Tihei Mauri Ora: the breath of life: the conceptualisation of Tihei Mauri Ora within a Bachelor of Midwifery programme

Abstract

Tihei Mauri Ora was designed as a culturally defined positive action plan for the recruitment and retention of Māori students into the health professions of nursing and midwifery. Tihei Mauri Ora was developed by Māori for Māori with a kaupapa Māori philosophical structure incorporating Māori concepts and values while situated in a mainstream polytechnic and subjected to the ethnocentric mores and values within that. This challenge of a kaupapa Māori support structure for Māori nursing and midwifery students was conceived in a questioning climate with Māori featuring negatively in health, education and welfare statistics and concerns raised about the safety for Māori within the monocultural structures of mainstream services. Concerns were voiced from many fronts and were the focus of a series of national hui called by Māori. Specific issues identified by Māori student nurses within their theoretical and clinical educational environments were heard by nursing educators and leaders. The National Council of Māori Nurses led the processes that culminated in the development and inclusion of cultural safety as core papers within nursing and midwifery curricula nationally; a directive of the Nursing Council of New Zealand in 1992. Tihei Mauri Ora concepts arose out of those debates where Māori nursing educators at the Waikato Institute of Technology (Wintec; formerly The Waikato Polytechnic), assisted by Pakeha colleagues developed a programme to implement these ideas. The purpose of this study was to capture the voices of four key persons whose vision and energies culminated in the initiation of Tihei Mauri Ora, supporting Māori students in the nursing and midwifery programmes at Wintec. The stories focus on the vision, aspirations and the pioneering journey to provide a culturally safe learning environment whilst developing skilled health professionals strong in their identity as Māori and appropriately prepared to work with Iwi Māori. A kaupapa Māori framework was used as the research design so it was possible to position the research within a Māori worldview and conduct it in a culturally appropriate manner. These real life stories from the field identify the pervasiveness and constancy of institutional racism and some effects on individuals when implementing a kaupapa Māori concept within a monocultural institutional structure. Recommendations include ongoing consideration and positioning of the Treaty of Waitangi within organisations and its use as a living document to be truly reflective of the needs of tangata whenua. The necessity of cultural safety core papers in nursing and midwifery curricula is acknowledged for the acceptance, understanding and valuing of difference within health care services. Understanding these stories provides a significant insight into an approach used to increase the number of Māori nurses and midwives providing culturally inclusive and safe practice with Māori and contribute to improving the health of whanau, hapu and iwi Māori. Tihei Mauri Ora is an example to learn from, an elevated starting point for future pioneers.