Coronavirus DOES Discriminate. Here’s What We Can Do About That.

 

Today, we implemented our whanau plan for self isolation.

We have chosen to self-isolate slightly earlier than most in our region, but I still worry about whether we should have done it earlier. Our reasons are quite clear. Our baby is immuno-compromised, with a chronic respiratory condition that has seen her hospitalised numerous times in the past few years. We simply aren’t down for gambling with her wellbeing.

I spoke with our girls’ school, advised that they would not be returning, and asked for the next 2 weeks’ lesson plans. My partner arranged to make the drive into town to get some gears out of storage, planning his time so that he encountered minimal people during his errands. We spoke with my nephew who lives with us and is in conservation training about how we can support him to train and study from home. We checked our supplies to ensure we have 2 weeks worth of everything we need (I’ve messaged my partner a list of outstanding supplies that he can pick up but we have most of what we need already). I was conscious, even as we prepared ourselves in this way over the previous weeks, that this is a form of privilege that so many of my whanau cannot afford. Especially now that so many in our region are out of work. And even though I have often heard people say “Coronavirus doesn’t discriminate” – This is just the first way in which COVID-19 will hit Maori harder: economic barriers to preparedness for self-isolation.

We also live in an immuno-compromised region. We have 8 times higher than the national average incidence rate of chronic rheumatic heart disease. Our leading causes of death are heart disease, lung cancer and diabetes. We have more diabetes, more respiratory cancer, more asthma admissions, more bronchiolitis admissions, more pneumonia admissions, than anywhere else in the country. This makes us much more likely to require hospitalisation and ICU if we are infected with COVID-19. While it is particularly the case in my region, that is not unique to us… Maori, generally, suffer the highest rates of chronic illness and cancer across Aotearoa. Here we have reason number two that COVID-19 does, in fact, discriminate. Our history of colonialism has borne itself out in our chronic illness rates, making us more vulnerable to infection, and less likely to recover, than your average New Zealand citizen, upon whom the current government guidelines and policies are based upon.

So there will, much likely, be many more of us vying for spaces in the very limited ICU units around the country. Here in my region, our hospital (3 hours away from me) has 6 ICU beds.

According to the 2018 census we have 48,900 people in our region.

That’s one ICU bed for every 8150 people.

If just 5% of that contracts coronavirus (it will probably be upwards of 20% but let’s be conservative for argument’s sake) that makes one ICU bed for every 408 coronavirus cases.

If only 5% of all cases require an ICU bed (as per what has happened elsewhere around the world)… Then what we have is one ICU bed for every 20 coronavirus cases that need ICU. That’s WITHOUT trauma cases, strokes, heart attacks etc that will also require ICU care.

And I have been very, very conservative in those equations.

North of that hospital, as you get beyond our nation’s boundaries and deeper into our heartlands, the health services deteriorate even further. It’s not uncommon to be 2-3 weeks before we get a doctor to our health center for one day, and they are then soon booked solid. Nurses that work for Maori health providers are paid less, and along with being underpaid, are overworked. Consequently, they burn out faster and we have poorer health services. Reason 3 we are discriminated against – the racist health care system disadvantages Maori through inequitable access to health care.

So there we have it, three good reasons why COVID-19 will hit Maori harder. It will in fact discriminate in a multitude of ways.

And what can we do about it? Well, for all the reasons above we need to be pro-active at a whanau, hapu, and iwi level. Here’s what we have chosen to do as a whanau:

SELF ISOLATE
We have taken our girls out of school and asked for the next 2 weeks lesson plans. As we saw in Italy, a lot can happen in two weeks. We will reassess every two weeks but I’m guessing this is just the beginning. We are now developing our daily schedule for school time, exercise, and play.

We have discussed how we will approach shopping. This includes minimising the need to shop by:

• Eating from our maara, hunting, fishing, diving
• Shopping online
• Portioning our kai

When we do need to shop, we will likely be prioritising the local 4Square over the trip to town, and again avoiding peak business times.

The pocket hand sanitiser goes with you when you leave the house, and you disinfect regularly while away from home, and straight away when you step in through the front door.

We have asked whanau to call ahead if they wish to visit, and to consider an online video call instead. Anyone who is unwell is asked to stay away. This, we will also review, and are ready to make it a blanket ban on all visits (to be honest we don’t get many visitors where we live anyway, we are quite isolated).

Our acts of isolation and physical distance are not just in concern for ourselves, though – these are acts of aroha for our community and vulnerable whanau, as well.

 

(This stunning wahine and her love for her people. Ataahua).

PREPAREDNESS
We have supplies for at least two weeks for food, cleaning products, and medical supplies. Here is a good site for household preparedness, along with a list of household supplies for self isolation. We also have a generator and fuel backups in both gas and petrol.

We have spoken as a whanau (and in an age appropriate way) about the virus and the changes we need to make, and why.

We arm ourselves with quality information from reputable sources, and steadfastly ignore conspiracy sites/theories.

TIKANGA A WHARE
We all practice regular “TikTok” handwashing (washing your hands for the length of a TikTok) and hand sanitising.

Anyone who comes to visit is asked to sanitise when they come in the door. We have made our own hand sanitisers, and surface spray, and are also disinfecting. Below is the video tutorial on making your own hand sanitiser (You can access the recipe, and the soap and surface spray recipes by clicking on the Facebook icon on the bottom right of this clip).

