Dr Rawiri Jansen is interviewed in Ngā Korero No. 21 (May 2015) about the renewed focus of Te ORA.
Te Ohu Rata o Aotearoa (Te ORA), New Zealand’s Māori Medical Practitioners’ Association, has come into 2015 with a sharpened focus on its role within the New Zealand medical workforce to see improvements in three areas:
• greater career support for Māori medical practitioners
• greater cultural competency among providers, and as a result
• enabling New Zealand’s medical workforce to produce greater health outcomes for Māori.

We spoke with Dr Rawiri Jansen, chairperson for Te ORA, regarding its renewed focus and some of the encouraging trends and changes they are seeing across the sector. ‘I first connected with Te ORA as a medical student myself. I was already a qualified teacher but had become increasingly interested in health and set out on a second career,’ Dr Jansen explains. Dr Jansen initially combined his experience of both worlds, producing a Māori medical dictionary that provided Te Reo words for specific body parts and medical terms.

Then, as Te ORA became an incorporated society in 1996, Dr Jansen got involved as a medical student and later came on board as Chairperson for a period during the mid 2000s – a role he was recently re-elected to in December 2014.
‘The vision has always been there since the foundation of the organisation and the setting of the constitution in 1996. However, you get pulled in many different directions as an organisation,’ Dr Jansen explains.

‘We are regularly asked for opinion and input by international medical organisation’s medical colleges with a concern for indigenous health and wellbeing – especially among our Trans-Tasman peers. There’s great interest in how we are working things out in New Zealand and there’s a strong desire to learn from our experiences. We’re often not funded for this sort of work though, so balancing those demands can be challenging at times.

‘The short break at the end of the year was a great opportunity for us to reflect a little and we’ve come into 2015 with a sharper focus on what we’re here to do and the role we need to play, and the contribution we need to make in supporting the New Zealand medical workforce to achieve greater outcomes in Māori health and wellbeing.’

Te ORA focuses its activity across two roles: working directly to support their members and working to contribute to the medical workforce generally. ‘We have an even greater focus on our members than ever before,’ Dr Jansen explains. ‘We have close to 300 active members, which now includes medical students across all years and stages of study. That’s new for us and is very exciting – we are beginning to see real growth in the number of Māori choosing to pursue medical careers.

‘Last year, New Zealand graduated 67 Māori doctors from across both medical schools. Now, approximately 250 Māori medical students are working their way towards graduation across the range of medical study years. For the first time we are beginning to see population parity in our workforce; the next challenge is to address the burden of disease,’ he adds.

Despite these encouraging signs, Dr Jansen points to one area of continuing concern: ‘We are producing more Māori doctors than we have ever done before, which is fabulous. However, we are not seeing many of them going on to specialise. 'We decided to take a closer look at this issue specifically last year and expect to publish a report on the topic in the next few months,’ Dr Jansen adds.

‘Embedding evidence-based cultural competency across the medical sector is another area where we still have plenty of work to do. It has a huge impact on how accessible our services are – and that has a direct impact on how easy people find it to follow the advice and support they receive. It flows directly into improving outcomes across the board. There’s some great work under way but it’s something we really need to take seriously as a whole sector.

‘These are the two key themes that seem to matter most to our members as well; it’s what they want us to focus on,’ adds Dr Jansen. Figures published in 2011 by NZ Doctor suggest there are just over 14,000 doctors in New Zealand, with about 430 (3%) identifying as Māori. Te ORA not only plays a strong role in advocating for improved Māori health outcomes, they also provide a critical support network for their members.

‘The Royal Australasian College of Surgeons awarded funding to three of our doctors, inviting them to attend this year’s conference in Perth and offering a summer studentship to one of the students. In a similar example, other scholarships are being offered for the coming Leaders in Indigenous Medical Education conference this August,’ Dr Jansen recalls.
‘Māori doctors and medical students are in high demand for their input and expertise – we help connect them with a much wider network that introduces them to a much broader, international perspective on indigenous health. This exposure is great for their development and their perspective.

‘It helps them see that Māori health is connected to a much bigger international conversation about indigenous wellbeing, and also that Māori health is not just the business of Māori doctors – it’s the business of every medical practitioner. They can then help bring this perspective back to the organisations they end up working within. We still see a very segmented approach to Māori health in many organisations and it would be great to see that change in the coming years,’ Dr Jansen adds.

‘In our view, Māori health is an expertise – it’s a skill for organisations and individuals to grow and develop. Just because you happen to be Māori or hire someone who is Māori, or set up a Māori health team, doesn’t necessarily cut it. We’ve been privileged to meet a number of non-Māori doctors who are doing absolutely fantastic work in areas of Māori health and wellbeing. It’s in the expertise and the perspective they bring – it’s a competency we all need to develop,’ Dr Jansen explains.

Connecting new doctors and students with potential mentors, coaches, and those with other areas of expertise and experience is an important part of what Te ORA does. Its membership includes a number of obstetricians and gynaecologist fellows, general practitioner fellows, public health physicians, surgeons and other specialised doctors. There’s plenty of support available for those who want it.

When asked about the future, Dr Jansen hopes to see Te ORA’s membership continue to grow and to see the organisation develop further capacity and ability to respond to the increasing demands for input and advice across the sector. Ultimately though, it’s about seeing our medical workforce more effectively supported to address the increasing challenges we all face in reducing inequalities in health outcomes across New Zealand’s indigenous population.

‘We are particularly looking forward to hosting the Pacific Rim Indigenous Doctors Conference in Auckland next year [2016]. It’s a great opportunity to showcase indigeneity across the spectrum and share ideas and experiences with our indigenous brothers and sisters, as well as various organisations and agencies that have a close bearing on the opportunities and outcomes available to New Zealand individuals, whānau and communities.’