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Overcoming Maori women's resistance to cervical smears.

Ko Hinewehi te Maunga

Ko Whangape te Moana

Ko Ohaki te marae

Ko Ngatokimatawhaurua te waka

Ko Mare raua ko Reremoana Ropiha toku maatua

Ko Te Rarawa te hapu

Ko Ngapuhi nui tonu

Ko Leanne Lloyd taku ingoa

In the early 1940s-1960s, most Maori had large families and, for those within our whanau who could not have children, we would whangai a child to them, ie give them a child to raise as their own. This was a cultural practice as it ensured the child remained within his/her whanau, growing up knowing who their biological parents were, but raised as the daughter or son by other family members. This also ensured whakapapa, tikanga Maori and cultural values were retained.

The Adoption Amendment Act of 1962 saw this cultural practice made illegal and a "one taw for all" approach introduced--Maori would have to apply to the courts for their child to be legally adopted into extended whanau. Needless to say, most Maori could not afford this, so we continued to whangai our children quietly within the whanau, hapu and iwi.

This was also the era when unmarried mothers were hidden away or placed in centres, eg the Bethany Centre run by the Salvation Army, where they remained until the birth of the baby, and from where that baby was then adopted. Babies available for adoption were advertised in the newspaper. The fee for my adoption was 14 [pounds sterling].

I found my birth mother 24 years tater, after the birth of my first child. We lost contact for some time and re-established our relationship 15 years tater after attending the tangi of my younger brother. This has been a blessing, knowing where I come from and getting to know my birth whanau after all this time. This doesn't take away the aroha I feet for my adopted whanau who I was blessed to be loved and raised by.

My birth mother was indeed happy and proud to [earn I was a nurse. She didn't tell me how sick she was; it was my aunties who told me. Mum had cervical cancer, had undergone treatment and was being seen by specialists every three months. She had never had a cervical smear until her GP insisted after some ongoing problems. As with a tot of our older Maori women, our area of child bearing and child birth is tapu, the place where the whare tangata (future people) are nurtured. Having anything unnatural placed there is resisted and disliked.

I am a community smear-taker for the National Cervical Screening Programme. To convince some Maori women to have cervical smears is quite a task. The younger generation are aware this is important, yet some will still try to avoid having a smear. Others stick to the screening schedule religiously. Education by our kaiawhina and kuia from the cervical screening programme encourages some Maori women to join, but the ongoing struggle to convince Maori women in general to be screened is disheartening.

Just recently we had a cervical screening clinic and health day at our local marae. Although we talked and encouraged our women with our kuia present, only one chose to have the screening. I spoke to one woman who had had a hysterectomy because of an abnormal cervical smear and failure to seek treatment. She now stresses the importance of screening to whanau and friends because of her misfortune. It is regrettable that situations like this have to be used as examples. However, if it means our women seek the screening, it has a positive outcome.

Recently I ran a clinic at Christchurch Women's Prison. It was good to hear these women now had the opportunity to get all their health needs met, including smears. Outside prison, they did not have the time to see to these things, they said.

I am obliged as a smear-taker to ask my friends and family if they are up-to-date with their cervical smears. I am also fortunate to have a portable kit, so can screen women in their own homes free of charge. If opportunities arise, I take them.

Finding my birth mother has highlighted the risk of cervical cancer within our family. This is something I would never have known otherwise. I, too, have been through treatment and now have annual cervical smears. My mother's screenings have now been reduced to six-monthly. I probably would not be here today if I hadn't met a wonderful nurse who explained the cervical smear process and was very sensitive to my feelings. Because of my history and that of my mother's, I cannot emphasise enough the importance of screening to my daughters. I know there are other adopted children who wonder about hereditary issues and whether they are predisposed to particular health problems.

Unfortunately for some, they will never know. Our families must access the screening programmes available. Our tane, in particular, have a vital rote in encouraging their partners, sisters, aunties and mothers to be screened. They know the importance of whare tangata and the importance of tamariki and mokopuna. They also want their partners and wives beside them to see their mokopuna grow.

All of us have female relatives we would not want to lose to a disease that is treatable if diagnosed early through cervical screening. Kia kaha wahine ma, kaue whakama. We owe this to our whanau.

Report by Te Runanga o Aotearoa NZNO Canterbury representative Leanne Lloyd
COPYRIGHT 2006 New Zealand Nurses' Organisation
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Article Details
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Title Annotation:TE RUNANGA
Author:Lloyd, Leanne
Publication:Kai Tiaki: Nursing New Zealand
Geographic Code:8NEWZ
Date:Oct 1, 2006
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