Journals from NURS 298 Health Care in New Zealand
2013-02-08 Maori's Marae and Their Four Walls
Front entrance doors of Rotorua Hospital representing their culture and beliefs about their ancestors
Today we had the privilege to visit with the Maori Health Division and District Health Board members at the Rotorua Hospital.
Before going on the tour of the hospital, we sat down in their boardroom for a formal greeting, meeting, and introduction. To the magnificent chant in Maori, we walked into the room: women first, then men (men are supposed to be behind the women to protect them as they walk into the meeting house). Once in the room, the men sat in front to symbolize them as the head of household. Next came a series of speeches in traditional Maori, introductions from the health board, and a prayer. The District Health Board members seem to either have direct or close Maori relatives, or are otherwise very involved in the Maori culture because they all knew a great amount about the culture, seemed to know and understand the Maori chants, and were all very devoted in improving the health of all (Maori and others). Lastly, we all stood up and performed the Hongi, a traditional Maori greeting where each person embraces, touches noses and foreheads with another once or twice to symbolize the exchange of breath, the "ha". When the individuals' foreheads touch, the two become bonded as one by their ancestral ties (Maori or not), allowing them to recognize their ancestors, who they are, where they come from, and honoring them.
The tour of the hospital just confirmed how much they respect and worship their ancestors and tribes. The grand entry (pictured) had paintings symbolizing earth, Maori, and then land (land which was Maori and then donated to the hospital to be built on). In a large waiting room were woodcarvings representing multiple tribes that are found in Rotorua and amongst their population; as well as more common tribes throughout New Zealand and Hawaiki (land from which their ancestors are thought to have come). Something that surprised me was that the carvings were not behind glass, because they believe that they should not be on display, but should be honored and touched to help those needing guidance or support while staying at the hospital or visiting those who may not be able to make it down to see them. I think that brought a lot of perspective to me on how much they focus on holistic care- a concept still being grasped and worked on in the States.
In Maori culture, they come from a "four wall" thought process in healing, where each wall is found in their Marae, their meetinghouse. The walls represent: mental and emotion wellbeing (taha hinengaro); social wellbeing (taha whanau); physical wellbeing (taha tinana); and spiritual wellbeing (taha wairua). Something that I found interesting was that the spiritual wellbeing wall is at the front of the Marae, possibly because to them that is a very important aspect of healing. Their type of holistic healing focuses on those four walls. For spiritual wellbeing, they make sure that those with a spiritual background have access to it (they are trying to introduce a spiritual assessment into their care plans and general guidelines of care- as seen in the US). Social wellbeing is very important to them, especially to the Maori, due to their larger family involvement. Many nurses stated that even if it is past visiting hours, they would usually allow for friends and family to come and visit (as long as it is healthful for the patient). Physical wellbeing is somewhat self-explanatory- they come to the hospital to get better. Many healthcare sites have mentioned that they want to decrease the length of stay because a longer stay can lead to an increased risk for infection. Finally, the mental and emotional wellbeing of the patient usually involves just checking in on them and making sure that they feel emotionally supported.
It would be very hard to incorporate a religious/cultural structure into the States' healthcare system because other religions may get offended. However, holistic care would be a valuable incorporation to the healthcare. I believe that taking the time to care for all aspects of someone's life while at the hospital would decrease their stay length, increasing their healing, and increasing their trust in the healthcare system. I, as a nurse, would love to work on my holistic approach to healthcare because I feel it would make me a better nurse, open my eyes to new cultures and beliefs, increase my relationship with my patients, and increase the knowledge of those around me by learning from my patients and other healthcare providers. One thing that I have seen in the States that has worked well, but still needs to be increased, is family-centered care (FCC). I think that will be the closest thing to holistic care as seen in New Zealand, until we can be educated more about it.