Connect+ September 2022

OUR COVER STORY

This year the theme of Mental Health Awareness Week (26 September – 2 October) is ‘Reconnect with the people and places that lift you up’, and one that is underpinned by Te Whare Tapa Whaa - a Maaori health model of care which uses the four walls of a wharenui (meeting house) to symbolise the four dimensions of Maaori health and wellbeing.

Learn more about this model on page whaa (four).

Connect+ is produced by Counties Manukau Health. If you have something to share or would like Connect+ delivered straight to your inbox please contact communications@middlemore.co.nz

EDITOR: Nikki Allan

by Holly Sharples

From Pete

Kia ora taatou

It has been a big few months since becoming part of Te Whatu Ora - Health New Zealand alongside Te Aka Whai Ora - Māori Health Authority.

But while we have a name change, our commitment has remained as robust as ever and I am immensely proud of the way staff from all across Te Whatu Ora Counties Manukau have worked together to achieve great things over the challenging winter months.

I would like to thank our incredible nurses, doctors, orderlies, cleaners and everyone who has gone above and beyond – maybe unnoticed, often un-thanked – to support patients and colleagues alike.

The fact that the sun is now shining and the pressure from winter illnesses is starting to ease is fantastic - and has no doubt played a role in the recent changes to the COVID-19 protection framework that has seen us move into a new phase of our COVID-19 management.

I want to thank you, our community, for the way you have supported us, your whaanau, and friends over the past two and a half years.

Now, with this re-set, we have the opportunity to focus on how we can best use this once in a generational reform of our health system to improve health and wellbeing outcomes for all New Zealanders.

What you will begin to see is a simplified health system that is more accessible and has the voice of our communities at its heart, a system that provides healthcare closer to your home

and works closely with support organisations to best meet your needs.

But if we are to truly grasp the potential that is now before us, we must nurture and support our most valuable resource – our people – by being fully attuned to the requirement to urgently train, recruit and retain our skilled workforce.

I am confident that in supporting our people, combining resources, and prioritising access to those who need it most we will make a meaningful difference.

I am also confident that we are in very good hands and that the spirit of manaakitanga and kotahitangaalong with our tremendous commitment to the people of Counties Manukau rohe - will guide us on our journey.

This fact has made my incredibly difficult and sad decision to stand down from my role as Interim District Director-Te Whatu Ora Counties Manukau a little easier.

To be moving on after more than 30 years as one of the Counties team is a huge, huge wrench.

I am so very connected to this organisation and it has been my absolute privilege to be part of this whaanau we call Counties. I am humbled every day by the work our team does and I thank each and every one of them.

I will remain in the Interim Te Whatu Ora National Medical Director role for the immediate future and I look forward to continuing to support and work for our staff and community, albeit from a distance.

Ngaa mihi nui, Dr. Pete Watson

CELEBRATING THE CORNERSTONES OF Maaori health

This year the theme of Mental Health Awareness Week (26 September – 2 October) is Reconnect with the people and places that lift you up, and one that is underpinned by Te Whare Tapa Whaa - a Maaori health model of care which uses the four walls of a wharenui (meeting house) to symbolise the four dimensions of Maaori health and well-being.

Te Whare Tapa Whaa explains that all four components are equal and work together to achieve hauora (wellness of life) and health and wellbeing.

It is believed that when the four dimensions are not working in sync it can lead to sickness or ill health. Each aspect, or wall, is just as important as the other to keep the wharenui standing steadfast.

Turongo Paki, Kaihautuu Tikanga - Cultural Lead Advisor, Te Whatu Ora Counties Manukau, says understanding this model of health care and how it represents what is important to Maaori is vital for the services we provide.

“Working together with this model, we create solutions that encompass culture, values, tradition and a holistic approach to wellbeing to bring change through equitable solutions.”

Taha tinana (physical health) is how you look after your body, what you put it in and how you treat it. It doesn’t necessarily mean ‘physical’ as in physical exercise but also looking after our physical self.

Taha wairua (spiritual health) is your spiritual health or connecting to something that gives you meaning. It determines who and what we are, where we have come from and where we are going. The connection to culture can be spiritual, and learning and celebrating you culture or beliefs can strengthen you taha wairua.

