Jacquie Kidd: We need to get whanaungatanga right

Like a lot of kids, Jacquie Kidd came through school — up north, in her case — without distinction, but with any amount of potential and determination. Later, there was enough encouragement and incentive (especially in wanting to provide a better life for her little girls) for her to see a worthwhile pathway in nursing. And she’s made the most of that, earning a PhD from Auckland University along the way and becoming a professor at AUT. She talked to Dale about her life and the work she’s been doing, including making the health sector more welcoming for whānau — and the cancer research that, recently, has become even more personal.

 

Kia ora, Jacquie. Perhaps, if we were being formal, I’d greet you as Jacqueline.

Yeah. That’s my first name. No idea why Mum chose it. I think she just thought it was pretty. And it was a great disappointment to her that I responded to Jacquie as soon as I was old enough to do that. My middle name is Diane after an aunty on Dad’s side.

My dad, Peter Carr, was of Irish stock, but he was born in England. He was about two when the family, a big family of criminals, went to Aussie. But he came to New Zealand with Worth’s circus. He’d landed a job with the circus horses, when he was 14 — and he arrived here in about the late 1950s.

Then he met my mum, Maryellyn Amy, and they fell in love. She was 16 and he was three years older. My grandparents weren’t too happy about that. So, my parents decided that the only way they’d be able to stay together would be if she got hapū. So she did. And that’s where I came from.

On Mum’s side, we’re Ngāpuhi from north of Whangārei, up near Lake Omapere, and just inland from Waitangi. My marae are Parawhenua and Rāwhitiroa. Our whānau moved away from there in the mid to late 1800s. I’ve got a lot of whānau letters and stuff about them making a conscious decision to prioritise education. You can see the colonisation coming through in the letters. Like: “You kids keep your heads down and learn the Pākehā way of life.” So, it kind of hit us quite early.

My grandmother’s grandparents moved to Whangārei and then they moved further south. Most of my whānau have settled in Auckland. But my mum and dad moved around a lot, so I didn’t have any particular place to call home as a kid. Whānau was home, wherever we happened to be — and, in our holidays, we’d go back to my grandparents in Tāmaki.

But it was kind of weird because we’re all socially assigned white. My grandmother married a guy whose family originally came from France. His family, the Amy’s, had moved from France to England. But then he landed up in Thames.

So, my grandmother’s living in Auckland and he’s living in Thames. And then his brother and her sister got together in Auckland. So the two Amy brothers and the two Calkin sisters — Tirohia, my grandmother, and Hineira my aunty — ended up married, and the two couples lived next door to each other their whole lives in Tāmaki. There was this big whānau with all of us looking white as anything and living a life guided by tikanga and Māori values.

But, because we were all such an inward-facing whānau, it wasn’t until I was at high school that I realised not everybody lived like this. For us, it was all about whānau gatherings and rules like never sitting on the table, not brushing your hair in the kitchen, and not cutting your nails after dark. All that sort of stuff. I didn’t realise for a long time that not everybody lived that way.

Did your dad’s circus and horse connection run on down through the family?

Nothing so exciting. No, he became very stable after he met my mum, and he became a mechanic. Then he died of heart disease when he was in his mid-30s, so my mum was widowed with three kids. After that, we settled for a little while in Ahuriri, in Napier, and that’s where I’ve come back to live now.

When you were growing up, did it take a while for you to come to terms with being Māori and yet seeing this Pākehā-looking person in the mirror and just accepting that you were a fair-skinned Māori?

I’ve always felt Māori, so there was no problem. And I’ve never had a label. As a kid, I didn’t have a lot of friends. I just read a lot and I was crap at doing homework and stuff like that. So I never came to the attention of any teachers as being particularly smart.

I left school when I was 16, had my first baby when I was 19. I don’t know, that’s just what we did. We had babies young. We focused on whānau, and it wasn’t until my marriage broke up that I started to really think about who I was.

I had these two little girls, and it wasn’t enough to coast anymore. That’s when I did my nursing training. I was a single mum with two babies, and I just wanted a better life for them.

Was there anyone there to take you under their wing?

No. Not apart from my mum — and, of course, whānau were very much there. But we were so poor. We were kinda used to that, though, because we’d always been poor.

Had you given any thought to something different from nursing training?

If you’d asked me — although hardly anybody ever did — what I wanted to do when I left school, I would’ve said a journalist. I loved writing. But I failed School Cert, apart from a couple of subjects, including English.

