Empowering whānau with wellbeing

By Tāwhaki Simons – Kaiārahi Hōtaka, Cancer Society (Nelson and Motueka)

In October, Te Piki Oranga collaborated with the Cancer Society to host a whānau wellbeing day in Ōmaio (Stoke). Here is Tāwhaki Simons’ pakiwaitara:

Tāne Matua, Tāne-nui-a-Rangi, Tāne Whakapiripiri, whakarongo mai, whakarongo mai

Nāu i wehe ngā mātua, nāu ko te rā, nāu ko te pō Nāu i whakairi te whānau mārama, nāu ko te awatea Nāu i tiki atu ngā mātauranga, nāu ko te wānanga Nāu i pupuhi te hauora, nāu ko te tangata

Nāu ahau, nāu ahau Tīhei Mauri Ora!

The kaupapa of this day was to empower whānau by providing them with the opportunity to whakarongo, kōrero and connect around their hauora.

Kaumātua, rangatahi and tamariki, tāne and wāhine were offered information about services and support. A fun icebreaker quiz incorporated serious and relevant messaging about prevention, and giveaways also reinforced positive health messages.

Noi Burgess, Kaituhituhi Matepukupuku, spoke about the cancer support services offered by Te Piki Oranga. The highlight of the day was rangatira Te Ururoa Flavell’s kōrero about his haerenga with prostate cancer – his passion for life was inspiring to all in attendance.

Te Ururoa spoke engagingly about the emotional rollercoaster of receiving a cancer diagnosis, going through treatment and his willingness to throw everything at his illness for the sake of his whānau.

He passionately implored tāne to be proactive with their hauora and have regular check-ups. “It’s about relationships,” Te Ururoa emphasised. “When we’re not well, it impacts the whole whānau!”

The feedback from whānau was very positive:

• “It was good to talk to another tāne with the same cancer”

• “We need more of these sorts of events to keep people talking and thinking about their health for their whānau’s sake”

• “The manaakitanga and kai were amazing”

• “I actually only came for a kai with my whānau but ended up taking away some things to think about”

One tāne told me a few days later that his wife had insisted on him getting a prostate specific antigen test after listening to Te Ururoa’s kōrero.

Photos above: Kaimahi and whānau in attendance

Te Ururoa Flavell gave inspirational cancer kōrero

Self-expression through mahi toi

By Karena Martin - Pūkenga Manaaki (Mental Health)

For Mental Health Awareness Week in September, CARE Marlborough hosted an exhibition of mahi toi (artwork) made by its members – one of whom is Te Piki Oranga whānau Hinekura Omapii. Here is Karena’s pakiwaitara:

Hinekura has found art an excellent way to express herself. She says that creating her mixed-media piece, ‘Tapu Pounamu Taonga’, using clay and harakeke helped her “process grief in a healthy, gentle way”.

This was the first public exhibition that Hinekura has taken part in, and she now has the confidence to further extend her abilities.

Hinekura returned here from the North Island after about 14 years. She was previously my client and she remembered me and re-engaged once reinstated at Witherlea House in 2023.

Hinekura found out about CARE Marlborough via Witherlea House and joined not long after she came to Blenheim. She is a ‘joiner’ and likes to learn new skills.

Hinekura is involved with a few services locally and appreciates the kindness and mahi done on her behalf. In turn, we enjoy her company, independence and the hard work she does to achieve her goals.

Photo captions: Hinekua Omapii with her mahi toi ‘Tapu Pounamu Taonga’, made of clay and harakeke.

Te Puāwai he Kākano - a new era in maternity and early years services

By Cathleen Walker, Pūkenga Kaiwhakahaere Te Puāwai he Kākano

“Poipoia te kākano, kia puāwai
- Nurture the seed and it will blossom
”

This year, Te Piki Oranga was awarded a major new contract to provide maternity and early years services. Te Puāwai he Kākano is currently available to whānau in Whakatū / Nelson, described here by Cathleen Walker:

Te Puāwai he Kākano was created by integrating existing services and weaving through a new model of care where we engage with whānau throughout their journey into parenthood and for their child’s first 2,000 days.

Critically, our service is grounded in Te Ao Māori. Our multi-disciplinary teams offer culturally responsive care – from preconception to conception, from antenatal to postnatal support. By building relationships with midwives and lead maternity carers (LMCs), we can enrol whānau, and start to support them, early in their pregnancy. We offer:

• Wānanga Hapūtanga

•  Tamariki Ora Well Child services  Lactation consultancy

•  In-home immunisation

•  Te Hā Aukati Kaipaipa (smokefree support)

•  Social work and pūkenga manaaki navigation  

• Gestational diabetes services

Cathleen Walker

Wānanga Hapūtanga – kaupapa Māori antenatal classes

An exciting new option for expectant whānau, our wānanga provide māmā and pāpā or support partner with a blend of knowledge about contemporary and traditional Māori birthing practices.

Wānanga Hapūtanga are led by our antenatal educators, experienced midwives, nurses and whānau navigators.

