Across the Post-Colonial Divide: Reflections on the Treaty of Waitangi

Ruth DeSouza
Cultural safety
• Developed by Māori nurses in <strong>the</strong> 80’s.
• Conceptual framework for understanding power
inequalities structuring relationships and
practical strategies.
• Requires that all human being receive care that
takes into account <strong>the</strong>ir uniqueness (culture,
gender, religious backgrounds)
• Not a checklist of customs or practices
• Focused on knowledge and understanding of
<strong>the</strong> individual nurse/midwife
• Important to understand one’s own culture and
<strong>the</strong>ory of power relations
Four principles
• Improve <strong>the</strong> health status of New Zealanders
(Treaty, access, health gain of marginalised
groups).
• Enhance <strong>the</strong> delivery of services through a
culturally safe workforce (power relationships,
empowering users, understanding diversity in
own context and <strong>the</strong> impact of that, going
beyond tasks to relationships).
• Broad application recognising impact of context
(inequalities as a microcosm, impact of history,
employment etc, legitimacy of difference,
attitudes as barriers, quality improvement and
rights).
• Close focus on individual nurse (culture bearer,
power relationships which favour providers,
balancing power differentials, moving towards
equitable delivery and minimising risk to
marginalised).
Simply put
• Culturally safe
• Recognise
• Respect
• Rights
Implementation
• Treaty of Waitangi pivotal for resource allocation
for Maori.
• Compulsory in nursing education for <strong>the</strong> last ten
years.
• Driven by education providers ra<strong>the</strong>r than
service providers with little impact on negative
Maori health outcomes
Steps
• Cultural awareness: understanding that <strong>the</strong>re is
difference.
• Cultural sensitivity: alerts to <strong>the</strong> ‘legitimacy of
difference’ and to self-exploration.
• Cultural safety: enables safe service to be
defined by those that receive <strong>the</strong> service.
Health
• Labels have implications for resource allocation.
• MC and BC not mutually exclusive.
• CS can hold both but has focused on Maori.
• Need for expansion of cultural safety.
• Understanding self, <strong>the</strong> rights of o<strong>the</strong>rs and <strong>the</strong>
legitimacy of difference should prepare <strong>the</strong>
nurse to work with all people who are different
from <strong>the</strong>mselves (Nursing Council).
• Need for ongoing dialogue and discussion.
Conclusion
• The ethical relationship needs to go both ways,
try understanding our history our hopes and our
dreams, make space for us.
• The consumption of Indian ness needs to be
supplemented with understanding of social,
political, cultural and spiritual significance and
political power.
• Expand bicultural dialogue.
• Need for intercultural engagement.
• Need for a vision of Aotearoa/New Zealand.
• Develop multicultural policy that is sensitive to
bicultural issues and Maori.
• Cultural safety an example