Taha whaanau (family health) is all about the relationships around you in how you foster, celebrate and honour those relationships. Knowing who you are and where you are from. Whaanau provides strength as does the link to ancestors, and the ties with the past, the present and the future.

Taha hinengaro (mental health) is about your mind and emotions which also includes your conscience, thoughts and feelings. The way you think and feel, and how you communicate connects to your wellbeing. It is important for everyone to look after their taha hinengaro – whether you have a mental illness or not – relaxing, unwinding and taking care of the mind.

Wharenui at Tiaho Mai, Middlemore Hospital

Te Whare Tapa Whaa sourced from Mental Health Foundation

The future of health

On the 1st of July, we moved to a new national health system. At first it will look and feel the same, but having a national system means that changes can be made over time to achieve better outcomes for our health. These changes are designed to do things like:

#1. Simplify our health system This includes replacing DHBs with a single national health system that plans once where it makes sense and supports tailored local delivery. And we’ve created Te Aka Whai OraMāori Health Authority to improve Maaori health outcomes

#2. Strengthen the voices of our communities

Creating new ways to engage and work with different communities, to better inform the way healthcare is planned and delivered.

#3. Provide healthcare closer to home Supporting more local health workers including

Maaori and Pasifika providers, to make it easier for people to get to healthcare and to reduce the pressure on tertiary and hospital care.

#4. Plan and tailor better healthcare Tailoring better healthcare to community needs. Joining up health care, support services, and Iwi and community organisations locally to provide healthcare services that better meet the community’s needs. So that it’s efficient and consistent everywhere, for everyone, all the time.

#5. Modernise and invest in new technology We’ll be modernising and investing in new technology. Moving to more accessible online health services, and providing healthcare workers with modern tools, data and insights.

To find out more go to www.futureofhealth.govt.nz

Cancer diagnosis inspires Smokefree journey

Meet Davina, who after using our Smokefree service has gone over a month without smoking. She says she has tried to quit smoking many times over the years but this time she knew she had to do it after receiving a cancer diagnosis.

“I was diagnosed with breast cancer in June and I wanted to become a healthy person moving forward and hopefully set a good example for my teenage sons and their smoking friends as well.

“Before my operation, I was extremely nervous so out came the ciggy’s and then came the regret straight after. What a rollercoaster of emotions that was.

“I have not had any cravings, which is good. Now I do not see smoking in my future as I have never liked the smell of it on my clothes or fingers so I'm kicking that old habit.

"Thank you Living Smokefree Service.”

These awards celebrate initiatives that deliver great outcomes for the community motivated by a spirit of service. As finalists in the Service Excellence category the team are being recognised for achieving equitable Smokefree outcomes for Maaori and Pacific peoples by providing holistic, client, and whaanau-led approaches.

Many green fingers make light work

Sustainable healthcare is something that Te Whatu Ora Counties Manukau cares about.

Helen Polley, Sustainability Manager, says that there are some positive changes on the horizon especially with the Regional Climate Change Risk Assessment and Adaptation Framework recently being completed.

“At Middlemore Hospital, we have recently installed five water stations throughout the hospital that staff, patients and visitors can use to refill their water bottles,” she says.

“Our aim is to encourage everyone to make water their drink of choice as it is safe, healthy and free.”

Another exciting project underway is the collection and remanufacturing of calf compressors by Medsalv which reduces the amount of calf compressors going to landfill and allows us to purchase the remanufactured product back at a reduced price, saving our organisation money.

“We also aim to complete a food waste audit this year at our Middlemore Hospital site to monitor the amount of organic waste going to landfill.

“This will provide information about the need to create an organic waste stream across all of our sites.”

These along with our many projects that have been up and running for some time, continue to bring change to help our environment and we are excited for the future.

Most of these projects are heavily reliant on the volunteering of time and energy by staff in different services.

“Environmental champions are doing great work all around the organisation and I want to thank everyone who has been involved,” says Helen.

Emma Barraclough, Food Services Manager.

make global impact Local heroes

Local Heroes is an initiative designed to recognise and reward Te Whatu Ora Counties Manukau team members who have gone above and beyond in their service to patients, the community and other team members.

Every month, a handful of people nominated by other team members or the community are awarded and formally recognised by Dr Pete Watson, Interim District Director for Counties Manukau.