We create a safe and intimate space for whānau to learn and explore the processes of birthing and parenting practice, with a focus on the early days.

Whānau get to meet the amazing kaimahi available to support their parenting journey, from hapūtanga until their tamariki is five years old.

We are fortunate to have a team of wonderful kairaranga who attend our wānanga to share their expertise and mātauranga by teaching whānau to create their own muka-aho tāngaengae, ties made from harakeke to tie off the umbilical cord of pēpi.

Elevating antenatal options for whānau Māori with wānanga for midwives and LMCs.

Through Te Puāwai he Kākano, Te Piki Oranga can also support the professional development of midwives and lead maternity carers (LMCs) in the Whakatū rohe.

Just as our Wānanga Hapūtanga are a safe and intimate space for whānau to learn and explore, our Wānanga Muka-aho Tāngaengae are a nurturing space for midwives and LMCs to learn the tradition of muka-aho tāngaengae (ties made from harakeke), and how to use them to tie off the umbilical cord between pēpi and māmā.

The first Tāngaengae Wānanga this year was a significant event – the first of its type for Whakatū.

As more whānau choose to make muka-aho tāngaengae part of their birth plans, the knowledge these wānanga provide midwives and LMCs means that these amazing healthcare professionals can then correctly awhi whānau to make it happen.

Meri Kirihimete and useful contacts over our closure period

Kia ora e te whānau, this Thursday (19.12.2024) will be our last day of mahi for a couple of weeks. We are closed from Friday 20th December 2024 through till Sunday 5th January 2025, re-opening on Monday 6th January 2025.

Below are some useful conatcts and links should you need them.

• Community Pharmacy opening hours, services etc. Pharmacy • Nelson Marlborough • Healthpoint 

• GPs /Accident & Urgent Medical Care GPs / Accident & Urgent Medical Care • Nelson Marlborough • Healthpoint

• Immunisation providers Immunisation • Nelson Marlborough • Healthpoint
  

For up-to-date local heathcare provider information visit HealthPoint www.healthpoint.co.nz 

There are various ways to search for information on the site: key search terms, tick or drop boxes, geographical location, or by "open now".

Caring for whānau with cancer

Te Piki Oranga Cancer Care Service is here to awhi whānau as they navigate the complexities of cancer care.

We provide:

• Health education for whānau

• Cancer screening support

• Support with transport and kai

• Support to access services

• Support for GP and specialist appointments

• Telehealth, mobile clinics, and outreach immunisations

Our experienced team also build relationships with existing cancer-specific and support services within Te Tauihu to influence and help ensure equitable outcomes for Māori are being met.

We are proud to work alongside kaimahi from Health New Zealand / Te Whatu Ora, Manu Ora, the Cancer Society, Victory Community Centre, Nelson Bays Primary Health, Marlborough Primary Health and others to awhi whānau through diagnosis and treatment.

Introducing Noi Burgess

Kaituitui Matepukpuku / Cancer Care Co-ordinator

Ko Aoraki te maunga

Ko Te Ara-a-Kiwa te moana

Ko Takitimu te waka

Ko Kāi Tahu, Waitaha, Kāti Māmoe ngā iwi

Ko Murihuki te whenua

I te taha o tōku whaea Anaha Peterson

Ko Tarawera te maunga

Ko Te Puarenga te puna

Ko Te Arawa te waka

Ko Te Arawa te iwi

Ko Tūhourangi/Ngāti Wāhiao te hapu

Ko Te Pakira te marae ki te wahi o Whakarewarewa ki Rotorua

I te taha o tōku matua Hotene Haira

Ko Noi Burgess ahau

Heartland Services are here for rural whānau

Te Piki Oranga and Waikawa Marae are delighted to offer a new service to whānau living in rural and remote parts of Marlborough – Waikawa, Waitohi / Picton and Tōtaranui / Marlborough Sounds.

Te Piki Oranga is a leading provider of health and wellbeing services for Māori whānau in the Top of the South. With Waikawa Marae, the two organisations are now providing Heartland Services – for people in rural and remote regions of Marlborough.

Ricky Carr is Pūkenga Kaiwhakahaere (Site Manager) for the Te Piki Oranga services in Wairau. He says that Heartland Services will provide a much-needed presence and support for rural whānau.

“We can offer a physical location – a place to get things done in-person – as well as support on the phone or by video-conference,” Mr Carr says.

“Living, working and raising a family in rural and remote Marlborough can be challenging enough as it is. With Heartland Services we can provide access, information, support and specialist health and wellbeing services that will make life a little easier.

“Although it is early days we already have many Government and community agencies ready to run regular drop-in sessions and workshops in-person from our High Street hub in Waitohi, Picton,” Mr Carr says.

Allanah Burgess is Kaiwhakahaere (Manager) of Waikawa Marae. Ms Burgess says the decision to locate Heartland Services in Waitohi Picton township was made after first considering Waikawa Marae. By being in town, Waikawa Marae kaimahi are able to extend manaakitanga into a central location, she says.

