Maori Pharmacists Association Hui a Tau
HealthTena koutou katoa Nga Kaitiaki o Te Puna Rongoa o Aotearoa.
There is a special poignancy about being here at Owhata Marae today.
One of the distinguished features of this marae, is the sacred rock called Iriirikapua – the place at which the tupuna kuia, Hinemoa, would sit, listening to Tutanekai playing his kouaua from Mokoia Island.
Today, we think of the plaintive beauty of that sound as it lingered over the waters – and we grieve as we remember the koroua, Hiwinui Heke and everything he meant to us.
My heartfelt sympathies are with Whaea Ema and the whanau in the profound loss they bear.
For this organisation, the Maori Pharmacists Association, Hiwinui holds a special place in your hearts as the first known Maori pharmacist in Aotearoa.
Hiwinui leaves a great legacy of vision, support and encouragement for pharmacists along with his commitment to improving the health of his community and Māori in particular.
I am so pleased to learn of the Hiwinui Heke scholarship that has been established for Maori students showing excellence in pharmacy study, a very fitting tribute to remind us of his great legacy.
Te hunga mate ki te hunga mate
Te hunga ora ki te hunga ora
Tena tatou katoa.
I turn now to congratulate Wiremu Matthews – a former pharmacist with Central PHO in Palmerston North, in taking up the key leadership position in your organisation as your President.
I want to also mihi to Leanne Te Karu – a young woman with the most incredible energy, relentless enthusiasm and dedicated commitment to the field of pharmacy.
It has been my absolute pleasure to meet with Leanne over the years and I pay tribute to her for the vision she demonstrated in her nine years as President.
Leanne gives so generously of her experience and expertise as a clinical pharmacist in hospitals, a community pharmacy and a primary medical centre, as well as being a researcher.
We can all be so proud that last year she was named the Pharmaceutical Society’s first Pharmacist of the Year.
Along with Hiwinui, Leanne and others formed the Maori Pharmacists Association in 2005 and from the onset, as a network, you have participated in wide-ranging activities in support of Maori pharmacists and improving the health of Maori.
So often in our busy lives we veer from crisis to crisis with little time to stop and reflect about the gains we have achieved along the way.
I hope that over these two days together, you make it a priority to share the successes, to celebrate the progress made and agree how best to consolidate the work of your association in leading the pharmacy profession in its responsiveness to Maori.
You have done so well – and I am here today, to acknowledge that.
I have been asked to speak about my thoughts on the role of pharmacists in the Whanau Ora environment and to share some ideas about your strategic directions going forward.
Whanau Ora is essentially driven by the call to empower families, enabling them to control their futures and access support where needed.
I recently announced the establishment of two Whanau Ora commissioning agencies with a third one to be announced in due course. While still in their infancy, the new commissioning agencies reflect a strong community commitment to building whanau capacity and capability so whanau can take control, set their own direction, and map out achievable goals for their future.
Many of you, especially community pharmacists, will already be immersed in Whanau Ora as part of your modus operandi.
You are engaging with whanau in your communities – from babies to elders – advising on appropriate medication, dispensing and explaining the way to use medication and generally caring about the health and wellbeing of families in your community. Some pharmacists who have prescribing rights will be working closely with whanau within a multi-disciplinary team that is in essence a ‘wrap-around’ service.
In all these ways you are doing what you can to help whanau keep themselves well. You know, better than most, that for too many of our whanau, medicines play a vital role in mitigating risk factors and treating illness, both chronic and acute.
And you also know, better than most, that often our whanau don’t receive substantive engagement from health professionals in such a way as to understand their health conditions and the place of medicines in improving outcomes. This has two important edges to it:
- The need for whanau to make informed decisions about their own health and wellbeing
- Enabling whanau to achieve independence with medicines optimisation.
By medicines optimisation I am thinking about the challenge of keeping well while also ensuring that medicines are not prescribed or repeated inappropriately leading to unnecessary exposure to a medicine.
Such practices can sometimes cause adverse side-effects – and of course that in itself can undermine confidence in medicine-taking practice by whanau.
I have personally experienced the amazing value of on-to-it pharmacists with my own pharmacist in Wellington, who consistently requires me to demonstrate that I know the purpose of the magic remedy I am picking up.
He will talk to me about the component parts of the prescription, he will discuss possible side-effects, how to take the medicine and he is not averse to challenging the merits of a particular prescription with my GP if he judges fit.
I have to admit I love that approach – he encourages me to be actively involved in the decisions around my own health – to be health literate. We all know that there are very real issues about take-up - with approximately fifty percent of patients not taking their medication as prescribed and consequently experiencing poorer health status.
A key part of the strategy must be about empowering whanau to understand the value of correctly taking medicine as prescribed – understand why compliance is necessary - making informed decisions.
But equally the system must do much better in supporting our whanau to make good decisions about their health and their lifestyle behaviours. Health professionals must be able to meet with our whanau – at marae or at home – and have an opportunity to discuss things like antibiotic use for conditions like rheumatic fever, low respiratory tract infections or skin and soft-tissue infections.
Pharmacists are in a unique position to foster improved health literacy through working face-to-face with whanau, ensuring the medicines are right for the person’s condition and that the person understands what the medicine does and how it must be used to improve their health.
A really good example of this is medication for gout, which Leanne and others drew to my attention some time ago. There was concern that Maori were not being prescribed appropriate medication such as allopurinol. I want to really commend the efforts you have made to ensure gout medication messages are understood, and that whanau are in charge of their treatment.
Those of you who are clinical pharmacists in a hospital setting or within a medical practice also have responsibility to ensure communications are health literacy enhancing.
You have a perfect opportunity to influence your colleagues on how they interact with patients or with each other. I would urge you to find and seize those opportunities to make a difference.
What we’re really talking about here is cultural competency.
I want to thank Nga Kaitiaki o Te Puna Rongoa o Aotearoa for your leadership – and the mahi involved in providing Pharmacy Council endorsed education programmes to help pharmacists meet cultural competence standards related to Maori.
Finally, it is inspiring to be amongst a group of movers and shakers who are well used to wearing many hats – you are champions for our whanau, expert communicators of vital information, scrutinizers of products, quality control assessors, mediators, counsellors, advisors.
In short there is a lot resting on you – and your strategic advice and lived experience is an absolutely vital element of the Whanau Ora approach to life.
I thank you for your on-going commitment and hard work – and wish you all well for a constructive hui a tau.
No reira, tena koutou, tena koutou, tena tatou katoa.