I was disconnected because Dad was really sick, and we were on the move. So I didn’t do well at school, and then, because I didn’t come to the attention of any teachers, nobody told me that I could be a journalist.

I didn’t know how to get there. Not unless they put an ad in the paper saying: “We want 16-year-olds who haven’t done well at school to come and be a journalist.” I had no clues. Then, three or four years ago, Mum said to me: “You know how you never went to university? Was that because you thought we couldn’t afford it?”

And I just looked at her and went: “Well, yeah. Of course, it was never an option for me.” She was gutted. But at the time, as a whānau, we didn’t know university was available to us. It was another world. I just accepted that I needed to leave school, get married, have babies, and make a little bit of money. Not a lot, just a little bit.

And then I found myself on my own and had to make a more conscious decision about needing to do something for my girls, so I went into nursing, and that’s where I guess being Māori became a political identity, rather than just an internal one. It became who I was.

The racism was just astonishing. And I know that it continues to this day. I guess my politicisation happened over a period of maybe two weeks when we were doing a paper looking at the social makeup of New Zealand. It was always New Zealand, never Aotearoa.

This English-based nurse stood in front of the class and talked about Māori teen pregnancies and how terrible it was — and how part of our role as nurses was to stop this happening. And I’m like: “Hang on a minute. I think she’s talking about my grandmother here.” And then the next thought was: “Hell’s bells. She’s actually talking about my mum.”

Then it clicked. “You know what? She’s talking about me. She’s talking about my kids in this way that makes it sound like I was wrong to do this.” And I wasn’t wrong. I love my kids. And my mum loved us. My grandmother loved us. So what the hell was going on here?

That’s when I think I started to develop this anger and outrage at what people were being taught about us. At that point, I decided I had to join the real world. It’s not enough now to just coast along. I have to be a part of making things better, even if my part’s really small.

We’re moving forward, though, aren’t we? We are improving Māori health?

What’s improved is that we’ve got these pockets of Māori excellence. We’ve got amazing iwi-based health services or whānau-based health services around the place, and we’ve got exceptional leaders, like Whaea Moe Milne and Lady Tureiti Moxon.

But our general health sector is just as racist as it’s ever been, and our outcomes are just as poor as they’ve ever been. I was lucky when I did my postgrad education to be taught by Irihapeti Ramsden and to get to know her a little bit. I was in the first class where cultural safety became a part of our state exam.

And I don’t think we shifted the dial in all those years. I did my state exam in 1990 and, since then, kawa whakaruruhau has been watered down. It’s been argued against. And it’s only now that we’re seeing a renaissance where people are going back to the work that Irihapeti initially did and saying we need to revisit this.

She got it right, but we didn’t implement it properly because it was so watered down. It was made so that tauiwi were comfortable with it — which meant that it didn’t have the impact that it could and should have had.

This was something on the table 30-odd years ago, wasn’t it? And there was stern opposition, wasn’t there? There were those who refused to take the papers.

That’s right. In Christchurch.

Are we making progress?

I’m absolutely in favour of Te Aka Whai Ora (the Māori Health Authority). I’m not in favour of under-resourcing and over-scrutinising it so that it ends up looking like a failure when it was never given the opportunity. I’m scared, though, of this coming election. But I’m hopeful that Te Aka Whai Ora will be given the opportunity to make the difference to healthcare that we all need.

I’m a firm believer that getting it right for Māori means we’ll get it right for everyone. People sometimes tell me they don’t want a Māori-based health service — they don’t want us to develop this beautiful service that they can’t access.

So I spell out the facts: You can access it. Māori don’t develop these services and then bar non-Māori. You do have access. There is no bar.

I ask them: “Wouldn’t you prefer a health sector that’s more tuned into your whānau, and that sees you as a whole person and not just as a series of body parts?” And they go: “Yeah, that’d be awesome.”

Well, that’s what we’re aiming for. It’s the lack of that attention to the whole person and to their cultural space that has our whānau often opting to die rather than accessing health services.

Do you have the impression that more and more Pākehā are recognising that, in all walks of New Zealand life, including medical training and the medical professions, there’s liable to be racism at work?

Yes, it’s getting much more recognition these days. But then I listen to tauiwi colleagues say: “I started to go down this path of introducing anti-racism into my classroom, but the pushback was so hard that I had to take a step back and think about things before trying again.”

