Beginning the Journey of Becoming a Tiriti-partner: A Critical Reflection
Melville, Anton Jack
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Te Tiriti o Waitangi is a contractual agreement between Māori and the Crown promising kāwanatanga, rangatiratanga, ōritetanga and wairuatanga. Despite these promises, extensive breaches of Te Tiriti o Waitangi have occurred since its inception creating significant health inequities for Māori which continue to this day. Within the health system, the dominant biomedical model of practice prioritises Western views of health which continues to reinforce colonial systems and reduce equity for Māori. There is a critical need for healthcare practitioners to work alongside Māori, working as Tiriti-partners. This practice project aims to explore Māori experiences of health services within the literature through the lens of Te Tiriti o Waitangi and use these understandings to critically reflect on my practice and to use this knowledge to help me work as a Tiriti-partner in my physiotherapy practice. A literature search was completed exploring Māori experiences of hospital and rehabilitation services. The articles of te Tiriti o Waitangi were used as a framework for analysis. Utilising the key learnings which came from the framework analysis, a case was chosen from my practice to undergo analysis through critical reflexivity. This practice project has demonstrated how clinicians and hospital services influence the experience of Māori. These are influenced by how clinicians interact with Māori during the healthcare encounter and clinicians’ previous experiences through their training and own values or beliefs. Systemic structures also contribute to health and well-being through increasing financial and social constraints, institutional racism and bias. Through critical reflexivity, I propose ways of thinking and working that can support clinicians to reduce health disparities by creating space, prioritising, and being an equal participant in whanaungatanga, acknowledging Māori kāwanatanga and rangatiratanga, and supporting wairuatanga using te reo Māori and knowledge of tikanga. By acting in these ways, clinicians can begin to reduce inequities experienced by Māori in healthcare. However, acting in this way is just the first step in becoming a Tiriti-partner and only one of the pieces required to reduce inequities. To fully achieve pae ora, healthy futures, for Māori, we must make critical reflexivity and challenging our personal assumptions a life-long journey.