New Zealand is still falling well short of providing a fair share of health services for Māori. There are any number of reasons for that, but among them is the long-term shortage of health professionals with the background and training to serve Māori communities well. It’s the same for Pasifika. There is progress but the percentage of Māori doctors, for instance, is still less than 4 percent — and for Pasifika it’s not quite 2 percent.
That wouldn’t be such a problem if we could count on the other 90 plus percent (either New Zealand or overseas trained) to be competent culturally as well as clinically.
There’s significant progress, however, and that includes more and more Māori and Pasifika voices being heard and being influential.
One of those voices is from a Coastie, Suzanne Pitama, who’s the first Māori woman to become the dean of a medical school. She’s in charge of Otago University’s Christchurch med school — and here she is talking with Dale.
Kia ora, Suzanne. Let’s start this kōrero with your names and whānau connections, please.
I was named Suzanne after my mum’s best friend. They were pregnant together, but she lost her baby. Naming me after her best friend was a bit of healing for my aunty, because she and Mum were supposed to be having newborns together. I think of my name as representing love and connection between two women.
My second name is Georgina, after Mum’s sister, who was an active co-parent and nurse at the hospital when I was born. My maiden name, Meihana, designates my whānau, who come from around the Nūhaka area. We also whakapapa to Ngāti Whare and Ngāti Manawa, inland, but I’m definitely a Coastie.
How many in your family, Suzanne?
Well, there’s me and my brother, and we grew up in between Nūhaka and Wairoa. My dad worked at the freezing works. My mum and dad ran a social welfare home. We spent our time floating between Nūhaka, where all Dad’s family lived, and Wairoa, which was where work and school were.
Did you welcome having other kids staying with you?
It was just normal. If it wasn’t foster children, it was the cousins. I think my parents raised more than 350 children over the years that they fostered, and that doesn’t include short and long-term stays of cousins who came in and out of the home. It was a fun place to grow up, because there were always heaps of kids to play with, always games and activities.
It also made me grateful to have two parents and a stable home, because lots of the kids who came in and out of our home didn’t have that advantage. For the time that they were with us, it was nice for them to have three meals a day and be part of our whānau. When Dad passed away almost five years ago, many of those children came to the tangi. They were right up there with us.
That’s a wonderful gesture, to open your arms to those in need, and then, in adulthood, to have them still hold your folks in such high regard. It must have been quite moving for you.
It really was. With the Royal Commission of Inquiry into Abuse in State Care, there’s so many bad stories that have come out of foster care. I think that the environment that my parents created was probably different from the norm, and the response of those children 30 or 40 years after they were in Mum and Dad’s care speaks to the aroha and manaakitanga that always existed at home.
I think that was an extension of my paternal grandparents because their home was similar. Not with foster kids but being raised to care for people. Those values keep going. And although fostering hasn’t been my experience as a parent, the values I took from that upbringing explains why my brother and I ended up in mental health. It’s because we saw it as a need in our community as we were being raised.
What’s your brother’s name, and what does he do now?
He’s Denal Meihana, and he’s a qualified social worker who specialises in alcohol and drug counselling. But he has worked in lots of different places including Waipareira Trust, Hawke’s Bay District Health Board, Civil Defence and now in Fire and Emergency. Different environments, but similar kaupapa of manaakitanga.
After high school, you went to Auckland to study psychology. What was it that drew you into that field of study?
A careers guidance counsellor at school helped me enrol. She’d done a degree in psychology and thought that I’d like it. So I did my first degree in psychology and Māori studies and, to be honest, when you’re 18 you don’t really know what you’re getting yourself in for.
But when I started studying psychology, it just seemed to fit, and I didn’t find it too difficult. And there was a big call for Māori health professionals, and that was a way I felt I could give back to my own.
It’s hard to separate psychology from history when it comes to the psychological challenges that our people face. Do you think it’s necessary to have an appreciation of the historical context and the ongoing effects of colonisation? You did Māori studies and psychology. Were there ways that the two were woven together?
I think my journey was highly informed by doing Māori studies alongside psychology. It allowed me to understand how to decolonise the psych curriculum as I was moving through it. That was in the time when Ranginui Walker taught “Introduction to Māori society”.
I also had Pat Hohepa, and Wairete Norman took us for te reo. Now, as an older person, I realise what taonga they were. Back then, I didn’t appreciate the academic excellence that I was in the presence of at the time.
