The Kia Ora – E te iwi programme (KOETI) is an educational and support programme for Maori with cancer.

Ditre Tamatea GM Maori Health and Vulnerable Populations Te Waka Hauora says cancer is the single largest contributor to death and illness for Maori.

“You would be hard pressed to find a Maori whanau who hasn’t had someone sick with cancer or who has died from it,” he says.

Cancer is a complex disease with over 100 different types identified.  Mr Tamatea says Te Waka Hauora is working alongside communities to reduce Maori cancer rates in several priority areas including quit smoking services, and  cervical, breast, prostate and bowel cancer screening programmes.

Kia ora E Te Iwi can be offered as either a series of individual sessions or a more intensive noho marae-style weekend, tailored to whanau.

Cancer pathway specialist Dr Melissa Cragg joined Te Waka Hauora in 2018 to co-ordinate the KOETI initiative as well as other work under the He Huarahi Mate Pukupuku - ‘Improving Cancer Pathway for Māori’ project.

Facilitators from Te Waka Hauora, the Nelson Marlborough Health Maori Health team, work with patients and whanau to:

  • increase knowledge of cancer and cancer treatment
  • increase knowledge of oncology services
  • develop the confidence to ask questions
  • share stories and learn from each other
  • build coping skills – practical, emotional and spiritual
  • learn about support options available
  • plan for the future.

“We are trying to improve health literacy for whānau with cancer, especially their knowledge of early signs and symptoms of cancer, and an understanding the services and support available for whānau who are on the cancer pathway,” Melissa says.

“The Kia Ora – E te iwi programme is designed to do this, and by collaborating with the Cancer Society and local Māori healthcare providers we are now able to offer this to whanau.”

She says the programme also aims to improve the cultural competency of our health workforce so we deliver healthcare services that meet the social, cultural, and linguistic needs of patients.

“While we have some champions in our workforce, we have a lot of work to do to raise the level of understanding about Maori health status and really know our Maori population.”

The KOETI programme also helps strengthens relationships between the healthcare services.

“Whanau will come across a lot of services on their cancer pathway, which often work in isolation. This can cause confusion for patients around who is who and what their role is.”

Melissa says that the KOETI programme was developed as the kaupapa Maori equivalent of the Cancer Society’s ‘Living Well with Cancer’ programme. It is now funded to run in Nelson Marlborough with activities across the South Island.

“KOETI has been available in the North Island and it’s exciting to be able to offer it now to whanau in Te Waipounamu.

“Earlier in the year 12 new facilitators attended training led by Pauline Wharerau, and our vision is that all cultural support staff will eventually be able to offer KOETI support,” Melissa says. 

Thomas: walking the talk

Thomas Ngaruhe (He uri tenei o Waikato o te hapu o Ngati Mahanga) is a Poumanaaki  (Cultural Support worker) with Te Waka Hauora the Nelson Marlborough Health Maori Health team, and delivers the KOETI programme.

Cancer is a subject close to Thomas’ heart because he has personally walked this journey a cancer patient. Thomas describes KOETI as an empowering programme that allows whanau to make good choices, as well as encouraging more people to seek when things don’t feel quite right.

In February 2018 Thomas completed KOETI training at Whakatu marae in Nelson and he is now able to offer KOETI to Maori cancer patients and their whanau.

 “From being a previous cancer patient I believe this type of health delivery for Maori by Maori in not only the early signs and symptoms of cancer but through diagnosis and treatment helps identify the many issues and questions that go through the patient and their whanau’s mind,” Thomas says.

“I wish this type of service was offered during my diagnosis and treatment, “he says. “The positivity and proactivity of this model is strengthened by its close link to our natural models of health and wellbeing such as Te whare tapa wha and Te wheke that collectively contribute to waiora or total wellbeing.”