Dr Papaarangi Reid has little time for what she calls the “decorative and performative” changes that some New Zealanders are satisfied with as their contribution to making Aotearoa a genuinely bicultural or multicultural country. She wants something more than superficiality. As she explains here to Dale, she wants, and keeps working for, transformation — and not just within the health system.

 

Kia ora, Papaarangi. Here we are, about to take a wander through the story of your life which, I understand, has some very strong links with the Hokianga.

Yes. Dad is from Mitimiti in the Hokianga and he grew up on a farm in Awaroa near Herekino. My parents are buried there at Herekino, next to my father’s mother. And I’m privileged to have been brought up (the fourth of six children) in a happy marriage.

My father was William John Reid and my mother was Jean Mary Drury who he met when he was overseas in World War Two, in the Māori Battalion. My mother was an English war bride. They met, fell in love, and lived happily ever after. He was one of the lucky few Māori soldiers who were able to come back and be eligible for a rehab block farm for returning soldiers in Whakapara. 

I was born in the middle of the last century. Makes me sound very old, doesn’t it? We had a very settled life, a quite hardworking, farm life. But I escaped from that. And I’m never going to milk another cow. Ever. Both my brothers continued the tradition and became farmers, though. 

My parents were very committed to education. My father had one year at Hato Petera and was really sad because that was all his mother could afford. So he was especially interested in our education. My mother was committed, too, and all six of us children had some tertiary education.

I happened to be at Kohukohu on Armistice Day and I was stunned by the number of names of whānau Māori who didn’t come back. Their names are there on that archway of remembrance. It was a sobering moment for me. The sacrifices from the people of the Hokianga were major, weren’t they?

Yes. Five of my grandmother’s sons went to World War Two and all came home. But that was very different from the experience of her peers and friends in the district whose men lost their lives. 

My grandmother, Maraea Reid (nee Kendall), reported that she always felt lucky but also felt sad for her friends who lost sons and husbands and brothers during the war. It’s a terrible thing that mothers should feel guilty for being lucky in war.

It just makes us reflect on how ugly war is. How damaging it is to the soul of our communities. We can think about what would’ve happened, if so many hadn’t died. It’s not just who gets killed or injured but the loss of potential and also the scars that the returning soldiers had on their minds and souls from being part of the war. 

Tell us something about your mum, please.

Apparently, Dad met Mum in a bar in London. Saw her first through the bottom of a beer glass. They thought each other was beautiful. Mum’s father was in the British army and she was initially brought up in Egypt where her dad was stationed before the outbreak of World War Two. She went to a French convent in Egypt and had a rather posh lifestyle. When the family returned from Egypt, her father was stationed at Aldershot. She had good shorthand and typing skills and ended up working as a secretary for the military in London during the war.

Cross-cultural marriages often come with some difficulties for both sides. I’m from one as well. I wonder how your mum adjusted to life in this particularly Māori community.

Of course, it was quite a culture shock. And it was something that many of her friends and family had warned her against. But she came halfway around the world and got married here in her sister-in-law’s altered wedding dress. 

She loved Dad’s mother very much. Mum thought her mother-in-law was a magnificent classy woman. She thought the Māori community had amazing manners, protocols and ways of engaging with each other — all the things that she’d been brought up with as a flash English woman herself. So she didn’t feel out of place at all. She felt right at home in my grandmother’s house.

You said you and all of your siblings did tertiary study. It must’ve been quite difficult logistically getting to secondary school and then on to tertiary institutions. They’re a long way from the farm.

It was an expectation. It was just expected that we’d have some time off the farm and have an education that could lead to a career. At times, the farm wasn’t doing well, so my mother went to work as a shorthand typist to add to the income from the farm. She worked for the CIB in Whangārei — and, as teenagers, we couldn’t get up to much mischief because all the cops in Whangārei knew us. 

Can you paint a picture of the farm before you went away to university?  I’m hoping the farm is still in the family.

No. Some of the farm was taken by the Ministry of Works in the course of the drainage of the Hikurangi swamp. What was left became uneconomic as a dairy farm, so it was sold mainly to neighbours. It went to one of my brothers first and he made the decision that it was too small to exist as a dairy farm — and both of my brothers were part of the movement of Northland dairy farmers to Southland where sheep farming had become uneconomic and land was converted to dairying. But, because of their age, they’re not farming any more.

Farming was quite interesting for us. People who’ve grown up on a dairy farm know how your work is driven by different seasons — hay making, milking cows, driving cows to the runoff so they could have winter feed, feeding out hay, looking after calves. All that is seasonal. That’s the way your life runs. 

For some years, Dad and us kids would go to Mitimiti when the cows were dry in the winter to stay at the old homestead. We didn’t have summer holidays — we had winter holidays because of the demands of the farm.

