By Guest Author 17/10/2021

Rawiri Jansen, National Hauora Coalition

I write this as I charge my car, getting ready to head home at the end of a pretty good Super Saturday.

It started with coffee and checking the news feeds as any good day should. Between 9 and 10 am as I drove to the first Covid Vaccination event I made a couple of calls. Firstly trying to expand our call centre capacity to call out to Māori patients not yet vaccinated. We have got the COVID Immunisation Register data matched across our primary health clinics and we need to scale up as we roll out to support other Primary Health Organisations. We have two iwi provider call centres joining in, a culturally concordant workforce is essential, and the National Hauora Coalition (NHC) has a technology that smartphones can provide the next patient, the dial details, the script and buttons to record the answers. Sorted.

The next call was from my colleague in WERO – the tino rangatiratanga Hauora Immunisation Alliance. We need more supermarket vouchers, more of the beautiful face masks and more fried bread. These are going like literal hot-cakes at the four vaccination clinics last week, and the three events for Super Saturday need the additional resources. Sorted.

One more call, the team at NHC might be needed at a Super Saturday event later today! Short notice but can we help? 10 minutes later and we got a Registered Nurse Vaccinator, two Vaccinator assistants and a Covid swabber on stand-by. Sorted and honestly proud of the team.

Vaccination Information Event number one. Awesome whanau from an alternative social network have come together and called for this GP to turn up and answer the questions. Not patsy bullshit questions either. We covered some really important material about vaccine side effects and how these are recorded (answers included discussion of CARM, the Centre for Adverse Reactions to Medicines), we discussed myocarditis, we discussed interactions with medicines, epilepsy and one person who has a rare disorder affecting white blood cells. We discussed how to keep whanau safe if Covid breaks out, and this network invited me back. I have more work to do here. But the food boxes, hygiene packs, and face masks all went down well. The vaccinations were just getting started as I left. 

Driving down the country for the next Vaccination Information and Vaccination event, I joined a zoom meeting (using the one-touch dial function and bluetooth of course) with a couple of brilliant Māori colleagues working in the Public Health unit doing contact tracing and case management organisation work. We had a couple of other colleagues from primary care, and we are all trying to plan how we are going to manage in Auckland on a day not too far in the future when we have 300 cases in one day. How do we safely sort the patients based on a risk assessment, and then begin to organise the services around the needs that whanau will have? This includes some services that primary care hasn’t had much experience of organising or delivering – some whanau will need phones and data plans, or kai and household basics, some will need nappies and laundry stuff. But in primary care we are probably better (although not excellent) at figuring out who in the house has got what conditions and needs what medicines. And should we need an oximeter, exactly how do we get all of this organised and in place within a day or so for a family that needs to isolate, to shelter safely in their house? Not sorted, but we think that we are starting to see the complexity and the scale needed.

The Vaccination Information and Vaccination event in Huntly was at the request of the Mongrel Mob Kingdom and Women’s chapters. It has been in planning for quite a few weeks and the venue changed a few times too. The marquees are up, people are arriving, all socially distanced, masks everywhere. Introductions for myself, Assoc Prof Collin Tukuitonga, and Dr Anette Forrest from ICU – and then we’re into it. Same as earlier in the day, really awesome questions were thrown at us. People really wanted to hear questions being asked, and they really wanted to hear answers. The blunt reality of the stories from ICU were sobering, we could just see the impact, the sense that serious things are in our future. We discussed concerns about how the vaccine was developed so fast, we all kind of agreed to be sceptical about pharmaceutical companies, we agreed that there are some good medicines, we agreed about checking what health conditions people have, and on and on it went. Hell, the sunshine on the rugby league field just next to the mighty Waikato river was beautiful, and hot. Really hot. The questioning was pretty hot too. But genuine, valid and authentic conversations. And the Waikato DHB boss dropped by too. Nice, there is more work to be done, but building the relationships has started. The kai from the team at Waahi Pa was awesome, the vaccinators and swabbers from Nga Miro were great. And again just as I left the vaccinations started. Boom.

Then I got to drive over to the clinic where I work, Te Whare Hauora o Raungaiti just out of Waharoa. The awesome wahine were there getting through the last shots for the day, a few food parcels left and a raffle yet to be drawn, Another record vaccination day at the pa. I had one more zoom meeting, Māori leaders from around the country and Labour Māori Ministers – a really robust discussion. Blunt to be honest (and it wasn’t just me). Minister Willie Jackson had the timer going, and even though we don’t like the camera and screen meetings, actually we have figured out some impressive ways to get the main points across in the three minutes that Willie allows (can be extended if you talk without taking a breath). And some people have prepared typed notes that can be dropped into the chat. Everyone is activated by an intention for good outcomes for Māori, and obviously there are a range of views and a range of approaches. Not sorted, and we are definitely starting to see the complexity and the gravity.

Yes, so heading home, the car is nearly charged. I would have liked to drop in to Papakura Marae Health Clinic as I return to Auckland, the amazing crew that I miss so much since I left last December. They were vaccinating out to the end of Super Saturday. Awesome.

And I am planning for the coming days. We have to get our clinics ready. Covid is coming, and we need to prepare to look after our patients as the outbreak stretches every resource we have. Thought you were tired after Super Saturday? Well, take a deep breath, we’ve got more to do. Much more to do…

Dr Rawiri McKree Jansen is Clinical Director for the National Hauora Coalition, and a co-leader of Te Rōpū Whakakaupapa Urutā, the National Māori Pandemic Group.