For decades, Māori had argued for some space at the University of Auckland, and the year after I enrolled, Waipapa Marae was completed and the Māori Studies department building had officially opened. That stood me in good stead to be learning about colonisation and Te Tiriti. It balanced the colonial education in the psychology department at the time.
You went to Massey for postgrad studies. Mason Durie and the Tapa Whā model looms large over the campus at Massey, doesn’t it?
It does. His legacy is in the work that I’ve done. I was at Massey almost incidentally, because I was employed at the time by what used to be Specialist Education Services.
I hadn’t been keen to become an educational psychologist. But they offered me a job and paid for the training — and the best training at that time was at Massey, so they put me through. It was a working scheme, which was really helpful, because I was pretty poor after my first two degrees.
Hare, my husband, was finishing his training as a mechanical engineer, and for a young Māori woman with a baby, Specialist Educational Services was an amazingly supportive environment. Having a Māori academic like Mason Durie, who was a health professional, was a real strength, and helped with moving from theory into practice. Having the space at Massey to think about a culturally safe way to practise as a Māori clinician was pretty cool.
What does Hare do?
Although he trained as an engineer, he now works for New Zealand Trade and Enterprise, assisting Māori businesses export their products overseas. So, absolutely nothing to do with health.
Hare is named after his granddad. His whakapapa is bound here in Ōtautahi and throughout the Banks Peninsula. And that’s why we moved here 21 years ago. That’s how a Nūhaka girl ended up in Te Waipounamu.
Your PhD looked at the Indigenous health focus at medical schools. That’s an interesting kaupapa to raise. What did you learn in your research?
To become a registered psychologist takes eight years of study. During all that time, we had about two hours of hauora Māori teaching, and yet Mason Durie says mental health is the biggest epidemic affecting Māori, and a lot of that has to do with the impacts of colonisation and ongoing racism.
When I came to work at the medical school and looked into their curriculum, I saw the same pattern. I found myself thinking: “Are we really going to produce another generation of health professionals who aren’t trained to be responsive to Māori communities?”
The opportunity I’ve had at the University of Otago in Christchurch is to think about what curriculum would have better prepared us to meet the needs of our communities — and to create a curriculum so that all our graduates (not just our Māori graduates) are able to be responsive to Māori communities and see themselves as stakeholders.
I’ve come to realise that, just as the history curriculum in our schools has reflected a colonial agenda but can be changed and decolonised, so too can the health training curriculum become a method to advocate for Māori health equity.
I once interviewed Papaarangi Reid, and she said she felt sometimes, as she walked into the room, some of the more established academics would roll their eyes as if to say: “Oh, here comes Papaarangi.” I wonder if you’ve experienced any “Here comes Suzanne” moments. And is that changing?
I’m not gonna lie. There’ve been some bumpy spots along the road. Racism is well embedded in tertiary education and it’s well embedded in the health system, but also in our community — and that influences political parties and influences the media.
One of my colleagues, Jo Baxter, was just interviewed on Q + A by Jack Tame. Great interview. She’s so articulate, but my gosh, our whole team almost needed a debrief about the level of racist reaction on social media to our affirmative action for recruitment of doctors in Aotearoa.
It’s taken a long time to educate and to work alongside colleagues and to prove that there’s a huge benefit in producing hauora Māori competent clinicians. So yes, I’ve had lots of eye rolls. But the tide is shifting and now we have more allies than foes within the workplace.
And people are impressed by our graduates, Māori and non-Māori, because they are culturally responsive. But we’ve had to do the hard yards to produce evidence that what we’re doing is right.
It’s been an interesting ride. Does everyone clap their hands when I walk into a room? No. But I’m here to advocate for Māori health, and that means you sometimes make friends and sometimes you don’t.
You’re comfortable with being an academic agitator?
That’s a strong word. I think I’m more of an advocate than an agitator. I’m a psychologist at heart. So it’s about trying to understand where people are, where you want to get them to, and what information or approaches you need to make that happen.
It’s a question of how we can take our institution to a place where we can create cultural safety for Māori staff to be retained within our universities.
But, if we (Māori health academics) really want to make a difference, we have to leave a legacy of cultural safety behind us, so that the young Māori health professionals who are coming up behind us can see themselves in our position in 10 to 20 years — and see themselves as having a right to be in these spaces.