That’s privilege. Being able to decide that you’re not going to engage in the fight right now, and you’re going to wait until it feels more comfortable for you. It’s absolute privilege, and I worry about that.

When we look at the health scene and compare it with the reo model, we can see that it was our old nannies who decided we’ll just fire ahead and teach our kids in our garages or our lounge rooms or wherever.

Now, 40 years on, with a generation of these bilingual, sophisticated, digitally savvy people, some of them now grandparents, I wonder if there’s a lesson or a model in that for progress in health. Should we wait for the government to fund us? Or do we just get out and do it?

Absolutely. And, when you look around at people like Lady Moxon, Tina Ngata, and at what happened up north and down on the East Coast around Covid, that was the equivalent of teaching the kids in the garage, I reckon.

That was whānau getting together and deciding this is what we need to do. We need to block those roads. We need to stop people coming in and treating lockdown like a holiday when we haven’t got the services to support those extra people. We need to get vaccinations out to where our whānau are, instead of expecting them to drive five hours. Stuff like that is happening.

So, I’m not frustrated at the lack of progress in that way. I’m frustrated by the lack of systematising that, which means that every time a community decides that that’s what they need to do, they have to start from scratch.

Our health system isn’t set up to empower whānau to make those decisions. They fight it every step of the way. And we know that, down on the East Coast, the DHB had money that they didn’t give whānau to get the vaccinations or the RAT tests out there. Or the home packs with Panadol and pulse oximeters.

I’m not sure that we’re at the point where we could just relax for a moment and know that the system has our back, that we could stop fighting for every single scrap.

But, Dale, I didn’t want this to be a negative story. And one of the reasons that it’s hard to avoid this being a slightly negative story is that I’m dying of bowel cancer — and, if we’d had the bowel cancer screening programme in time, I might not be.

Oh, Jacquie, Jacquie. I’m sorry to hear that, Jacquie. And it came a-calling in our house too, with my pāpā. I’m on the bowel screening programme as well.

You know, there’s a lot to love about the way you roll, your thought patterns. It pisses me off that School C was seen as such a critical hurdle at a time in our lives when, as neuroscientists would remind us now, our brains haven’t even fully developed.

And here’s you knowing and saying: “I could’ve done anything. But I didn’t think I was up to it.” Now you realise that you were truly up to it, that you were bestowed with any amount of brain power from those who came before you.

Yeah, it was weird. I’m sure I went on to get a PhD partly because I was so under-recognised at high school. For the most part, school was just an exercise in following the rules. That’s why I say to a lot of kids, school isn’t make or break. School’s just a step on the ladder. You can decide later on what you want to do.

Tautoko, Jacquie, I don’t mean to pry, but you surprised me when you told me that you’re dying. What exactly is the situation?

Right now, I’m not particularly symptomatic. I have bowel cancer and they thought they’d caught it in time. But obviously they didn’t and now it’s in my lungs. And we know that it’s not treatable and it’s getting worse.

There’s some chemo that I probably will have later this year — and that may extend my life a bit. If the chemo doesn’t work, perhaps we’re looking at a year. If it does work, maybe looking at a few more. I heard somebody talking about it the other day as if I’ve now got a “best-by” date on me. And you know, sometimes you can go past those best-by dates and nothing bad happens. But I’ve got a time limit now and I know that I’m facing being debilitated, which isn’t exciting.

How are your girls handling this?

I’ve got four kids now — Tracy, Ellie, Caitlin and Drew — and five granddaughters. And what’s left for me now includes wrapping up a whole lot of the stuff that I’ve done, to try and make it more accessible for people because academia is not where it’s at. Communities are where it’s at. So, I need to find out how to make some of the things that I’m doing more available to whānau to use those tools. That’s a part of what I’m doing.

The other part of what I’m doing, I guess, is modelling and showing my own whānau, and everybody else as well, how to say goodbye. Because, like you know, we’ve got this feeling that we’re all invincible and then something horrible happens where your mum pops up on the whānau WhatsApp chat and goes: “Guess what, guys? I’m not going to be here for that much longer.”

I’m okay with it. And I’m working hard to help make the people around me okay with it as well.

By sharing it, you’re also showing how it can be handled. Much love to you, sis. I can understand why you’ve been interested in these areas for a long time now. Especially Māori lung cancers and colorectal cancers. Were you interested in these areas before you realised that it was affecting you? Or is it an interest that you’ve developed since realising your own situation?

