Got to thinking about whanau ora. Tariana says that whanau ora (family wellbeing) requires a radical change of mindset about how we deliver services. She said it is not about "growing service provision or organisations" it is about families and their wellbeing.

Anyway, in thinking about this I came up with the following scenario. A Maori man aged 54 years presents with all the indicators of someone who has type 2 diabetes. He lost his job during the latest recession. He is a proud man used to providing for his family- this is the first time he has been out of work and he sees no hope of getting a job in his future. Age and health are against him. He suffers feelings of hopelessness and helplessness. But! good news his wife is working 30 hrs per week at $12.75 per hour a grand total of $383:00. They live in a 1950's State house with no insulation and an open fire. Their 16 year old grand daughter lives with them, her school work is deteriorating they suspect her boyfriend hits her and that he is "doing" drugs and are worried that she might follow.

Currently we take a microscopic approach to meeting the needs of people who present for treatment or support i.e treat the diabetes counsel him about the need to exercise (even though he can't afford good walking shoes) the need to eat a well balanced diet protiens, good fats, natural sugars etc (have a look at their income!). If we take that approach we may be meeting our contractual obligations to the funders we might even believe that if he doesn't get better its because he is being non compliant BUT we will have totally missed the mark for this man. We may as well have saved ourselves the trouble and put a nail in his coffin. As health professionals and in the words of a well known local health professional himself Robert M Elliott “Our professionalism negates suspicion”

A whanau ora approach would have us facilitating a meeting with the family to identify what they believe to be the most pressing issues facing them then prioritising a whole of whanau approach. This man and his wife may have as their first priority the safety of their grandchild or insulation for their home or employment. The thing is that this man together with his whanau will identify what their priority needs are. The whanau ora worker in a facilitative role underpinned by their professional knowledge and skills will support the whanau to access the means to meet these needs. In so doing, the professional (nurse, social worker, psychologist, doctor, domestic violence expert, corrections officer etc) or care giver working in their capacity as a whanau ora worker supports in a strengthen based manner the whole family in their quest for wellbeing. Experience tells us that with each achievement towards meeting their goals, confidence grows, pride returns and a sense of wellbeing increases.

The process is as simple or complex as those who have a vested interest in making it work or fail determine. Funders need to stop using "accountability" as a tool of power and control over service providers- a barrier to innovation in service provision and to changing the mindset on how we provide services. A number of organisations are already operating within a whanau ora framework strengthening the whanau and the members therein. Where evidence exists that this is happening, those organisations should be recognised and their contracts should be fairly applied.

Na Mere Balzer