 

Here is a good, informative link about disinfectants and surface sprays. We are wiping down anything that is bought from the shop as we have no idea who has handled it, and differing reports (the science still appears out) estimate anything from a few hours to a day or more of time that the virus may survive on a surface.

We commit to keeping our whare light in heart. Screen time is extended. We let them have their time on their devices. We are trying to just make the most out of having more whanau time together. Sharing loads/responsibilities and making sure we have our own “breakaway” time to help manage the stress or anxiety. We are blessed with extensive yards/gardens to hang out in. Make the most of that if you can.

HAUORA WHANAU
We are keeping healthy, as a whanau. Fresh fruit and vegetables, healthy meals, exercise, fresh air, hydration, and lots of wai-kawakawa (our traditional cure-all drink) to keep our health as well as it can be. All of their regular medicines are stocked (pamol, inhalers etc) and we have their vaporiser on at night. We want to avoid, if possible, engaging our health services which I’m anticipating will be overwhelmed very soon (they are already dysfunctional, overwhelmed and are usually doubly overwhelmed come winter flu season). We certainly want to avoid taking our girls into hospital if possible (for anything), as that will likely be one of the most infectious zones in the near future. So keeping ourselves as healthy as possible to avoid the need to go to hospital or health clinic to start with.

Sort a routine for school/work/housework (which is more important than ever even though I loathe it just like last month) play/exercise and try to stick to it (easy to say on Day 1 huh).

Look after the sleep routine (she says as she stays up late to write this blog ON Day 1).

HAPU/COMMUNITY/MARAE
Here are some precautions you may want to email the Aunties/Uncles about and get the conversation going:

Are there unnecessary bookings at the marae that could be cancelled?

Do you need to consider closing the marae, for the safety of ahi kaa?

Do you have the numbers of ahi kaa that are not immuno-compromised or otherwise vulnerable, to staff your marae if you have a pohiri/whakatau? Do any of them live with immuno-compromised or otherwise vulnerable whanau?

*NOTE: IMMUNO COMPROMISED MEANS Conditions that involve lungs / breathing problems (e.g., asthma, COPD, lung cancer). Heart conditions, particularly chronic cardiovascular disease (e.g., hypertension, congestive heart failure, atrial fibrillation). Conditions that involve compromised immune function, or that require taking immunosuppressant medications (e.g., lupus, arthritis, organ transplantation, some forms of cancer). Other chronic hematologic, hepatic, metabolic, neurologic, neuromuscular, renal, or disorders (e.g., sickle cell anemia, diabetes, muscular dystrophy, kidney disease).

If you don’t have ahi kaa that will be safe (and I’m banking this will apply to most Maori communities) – then are you in fact willing to ask your ahi kaa to take this risk of their own lives, or their whanau that they live with, for carrying out the duties of pohiri/whakatau?

For those that choose continue with hui:

Should these be essential hui only and what qualifies as “essential”?

Who will be responsible for “policing” hand washing and sanitising regimes?

Do you have a surface sanitising plan?

Are you suspending hariru?

Can you message whanau who are unwell, have recently travelled, or are vulnerable (see above), to NOT attend the hui, for their own sake and that of attendees/their whanau/communities?

Can the younger men man the pae in order to further protect the pakeke?

How might the ahi kaa safely shop for catering?

For rural marae/communities: can you message out on your marae page and ask whanau to consider virtual gatherings/catchups rather than coming to visit from town?

Checking in on pakeke – do they need anything picked up from town? Call them on the phone for chats – this is a scary time for them and potentially lonely. Mental and physical health is tightly interwound for our pakeke and loneliness/depression can often lead to poor physical health.

Check in on your whanau and friends too – call each other for chats. There are a lot of us who are scared, unsure, or are missing friends or lovers, or whanau because they are stuck overseas… there are people who have lost loved ones. Call, chat, send love, even just a few words of support in a message can pick someone up for the day.

Here is a good card I’ve seen doing the rounds to offer help in your community. Of course this needs to be done in a way that is safe and minimises physical proximity (kaua e @ mai e pa ana ki te reo, ko te whakaaro te mea nui).

Also just gonna say… in my Nanny’s day, they were very decisive about the protection of their hapu borders. I’m gonna just leave this here:

Moving right along…
IWI

Iwi often have political relationships that can be handy at a time like this – how can iwi be leveraging their relationships with ministers and agencies at this time to support hapu in their approaches, and support whanau who are struggling, whilst also securing enhanced support for iwi health and social service providers?

Support for whanau to upskill in virtual hui, or access devices to call their whanau and friends, is a simple, concrete action that can be taken to alleviate the emotional anxiety many will be going through at this time.

They usually also have offices – which will need their own rules/policies developed to protect staff, who are so often our own whanau as well.

Here’s the ever-inspirational Ngati Kahu response that I think gave many iwi/hapu around the country something to think about:

 

Even though we are self isolating, there are ways we can support each other. Phone calls, remembering to also post light, funny, supportive content on media alongside the natural concern. Try to minimise the panic posting/panic buying/panic stressing. Stay informed from reputable sources. Here is a really great COVID-19 in Aotearoa Facebook page that I’ve found solid advice on so far.

As Indigenous peoples, we have always adapted and survived. We can adapt and survive  this too. It won’t last forever, but it is important that we understand our own agency to act, how important it is for us to do what we can, as soon as we can, and to be proactive in our own protection.

Kia kaha ra. Don’t buy all the toilet paper.