“A lot happens on a marae, more than may be appreciated, such as our provision of health and social services like Whānau Ora that enable whānau and wider community members to thrive.

“When discussing how to make these essential new services available to whānau and others who need awhi, we decided in favour of the High Street hub from iwi-owned premises. This way we can uphold the tikanga of whakaruruhau to provide a safe, comfortable place as we do on the marae, and that happens to be in a convenient, central location for people.”

What is Heartland Services?

Heartland Services is a Ministry of Social Development initiative, with locations from Northland to Southland. Waikawa Marae and Te Piki Oranga were successful in their co-bid provide the newest Heartland Services hub, from Waitohi / Picton. The main services are:

• assistance with technology: email, printing, photocopying, scanning, phones and internet

• support with accessing government and community service forms, applications and websites

• a place to meet with government and community service staff, kanohi ki te kanohi (face to face) or via videoconferencing

Drop-in sessions and health clinics

Government and community service staff are available on specific days, including:

• Inland Revenue (IRD)

• Workbridge and Connect agencies, for jobseekers and employers

• Diabetes support group

• Cancer information group

• Community Law (kaupapa Māori)

• Justice of the Peace

• Māori Land Court

• Whānau Ora navigators (from Waikawa Marae)

• Employment support (for both employers and employees)

Appointments are needed for some sessions – see the main webpage for detail

Awhi aplenty for flood-affected whanau

Awhi aplenty for flood-affected whanau

Lorraine Staunton, Kaiwhakahaere Ratonga (Service Delivery and Operations Manager) managed Te PIki Oranga’s response during the worst of the severe weather event in Te Tauihu in late August.

Lorraine coordinated the team as they placed 1,336 calls to whānau who were evacuating or potentially affected by flooding.

Anne Hobby, Tumuaki (General Manager) checking in with whānau

The first step was to know who to call, made easier with the support of Te Whatu Ora - Health New Zealand - Nelson Marlborough data analysts who provided maps indicating the location of whānau in flooded areas.

"We were provided with lists so that we could call our whānau who were enrolled or had previously been enrolled,” Lorraine explains. “We had a team working for four days making calls, right through the weekend. We had a team in Wairau, Motueka, and Whakatū. We wanted to provide the lists by region because our people know those areas geography-wise because the questions they might get from whānau would be more common to them.

“Often whānau were being called at the time they were actually packing to evacuate so we talked through their plans and saw if they needed some support that we could offer them. For example, they’d say, ‘we’re going to our mum’s. There’s five of us, our mum’s got a little place and no food.’ We were able to have food ready for them by the time they got to their mum’s. They were just really relieved, it was one thing they didn’t have to worry about.”

Closed roads, increased traffic, and heavy rains meant that many were unable to go to pharmacies for time-sensitive, specialised medications. To combat this, Te Piki Oranga sought emergency authorisation to be able to collect medications on behalf of whānau by working with doctors and pharmacists.

To deliver medication and kai, Te Piki Oranga contacted Civil Defence and provided them with the specific needs of each whānau. If the household was in a closed-off area, kai and medication would be delivered via helicopter. However, having that initial first contact with a familiar organisation meant a lot to those who received the calls.

“A lot of it was reassurance and psycho-social support that we were able to give them over the phone. We made it clear we were coming from a health response, but we were able to connect them to the other support that they may require, like Civil Defence.”

For longer-term, less immediate kai needs, Te Piki Oranga referred whānau to the charitable organisation Te Pātaka, food banks, or other relevant service providers.

In addition to providing immediate support, the calls were a good chance for Te Piki Oranga to connect with whānau who had not been enrolled for a while and had new health needs.

Brenda McQuillan, CAMHS

“Other conversations that came out of the calls were in regards to other health worries they had. They had us on the phone already so they were able to say ‘hey, I’m really worried about my teenager,’ for example, and we were able to refer them to our CAMHS team for follow-up.

“The reconnection was really good. People were grateful for the calls – ‘oh man, you guys are cool, thank you for thinking about us.’”

In addition to directly calling whānau, Te Piki Oranga also kept in touch with the community via their social media channels during the worst of the weather event. Kairukuruku Whakapā (Communications & Telehealth Co-ordinator) Grayson Nepia stayed on through the weekend, pushing out details on hand hygiene, road closures, and boil water advisories. To these messages, Grayson added Te Reo and the friendly tone their audience is familiar with.

Lorraine says that going forward the flood response experience “added to the knowledge for our kaimahi that there will be fallout from the flood response in regards to the continued support that is needed. This morning, I sent an email out to our staff about the pharmacy closures and short staff so that they are aware of the challenges whānau will have. It’s not just the flood, it’s obviously sickness as well that’s caused changes in the community.

“Going forward we’re continuously informing our staff to be able to inform whānau they are working with about any updates or services that could be valuable and needed to provide support.

