Public health success in Hawke's Bay.

E hiwawa ana te au marire o taku awa ki te mihi atu, ki te runga rawa tena koe, ki nga wairua e moe te moenga roa oti atu, Ki nga mana, tena tatou.

"Hei manga wai koia kia kore e whitikia." No reira tena tatou katou.

Hi there! I'm Sandra Corbett, and am presently in my second term as Te Runanga's representative for Hawke's Bay. My introduction to this awesome national komiti came about through the encouragement of the previous vice chair and Te Runanga representative for Hawke's Bay Margaret Jackson. Margaret's commitment and knowledge have guided me and been invaluable, as I have stepped up to the challenge of belonging to this national forum. Ehara koe i te tangata!

Te Runanga executive komiti members are an awesome team and have grown so much since I began my journey with them. We all come from different work areas and bring many attributes to the table. We awhi and tautoko each other, and the knowledge that is shared has contributed to the evolution of this komiti.

I have gained a great insight into how NZNO works, and an awareness of national issues affecting nurses and particularly Maori health. Our strategic vision for Te Runanga 2006-2011 is inspiring: "Hei oranga motuhake mo nga whanau me nga hapu me nga iwi"--We will achieve the highest level of optimal "wellness" for Maori as determined by whanau, hapu and iwi.

I would like to encourage all Te Runanga members to think about getting involved. It will extend your horizons, and will contribute to your personal and professional growth.

Benefits of cervical screening programme

Now a little about my mahi. I am employed by the Hawke's Bay District Health Board (DHB) as the kaiwhakahaere for the regional cervical screening programme. I began working with the programme in the early 1990s as a nurse smear taker, and, from 1999, accepted the challenge of Maori co-ordinator for the region. Over the years much has happened both nationally and locally, but I want to share some of the benefits this programme has brought to our region. In the first ten years, the mortality and incident rates of cervical cancer were almost halved. Prior to the programme, Hawke's Bay had one of the highest rates in the country, with much higher rates for Maori women. The increase in nurse smear takers as service provider who offer services that are effective and acceptable for Maori women, with an holistic wellness approach, have been integral in encouraging Maori women to participate in screening. Hauora, marae, work place, home clinics and education venues, with Maori women and health professionals involved in planning and providing services, have been key to women's increased participation rates. Champions such as Maori Women's Welfare League members have been invaluable with their support of local initiatives to overcome the barriers to women participating in screeing programmes.

Finally, the Kaitiaki Regulations that protect Maori women's data and ensure it is used for the benefit of Maori are a landmark. They also include the principle of the sanctity of te wharetangata and the need for culturally appropriate protection of information taonga. While much has been achieved, statistics show there is still much to do to reduce the rates of Maori women affected by cervical cancer. Me aro koe ki te ha o Hine-ahu-one. Pay heed to the dignity of women.

The challenges of the MeNZB programme

Working in public health in Hawke's Bay and tackling inequalities in health continue to challenge all of us, including our immunisation team. Our Maori and Pacific populations are at a greater risk of contracting Meningococcal B disease than the rest of our population, therefore the importance of vaccinating these groups was one of our goals. Under five-year-olds are the most at risk age group, so outreach has focused on these babies and preschoolers.

In our region, five Maori providers and the Pacific Resource Centre were contracted to work with the MeNZB outreach co-ordinator. This was to ensure Hawke's Bay, from Wairoa to Takapau, had good coverage, so every child in the region was given the opportunity to receive the full course of vaccinations

Importance of outreach service

Extra training was included for all vaccinators working in isolation, but prior to this they needed to be authorised vaccinators. Weekly reporting kept them in touch, especially in the early stages. Meetings with the teams were very beneficial for planning, looking at improvements and sharing issues. The teamwork was tremendous and the different health providers shared information and their experiences in a united way. Barriers prevent some families/whanau visiting GPs, so an outreach service for all immunisations is very important. This has become even more apparent with the MeNZB outreach service, as our providers have found many children under-vaccinated, without a well child provider and no MeNZB. A strong rapport has built up with these families and Maori providers as they return to complete the MeNZB course. The downside is the huge work increase for busy Maori providers but the improvement in children's health from having well child support is very rewarding. At the time of writing, 2745 MeNZB vaccinations had been given by the outreach service. Hawke's Bay has not had a notified Meningococcal B case since July 2005. From January to June 2005, there had been 13 notified cases. Protecting our whanau from vaccine preventable diseases, especially Meningococcal B, is so important.

A celebration lunch was held recently with the Hawke's Bay DHB MeNZB team and the wonderful staff from the Maori organisations. Well done to all. A special thanks to Te Kupenga Hauora-Ahuriri, Te Taiwhenua 0 Heretaunga, Choices, Takapau Health Centre and Kahungunu Wairoa. Kia kaha!