If there aren’t more Māori deans in the future, we wouldn’t have achieved the goals that we’re setting out to achieve.
Well, we have one in yourself. You’re the first wahine to be a dean of a med school. Does that suggest that we might be witnessing, albeit slowly, some sort of cultural revolution in academia?
To become dean, I needed a lot of support from my colleagues. It’s an interesting job to get, because you have to have a groundswell of support. In this instance, my peers were ready and excited about Māori leadership. I think that’s an indication of change.
Something I reflect on is that Maui Pomare and James Carroll could walk into university because there was a structure to support them while at Te Aute. Then that structure fell over, and we had decades pass before we were again seeing Māori graduate in numbers at university.
True, there’s been a groundswell of support now to enable me to take up this position, but what I am concerned about is for people to say: “Okay, that’s enough Māori leadership for now. Let’s go back to what we’re used to.”
For me the question is this: “What do we have to do to keep the structure supporting other Māori leaders to step forward?”
So we’re trying to build capacity within our organisation.
Māori academics are pretty exhausted because they’re trying to do their own work as well as support the institution to become more culturally responsive. So we’ve got a lot of work to do to try and keep up the traction.
And I don’t think that work has slowed down because I’ve become dean. In some ways, it’s sped up because we’re saying: “Well, if we can be dean, can we be a pro vice-chancellor? Can we be a deputy vice-chancellor? Can we be a vice-chancellor?”
So I’ve been a bit nervous that everyone’s attitude is: “Oh, yay, we’ve got a Māori dean, we’re all sorted.” But that’s not our perspective. There’s still heaps of work to do.
At the moment in Otago University, we’ve got amazing leaders, but it’s not embedded in the institution. David Murdoch, our new vice-chancellor, is very focused on Te Tiriti-based responses and Māori leadership. He has the right personality and the right qualities for us to flourish. But the challenge ahead for him and us is to create an institution that still allows Māori to flourish when we all move on.
We want it to be normal that Māori success happens because of the policies and procedures that are in place within our universities, not in spite of them.
Racism has existed for centuries throughout academia. It doesn’t take much to see the inequities. Now that there’s a changing of the guard, there’s a predictable backlash. But would you say the redneck days are numbered?
Yeah, and they’d be numbered quicker if social media comments were turned off. You know, there’s still a huge cultural tax on Māori academics. When we’re presenting good research and evidence about Māori health equity, there’s still a reaction from rednecks who feel that everyone should listen to their opinion, even though it’s not evidence-based.
They’re a small group, but they’re loud, and with the recent pandemic, there’s been a further radicalisation of that group. What I’m nervous about, next year being an election year, is how much space the media will give to the radicalised redneck minority. And how that often can frighten the middle ground of Aotearoa which has been supporting positive changes.
You’ve been acknowledged for your mahi with a prime minister’s award and an award for building relationships. What do you consider has been your most important achievement?
In terms of professional life, if I was signposting what success looks like to me as a Māori academic, it’s that I have an amazing community of practice of Māori academics. And I’ve had the privilege of supervising Māori masters and PhD students, and been able to mentor Māori psychologists and medical students specifically. My grandfather and my father wouldn’t have imagined that I’d be able to have this many Māori in my community of practice.
I think about one of my students. She came and worked for me as a research assistant. She went on and did her bachelor’s degree. I supervised her master’s, and she became a health professional. I then was able to supervise her PhD. And now she has the job that I stepped out of to take this role as dean.
The other day, I was teaching alongside one of my former medical students from a small rural town, and now she’s a consultant, and she and I were co-teaching other doctors. And you can start to see that when you leave the room, it will be full of others who’ll be able to keep carrying that forward. That is the most amazing feeling.
Stepping away from your professional life for a moment, what you do with your time off that gives you joy and gears you up for Monday morning?
Time with whānau. I have a lot of nieces and nephews. I don’t get to be with them all the time, but seeing the next generation come up and normalise tertiary education and normalise the place of Māori in Aotearoa, and having the privilege of them being able to enjoy te reo. It’s the harakeke analogy of seeing these young shoots come out and grow up and now have their children. That brings me to one of my greatest joys, and a source of immediate self-care.
I’m also grateful to live alongside my husband’s whānau in Te Waipounamu. It’s just such a beautiful place. With the hills and the beach right here, and peer and whānau support. Whenua, whānau and laughter — my happy place.
(This interview has been edited for length and clarity.)
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