“I am really proud of our organisation for stepping up and doing what they needed to do at such short notice and between our COVID response and all of the other high-needs things that we do. I’m proud that we were able to respond the way we did. It was a great collaborative approach to supporting whānau in this time of need.”

Hari huringa tau, 100 years old!

Hari huringa tau, 100 years old!

Coralie has been participating in the TPO Noho Pakari (Sit and be Fit) programme in Wairau on a regular basis since we started. 

She is a wonderful role model to us all.  She drives herself to class, lives on her own and is a very keen gardener, growing her own vegetables.   Coralie is a humble, friendly, respectful person who engages & interacts with others easily. She smiles & laughs often and is always willing to try new things at Noho Pakari.

She has fully embraced the Māori culture -sings waiata, waiata-a-ringa, poi, rākau, tira, handweights, plus line dancing, resistance bands & all the other crazy things we do to keep our bodies moving. When we sing & boogie to the song “You’re 16, You’re Beautiful” -we remember that was only only 84 years ago for Coralie!!

Healthy kai tips – Matariki edition

By Brittani Beavis, Te Puna Kai Ora (Dietician)

With Matariki well and truly occurring, it is time for us to look towards the past and take the learnings of our tupuna to keep us healthy, fit, and well.

There are lots of coughs, colds and flus going around in Winter and we want to keep our immunity boosted as much as we can. This can involve eating our 5 veggies and 2 fruit per day, drinking lots of water, taking part in enjoyable movement for 30mins a day, and connecting with friends and whānau to support our mental wellbeing – which can positively affect our physical bodies.

Winter is a time when most of our colourful fruit and vegetables are unavailable but that doesn’t mean that we can’t get all our nutrition from other sources, including frozen and canned fruits and veg! We should look to our whetū for guidance for what kai we should be eating during this time.

• Waitī – This whetū is connected to fresh water. Flowing water is sustenance for the land, vitality for mankind, and a food basket for the people. For example: whitebait, flounder, and eels

• Waitā – This whetū is connected to the ocean and the kai gathered from it and depending on where Matariki sits in the sky influences tides and floodwaters. For example: Kaimoana, ocean fish and crabs

• Tupuānuku – This whetū is connected to kai grown in the ground, including all cultivated and uncultivated foods. When Matariki sets in the sky at dusk in May it signifies the end of harvesting season and the beginning of winter. For example: Pūhā, Pikopiko, Kūmara

• Tupuārangi – This whetū is connected to everything that grows up in the trees, including fruits, berries and particularly birds. Historically Matariki is the time of harvesting, cooking, and preserving birds who are rich in fat, as well as gathering berries.

Thinking of the whetū some dishes you might want to try to boost your immunity this winter and celebrate Matariki: Seafood chowder with frozen spinach, peas and corn, Canned tuna kumara bake with frozen veggies, steam some mussels and have them on a bed of baby spinach with some canned vegetables (such as beetroot).

Here are some recipes to try!

https://www.heartfoundation.org.nz/wellbeing/healthy-recipes/seafood-chowder

https://lovefoodhatewaste.co.nz/recipes/henrys-hearty-chicken-vegetable-soup/

Cruise into autumn with hearty, healthy kai

Are you after some inspiration for meals that won’t break the budget? You could try the Easy Choice Family Kai seasonal cookbooks from Love Food Hate Waste.

The ngahuru/autumn cookbook is out now, inspiring us to make the most of ngahuru tikotikoiere – harvest time.

The guides give you tips about seasonal shopping to save money, kai storage, cooking to give you confidence in the kitchen and how to avoid wasting food.

Recipes are nutritionally balanced, packed with healthy vegetables, beans and wholegrains. The meals are zero waste — all the ingredients you buy should be used by the end of the week, so no food goes to waste, and there are bonus recipes for leftovers.

Download the cookbooks and guides at www.lovefoodhatewaste.co.nz/easy-choice-meal-planner

Iwi immunity

Te Piki Oranga nutritionist Brittani Beavis explains how you can boost your health through kai

With COVID-19 in the community and winter on the way we need to make sure that we are as healthy as we can be, to get through.

To start with we should look at kai that can support our te taha tinana (physical health). This includes eating lots of whole foods (unprocessed foods) and ensuring we’re eating ‘all the colours of the rainbow’.

You don’t need to break the bank by purchasing a tonne of fresh fruit and vegetables – frozen, canned, and dried kai works just as well!

The main immunity-boosting vitamins and minerals we want to include in our diets are vitamin C, vitamin D, all the B vitamins and zinc. Here is the run down on these vitamins:

Vitamin C

This is the one most people know and talk about. Think oranges, kiwifruit, kumara and silverbeet. Vitamin C is super important because it helps to protect our bodies from toxins in the environment (such as pollution, sun exposure and cigarette smoke). As a bonus, it supports our skin health to keep us looking youthful!

