Cultural challenges in New Zealand

The Treaty of Waitangi, signed by the Crown in 1840, guarantees rights for the indigenous people of New Zealand. However, in the health sector, achieving this goal has been problematic : the acknowledged barriers which stop Maori accessing the healthcare system have resulted in a higher risk of heart disease, cot death, asthma, suicide, obesity, diabetes, etc.

Legislation and nurse training are being developed to address the barriers of potential prejudices amongst health providers.

As Crown agents, student nurses study modules on cultural safety, the Treaty of Waitangi and Maori health(1). Cultural Safety training is a transversal competence taught by all staff. Nurses’ own complex cultural and moral values are explored, and are then supported in order to be non-judgemental and flexible in their attitudes towards others and the way to take care of them. Any action which demeans or disempowers the cultural identity of an individual is proscribed(2). Cultural awareness may result in hospital planners designing rooms with sliding doors to accommodate extended family, for example. If a patient dies in hospital, a Maori Kaumatua will bless the room before the next patient can be admitted.

Previously, herbal and traditional medicines may have compromised a doctor’s prescription. Now, nurses and nurse practitioners(3) are educating in hospital, in the community and in the home, where medical compliance, hygiene and dietary practices may need to be supported.