooke Blair as they unveil the new hoops during the school’s Hakinakina, Hauhake, Hauora day.

Ms Holmes says as well as celebrating sport (hakinakina) the school community will see the first steps being taken in an exciting new mara kai or food garden project happening at the school. Staff from local orchard and packhouse company Riverland will be on hand helping students build a large raised garden. “We want students to learn how to plant seeds and harvest (hauhake) food for themselves and their whanau.”

There will also be a strong health focus for the day led by local pharmacist Sean Shivnan. Mr Shivnan is supporting the school with education and resources to help whānau overcome common school-age illnesses and infections including eczema and headlice.

Cobham School is a decile 1 school in Elgin with 39 students, three teachers, a kaiāwhina, and a number of ancillary staff. Ms Holmes says Cobham School aims to be at the heart of the community and Hakinakina, Hauhake, Hauora is one way to share the school’s aims and its strengths with school families and the businesses that support it.

​Students from Cobham Kura, Te Kura Kaupapa Māori o Mangatuna, Elgin, Muriwai, Te Hapara, and Patutahi Schools, and Te Kainga Whaiora Children’s Health Camp have also been invited. 

As Christine Nepia clocks up 20 years at Tūranga Health she recalls it took two attempts to get a job with the hauora.

“Someone told me to apply for a job as a drug and alcohol educator but that was after I had applied for a kaiāwhina job...and didn’t get it!” says Christine, also known as Nogs.

Christine told her whānau “nah, they’ve already declined me!” But the whānau perservered and it’s been Tūranga Health’s good fortune to have her on the team ever since.

Christine is Ngāi Tāmanuhiri on her dad’s side and Ngāti Porou through her mum. She spent some of her early life up the Coast but when her maternal grandmother passed she reconnected with her Ngāi Tāmanuhiri roots back in Muriwai.

Christine’s first health job was in 1996 as a health promoter with the Public Health Unit (PHU). At the time she was noticing Māori seemed to become unwell and die earlier than non-Māori.

“I lost my dad to cancer in 1988 and I was always wondering ‘why has this happened?’ I didn’t want to see my own whānau, hapu or iwi go through what we did. What could I do as  a Māori wahine to contribute?”

Christine worked alongside health leaders like Riki Niania, Ann Shaw, Jan Askew, Kuini Puketapu, Nona Gaskin Ashton and Heather Roberston, and they shaped her passion for improving the health of others for the next 25 years.

After the PHU Christine was employed at Matapuna Training Centre and for a time was also a caregiver at a rest home. Then she found work at Tūranga Health as a drug and alcohol educator.

“This was the first Māori organisation I had worked for and it felt great. When I was at the PHU I found it difficult to help non-Māori understand the extra challenges and cultural layers facing whānau. Now I was somewhere there was an understanding.”

If someone told her to “visit Uncle Charlie on Papatu Rd,” she didn’t need a database to tell her who he was or whether she was going to be able to help him. “My whakapapa meant I already had a foot in the door.”

After a few contract changes and different roles, Christine really hit her straps when she moved into the Aukati Kaipaipa smokefree programme championing kaupapa Māori-based approaches to smokefree lifestyles. The programmes demanded unique ways of working with individuals and groups. Christine and her colleagues visited people in their homes, hosted quit programmes at workplaces, and encouraged sports teams to become smokefree. As a former smoker she could relate to the challenges and she was good at her job.

These days Christine works with Vanessa Lowndes Centre staff helping them with the skills they need to live independently. She will often be in the centre’s huge catering kitchen helping whānau learn to cook for themselves.

It was in this kitchen, during the Level 4 and 3 Covid-19 lockdown that Christine and colleague Nyoka Fox made a huge difference to hundreds around the rohe.

The pair created well over 1500 meals for delivery to whānau in need. Christine was grateful to chief executive Reweti Ropiha for laying down the challenge and giving her and Nyoka space to manage it how they saw best.

Christine says during the chaos there were some amusing times. For example, she and Nyoka would debate who would do the huge shops at Pak ’Save. They weren’t scared of Covid. “Nah, that was fine. It’s just that when Māori see Māori with a huge shopping trolley, they naturally assume someone has passed. All the way around I would get asked  “who is the tangihanga for?”

With New Zealand now operating at lower lockdown levels Christine has found time to spend more time with her granddaughter Araia and pursue her other loves.

“If I wasn’t in health, I would be a fashion designer,” she says. With that, Christine pulls an impeccably made mustard coloured Covid mask featuring gold trim. “The ultimate in mask evening wear!”

Chief executive Reweti Ropiha isn’t surprised at anything Christine says or does. “She’s got the desire and the intent to always do well. Her approach is innovative and about the people. She has a lot of connections in the community and a good understanding of everyone. Congratulations on your 20 years Christine.”

Saying it like it is! Classic quotes from Nogs
On Aunty Jacinda: “Now there’s a leader who has actually taken the time to lift the mat and vacuum underneath.”