 Vitamin D

The beautiful sun is the best place to get vitamin D and living in Te Tauihu we’re blessed to get lots of it! However, if you’re mauiui (sick), have dark skin, or spend a lot of time indoors, then it’s important to get enough vitamin D from kai instead of relying on the sun. Canned tuna and salmon, eggs, and dairy products are a great source of vitamin D, and they are relatively inexpensive. Vitamin D helps to strengthen our bones, helps to make us happy, and boosts our immune system!

 Zinc

Zinc has so many functions in our body and is important for hair growth, a healthy immune system, wound healing and even taste! It can be a little difficult to find zinc in kai, but mussels, milk, and lean steak are a good starting point! If putea is tight then wholegrain bread rolls with peanut butter provide a small amount of zinc in your diet.

 B vitamins

There are many different types of B vitamin and all of them support our immunity, as well as break down all the kai we eat! Eating a good range of kai including wholegrains (get oats), nuts, meat, fish and dark leafy vegetables will keep you topped up on B vitamins. If you’re hapū (pregnant) then folate (B9) is vital for helping pēpī to grow a strong spine and nervous system. If you are a vegan then B12 can be really difficult to include in your diet, as it comes from animal products, and supplements might be needed. 

Don’t let the flu get you this winter

Covid-19 has shown us how simple but effective steps help us stay well – hand washing, covering coughs and sneezes, staying home when we are unwell, and vaccination. It has shown how our whānau can really step up when it comes to their health and that of their whānau and community.

While our Covid-19 vaccination programme continues, we are now also looking ahead to winter and the flu season.

Many of our whānau get their flu vaccine each year and this year it is even more important as we prepare for the return of seasonal flu now that international borders are open again. While the flu virus can circulate year-round, we mostly have seasonal outbreaks in Aotearoa. Each year a different variant of the virus makes its way here from the Northern Hemisphere where it has already had the northern winter to thrive and spread.

The flu can be dangerous for kaumātua, hapū māmā, tamariki who have been unwell before with respiratory illness, and any whānau with diabetes, heart and lung conditions and other illnesses. Vaccination is free if you are in these groups, but the criteria is broader than this, so if you are worried about how the flu would affect your health this winter please get in touch.

Flu vaccines are usually available from April, and we’ll provide more information on our website, Facebook and Instagram closer to the time.

Let’s get ready for winter by protecting ourselves against debilitating flu as well as COVID-19 – and yes you can get both vaccinations at the same time

Māmā and pēpi feel at home with kaupapa Māori care

Sarai and Māreikura

Sarai Tuhua lives in Whakatū, Nelson – a long way from her family in Rotorua. When her fourth child Māreikura was born she sought out kaupapa Māori support through the Tamariki Ora service.

This was the start of her relationship with specialist nurse and lactation consultant Debbie Kotua, who became Sarai’s clinician when Māreikura was a few weeks old.

 “I wanted to have a kaupapa Māori health service looking after me and my newborn this time round,” says Sarai.

 “I don’t have much whānau here in Nelson, and I felt this was really important for me. The service Debbie provided turned out to be the best I’ve experienced. It just made me feel so comfortable even though I’m a long way from my own whānau.”

 Sarai loved the way Debbie came to her house for appointments.

 “I didn’t have to pick up my newborn and take her out to a clinic – Debbie visited me in my home which really helped.”

 Sarai had a lower milk supply than she’d experienced with her previous children. She worried that Māreikura was not gaining weight and needed reassurance that everything was OK.

 “It just was not as easy as with the other three, and I did get a bit panicky.”

 Debbie helped with close supervision and monitoring of both māmā and pēpi, and had plenty of tips and advice on breastfeeding and nutrition.

 “Debbie visited whenever I needed her, and she really went the extra mile. She was accessible by phone, even if she couldn’t get to see me.

 “She watched me feed, gave me information on different recipes to help boost my supply, and built my confidence up that everything was OK. She was very non-judgemental – I felt very comfortable when she visited me in my house.”

 Sarai said one of the biggest advantages of using a kaupapa Māori service was Debbie’s awareness of Sarai’s needs and how best to help her manage any problems.

 “Debbie was just like an auntie – in fact I think Māreikura thinks she is an auntie! She made me feel like my child was special, even though I know she has many others to look after!”

 Māreikura is now two and a half years old. Debbie is still available for the toddler’s Well Child checks and she and Sarai keep in touch by phone and text in between visits.

 “Debbie is fabulous,” says Sarai. “She’s just very good at her job!”

Whānau at the heart of Tamariki Ora

Our Ngā Pūkenga Hauora Tamariki Ora/Well Child Tamariki Ora Service is here to help māmā and pēpi thrive during those special, and crucial, years from birth to age five.

Part of the national Well Child (Plunket) programme, Tamariki Ora is just what whānau in our region need. Our specially-trained nurses offer Well Child checks, specialist lactation advice and support with breastfeeding, childhood immunisation, safe sleep and creating a smokefree environment for pēpi.

We care for māmā of all ages, talking through things like kai and nutrition, sleep, exercise, and wellbeing. And if you need it, our pukenga manaaki/counsellor is available. We can also connect other whānau members to other health and wellbeing services they may need.