How did you end up at university?

Well, we were all expected to do reasonably well at school and we did. I went to Hikurangi Primary School. I wasn’t the brightest Māori in my class. There were some fantastically bright Māori kids there, but despite this, they weren’t streamed into the higher academic streams at high school — and their parents didn’t feel able to protest, whereas Mum and Dad would put on their best clothes and go off to see the teachers.

So I ended up in a high-stream academic class doing Latin and French at Kamo High School near Whangārei. Māori wasn’t taught in those days. The ones who were brighter than me at primary school ended up in the trade training type of streams which, looking back, we can see as an indictment of racism in our education system.

Did you study at Auckland University?

I did mainly sciences in the latter part of my secondary schooling. I really enjoyed biology which, I guess, shows that I had a great teacher for that subject. My mother was keen to have a doctor in the family, so she kept feeding that idea into my mind. I just wanted to escape, grow up and earn some money. 

So I did a science degree at Auckland in the first instance and then I applied for medical school as a graduate and was accepted into the University of Otago. I did two years there, but because my father had passed away and the family was struggling a bit, I asked to return to Auckland. And I transferred and did my fourth, fifth and sixth year of medicine at Auckland where I graduated.

Let’s back up a bit. Did your father have any Māori names, too? And where did Papaarangi come from?

Dad didn’t have any Māori names. My first name is Mary-Jane, a very English name from my mother. All of us got Pākehā names. Jennifer, Susan, Prudence, me, William, John. When I was at secondary school I asked for an ancestral Māori name and got Papaarangi. That’s associated with key male leaders in our hapū but it was my great-grandmother’s surname — Neta Papaarangi. It’s a beautiful name and I love it.

What prompted you to request a Māori name?

A number of things. I suppose I was just waking up to all the issues surrounding me — race, ethnicity, Māori. It wasn’t really cultural. It was the old debate about racism and the awareness of that — and the right to occupy the Māori space. I guess that’s what prompted me at quite an early age.

I think my father was pleased but he was sort of scared for me, too, because he was of a generation who tried to protect their kids from racism.

You’re credited, among other things, with taking an Indigenous perspective into your work. That’s been a constant through your career. Was there something in particular that helped you focus on this Indigenous approach and on the disparities in health care?

Absolutely. And I’m totally grateful that I was at university at such an interesting time in Māori development and New Zealand history. I was at university when the Land March was on. I was at university when Takaparawhā (Bastion Point) was being occupied by the people of that land. I was at university when He Taua confronted the engineering students. There was the Springbok tour. And there was also the feminist movement. I was very involved in what we call the Black Women’s movement.

So I was lucky being at university at that time, even though we were pretty busy with our medical training. In the Black Women’s movement it was Ripeka Evans and Donna Awatere and Hilda Halkyard and Ngahuia Te Awekotuku and Titewhai Harawira, and a number of others who challenged us to reject the negative stereotypes about Māori. It was great to have these issues questioned and to have a bit of a space to think them through. 

I was the only Māori in my classes when I was at Auckland University. David Tipene-Leach was the year ahead and there was Wendy Walker and others the year behind. But we’d get together and discuss the inequities and question why we were being taught negative stuff about Māori.

There are still times when there’s a reason to point out something racist. But that can be turned to advantage. It can help shape the way we can speak out against it. And, horrible as it may be for the students, it can provide them practice in speaking out against injustice. Sadly, some of our best teachable moments come from bad life experiences.

There has been, I feel sure, a growth in the confidence of many Māori students in identifying racial bias in the medical world. But, of course, there’s another significant element in this issue, and that’s the attitudes of non-Māori. 

One difficulty is that people are often blinded to their own privilege so they wouldn’t have been able, for instance, to understand the anger I felt when my kids were born and I knew that they had this increased chance of early death, of a lower life expectancy and increased chance of higher mortality morbidity simply because they’re born Māori.

The research and the data became so vividly real and I became a lot more motivated when it became so very personal for me. But, still, some people can’t see the inequity. People can often see injustices in abstract form. But, when it’s a matter of them needing to do something, like changing their behaviour and their practices, half of them will give up. They’ll go and hide in a corner. Not many will be brave enough to act. And it can take a while to develop that bravery.

Over the last 30 or 40 years now, I can sense that some of your less committed colleagues, at a conference for example, have been saying: “Watch out. Here comes Papaarangi. She’s gonna hold up a mirror and we’re gonna have to look at ourselves and our attitudes.” You’ve been a constant for a long time holding up that mirror — which we should’ve been doing ourselves. Non-Māori, too. Thanks to the bravery, though, of you and others, there’s been change. More gradual than we’d like. But definitely some progress. 

