Indigenous Environmental Health: Report of the Fifth National Conference 2004

Widening the Thin Edge of the Wedge: Benefits of Indigenous Community Control and Involvement in Environmental Health Initiatives

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Maria Jellie and Dr Jeff Foote, Institute of Environmental Science and Research Limited, New Zealand

Maria Jellie

I’d like to acknowledge our co-researchers who couldn’t be here today, Marara Rogers and Hone Taimona from Hokianga Health Enterprise Trust. As always, it’s funding that inhibits these things, but hopefully next time they will get to come.

I’d like to explain the title ‘Widening the thin edge of the wedge’. In 1999 some devastating floods in the Hokianga led the Ministry of Health to sponsor a pilot program to see if it was feasible to provide safe drinking water at small, isolated Maori communities. A Ministry of Health representative went up to the Hokianga and spoke to a health protection officer to explain what they were going to do. The health protection officer said, ‘Why are you doing water? That’s the last thing on our list of priorities! Our first would be unemployment, the second would be housing, third would be sewerage and fourth would be water - why are you doing water?’ The answer was ‘Well look, the government said they’re going to do this pilot. You’ve got to grab that opportunity, use it as a thin edge of the wedge, so other spin-offs may come from that. ‘This is really what our presentation today is about, how the pilot has been the ‘thin edge of the wedge’ and other spin-offs that have come from it.

Jeff Foote

First I am going to talk about the Hokianga region, which is located on the west coast near the top of the north island, about three hours’ drive north of Auckland. It’s a small, isolated region with a population of about 5000 people, and it’s thinly spread over a number of marginal roads. It’s an amazing place of incredible beauty, but the Hokianga also suffers from multiple disadvantages, with high levels of sub-standard housing and unemployment, and high rates of disability and illness. In recent years a number of Maori have come back from the cities to the traditional lands that surround the 36 marae clustered around Hokianga Harbour. Marae are central to communities because they’re a place where guests are housed and fed when they attend weddings and funerals and they’re also an important place where people can come together to talk about issues of importance to the community. The marae is actually the whole complex, so it not only includes the meeting house or wharenui, but also the kitchens, the ablution block and the eating area.

The work that Maria and I are reporting on today, which was not part of the pilot, but used the pilot as a case-study, looked at how community development principles can be used to address tricky environmental health issues like drinking water quality in rural, isolated communities.

With the Hokianga Health Enterprise Trust that the Ministry of Health actually contracted to manage the pilot and one of the participating marae communities we undertook a collaborative evaluation of the pilot from a community development angle.
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Maria Jellie

Through talks with the Ministry of Health, it became clear that the pilot needed to be community-driven. History has led to a lack of trust of anything that comes from government. The Ministry of Health therefore approached the Hokianga Health Enterprise Trust, which is a community-owned health trust, to undertake the contract and be the interface between the Ministry and the community. The Trust became responsible for the engineering design and manufacture, and the management contract.

A key aspect of the success of the pilot was that the Trust employed a Kaupapa Maori consultation process to determine which marae and communities would be interested in participating in the pilot. Kaupapa Maori means doing it as a Maori process as opposed to a Western process.

They carried out the Kaupapa Maori consultation process by employing two kaiwhakakokiri, or negotiators. The kaiwhakakokiri were two local Maori who had genealogy to the Hokianga, they could speak Maori fluently and they knew Maori customs. They also had some technical knowledge so they were able to liaise between the engineers and participating hapu, which are sub-tribes. That was important because they could talk to the engineers, understand what they were talking about and then take it back to the community and say what the options were and what was happening.

An example of how the pilot could have fallen over had they not followed the Kaupapa Maori process, is that there was not enough funds for all 36 marae in the Hokianga to gain safe drinking water. The Maori world is very political. If some marae got to participate and others didn’t, it could have had huge repercussions for the relationships between different sub-tribes and relationships between the Hokianga Health Enterprise Trust and hapu. The two kaiwhakakokiri threatened to resign if all the marae did not get done so the Trust ‘looked outside the square’ for other funding. They brought in the Auckland Savings Bank Trust (ASB) to talk to individual marae to see how they could help finance the pilot. Each marae then had to negotiate with ASB Trust about what was needed, and many were able to get new ablution blocks and kitchens. This relationship with ASB Trust continues today and every year marae put in applications for funding for different projects.

Some of the other spin-offs are:

• Elders are now able to stay longer at marae because of improved facilities. Before they couldn’t stay because they wouldn’t be able to use the toilet facilities or be able to shower.
• Educational projects such as Maori language and genealogy are now being undertaken regularly at marae, building and reinforcing cultural identity.
• Improved project management skills, through each hapu negotiating with ASB Trust and also getting their safe drinking water in, means hapu are able to undertake further projects, whether they be capital works, educational or health, so as to benefit the hapu.
• The pilot has also strengthened the relationship between the Hokianga Health Enterprise Trust and hapu allowing further public health initiatives such as smoke-free marae, fire safety and food safety.