Whakatū Tamariki Ora nurse and lactation consultant Debbie Kotua helps māmā with breastfeeding, advises about nutrition for milk supply and checks that pēpi is getting enough food and growing well.  

She does Well Child checks as pēpi grows but says that the health of the whole whānau is important as well.

“There are several ways we tailor things to whānau,” says Debbie.

“First there’s the cultural connection that comes through from Te Piki Oranga’s kaupapa Māori approach and vision of whānau ora and tino rangatiratanga. 

“We use te reo as much as we can, and it’s really important to me to take the time to build a rapport with māmā, tāne and whānau as they all play a role in raising their tamariki. Māmā and pēpi are at the centre but we take the Te Ao Māori view of hauora and wellbeing.”

Debbie says that the four dimensions of hauora are integral to healthy tamariki and their whānau. These are: taha wairua (spiritual health), taha hinengaro (mental health), taha tinana (physical health) and taha whānau (family health).

“We put a high value on the connections between the four dimensions within the whānau as a whole and as individuals. Because Tamariki Ora nurses have access to Te Piki Oranga’s other services, we can make referrals for other issues that come to light – it’s a wraparound service that benefits the whole whānau and leads to better outcomes for everyone.”

 Debbie has been with Te Piki Oranga for nine years, five of which as a Tamariki Ora nurse and lactation consultant. Debbie is tangata whenua from Whakatū, of Ngāti Koata, Ngāti Toa, Ngāi Tahu and Ngāti Raukawa descent. She lives with her partner and four tamariki aged between 10 and 17 years-old.

Rethinking drinking

Over the raumati break you might see our new health promotion video campaign called Te Pito Mata - calling for whānau to rethink their drinking over the Christmas holiday.

The videos ask people to consider how and when social drinking can become harmful, with the overall goal of reducing the amount of alcohol we drink.

Whakataukī (Māori proverbs) inspire and encourage whānau to consider behaviours that support their growth, to plan ahead for future generations and to consider alternatives to alcohol when facing social pressure to drink or other challenging situations.

You will see one video focusing on the risks of drinking while hāpu. The other two highlight the impact of social drinking, and its potential harm, on whānau – particularly tamariki and rangatahi.

"In the lead up to Christmas, we want to reach people's hearts and minds," says Charles Clover, Te Ata Pūao programme coordinator, who narrates two of three videos. "We want whānau to know they are all worthy of good health.

"We also want to let everyone know of the many services we have available - our navigators, doctors, programme facilitators and clinicians are here to discuss hauora options with you."

Sonia Hepi-Treanor, who narrates the third video, reminds wāhine there is no known safe level of alcohol consumption during pregnancy and encourages those who are planning to be hāpu to contact Te Piki Oranga Māori Wellness Services for advice.

Look out for the videos on Te Piki Oranga’s social media platforms, including Facebook, Twitter and on tpo.org.nz over raumati.

"Whānau can click on links and self assess before making the choice to change their behaviour and deciding to commit to a health service journey," says Charles.

Ngā Pūkenga Toitu Te Ora, a Waipiro me Tarutaru Kino (alcohol and other drug counsellors) will be available to support those who want to make changes.

Charles would like to acknowledge ‘Te Hiringa Hauora Health Promotions’ for offering this opportunity to promote alcohol reduction messages to the communities of Te Tauihu. He also acknowledges alcohol.org.nz who do an awesome job by offering freely accessible information and acting as a community/digital connector.

Te Piki Oranga helps achieve high vaccination rates among Māori

Te Piki Oranga helps achieve high vaccination rates among Māori

Māori over 65 years old hit vaccine milestone - ka pai

Te Piki Oranga COVID Response Manager Claire McKenzie says it’s reassuring that 93% of Māori aged 65+ are now fully vaccinated, given the risk to them of developing severe illness if they contract COVID-19.

"Nelson Marlborough Health has been focused on equity, and I’m sure Te Piki Oranga has contributed significantly to our region’s high overall vaccination rates," says Claire. "Koro over 65 years old living here are now just as protected as Pākeha."

Since the first Te Piki Oranga vaccination clinic in April this year, there have been more than 60 clinics. These clinics, along with those organised by Primary Health Organisations (PHOs), mean that 78% of Māori living in Te Tauihu, aged 12 and over, have now received their first dose of the COVID-19 vaccine, while 64% have received their second dose.

The Nelson Marlborough region overall has achieved a first dose vaccination rate of 90% and 83% have received their second dose.

Kaumatua can now get a booster

If you had your two vaccinations six months ago (before May 24) you can now get a booster vaccine. The COVID Response team at Te Piki Oranga are currently planning clinics to offer our kaumātua and at-risk whānau this immunity top-up. Keep an eye on our website for details.

Rangatahi - come get your shot on 18 December!