On holiday travel once husband Mike stopped needing to get out for a smoke: “Turns out it doesn’t take seven hours to get to Shannon!”

On Turanga Health: “There’s something good going on here. It’s about time services are provided by Māori for Māori.”

On health promotion: “To succeed it’s about 80 percent preparation, 20 percent presentation.”

 

AS a young father, Avenir Maurirere took a “whatever it takes” approach to supporting his growing family and that's what he brings to his work life.

As a navigator for Turanga Health, Avenir works with whānau targeted for support under Manaaki Tairāwhiti's 50 Families scheme.

And he knows all about the challenges whānau can face.

Raised in Mangatuna and Kaiti, Avenir and his “soulmate” started their family very young so he had to make the choice between staying at school or going into the workforce . . . the workforce won.

From there the roll-out of challenges continued until, while living and working in Hastings, Avenir and his partner faced multiple deaths in the whānau that brought them back home to Gisborne, and led to some tension in their family unit.

“All sorts of things can have an impact on your life and it is that understanding, that 'lived experience', that I bring to our 50 Families whānau,” he says.

“For my own whānau finding a nice home was a real turning point so I see how just addressing one thing can make a huge difference.”

Housing might be something Avenir (Ngati Iranui, Te Aitanga-a-Hauiti/Ngati Porou) talks about with whānau. Or it they might need help to navigate social development systems, justice, education . . . whatever it takes.

“Many whānau have a preconceived idea of what social services means but my approach is just 'this is me, and I'm here to help',” says the proud father of three.

“One of the most rewarding things is that, between us, we can help bring about systemic change in encouraging agencies to help whānau achieve their goals, not get in their way.”

Avenir's unusual name is derived on the French word for “the future”, and he says that's what he's firmly focused on.

“We listen to whānau, we help them work out a plan, and then help them work towards their goals.

“But though everyone is different, the one constant is that our relationships are entirely built on trust. If whānau trust us, they can be open with us, and then the real work can begin.”
 

 
 

AFTER more than 30 years as a hairdresser, Marnie Evans went for a career change that’s not quite as radical as it seems.

As a navigator for Turanga Health, Marnie works with whānau targeted for support under Manaaki Tairāwhiti's 50 Families scheme.

“Any hairdresser will tell you that the job is just as much counselling as it is working with hair so I've had a lot of experience in that area,” she says.

“And in any case, throughout my life I've always taken in kids in trouble, those who have needed a bit of help, so this is a natural fit for me.”

With Under 50 Families, the approach is “whatever it takes” to help targeted whānau -- both for their own good, and for the good of generations to come.

And “navigator” is a good term for Marnie's role as her job is not only to support whānau in good decision-making, but to help them untangle the systems they may need to work through.

For Marnie (Te Aitanga-a-Māhaki), “whatever it takes” means she and her colleague Avenir Maurirere listen to whānau before working out a plan.

“It is not our place to tell them what they need, it is for them to tell us what they need,” she says. “Our role is to build trust, to hear what they are saying, and to do whatever it takes to get it done.”

So on any one day she might be helping a whānau member get to the doctor, supporting them in court, teeing up counselling or just taking the time to talk through what is affecting them.
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“There's a lot involved but it never feels like work,” says Marnie. “Being able to help whānau achieve their goals is the most rewarding thing you could ever do. It just makes me happy.”

Years ago while working as a caregiver for the elderly Shannon Maats-Niwa decided she wanted to be a nurse and offer exemplary care.
 
“I wanted to be the kind of nurse that a person deserved to have,” she says.
And now she is!

Shannon has been a nurse for seven years and is loving her new role at Turanga Health as a tamariki ora nurse supporting new māmā and their pēpi.

She started with the iwi health provider just before New Zealand went into lockdown in response to the COVID-19 pandemic, and so for the first few weeks in her job she provided virtual care to whānau over the phone.

It was vastly different to her previous nursing jobs including stints on various wards at Gisborne Hospital and four years on the frontline at the Rhythm and Vines music festival.

“I wanted a job in primary care to help shape me and I have discovered I love being on this side of caring for people.”

“It’s humbling” visiting whānau in their own home. She says some of the strong wahine she supports live with very little in the way of life’s luxuries and it makes her appreciate her own family and extended Dutch and Māori whānau.

With an insatiable thirst for learning Shannon, 34, has her sights set on expanding her nursing career. Since graduating she has already added a post-graduate certificate and post-graduate diploma in nursing. Becoming a nurse practitioner, one of the country’s most qualified nurses, is her long term goal.

“I like to keep on learning. I get stale if I stay in the same thing for too long” says Shannon, who along with husband Adam is bringing up their four children.

There’s a chance her curiosity and motivation comes from her unique and stimulating childhood. Shannon and her two siblings grew up in a house truck for nearly five years traveling around much of New Zealand. They had a childhood surrounded by a range of unique and worldly people with the added bonus of being home schooled to a high standard.

“It was an adventure,” remembers Shannon, who finished her education at Lytton High School.
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Turanga Health welcomes Shannon Maats-Niwa.