A cure of pork fat and eel
As a young boy with severe breathing problems, western medicine could not help New Zealand author Witi Ihimaera. So his mother sought out a famous Maori tohunga (spiritual expert), Paraiti, the scar-faced healer who travelled on horseback between the North Island's east coast villages curing the communities' illnesses.
She steamed the young Ihimaera in a concoction of native plants, plying his throat with manuka honey. After three days she fished the phlegm from his esophagus, and, according to Ihimaera, saved his life.
She became the protagonist of his novella Medicine Woman which inspired the film White Lies, and Ihimaera's experience with Paraiti is fictionalised in the film.
Partly set and shot in the Tuhoe town of Ruatahuna, the story is of the survival of a culture and a way of life in the face of a colonial force that outlawed the practice of traditional Maori medicine with the Tohunga Suppression Act in 1907.
But rongoa Maori (traditional Maori healing) survived, initially through the underground practice of travelling healers. Today, the traditional medicinal and spiritual healing practices of Maori are still vital parts of the culture and tribal health services, often complementary to mainstream medicine.
Rongoa could also be part of the cure for failing Maori health outcomes.
Ruatahuna's current medicine woman works in a modern environment that features anatomy diagrams and eye charts. Tangiora Tawhara's practice sits above the gravel road that winds through the Urewera rainforest and cuts the small town in half. When the White Lies film crew came to town she was hired as the rongoa adviser and even snuck in a cameo appearance.
Outside the clinic are karamuramu and kokomuka trees, in the nearby bush are mamaku and kopakopa plants. Tawhara uses the leaves to treat kidney problems, eczema and boils.
"Those are the trees that are plentiful here and those are the trees we use. You just boil it until it is soft. For a cream we use beeswax, milk, cream, pork fat," she said.
"Our kuia swear by pork fat. They use it as a base to mix everything up. We have been experimenting a bit so we add a bit of lavender. It's to disguise the smell of the pork fat."
In a back shed, herbal medicines are bottled in old wine bottles and stored in beer crates, ready to be added to a bath to help skin problems.
Like a disproportionate number of Maori, Tawhara is a diabetic. She has managed to reduce her insulin dose by drinking water boiled with the leaves of karamuramu .
The clinic is busy seven days a week, with Monday and Tuesday reserved for mirimiri sessions (traditional massage) for the older folk.
"Especially the younger generation now, they really want to learn about rongoa and how they can fix their children. It is something that needs to be shared. Otherwise who else is going to carry on the tradition," Tawhara said.
Anecdotal evidence on the success of traditional Maori medicine is common, but without research to show the techniques are producing successful outcomes, rongoa has struggled to receive mainstream credibility and funding.
In February Winston Peters criticised the $1.9 million taxpayer funding of the traditional healing because it could not show measurable benefits for patients.
"It is a recurring challenge around what value are they getting for funding traditional healing services," said Maui Hudson, deputy director at Waikato University's Te Kotahi Research Institute. In a report released last year, Hudson was part of a team that for the first time tried to measure the health outcomes rongoa Maori had for patients, to help the practice gain support and resources.
Operating in the shell of a converted church, Te Tapenakara o te Iwi clinic is one of four rongoa practices trying to measure the success of their services as part of the report's research. Forty minutes south of Whakatane, in the tiny town of Waiohau, Rita Tupe heads a whanau staff of nine traditional healers where her father once led the congregation.
From a long line of tohunga, Tupe was about 25 when she was identified as a spiritual healer. She spent two years training in the skills of rongoa Maori.
She opened the clinic in 1990 and for 15 years it served the community without any funding. Now they get about $100,000 of the $1.9m of annual Ministry of Health money for rongoa Maori. Tupe's clinic is only funded for the mental health support it provides.
The clinic has more than 500 patients who travel from throughout Bay of Plenty. They have also had visitors from overseas, looking for alternatives to western medicine.
"We've had people from Germany, Tahiti, Hawaii, Japanese and Pakeha," Tupe said.
The services are free but the clients will often leave a koha (gift), either a cash donation or food.
