hau 240 Epidemic Preparedness Bill- Te Ururoa Flavell

Life And Death Decisions

Written by Te Ururoa Flavell
Wednesday, 13 December 2006

Law Reform (Epidemic Preparedness) Bill
Te Ururoa Flavell; Third Reading
Wednesday 13 December 2006
Some debates made in this House, are, concerned with nothing less than life
and death decisions. The series of seven bills which impact on the
preparedness of the nation to face the onslaught of an epidemic under final
consideration here is exactly that. And for the Maori Party, we recognize
the heavy responsibility that this Parliament brings to bear, when we take
into account the inevitable, and disproportionate impact of an epidemic upon
Maori. The association with Maori and Œepidemic¹ is one that is far too
frequently made.A month ago, Professor Martin Silink,A month ago, Professor
Martin Silink, head of the Brussels-based International Diabetes Foundation,
told the international conference that the diabetes epidemic could wipe out
Maori and Polynesian Islanders by the end of the century. Or there¹s the
meningococcal disease which has been categorised as an epidemic since 1991
with demonstrably more adverse impacts on Maori and Pacific populations. Dr
Lis Ellison-Loschman who has been following the work of the Maori Asthma
review, has described asthma mortality rates for Maori as reaching epidemic
rates in the 1970s and 1980s. Neil Pearse has also described a major medical
controversy around the asthma drug, fenoterol, which some fifteen years ago
caused an epidemic of asthma deaths.Madam Speaker, the significant and
growing ethnic and socio-economic inequalities in lung cancer mortality in
New Zealand; and the relatively high lung cancer incidence and mortality,
particularly among Maori has been reported in the New Zealand Medical
Association Journal as an epidemic.The Obesity, Food and Policy: New
Solutions Workshop held at The University of Auckland on 16 November talked
about an obesity epidemic. And Associate Professor Wayne Cutfield has
revealed an escalating epidemic of childhood obesity, reporting on the
situation in Auckland wherein an estimated half of Pacific Island and a
quarter of Maori children are overweight. Held at The University of Auckland
on 16 November talked about an obesity epidemic. And Associate Professor
Wayne Cutfield has revealed an escalating epidemic of childhood obesity,
reporting on the situation in Auckland wherein an estimated half of Pacific
Island and a quarter of Maori children are overweight. We have the concept
of epidemic used in connection with cannabis or methampthemine. So in short,
Maori seem to attract epidemics if we are to believe all this information.
And these are not just recent occurrences. I refer to a statement from our
first New Zealand trained, Maori medical doctor, Te Rangi Hiroa ­ Sir Peter
Buck, who said: "Various epidemics were introduced by civilisation and have
remained with us ever sinceŠŠmeasles, typhoid, scarlet fever, whooping cough
and almost everything, except plague and sleeping sickness, have taken their
toll on Maori". Indeed, almost everything has taken its toll on Maori. In
the initial years following colonisation, the Maori population suffered a
period of almost unbroken decline from 1858 to 1896; with the susceptibility
of Maori to epidemics and other diseases introduced by the settlers being
described as a major factor. But if there was one epidemic to outdo all
others, it was the influenza pandemic of 1918, in which at least 2160 Maori
lost their lives. So, our history provides us with visible and violent proof
of the high likelihood of Maori experiencing significant mortality and
morbidity, in future epidemics. Alongside our history, alongside the
epidemiology of disease; there is also the policy incentive provided in He
Korowai Oranga which demands that specific provision must be made to protect
and enhance the well-being of Maori and to ensure that Maori health
disparities are reduced. Which demands that specific provision must be made
to protect and enhance the well-being of Maori and to ensure that Maori
health disparities are reduced. Achievement will require a total commitment
from government; a commitment to the elimination of institutional racism
across the board - incomes, housing, employment, justice, as well as health.
It will require an about turn on the denial of rights for tangata whenua,
for how can a person be whole and healthy, when assumed to have only sub
human rights? Dr Lorna Dyall, Senior lecturer in Maori health in the
University of Auckland's Faculty of Medical and Health Sciences, has
suggested four integrated pathways of work to run alongside each other, in
the case of a pending epidemic.
* The need to rebuild and strengthen whanau;
*
* The need to involve Maori at all levels of decision-making;
*
* The need to ensure Maori can access and receive effective health services;
* and
*
* That a whole of government approach be taken towards addressing Maori
health
* matters.
*
Madam Speaker, it is said that vision without action is a daydream. Action
without vision is a nightmare. The Maori Party has a vision in which Maori
interests are able to be placed at the very centre, our wellbeing protected
and enhanced, so that our future and survival is assured. The action that
we see these seven bills could drive, is in bringing on board the
appropriate Maori leadership, use of Maori infrastructures and networks, and
the ability of health workers to engage with iwi and Maori communities ­ in
helping to fight the excessively high rate of mortality all predictions
expect to occur in the likelihood of an epidemic. We want action in which
our whanau are actively prepared and ready to support and care for tamariki
and pakeke in the event of an outbreak of an epidemic. Should avian
influenza or indeed any infectious disease prove itself to be capable of
becoming an epidemic, our communities need to be on high alert about how to
preserve our most precious resource ­ he tangata, he tangata, he tangata.
Madam, the particular anxiety expressed by many tangata whenua around this
Bill has been in looking at the concept of how best to minimise face to face
contact. Questions have arisen specifically around our tangihanga ­ and
whether the risks will entail mass burials to occur ­ and therefore
disrupting long-held expectations about the traditions associated with
paying our respects to the deceased and their whanau. And in this regard,
we welcome the recommendation from the Government Administration Select
Committee, that the issuing of an epidemic notice must be issued only for
outbreaks of Œquarantineable¹ rather than Œinfectious¹ diseases per se. The
notice should be the sole preserve of highly infectious diseases capable of
becoming a pandemic. We have considered the viability of marae for use as
quarantine centres. The changes to the Health Amendment Act increase the
powers of Medical Officers of Health to detain people for medical
surveillance for a period of up to 28 days. We note that the Police will
also be able to use force to detain people suspected of suffering from bird
flu. We would suggest that rather than the enforced authority represented
by either the Medical Officer of Health or the Police, it would be
preferable in the interests of safeguarding public confidence and
accountability, for encouragement to be given to utilise venues which are
already familiar to the people ­ such as marae. We would also suggest that
MPs take on board the need to inform their constituencies of what can be
done to be 'epidemically prepared'. Accessible and widespread information
will be critical to effective preparedness. Madam Speaker, in closing
census 2006 results were released last week showing that New Zealand¹s Maori
population has experienced a growth exceeding 7.4% since 2001, to reach a
grand total of 565, 329. A century ago in 1905, the Maori population hit an
all time low of 45,000 and were at risk of extinction. Not only did tangata
whenua survive, but we have sustained a substantial and vibrant level of
population increase since then. We celebrate that growth ­ and we look
forward to it continuing. Our future as a nation, depends on our young
population, our Maori population, being able to thrive on many counts. We
want to see our population contributing to the Maori economy of the future.
We want to know our taonga will be protected for future generations. And we
want to be content in the knowledge that our very survival is not at threat.
Voting in support of the seven bills debated today - Bills which were
previously grouped together as the Law Reform (Epidemic Preparedness) is one
more step along the way towards achieving this.