Monday, January 23, 2006

An unhealthy disregard for rongoa

In 1999, after several years of discussion and debate, the Ministry of Health and Nga Ringa Whakahaere o Te Iwi Maori developed and published national standards for traditional Maori healing practice.

The work was in response to a 1995 recommendation to the minister of health by the National Advisory Committee on Core Health and Disability Services that: "Regional Health Authorities purchase aspects of Maori traditional healing, to be provided in conjunction with other primary health services, where there is reason to believe this will improve access to effective services for Maori and lead to better health outcomes."

Today's National Party has no room for more effective services for Maori, if they choose not to accept Pakeha cultural models of health delivery.

A Sunday Star Times hack job on rongoa claimed "the government spends more than a million dollars a year on traditional Maori therapies - and has no proof that they work."

Other alternative therapies, such as homeopathy and naturopathy, receive no public money, it says. Maybe, but the government will shell out for other therapies like chiropracty - maybe that's the test. When there is state funding, it is no longer "alternative".

Reporter Greg Meylan's authority that the therapies don't work? New Zealand Skeptics chairwoman Vicki Hyde, who on one hand admits studies had shown some of the traditional herbal remedies used plants containing active ingredients, and in the next breath "questioned whether public money should be spent on therapies which were probably effective only because of the placebo effect".

So what are they: active compounds or placebos? Are the Skeptics saying health is a chemistry experiment? That is a drug company line, not one the medical establishment would accept any longer.

Not to worry though, National's health spokesman Tony Ryall has the cure.

"There's nothing wrong with alternative therapies but the taxpayer shouldn't be expected to foot the bill," Ryall said.

He said his party worked on the principle that medicine should be proven and that policies should be colour-blind.

Actually, his party brought in this funding, obviously convinced the treatments helped some people.

It took years of study and debate to win acceptance in professional and policymaking circles that medicine was not colour blind, and culture influences health. Politicians pandering to prejudice and shallow reporting could roll back those hard won gains.

As for the costs, $1.3 million a year among 12 Maori health providers - a pittance in the wider scheme of health spending. A major hospital probably spends that every year on latex gloves.

3 Comments:

Blogger Sarge said...

I'll bite.
There are many medical interventions that are proven to work that do not receive funding. Without such evidence based medecine, rongoa is just quackery.

Now, if you really wanted to get traction, you'd put rongoa treatments through a double blind test, publish the results in a peer-reviewed journal and then we'd know if they worked or not.

And I would be completely unsurprised if not a few of them actually did work. Many, many effective medecines come from traditional knowledge. The archetypal case is aspirin. The original active ingredient, salicylic acid, was isolated from willow bark. A clever chemist added an acetyl group to make it more tolerated by the stomach and we get acetylsalicylic acid.

Using a cultural approach to medecine may make medecine more approachable to cultural groups - but there's little point in making such medecine more approachable if it doesn't work.

"In God we trust, all others bring evidence" - W. Edwards Deming.

8:51 AM  
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11:30 AM  
Blogger WebberNZ said...

I've managed a rongoa clinic and the evidence is there for anyone committed enough to look that it provides a much needed and useful approach for those not content with a generic model. Active ingredients aside, there's already sufficient scientific evidence that shows how healing can occur with the right mental and environmental approach for the patient, which rongoa certainly provides. As far as formal research goes, I don't feel the scientists and western frameworks should have full access to indigenous knowledge until proper respect has matured and indigenous people can maintain an included partnership with western approach, without being criticised or having their knowledge plundered, commercialised and abused (which current frameworks do without adequate protections in place in contrast to indigenous rights of passage). On the flip side, I believe the rongoa sector needs to develop further with it's own processes for moderation and quality control and should have public support to do so as a viable service in the community. Despite being delivered in a Maori-centred way, this does not mean it is only for Maori - most healers I know are colour-blind and if true to their gift heal where-ever there is need. The actual plants used are only a part of holistic healing.

11:27 PM  

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