Recently, Suzanne Le and Kirsten Van Asten from the National Burns Centre, located at Middlemore Hospital, were deserving recipients of a Local Hero Award.

Suzanne and Kirsten are a Burn Occupational Therapist and Physiotherapist respectively with considerable experience in working with patients who are recovering from burn injuries. They were approached by a group of Occupational Therapists that set up the Facebook group called ‘OTs4Ukraine’.

Working alongside a few therapists from the United States, drawing on their extensive experience managing patients with severe burns, Suzanne and Kirsten developed a Zoom webinar which was delivered to occupational and physical therapists in Kyiv, Ukraine.

When congratulated, Suzanne and Kirsten said for them developing and delivering the webinar was a small contribution in helping the people in Ukraine during this difficult time.

Service Manager Crisna: “Suzanne and Kirsten are very hard working, nothing is ever a problem. They’re both very dedicated and we’re lucky to have them”.

Ka pai too mahi! Well done and thank you Suzanne and Kirsten for taking your locally developed knowledge and sharing it globally.

In pursuit of excellence – AND A PHD

Pursuing excellence is nothing new to Dr Julienne Faletau, an analyst for the Pacific Health Development Team.

"It's ingrained in me. Raised in the anga fakatonga way (Tongan way). My culture teaches me how to treat and relate to people and has influenced my work ethic.”

Her father comes from Hala Tu'i Nuku'alofa, and her mother's village is Lakepa, Tongatapu. They migrated to New Zealand, completed their education and gained skills to start their business and raise a family. The oldest of five, Julienne was born here in Middlemore and raised in Otara.

While far from the motherland, her parents instilled Tongan values. For Julienne, it's faith, family, and education, above all.

"Everything I do is about Pacific People and improving their lives.

"Working in the Pacific Health Development Team allows me to use my health science and research skills to help better the health of my people. As an analyst, I'm responsible for intelligence and information gathering for Pacific Health."

Julienne monitors the health status of Pacific patients in Counties Manukau and provides advice for population health.

"I also sit in the Pacific Health Equity team, a position I don't take lightly. I want to help reduce health inequities and collecting Pacific Health data is a crucial part I can contribute to this.

"I know the value of collecting and analysing this data because it can help inform policy, implement solutions and highlight areas we need to focus our efforts on."

She was exposed to Pacific Health research while studying for a Bachelor ’s of Health Science. After that, Julienne pushed herself further, embarking on a Master's in Public Health and got the opportunity to return to Tonga, focusing her research on the impact of cataracts on poverty for Tongan people.

"I then got a scholarship for my PhD in Health Sciences exploring risk perception of Tongan people with pre-diabetes and the associated risk communication of primary healthcare professionals.”

Julienne's research is informed using pacific methodologies. For example, the Kakala methodology is likened to the method of making a flower garland, and she adopted these steps for how she approached her work.

"Using cultural knowledge is a great way to relate to our patients.

"I'm proud of our language. I learned to speak Tongan from attending church and listening to my parents at home, and when I went to uni, I took a paper to write in Tongan."

Her hard work has paid off. Once again, she will cross the stage later this year at the University of Auckland to graduate with her PhD.

Dreaming big for the future, she plans to have her own research centre one day.

TELEHEALTH

Connecting whaanau and removing barriers

COVID-19 has changed the way we work, and some of these have turned out to be beneficial for our community. Telehealth is one of these benefits and is a great example of new technology and innovative thinking coming together to open doors for our community.

The Telehealth initiative enables healthcare appointments to be done over the phone or by video (Zoom), which means if an appointment is suitable for Telehealth, patients don’t have to take time off work, battle traffic, pay for parking, or organise care in order to get the healthcare they need.

What’s more, if a patient has whaanau in other parts of the country, or even overseas, who they want present throughout their care journey, Telehealth appointments can enable that. A patient can simply forward the video Zoom link they receive to a family member or support person who can then join the video appointment.

With the use of video meetings in both our professional and personal lives becoming more popular we have a first-hand understanding of the difference being able to see someone can make to our interaction

with them, and as Health Psychologist, Sonali Dutt explains this relates to medical interactions too.

“The ability for a clinician to see the patient and observe their body language is a helpful component of therapy. It also helps to facilitate a rapport and establish a connection between clinicians and patients.

“Telehealth also has the potential to remove some barriers to care such as access difficulties with transport to appointments.