A big shout out to our rangatahi! Māori aged 25 to 34 are least likely to have received their first dose, and many are still needing to have their second dose. Also, only 39% of rangatahi aged between 12 and 24 have been fully vaccinated, although 64% have had their first dose. Let's keep going! #karawhiua

Sealord helps whānau get to healthcare appointments

Sealord helps whānau get to healthcare appointments

Te Piki Oranga understands that sometimes it’s tricky to get to appointments with healthcare providers. You might have a car but don’t always have the money to pay for petrol. Or perhaps you don’t have access to a car and need help paying bus or taxi fares. If your mobility is impaired, we know it’s even harder for you to get to appointments.

Sponsorship from Nelson-based seafood company Sealord now enables Te Piki Oranga to provide whānau, who need help travelling to and from appointments, with funds to help pay for travel.

Until now, Te Piki Oranga has not had funding to cover transport costs, and from time-to-time kaimahi have had to drive whānau to important appointments, but this takes them away from their main mahi.

"We're so grateful for the funding from Sealord," says tamariki ora nurse Amber Ford. "Not having transport has historically been such a barrier for our whānau to get to really crucial health appointments, so it's so good to have that extra koha to help. As a nurse, it really takes a lot of time to transport whānau, so having access to taxis and other sources of transport is going to make such a difference."

Sealord will contribute an amount each year for the next three years to cover transport costs for whānau in the Nelson Tasman and Marlborough regions.

Sealord CEO Doug Paulin says that the sponsorship is a natural fit for Sealord.

"Sealord is half-owned by Māori and 15 per cent of our employees are Māori," he says. "It is important to us to support our people’s whānau and their communities. Covering transport costs of whānau enrolled with Te Piki Oranga is a tangible way for us to support the health of many across Te Tauihu."

Doug says this partnership is one of Sealord’s major sponsorships for the next three years and that the company is open to considering other opportunities to provide support where they can.

For example, Sealord also donated 300 frozen hoki fillets for the vaccination BBQ we co-hosted at the Super Saturday Vaxathon at Nelson Intermediate School on 16 October.

Meet our two nurse practitioners

Meet our two nurse practitioners

Meg Robertson and Carol Whitfield are Te Piki Oranga’s two nurse practitioners, both based out of Te Piki Oranga’s offices in Bishopdale, Whakatū. They are part of a small (300-strong) but growing group of nurse practitioners now practicing around Aotearoa.

Meg is Pou Whirinaki Hinengaro, a nurse practitioner specialising in adult mental health; Carol Whitfield is a nurse practitioner who takes care of whānau members with chronic and physical health issues.

Nurse practitioners - highly qualified

Nurse practitioners are highly skilled, and have advanced education, clinical training and demonstrated competency. To qualify, they must have five years experience as a registered nurse and a Master’s degree in clinical practice. Once qualified, they have the legal authority to practice beyond the level of a registered nurse. This means they can diagnose health complaints and prescribe medications.

Visiting you in your whare or at TPO

While Meg and Carol will see people at Te Piki Oranga’s sites, they prefer to visit whānau in their own whares wherever possible, because it helps them to develop a more holistic treatment plan.

They have travelled as far as Golden Downs and Murchison, southwest of Whakatū, and to Rai Valley in the east.

However, Carol stresses that it’s up to whānau to decide where they want to meet, as they may wish to come into Te Piki Oranga and speak privately about a health concern.

Preventing something turning nasty

"My role is often about trying to prevent and manage chronic health issues; about trying to avoid something turning into a nasty, acute health condition that may require hospitalisation or worse," she says.

A lot of both Meg and Carol’s mahi is also about bridging and navigating the health system. They often accompany whānau to appointments.

"It’s about being there as a support person and ensuring the right questions get asked," adds Meg. "Whānau might not ask the hard questions because they fear being judged."

Carol explains that nurse practitioners do not replace the role of a general practitioner. "The people we work with often have multiple health concerns and I really encourage them to have a GP who is really focused on the whole of their health. We work alongside the GPs."

Working together, holistically

While Meg and Carol work independently, they will refer whānau to each other when needed.

"We treat our whānau holistically," Carol explains. "Managing an illness doesn’t come without stress. It’s about trying to identify when that stress is over and above what you would expect, or when another mental health issue hasn’t been identified or well managed in the past, and referring people them to Meg, because her strength is in that. My strength is more in physical health. But we both work across both areas."

In the mental health area, Meg says a lot of the whānau she works with are often either vastly over-treated or under-treated; many of those she supports have undiagnosed conditions.

"I do work in conjunction with their GP but often whānau have only got 15 minute GP appointments, whereas I’ll sit down with them for an hour and a half. We’ve got the time; time is a great luxury. When I first trained as a nurse practitioner, everyone was very excited about being able to prescribe medications but it’s actually a really small part of what I do. Medication is only one part of the solution, therapy is another, then good sleep, healthy eating and walking are all important."

Carol says it's about having conversations around lifestyle and optimising medications or at least talking through the medications so they understand why they’re taking them, especially when they don’t feel any better to begin with.