Oh, no. I’ve been doing it for a long time. One of the things about my career is that almost nothing I’ve done has been part of a long-term plan. It’s all been about what should I do next? And no, we hadn’t had cancer in our whānau. It wasn’t something that had touched us personally.

But the wrongness of the Māori cancer journeys was just so striking. So, I’ve been involved in cancer research for about 15 years. My research is very story-based. It’s all about what whānau are saying and what they’re going through.

Whānau have talked to me about the hospital experiences they’ve had or the stories they’ve been told. And it’s all very well that we’re telling those stories to each other. But our kids are picking up their own experiences too when they accompany their koro or other whānau on a hospital visit. And, too often, they’re treated like shit. They’re pushed out of the way or told that they’re a nuisance and shouldn’t be there. Or that there are too many visitors, and all the rest of it.

But what healthcare practitioners may not realise is that the whānau are the rongoā, the medicine. You need them there to help the patient become well — and your job as a nurse or doctor is to support that whānau to get that patient well. And we shouldn’t be treating kids like a hōhā, but like the treasures that they are. They’re the reason that that Koro or Nana is going to get out of hospital.

There’s no point in being unfriendly and creating another generation of kids who don’t want to come into healthcare when we desperately need them to be nurses and doctors and pharmacists and occupational therapists.

As you look over the whole health scene, is there any particular change that we should be pushing for?

The first thing that comes out of every single research project I’ve done is the need to get whanaungatanga right. And that doesn’t cost you anything. What’s frustrating is that, when you’ve got a burnt-out and exhausted workforce, distancing is one of the causes as well as an effect. If there was more whanaungatanga, they’d find their work less exhausting.

And if we could make the health sector more welcoming, more whānau would go there. Sometimes all you need is for one whānau member to have a reasonable experience in the healthcare sector, and others will go: “I wanna work there.” Or ‘’That was okay. I think I can bring myself to go and get checked.” Or “I’ll take part in the screening.” Or “I’ll go and get my cough checked out with the GP.” Whanaungatanga is such a small thing to take care of.

So the first thing on my bucket list is a health sector that can embrace the idea that we’re here for people. You know, I get to work with lots of baby health professionals and they all talk about wanting to help, wanting to be that person who makes a difference. And then they go out into clinical practice, and, in a really short time, they lose that desire. Because they’re so overworked and it all gets focused on jobs. I’ve got tasks to do. I’ve got this many things to do.

And so the person who leans on the buzzer because they’re really anxious and because their whānau’s not allowed to come in because it’s not visiting hours yet, they become the hōhā instead of an opportunity to sit down and talk to somebody and put some things in place that make them feel better.

Thank you for that, Jacquie. I really like what you’re saying about whanaungatanga. But, moving away from your hopes for the health sector, I do want to talk about the things you love about life, and what might be in your bucket list that’s just for you.

One of the gifts of being given the diagnosis that I’ve had is the opportunity to go: “What would I change?” And then the realisation that I would change nothing.

I’m doing a job that I worked hard at, but it wasn’t even a goal. But I’ve arrived and it’s very cool. And I’m working with some fantastic people. I’m living in a little house with my husband and a dog. We’re fostering some kittens for the SPCA and, when we get time, we go for walks. And it’s just so good, Dale. It really is.

So, for me, there’s no bucket list. I’ve done something worthwhile. I haven’t changed the world, but I never set out to do that. I just set out to have an impact on the people around me, and I didn’t always get it right.

Occasionally, I’ve looked back at some of the things I did as a younger version of me, and who knows, maybe I’m still doing it, and go: Damn. I wish I hadn’t done that.

But, on the whole, on balance, I feel really lucky.

I feel lucky to have had this conversation like this with you, Jacquie. Much love to you and your whānau. And thank you for sharing those rich words. It’s a beautiful kōrero and I think it will touch many people. Mauri ora kia koe, Jacquie. Thank you for being so open and honest. I really appreciate the time you’ve spent with me and our E-Tangata whānau.

Thank you. And it was so lovely to be asked. And the timing’s perfect because I’m still well enough to do this stuff. So that’s lovely. And let’s hope I can convince at least one kid who’s struggling at school that this isn’t the end of their life, that they can make other choices later on and then go off and do something that they really want to do. Like you know, it’s all possible.

Yes, it is. Much love, Jacquie. Thanks so much.

(This interview has been edited for length and clarity.)

© E-Tangata, 2023