“For example, one of my patients is in a wheelchair and is heavily reliant on a support person, Telehealth makes it far easier on my patient and eliminates the issues they have in getting to appointments,” says Sonali.

Not all appointments can be carried out by Telehealth, as patients need to have access to Wi-Fi, but Michelle McRobbie, Telehealth Lead - Healthy Together Technology, explains that the team at Counties Manukau is well equipped to support the community to get the help they need.

“We have a Telehealth team at Counties that can help patients to use their devices to connect to a video appointment. We can also help with downloading the free Zoom App and do a preappointment test with a patient if required.”

If you think Telehealth is for you, talk to the booking coordinator or your clinician about the possibility of using Telehealth for your appointment.

Teaming up to SAVE LIVES

Counties Manukau and Waitematā have joined forces to deliver a bowel screening education workshop for the Chinese community in Pakuranga which can save lives.

With the uptake of the National Bowel Screening Programme within our Asian community found to be low, the two districts have come together under the Te Whatu Ora umbrella to host education sessions and better utilise resources.

Health promoter from Te Whatu Ora –Waitematā, Jun Li, played a crucial role in the programme.

“For many, language is a barrier, so hosting these education sessions helps those who aren't aware free programmes like this exist with one participant telling me her friend died from bowel cancer, and this talk let her know the importance of bowel screening.

"She's received the kits before but didn't use them because she didn't understand what it was, but now she's keen on doing tests for herself and her husband," says Jun.

Participants enjoyed learning about the programme and took great interest in Bella the blow-up bowel which gives people a peek into what you can expect bowel cancer to look like and how to check for symptoms.

Counties Manukau Bowel Screening Service Delivery Manager, Hasitha Samarasinha says it's vital to undertake outreach and improve participation from all communities.

It can help find more cancers early, where treatment will significantly benefit our community.

"Our current participation rate within the Counties Manukau Asian Community is only 49%, so we need greater participation to get the most out of this programme.

"We're hoping we'll be able to host a lot more education sessions, so we are happy to oblige any groups out there that would like us to get in touch.

“It's a free programme for those aged 60-74 who can get a home test kit and can sometimes pick up changes in your bowels before you notice symptoms.”

It's simple to use, and it could save your life!”

“People don’t have to die

– but some still are!”

Temira Mataroa knows how precious life is.

After the devastating and tragic loss of two of her children to a rare Leukodystrophy Disorder, Temira doesn’t take anything for granted especially when it comes to health.

Her strength and the desire to stay fit and healthy is what drove her to sport and now Temira plays rugby, alongside her daughter Paris, for the Counties Heat Farah Palmer Cup team.

Temira previously worked for the Counties Manukau Screening team based at the Manukau SuperClinic, and is now working for Te Whatu Ora - Waikato.

“Screening is something I am passionate about – especially when some cancers don’t need to happen,” says Temira.

“They can be found early and treated and that is what screening is all about. It gives you that chance to find it early. People don’t have to die – but some still are.

“I work with our communities, iwi and marae to bring awareness and hopefully encourage our people to be make their health a priority, because they deserve it.”

Cervical cancer is one of the most preventable and successfully treatable forms of cancer and Temira encourages wahine to complete the three yearly smears recommended for those aged between 25 and 69.

Cervical cancer has a link to HPV infection, with nearly all cervical cancer cases attributed to HPV. Anyone who has ever been sexually active can get HPV, and cervical screening can help find the problem early. The HPV vaccination is also free for those aged 9-26 years.

“If you can do something to prevent cancer – just do it. The value of life and being there for your whaanau, is precious.”

A SUPPORTIVE, whaanau vibe!

It was the relaxed, supportive whaanau vibe that Henry first noticed when he turned up to an appointment at our Renal Team.

“Mum had been sick for a while. She had diabetes and heart failure and then we learnt she only had 20% of her kidneys functioning,” explains Henry, who was the carer for his Mum, Betty.

He says the support he received from the Renal team is what really stood out and made the difference.

“The team would send me emails with dietary information specifically for kidney patients which was good. I was doing all the cooking, so it was really helpful to have that advice on what to make.

“Straight away they set up a meeting with Needs Assessors and an assessment with the Dementia team. We hadn’t had that support before and they were really going above and beyond.”