As part of the research pilot the healers have started to record the patients' health outcomes in a "wellness framework" chart.
"We trying to work with the healers to identify what outcomes they were looking for when they worked with patients," Hudson said.
By recording the benefits rongoa provides, Hudson hopes to increase the resources and funding available to traditional healing clinics.
"But to do that they will need research to support all of the evidence that they have already collected," Hudson said.
The ministry does not fund any plant-based healing because it "felt there would be too much kick back from the pharmaceutical industry", Associate Minister of Health Taraiana Turia said.
But rongoa was not just about treating illness, it was about physical, spiritual and cultural health, she said.
"It is a body of knowledge that is about enhancing your overall wellbeing. It's what you eat. It's whether you exercise, it's not only about taking some medicinal plant to make you well," Turia said.
Western doctors already recognise the benefits the traditional healers bring to the community. Whakatane GP Dr Mike Warren collaborates closely with Tupe and her clinic, and patients are referred in both directions. Treatment often ends up being a combination of rongoa and mainstream medicine.
Warren was born in Zimbabwe and worked in South Africa where he saw traditional medicine function with western medicine. New Zealand mainstream practice must be more open minded to the benefits of using rongoa to engage Maori in health services, he said.
"The problem with modern medicine is we tend to say, ‘you will do this whether you like it or not'. We do have to accept the cultural aspect behind these sorts of things which has been neglected in a lot of first world medicine," Warren said.
Rongoa healers continue to struggle to get general acceptance for their practices. This is reflected in the limited parts of rongoa funded by the Ministry of Health.
"The things that people probably struggle with a little bit is the spiritual elements. A bit of skepticism arises," said Hudson, who compared the spiritual healing with the work of a chaplain in a hospital, who helps patients find comfort and peace while dealing with an illness.
Tupe says her work goes deeper and the connection with the spirit is part of the body's overall health. On arrival, a patient's wairua (spirit) is assessed and the psychological causes for their ailment measured and connected to their lifestyle choices.
Spiritual and physical health are treated holistically and simultaneously by rongoa. Any physical ailment was connected to the wairua, Tupe said.
"We can feel things around us, and feel things that are not right on that person's tinanga [body]," Tupe said. "In the Pakeha setup you go to your doctor to tell them what is wrong with you. If you come here we will tell you what is wrong with you."
The Waiohau clinic functions like a community meeting house. Nine kuia show up in the late morning for their monthly mirimiri. During the massage, one of the healers identified her patient's diabetes by small white spots on the soles of her feet.
Cousins and uncles come and go. Food arrives, stews and sandwiches, and the table's health concerns are openly discussed over lunch.
For Maori there is a cultural fit, a familiarity with the values that are inherent in rongoa's practices that make it easier and more comfortable for them to engage with.
There are fewer barriers than western healthcare, the treatment is much less expensive and offers extended time with a practitioner.
"Being able to provide a variety of options and entry points to the health system, and into an integrated health system is really important," Hudson said.
Health outcomes are dictated by larger socio-economic and cultural factors, not merely healthcare. Traditional healing and its potential to function within the health system is an opportunity for Maori to continue to take elements of autonomy over the health of their population and culture.
"It is important to preserve the traditional practice of traditional medicine and traditional healing as an integral part of the culture. If they are able to work in with the health system and health services it is more likely to be retained and developed," Hudson said.
White Lies is a celebration of this persistence of the Maori culture despite attempts at its destruction.
"It is about people trying to survive through the maintenance of their practices. Had it not been for the guardians of that language, that rongoa, then we wouldn't be where we are today," Ihimaera said.
He continues to look to rongoa when western medicine doesn't provide a solution.
He prescribes manuka honey as the best thing to use for a sore gut. He uses harakiki and kauri gum to treat burns. And he hasn't had dandruff since he used wood charcoals.
"My grandmother used to pour eel oil into my ear for ear aches. Lately I have been using a concoction that the chemist gave me, but I think when I go back home I will ask my sisters to get some eel oil," he said.
- © Fairfax NZ News
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