Well, I’ve been blessed by having fantastic colleagues along the journey. And you may know that, for some years, I was mentored by Eru Pōmare who was an esteemed scientist and a beautiful man. And then, when he passed tragically young, the team at our research centre in the Wellington School of Medicine at that time included Vera Keefe-Ormsby and Bridget Robson who were fearless Māori women.

And one of the interesting things that we did was to assume our right to monitor the Crown and document their action and inaction. So we spent a number of years — and sadly, we’re still doing it now — applying pressure to make sure that we’re being counted properly. And responding if, as happened at the last census, they don’t measure Māori properly.

Statistics NZ failed Māori in 2018. It was entirely predictable but they didn’t listen. We need great ethnicity data in all datasets. This should be a baseline commitment — it’s Treaty business — but they’re so reluctant to commit to it.

How can Māori plan our futures and analyse our past unless we have good data — at least as good as non-Māori have? For this to happen, for us to understand what our challenges and opportunities are and what we should do in the future, we need accurate census data.

We must never stop checking on how the Crown is doing. But inequities isn’t an issue just for Māori in Aotearoa. It’s an issue worldwide, and we’ve linked up with some great academics and advocates internationally, like Sir Michael Marmot in London, and others like Professors Shaun Ewen and Maggie Walters in Australia, and Indigenous colleagues throughout the Pacific region and our Indigenous and African-American colleagues in the US and Canada.

It’s been fascinating to be part of a movement of people of colour, of Indigenous people and of social justice warriors around the world and to apply leverage internationally. We all have in mind this mythical beast of health equity and we keep trying to get people to understand the underlying determinants of health.

One of our allies is Dr Camara Jones who’s been here from the US, and her message is that Māori and other Indigenous people have different health outcomes for three reasons. 

First is that we have different access to the basic determinants of health. Less access to education, lower income, poorer housing, and so on. The second thing, she says, is that we have differential access to the health services. And the third is that we have a poorer quality of care.

And underlying these three issues is not genetics. It’s not “bad behaviour” by Māori. It is actually a belief in society that Māori are worth less and therefore deserve less. Racism.

We have to understand racism to know why our education system is not delivering as well for us, and why the criminal justice system isn’t, either — why, despite well-intentioned health practitioners, the health system provides lower quality care for Māori.

We have to understand that racism didn’t just pop up in the 1950s or the ‘60s. It came through the ideology of colonisation — a belief that you can come to somebody else’s land, declare sovereignty, confiscate land and resources, and assume that we all want, and need, western systems of law and government.

This all comes from that ideology of colonisation and it’s very difficult to get doctors, health workers, students, parents, all these people to be able to say: “Okay. What shall I do about it?” And fight back. They just go into denial.

I think you’re right on the money, Papaarangi. Now, just looking at the Covid situation, there’s been room for improvement, hasn’t there, in our Māori health experts having a say in the planning, as Treaty partners. Instead of being dictated to. We haven’t had a Māori face accompanying Ashley and Jacinda, have we?  

Well, over the past few years we have taken some strides towards telling ourselves that we’re beginning to honour the Treaty, and some of that’s real. We have more te reo Māori being spoken. We’ve got more people who want to tell us their pepeha. More people going to the marae. More students than ever before having studied the Treaty, or at least having read the Treaty, before they’ve come to university.

However, when it comes to the crunch, the Treaty commitment often disappears — zap! — and it’s back to white business as usual. What’s happening, I think, is that we’re taking on board little “skills”, such as being able to pronounce Māori names, or saying: “Kia ora.” And sometimes we’ll do a karakia. But these are decorative and performative rather than being transformative for our nation.

If they were part of a transformative, meaningful Treaty relationship this wouldn’t have happened. We would’ve had senior Māori involvement in understanding Covid risks and planning ways forward from the very start. We could’ve had senior Māori present at those press briefings. We would’ve had a consideration of equity right from the beginning. We would’ve had more Māori voices and not just as an afterthought when prompted. 

So I believe these events have shone the light on the superficiality of the progress that we seem to have been making towards becoming more bicultural — and that’s concerning because we seem to keep reverting back to Pākehātanga.

One other thing that I’d like to say about the Covid stuff is how well Māori have met the challenge. We knew what to do when the contagion appeared and we saw the danger. We’ve adapted our precious tikanga and closed our borders. We’ve been sovereign. We’ve contacted our kaumātua and organised to support as many of our vulnerable as we can. We’ve listened about staying away from health services. 

Now we need to see when it’s safe to go out again, to go to kura, and to have our check-ups for cancer and heart problems, and have our cervical smears and mammograms and make sure that our diabetes is diagnosed and under control. 

So our challenge now is to talk with each other and work out when, over the next few months, it’s safe to engage again with the health and other services.

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

© E-Tangata, 2020