Rongoā Māori tūturu is in grave danger of being lost. Not only has the environment in which rongoā Māori was traditionally passed on just about disappeared, but the natural world of the ngahere has also degenerated to the extent that it is becoming very hard for healers to access the plants they need. Public lands are off limits for unpermitted harvesting, many farms, orchards, market gardens, pine forests and roadsides are contaminated with sprays or worse, and our native plants have been displaced.
Our teachers are passing on without having anyone to pass their knowledge onto. Many Māori are uncomfortable in the Māori world due to the associated expectations we place on ourselves and others place on us simply because we are Māori. Whakamā is contributing to our deteriorating health and to the loss of matauranga Māori. The effects of colonisation have robbed many of us of confidence in the world of being Māori.
Our healers are finding it increasingly difficult to sustain their practices based on the koha system. Competition for public health funding is also tight. There quite simply is not enough money to go around and introducing another expense line to the health budget is unlikely to win favour from those hoping to minimise cuts to their own important portfolios.
Another issue is, there is little or no evidence to guide health practitioners or rongoā healers on how the combination of modern medicines and rongoā Māori (in its various forms) might impact on a patient. The use of rongoā Māori is almost always discouraged by medical health professionals in situations where doubt or knowledge gaps exist. We need to fix this.
Consumer expectations also have a role in the demise of rongoā Māori. We expect our health professionals to provide the quick fixes that modern medicines and some rongoā can offer. This is until we realise that they may only be masking a worsening problem. Only then are we prepared to start looking at the real issues and commit to healing ourselves. Like it or not we are all responsible for our own healing, not our health professionals. We cannot pay someone else to assume that responsibility for us. Modern legislation is having as profound an effect on rongoā Māori as the 1907 Tohunga Suppression Act, which saw healers withhold knowledge and destroy early rongoā writings to keep people safe and law abiding. Rongoā and Māori health is still paying the price for this today.
The Medicines Act (1981) prevents rongoā Māori practitioners from supplying traditional remedies for therapeutic purposes unless they are approved medicines. The net effect of this legislation is that most rongoā Māori practitioners are forced to operate outside the law or cease to provide remedies to their people. Health Practitioners Competency Assurance Act (2003) prevents rongoā Māori practitioners from applying some traditional manipulative techniques to restore function in patients. This is despite Māori having safely practiced these techniques for hundreds of years without complaint and much longer than those practices deemed safe under this legislation.
New Zealand National Standard for Rongoā Māori, Tikanga a Rongoā (2014) was developed by the Ministry of Health ignoring the advice of their technical expert advisors (including rongoā Māori practitioners, researchers and medical professionals). These standards have been imposed on those wishing to apply for Government contracts to fund a small number of rongoā Māori services. The standards fail to acknowledge key aspects of rongoā Māori and are more akin to a sanitised version of what rongoā Māori encompasses according to the Ministry of Health than traditional rongoā Māori practice.
The Natural Health Products Bill in its present form denies Māori the right to continue to make for sale rongoā Māori via a store front (including the internet) unless intellectual property pertaining to ingredients, method of manufacture and therapeutic application, is disclosed to the Government, some of which will be made publically available. Māori are increasingly wary of the potential for commercial exploitation of mātauranga Māori, which is not for sale.
"If rongoā is going to survive it is going to need help from Māori health care practitioners willing to walk in the rongoā Māori world alongside our healers until a new type of tohunga emerges, one who understands and values both the medical advances and our ancient wisdoms and practices."
The Bill also prohibits products sold over the counter for application to the eye. It adds cost to the delivery of rongoā Māori services, which in most cases rarely break even, pushing the practice of rongoā Māori further underground or out of business. As a result, the proposed legislation will make the production of rongoā Māori even more uneconomical for Māori. It is not yet clear what evidence supports the fact that constraining rongoā Māori practice in this way will deliver any substantial risk reduction to consumers, which is the primary objective of the Bill.
Rongoā Māori tūturu is already on the brink of extinction. These recent initiatives will undoubtedly have a significant detrimental effect on the safety and intergenerational transmission and sustainability of mātauranga Māori and equally as important, the opportunity for Māori to care for our own in a way that is more culturally appropriate. These Government edicts beg answers from the current administration to the following questions:
• Do Māori have the right to practice their healing traditions unimpeded by the cultural values of others?
• Is it appropriate that the safety and practice of rongoā Māori (based upon a Māori world view, values and tikanga), only be permitted, subject to the endorsement of another tradition and healing paradigm?
• Who should define what is rongoā Māori tūturu?
Decisions that effect Māori health and wellbeing are being made by those least impacted by the decisions.
Despite significant investment, Māori health statistics remain grim reading. It is time for a new and co-operative approach between Māori medical professionals and traditional rongoā Māori practitioners. As Māori we need to take charge of our own health and wellbeing and only we can do this.
Rongoā Māori is a largely untapped opportunity to help achieve true parity in our health statistics for all peoples.
"Modern legislation is having as profound an effect on rongoā Māori as the 1907 Tohunga Suppression Act."
To pull rongoā Māori back from the brink we need to identify current skill base and training requirements in rongoā Māori practice and facilitate opportunities to integrate modern medicine and rongoā Māori practice to enhance patient safety. This requires more research to quantify the current and potential economic value of rongoā Māori practice, as well as the opportunity cost of not growing the practice of rongoā Māori.
Rongoā healer Rob McGowan has said we all need to work hard to keep rongoā alive, but in a way that fits this very different world. Today rongoā practitioners need to have a solid knowledge of contemporary medicine. If rongoā is going to survive it is going to need help from Māori health care practitioners willing to walk in the rongoā Māori world alongside our healers until a new type of tohunga emerges, one who understands and values both the medical advances and our ancient wisdoms and practices. One who is willing to help influence health policy in a culturally appropriate way and redefine new standards of rongoā practice in a modern world. The foundation of rongoā Māori is taha wairua, a foundation that draws very much from connection to the whenua. This is something which fewer and fewer people today are able to draw on. We need leaders who can walk confidently in both worlds. We must be the change makers. We need to demonstrate to the people of this land what is so special about rongoā Māori that warrants our attention, protection and a place alongside the rapid advances we witness and value in medical science today. We need to listen to our few remaining true practitioners so that we can learn and offer choices beyond the limits of modern medicine.
We all need to advocate for greater self-determination over public health initiatives for Māori by moving the practice of rongoā Māori from a place of real crisis to one of mana motuhake with real potential to add value to the health and wellbeing for all people of Aotearoa.