"Medications for diabetes or blood pressure, for example, don’t always make you feel any better. It’s not like taking a panadol for a headache. Prescribing is often about optimising treatment or reducing how many are taken."

When she’s not working, Meg loves spending time with her two children, her dog and other whānau members. She plays ultimate frisbee, enjoys swimming and running and loves cooking.

Carol lives with her husband on a walnut orchard. She enjoys cooking, sewing and other creative projects. She’s even made a pair of shoes!

Motueka Riding for the Disabled visits: ‘the highlight of our week’

Motueka Riding for the Disabled visits: ‘the highlight of our week’

We can learn many life lessons from horses; they teach us to be flexible, stay present and be bold enough to try new things. Since the beginning of term four, ponies Fudge, Toby and Koby have been leading the way at Motueka RDA for Grace and her two girls, six-year-old Nikaiah and three-year-old Allyssa.

Grace first brought Nikaiah and Allyssa to Motueka RDA at the beginning of term one this year to learn how to ride and care for horses, in therapeutic horse-riding sessions that are designed to enhance and improve physical, psychological and social abilities.

More recently, a grant from Network Tasman Trust means Grace no longer has to watch from the sidelines. She and her two girls are now one of three family groups – comprising a parent (or caregiver) and up to three children – funded to take part in weekly sessions for the whole of term four.

"It’s much more beneficial for whānau to participate together," says Tūhono Pukenga Manaaki Paula Bethwaite, who accompanies the whānau to the riding arena each week.

Grace says the Motueka RDA visits are the highlight of the whānau’s week, with ‘improved confidence’ being the biggest benefit for her whānau.

Nikaiah and three-year-old Alyssa enjoy watching their māmā have fun too.

By helping develop a stronger bond between whānau, this equine therapy programme aligns perfectly with the goals of two of Te Piki Oranga’s services: Tūhono and Tamariki Ora.

Tūhono provides a kaupapa Māori intensive, personalised programme that aims to build a strong bond and relationship between māmā (or mātua) and tamariki, developing parenting and life skills along the way, while Tamaraki Ora aims to improve and protect the health of tamariki.

In this case, the two Te Piki Oranga services provide Grace with wrap-around support, for both her, the two oldest girls and her 18-month-old pēpi.

When asked to describe her role, Paula turns to Grace, asking, "Do you think of me as an acquaintance, but someone you can ask more of than you would a friend?"

Grace nods and smiles, then puts on her helmet and mounts her pony Fudge.

Manu Ora thrilled with the response to its opening

Manu Ora thrilled with the response to its opening

"I come away from work feeling my soul is full; it’s pretty special," says Dr Sara Simmons, one of the three mātanga rata (general practitioners) working at Manu Ora, a new ‘by Māori, for Māori’ Hauora centre in Howick Road, Blenheim.

Te Piki Oranga established Manu Ora in collaboration with Simmons and fellow GP Rachel Inder, with support from the Marlborough Primary Health Organisation and Rangitāne o Wairau, and has since received funding support from other agencies including Nelson Marlborough Health.

The new practice opened on 9 August but lockdown soon followed, so it only got to celebrate its official launch with a pōwhiri on 5 October.

Manu Ora has been established to support Māori whānau with high needs, as well as other vulnerable communities.

"With more than 500 enrolments already, we’re tracking ahead of our targets," says Sara. "Of these, many either didn't have a GP or don’t have a strong relationship with a GP, and many have complex care needs. We’re thrilled to have them with us."

Manu Ora is still taking new enrolments. Sara says the practice can take up to 1,000 enrolments and can continue to support a much higher proportion of those with high needs.

"We haven’t yet actively promoted Manu Ora to these whānau," Sara adds, "It’s all been word-of-mouth. We’ve also built enrolments because Te Piki Oranga’s kaimahi have been referring people."

When a patient first signs up, they are offered an extended enrolment appointment with a nurse and a GP from the team. Following this, a coordinated management plan is developed and documented to ensure each patient’s health needs are met.

"The longer appointment times make a real difference," says Sara. "It gives us time to learn about each person’s background and home life. We can really get to know people and build a relationship and trust, which enables us to understand what other things in their life might influence their acute healthcare needs.

"We’re family-first, whānau-centred."

She also predicts Manu Ora’s other key to success will be its much higher staffing ratio (to patients). Manu Ora currently employs three GPs, three nurses and three receptionists. All nine Manu Ora kaimahi are deliberately employed on a part-time basis.

"In general, the pressures on kaimahi are so great in general practice," says Sara. "So our decision to work part-time is quite purposeful. We’re also a small enough team to be able to adapt and improve quickly."

Nationally, there is one full-time equivalent GP for every 1,700 patients. At Manu Ora, there is one full-time equivalent GP for every 1,000.

Manu Ora is also a not-for-profit organisation, which makes it quite different from other medical practices.

"We’re not a business, but a charity, focusing on providing quality care for low or no cost if people are unable to pay and enabling us to continue to attract more funding," says Sara.

Visit the Manu Ora website if you would like to enrol as a patient.