Best health outcomes for Maori - Medical Council of New Zealand

In fact, one approach need not exclude the other;
cooperation between traditional Mäori healers and
health professionals is now becoming acceptable to
both groups. Mate Mäori does not mean there cannot
be a coexisting mental disorder. At best, the term
is a comment on perceived causes of abnormality
rather than on the symptoms or behaviour which
might emerge. Yet it remains a serious concept within
modern Mäori society, and to many people, mate Mäori
sounds more convincing than explanations that hinge
on a biochemical imbalance or a defect in cerebral
neurotransmission.” 46
Death and dying
Death and dying are times of stress in any culture, and
every culture has certain rituals surrounding these times.
Some cultural ceremonies are more complex than others,
and most, when unfamiliar, can seem odd or intimidating.
For Mäori, death and dying are deeply imbued with cultural
significance, and it is not uncommon even for Mäori who
are otherwise relatively unobservant to follow very traditional
practices when they or loved ones are near death. The
communal nature of Mäori society is particularly apparent
at these times of stress, with whänau members from all over
hurrying to visit and stay with the patient. A medical team’s
ignorance of Mäori practices could unintentionally make a
difficult time for the family infinitely harder, for example by
interfering with the family’s need to see and speak to
the deceased. 6
2 Best health outcomes for Mäori: Practice implications
For this reason, it is particularly important for the family
to have familiar faces on whom they can rely. This is a
time when Mäori families, like most others, may be very
dependent upon their GP for help in understanding their
medical environment. Even if the patient’s care is mostly in
the hands of specialists, do not forget that the GP is likely to
have the strongest relationship with the family, and for that
reason should continue to be involved in the patient’s care
and in the discussions with the whänau. Times like this will
make or break your relationship with the whänau, and your
continuing close involvement can do an enormous amount
to alleviate their anxiety and suffering. If you are familiar with
the family’s cultural preferences, or are comfortable asking
about them, you can provide a much needed interface
between them and other, less informed medical staff. As
with all cultural practices, do not allow your unfamiliarity
or discomfort with talking about issues like dying, death,
handling of remains, or funeral practices prevent you
from helping your patient and their family; ask respectful
questions so that you can help the family work with the
hospital to make the experience as painless as possible,
under the circumstances.
The Mäori view of dying and death is quite different from
the non-Mäori view, as is the Mäori way of grieving for the
dead. In Mäori culture, the past is considered ‘in front of’ us
because we know about it, understand it, and our current
actions are based upon it, while the future cannot be seen
and is thus considered ‘behind’ us. 15 This is completely
opposite to the Western view of ‘past behind’ and ‘future