Introductions mean a LOT for us in Te Ao Māori – we have ritualised first encounters, and getting to know each other, in sophisticated and deliberate ways which help us to honour both our difference and similarities as a grounds to moving forward. There are small jokes commonly heard in these encounters, one of which is “I’m from [small rural town] – center of the universe” and we all laugh at the irony, but also appreciate that to each person, that small town, in land and blood, is their umbilical tie to the world around which all else has grown.
My home is just one such of these places. Matakāoa is perched on the tip of the eastern fin of Te Ika a Māui, the great fish of Māui. Traditionally it refers to a peninsula in our region but it has come to encapsulate the collection of communities from Pōtikirua to Ōtiki, and south to Whakaangiangi. We have 16 hapū in our rohenga. Our area currently holds about 1800 people, but this swells about 4 x that size over the summer as descendants return from around the country return to connect with their umbilical center for the holidays, and regional, inter-regional, and international visitors descend upon us to enjoy our famed beaches and “wild, remote” environment. I’ve written a number of times how this becomes a problem for us in the context of a pandemic, because we have limited health infrastructure, and long after people have packed up and gone home where they have access to pharmacies, emergency services like paramedics, GPs and hospitals – we remain here dealing with the fallout of their visit, but without the health safety net to assist us.
If there is a trauma incident, we have no paramedics. Ambulance transfers can take up to 5-6 hours or more. If you need medicine, you need to wait for the next courier (ie you need to order it before 1pm or wait for the next day/Monday). Access to a GP is not a given, nor is access to a vaccine or PCR test. Secondary services (dialysis, physiotherapy, chemotherapy) are the same 3-4 hour drive away. It’s difficult to convey exactly what it’s like to have this as the norm. Most who visit here don’t really understand what its like until they have a very sick child at 10pm, or a severe accident, and there is nobody to come and help them.
When I listen the discourse on remote, isolated, rural communities, there are some common assumptions in the subtext – one being that our difficulties are borne out of our geographic location. What I don’t see much appreciation of is the fact that the very notion of being “isolated” is imperialist in nature. One must ask: isolated from whom? From where? An isolated community on the fringe of somewhere depends entirely upon someone defining where an infrastructural center is, so who gets to make that decision, and in whose interests is that decision made?

If you turn the years back to pre-colonization – the various communities of Matakāoa were anything but neglected, because they were anything but remote or isolated, and this is because Aotearoa had not arranged itself according to an imperialist paradigm that centralises power and decisionmaking. Decision-making was localised, the management of resources was centered around that resource, and the intergenerational strengthening of the relationship between person and place ensured that the management enhanced with every generation. As one generation passed on all they knew about their river to the next generation, and taught them all of the science and skills in how to care about it, the next generation, living on the river, would grow that science and those skills, continue the observation and care (upon which their own existence and comfort depended), and through these means, the science remained relevant, contextual, and robust. Science, within this context, supports abundance. While people marvel at the strength of Indigenous science in caring for biodiversity and abundance, what they often miss is that it is a very predictable and natural result of an extended relationship and interdependence upon their traditional territories. What they also often neglect to discuss, is the fundamental political reality that the theft of Indigenous lands and waters, and the refusal to return stolen Indigenous lands and waters is not just a crime against the people, but also against the environment.
Before colonization arrived, we were not dependent upon a regional center to provide us with medicine, or skilled medical staff, or transport to care. We cared for each other, and our environment and it in turn provided for us. We were the center of our own universe. We were not dependent upon Wellington to provide us with funding or to include us in decisionmaking about our river or coastline. Power was distributed much more broadly, much more efficiently, and in a more localised fashion.
