By: Jamie Morton

Dr Matire Harwood says health experts need to do research with indigenous communities rather than on them.

No one in Matire Harwood’s whanau had gone to university.

But Ngature Matenga Werekake saw something different in his 7-year-old granddaughter – and told her she’d one day be a doctor.

Four decades on, Dr Harwood’s work is helping shape indigenous health policy in New Zealand.

She still feels her grandfather guiding her each day.

“There are times when I’m worried about a decision I make, or feeling I might not be on the right track and I do get a sense that he’s watching me,” Harwood says.

“I think Papa would be immensely proud.”

Harwood, a University of Auckland clinical researcher focused on tackling some of the biggest health inequities in our society, has just been awarded this year’s L’Oreal Unesco Women in Science New Zealand Fellowship.

The $25,000 grant it came with will help her fund a research assistant to work toward turning the data she has collected into action.

Maori health has been made a priority in the Government’s new health research strategy for the next 10 years, and for clear reasons.

The latest statistics showed Maori have higher rates for most health risks and conditions – notably smoking, obesity, type 2 diabetes, heart disease and respiratory conditions.

Though cancer may be considered the biggest killer of New Zealanders, for Maori, it’s cardiovascular disease.

Maori are more than twice as likely to die from it than other populations, and 1.5 times as likely to be hospitalised for it.

But the issue isn’t unique to our country – better health has become a global priority for some 370 million indigenous peoples living in more than 70 countries, with long-term conditions proving the biggest contributor to life expectancy gaps everywhere.

Harwood’s work to date suggests indigenous-led interventions help gain better results, and she plans to review how effective these have been in tackling the big problems.

“My focus has been trying to improve health outcomes with communities, families and individuals outside of hospital,” she says.

“I’m at the point now that, while I think it’s great to collect that data, I’m more interested now in trying to address those outcomes by using evidence bases, using clinical method but also understanding people’s context and what’s actually going to help them take charge of their long term condition.”

Harwood has also had personal insight.

“My own dad had a stroke at the time I was working in a stroke unit.

“And a lot of the discourse or narrative from my clinical colleagues was that Maori do badly after stroke because the family want to take over and do everything for them. And that was not my experience.

“My experience was actually that we weren’t being offered the same level of care or quality of care in ways that would help people to do well.

“I just feel we make assumptions about what we think will work for people. And when things don’t work we tend to blame the person when actually we need to keep adapting.

“So that’s what I enjoy doing about this work. Looking at how science and systems need to change or adjust or respond to people’s needs in order for them to achieve the highest attainable health outcomes possible.”

Harwood, who is considering applying for associate professor next year, also hopes indigenous healthcare researchers globally can pool their findings and resources over the next few years.

“In the last couple of years there have been two papers on indigenous health and wellbeing and the leading authors were Australian aboriginal and a New Zealander and part of that is because they’re leading the world in terms of that data collection to ensure that indigenous health is being monitored well across the world.

“All the major medical papers picked up on that, saying it was outstanding that we’ve got this fantastic data now but I think there is a clear call for people to be addressing indigenous health leadership and nobody’s really doing that very well.

“So that’s what I hope to do – to get out there and show people it’s not that difficult, it’s not that complicated. Don’t put it in the ‘too-hard basket’.

“We need to get in and we need to bring communities on board and start doing research with them, rather than on them.”

She plans to also use her grant to advance other indigenous women in science and will help fund writing retreats for seven women she is supervising.

“I want to get them on track for their PhDs and move them forward into academic careers. So writing papers and writing research grants over the next year,” she says.

“There are so few of us and the indigenous women in health tend to be in public health positions.

“I would hope there will be indigenous women clinicians who are leading research in their own particular specialty and be proud of it.”

For herself, the fellowship is huge kudos.

“I became aware of the publicity surrounding the other women who’ve won it here in New Zealand.

“They weren’t only acknowledged for the work they were currently doing but also I saw how much they’d moved in their career since they’d had the support and recognition the award brings with it.

“So it’s an outstanding award for a woman scientist like myself to win.”

But she says Waimarie, 6, and Te Rangiura, 11, are keeping Mum humble.

“They’ll come and ask me a tricky question like ‘why’s the iPad not working’ and I won’t know … and they’ll say but Mum aren’t you supposed to be the ‘New Zealand Woman Scientist’ of the year or something.

“So I’ve got that grounding from the whanau. You’re still Mum to them, and a daughter and a sister.”

Thoughts always return, too, to the grandfather whose prophecy she’s fulfilling.

“I can hear him saying ‘you’re alright, bub’ .. because that’s what he always used to say to me, just rub me on the back and say ‘you’re alright bub’.

“So I’m sure he would be really, really proud of what we’re doing.”

Women in science

  • Established two decades ago, the L’Oreal-Unesco for Women in Science programme celebrates women researchers around the world while encouraging young women to enter the profession.
  • There has long been a noted lack of gender and ethnic diversity in science. Figures collected by the Association for Women in Science, as at 2011, showed a disproportionate number of men in senior positions at the country’s Crown research institutes and among science heads of departments across our universities. The large majority of major science prize recipients have also been men.
  • The recently-renamed Royal Society Te Aparangi – of whom just 12.5 per cent of fellows are female – has begun pushing for greater diversity among its membership.

Source: NZ Herald

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