The team at the Renal Service was able to undertake advanced planning and discuss options for Betty’s care which included dialysis at home or in hospital.

“They made it easier on me as a carer and didn’t just speak in medical jargon. We talked about our options and what may happen down the track.”

Sadly, Betty passed away of a heart attack earlier this year.

“I have nothing but praise for the whole Renal Team. They go above and beyond and you can tell they are a strong team that work together to really care for their patients and the whaanau.”

“I want to thank the team for making the process so much easier and straightforward and for helping us out with stuff that was outside their job.”

The Eastern side of the new Dialysis Unit in Scott Building was opened on Monday, 13 June 2022. The second half of the unit is expected to open in October this year.

Innovative outreach TO IMPROVE VACCINATION RATES

In what is believed to be a nationwide first, Counties Manukau has recently employed two pharmacists, Valentina Missen and Vanessa Green, to work on a pilot programme moving around South Auckland pharmacies focusing specifically on engagement with Maaori and Pacific clientele.

Both Vanessa and Valentina have extensive experience within the vaccination space, and have been working with individual pharmacies for up to three days at a time to motivate, upskill and increase staff knowledge, not only in the offering of the Measles, Mumps and Rubella (MMR) childhood vaccination, but also for other important vaccinations which are strongly recommended during pregnancy.

This direct community and pharmacy engagement provides further opportunities to offer guidance on the many free childhood vaccinations that are available to whaanau, and also on HPV immunisations for adolescents and young adults, and lifetime vaccinations for older members of our community.

This innovative programme is designed to encourage a proactive approach from pharmacists and their teams, so that they can help to deliver a better uptake of vaccinations across the region and it is already giving us a deeper understanding of the vaccination opportunities that exist within the local pharmacy environment.

If we can further develop methods on how to better support and motivate pharmacies to initiate discussions with whaanau,

we believe we can create more impetus for our childhood vaccination programme, something that is currently of vital importance to the long term health and resilience of South Auckland’s communities.

This work has been leading edge, and while other work has been completed in this area, until the project started no community pharmacists in our region had focused specifically on childhood vaccination catch up programmes before.

Although still early days the innovative work has been achieving good numbers and is once again highlighting to everyone the importance of continuing our direct engagement with and for our communities.

Valentina and Vanessa and the rest of our Te Whatu Ora Counties Manukau district Integrated Immunisations Team are adding to their already considerable knowledge, as well as building a knowledge base and resource that we hope will deliver positive results in the months and years to come.

STREET CHATS:

Koorero with the community!

Street Chats is a Te Whatu Ora Counties Manukau district initiative bringing kaupapa and koorero to the streets of South Auckland.

It’s is all about improving health literacy and education in our rohe through korero and engaging with the wider community.

Te Whatu Ora Counties Manukau district launched the initiative during the COVID 19 vaccination rollout as a way of connecting information with whaanau in a more hands-on way. The team works closely with providers and Street Chats partners to co-design Street Chats activations in a way that best suits each community.

“This is not a one size fits all approach,” says Matt Poland, Communications Lead, who works closely with the team.

“We are respectful of the diversity within our communities and appreciate that each community responds to health information differently and each provider has their own unique approach.”

The friendly Street Chats teams (also known as Street Chatters) get out and about, talking to families about things like immunisations, whether it is the childhood vaccination programme like measles, or wider programmes like flu, and COVID-19.

“This is a unique initiative and came about when we were looking at ways to cut through the vast amounts of vaccine information in the public arena last year,” says Matt.

“Having two-way koorero empowers people to ask their own questions and form decisions based on conversation and trusted relationships.”

The team answer questions and address concerns or provide information around people’s eligibility, how to access immunisations services in the community, immunisation status, and more.

The teams are made up of local community champions from Manurewa Marae, Papakura Marae, Urban Neighbours of Hope and I AM Mangere, and attend a range of community events and run their own local activities.

Craig Wilson from the Papakura Marae says that tailoring the Street Chatters to the community has been crucial to them being able to get their messages across.

"Having young Maaori mums on the Papakura Marae Street Chats team, who are also student nurses, has given us the ability to connect with whaanau in a friendly and clear manner which they can relate to.”

Photo: The Street Chats Team from Papakura Marae at the Oranga Wahine Oranga Whaanau event last month.