So what has this process of centralising power meant for communities like mine? In an imperial paradigm, the remote regions are treated as extraction zones. A Doctrine of Discovery mentality legitimises exploitation of the remote regions, for the benefit of the center. Each center in turn, contributes to the next-greater center until you reach the power-hubs of Empire (hint, these aren’t in the southern hemisphere). Think I’m being dramatic? Not too long ago I sat in an environmental commission hearing and listened to the council describe the characteristic of a small area nearby as being one of “extraction”. When I asked what they meant by that, they stared blankly at me like I should know and then explained that all rural sites are considered an extraction zone because we are not in the city or suburbs. I found this assumption (and it’s apparent normality to everyone in the hearing) deeply disturbing. Rural communities have been subjugated without consent as sites of exploitation for the benefit of selected centers. Geo-positioned into subservient roles because someone, at some point, determined that Tūranganui-a-Kiwa (Gisborne) would be the regional center upon which we depend. Our classification as an extraction zone functions within the resource management system to justify the continued exploitation of our waterways, soils, and coastline for the benefit of empire.
It’s not just environmental exploitation that shapes our reality, but social exploitation as well. Power and decisionmaking is accompanied by infrastructure, it comes with other supportive jobs and industries. It comes with training and education – so when power and decisionmaking is centralised all of the infrastructure that surrounds power and decisionmaking also becomes centralised. Not only do places like Matakaoa then become powerless extraction zones, but the dominant income is medium to low, often involves further exploitation, and is manual in nature (which means higher risk of injury). When the average income is below the poverty line, and utility services like plumbing or electricians are more expensive (because they too are centralised and charge for travel), housing is going to be poor. When the dominant jobs in a region are manual and high-risk, and housing is poor, people are more often injured or sick, so the demand for health services is greater and more complex, but guess what – health services are centralised, too. So not only is the need greater, but the access to care is significantly lesser. It’s hardly surprising that young families who want better health care or employment prospects opt to move to the cities. When funding and infrastructure is determined by population base, it so often discounts the role colonialism has in the re-distribution of populations, and so on it rolls with roading, energy and communications infrastructure being centered around urban locations, and these same vital systems being severely neglected for rural isolated regions.
Is this experience of rurality the same all over the country? No – in fact some of the wealthiest communities in Aotearoa are rural farming communities. Farming stolen land, taken from Indigenous hands many generations ago, and exploited for material gain. Unsurprisingly, these are the families who often have intergenerational access to regional power through seats at council. Councils around the country started off as roading authorities, existing to enable access for landgrabbers to farm Maori land from the late 1800s, and since then they have been largely dominated by these interests. Consequently the bylaws, processes, decisions and plans coming out of these councils have benefited that same demographic. Rurality is very much racialised, and the economic realities faced by a young Māori family trying to stay on their family land in Te Araroa is incomparable to that of a wealthy pakeha farming family in Te Awamutu – yet somehow I often find myself at the same table with them when it comes to discussing rural health.
The redesign of our health system in Aotearoa has recognised the need for a rural health care strategy – and we have yet to hear anything about what that strategy entails, but if it hopes to account for our own nation’s history of injustice, it must take into account that rurality is deeply racialised, that we are not inherently remote but made that way by colonization, and it must deliberately aim to return power back into the hands of those who have been treated as second-class sites of exploitation, for too long.
The submission was enlightening to a white reader interested in caring and helping indigenous groups where I live. Thank you!
Very interesting comparison between rural regions with Pākehā farm-owners, and rural regions with Māori populations, and how this affects where health services are centred.
Kia ora Tina, I’m sitting on my couch In Ruatoria listening to the rain and have just finished enjoying your article. I actaully spent the day up at Te Araroa – why are the fish and chips so much better than Rua’s when it’s the same folk running them both? Not as important a question as the one you pose about rural healthcare. It certainly resonated with me, and my families experiences on the Coast. Ngā mihi o te tau hou, Stephen
Tena koe e Stephen. The rain has not yet arrived here in Te Araroa but we are sure due for a battering in the next couple of days ne? Made sure all our isolating households are stocked up and prepared for road closures over the coming days. Stay safe e hoa, and I’m glad you enjoyed the musings. xxx