Jeff Foote

Through a series of workshops with the Hokianga Health Enterprise Trust and one of the participating hapu, we had a close look at what aspects of the pilot worked and we were able to identify a number of success factors.

The first success factor was devolution of central government money to a community organisation - the Hokianga Health Enterprise Trust - that had a good relationship with its community. This quote from the Trust nicely captures this:

What they were asking us to do was to be the go-between for the Ministry, [to be] an interface for the community … distrust [of the pilot] was [going to be] one of the things. But we also knew that we did have a lot of respect from the community from our health services [and] the fact that we were a community organisation and that we already had fairly good links with the community.¹

The second and related success factor was the employment of the two local negotiators who were able to engage with communities on their terms:

One of the things that actually gave credibility to Hokianga Health [with the communities] was the appointment of two men who could [speak] Maori clearly and understood the [customs] of Hokianga. So it wasn’t just the fact that they could [speak Maori] they had to be have genealogy back, know the history. They [had to] know how Uncle Bill was related to Uncle Bob.²

The third success factor really gives an indication of the dedication of the local kaiwhakakokiri —the time and energy they poured into the consultation and liaison:

[The consultation] was quite varied from marae to marae and community to community … In some cases you went and had one [gathering] on the marae and people came. You had the [talk] and everything was okay. And in other cases you were called back time and time again … It was any time of day and any day of the week. If [we] were asked to come and meet and address an issue that’s what we did. It wasn’t quite a nine to five job. But we expected that. That’s again the way in which community process works. Right up front we said we would be open to discussion whenever, however.³

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The fourth success factor relates to seeing health in terms of community ownership and capacity rather than just the absence of waterborne disease:

I [would] give them the invitation for them to take it over and they [would] take it over … [I] don’t [want to] be with them, but be at the back of them. That’s the concept. The key for us is to make ourselves redundant from [the] project and go on to the next project, you know. Because now they can do it. You were just there initially [to] help them and then the more they can do it themselves the more you step back. ⁴

Another success factor was that each organisation saw the pilot as a way to further its own organisational interests beyond providing drinking water. Take for example, the Ministry of Health - Maria talked about this idea of widening the thin edge of the wedge - they saw the pilot not only in terms of clean drinking water, but also as a way to highlight other important environmental health issues in the Hokianga. What’s really exciting is that Hokianga Health has seen the pilot as a way to develop its thinking around community development, and particularly how they can use the Kaupapa Maori consultation process to look at other health promotion/health protection issues like fire safety and nutrition. And the hapu themselves have also used the pilot as a way to achieve other goals, like employment, and also highlighting issues to do with kaitiakitanga or stewardship over the waterways.

Through the workshops we all gained a deeper understanding of what makes community development processes sustainable. We now see community development in terms of widening the thin edge of the wedge or a virtuous cycle, driven by best practice.

However, we realised that implementing best practice is really difficult and can potentially create problems that can turn a virtuous cycle into a vicious cycle, where problems lead to loss of confidence and people are less likely to expand projects. This led us to the conclusion that the success today of Hokianga Health Enterprise Trust and the participating hapu had been their ability to manage ‘best-practice tension’.⁵ For example, at the start of the pilot there was a possibility that the Trust would have to ration access to clean drinking water. They harnessed that tension and came up with a novel solution - the ASB Trust funding - that led to a number of spin-offs that helped drive a virtuous cycle forward.

Maria Jellie

What now? Well, we have some future collaborative research with Hokianga Health Enterprise Trust and hapu in the Hokianga. In 2003, Hone Taimona from the Trust decided to widen the wedge a bit further and asked if we could help refine the community development model by applying it to failing septic tanks at marae. So we, along with the Trust, and in consultation with hapu, developed a three-year Health Research Council bid to refine the community development model and apply it to septic tanks at marae. In May 2004 the bid was successful and in December 2004 the work will begin.


For further information
Maria Jellie
Social Scientist,
The Institute of Environmental Science and Research Limited
PO Box 29–181, IIam, Christchurch, New Zealand
Phone: +64 3 351 6019
Fax: +64 3 351 0010
Email: maria.jellie@esr.cri.nz

Footnotes
1. Hokianga Health Enterprise Trust, 2002
2. Hokianga Health Enterprise Trust, 2002
3. Verbal Communication, Kaiwhakakokiri, 2002
4. Verbal Communication, Kaiwhakakokiri, 2002
5. Huxham, C 2003

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