“When I started to talk about how terrible things are, I became overwhelmed”
The way NRHCC official have treated Pacific providers seeking to co-design an ethnically targeted community care programme has been “beyond depressing, it’s rude”, says Manukau specialist GP and chair of the RNZCGP Pacific chapter Api Talemaitoga.
After weeks of working with the Northern Region Health Coordination Centre, Dr Talemaitoga withdrew from the process earlier this week and flew to Christchurch to work at his Normans Road Surgery.
“But it is not for the want of trying or a lack of desire, it’s been exhausting,” he says. Dr Talemaitoga is also co-owner of Cavendish Doctors in Manukau and chairs the Pasifika GP network.
“This is about lives, and I’m out of ideas for how to get people to understand that there is a better way than ‘one size fits all’. Christchurch is much more peaceful.”
Lack of trust
Dr Talemaitoga was part of a collective of Auckland’s Pacific healthcare providers, clinicians and partners who have developed a model of care to make self-isolation work better for Pacific families.
He says the providers have a track record of success throughout the pandemic response and know how to engage with disaffected communities and build trust.
“We were saying, ‘Yes, we can do all that, the wrapround, the housing, the welfare’, and then we were told how to suck eggs. “There is still a lack of trust, or ‘we don’t know if you can deliver’ and, after all the work everyone has done, I find that more than depressing. It’s beyond depressing, it’s rude, and I’m tired of banging my head against a brick wall.”
They have been pushing for the establishment of a Pacific hub, a central point where positive Pacific cases can be referred for assessment before being provided with wrapround support and assisted to isolate safely, whether at home, in MIQ or in hospital.
A statement released to New Zealand Doctor Rata Aotearoa yesterday by NRHCC communications adviser Katherine Irvine says a pilot programme has been signed off by the Pacific clinical leadership group and the NRHCC working group and will begin next week. It will be run by Pacific healthcare providers South Seas Health and The Fono.
NRHCC declined to respond to Dr Talemaitoga’s criticisms, but his views are supported by South Seas Healthcare chief executive Silao Vaisola-Sefo.
He says their practice’s wellbeing hub successfully contained the Assembly of God and Mongrel Mob clusters after the “one size fits all approach” failed, but their attempts to assist further Pacific clusters went nowhere. “It was like there was a bottleneck somewhere. Then this new community care plan came in and we were back to the old model.
“I understand NRHCC are overwhelmed, but give us more ownership, we can do this. I 100 per cent support what Api is saying, I have been frustrated as well.”
Debbie Sorensen, chief executive of whānau ora commission agency Pasifika Futures, is also losing patience with the attitude of health officials toward Pacific providers.
She says her deputy had to haul her out of a recent meeting after she started to lose her temper.
“Last week, I felt like I had fallen down a rabbit hole and when I started to talk about how terrible things are, I became overwhelmed.”
The Ministry of Health yesterday confirmed the third death in seven days of a person isolating at home and Ms Sorensen says, with the situation expected to worsen, she is fearful about how the community care plan is rolling out.
“I’m fearful for our people, I’m fearful for those now sitting alone at home, and I’m fearful for the mental health and wellbeing of our workforce. There seems to be this belief general practice has all this spare capacity…”
After allocating $12 million on things like MIQ support, food parcels and incentives for vaccinations, Pasifika Futures is also fast running out of money and is yet to be assured more funding will come, she says.
Asked about this, associate health minister Peeni Henare responded via email: “I am advised that officials are aware of the situation and are currently looking into it.”
Ms Sorenson says getting help from officials in Wellington has been complicated by the large number of COVID-19 committees.
As well as being part of the Pacific expert advisory group and talking three times a week to the wider network of Ministry of Health agencies and healthcare partners, she says she is dealing with a variety of other working groups.
“There are just too many, the system is too complex, and they really need to talk more to the people on the ground dealing with this situation. I don’t think you need to be in Wellington and understand the pressure, the daily effort, and the intensity of what is happening.”
She points to a worsening depth of need among Pacific families, especially within those who were already in poverty when COVID-19 arrived. Pasifika Futures has distributed 47,000 food parcels during this outbreak; this means one in three Pacific whānau are now receiving their aid. She says mental health issues and domestic violence are spiking.
At the same, she says healthcare providers are now going door to door to get vaccines into people arms, a process she says would be helped in they knew who and where the unvaccinated people are.
“[Whānau ora commissing agency chief executive] John Tamihere has been working hard to get that information, but I have to ask, why does he have to go to court for it? Why did the Ministry of Health think it was okay to fight back?”
Europa Kupu, whānau ora manager at Pacific healthcare provider The Fono, says the domestic situations her staff are encountering require ongoing counselling from their mental health team.
Ms Kupu’s team of 15 has also been working without a day off for weeks, responding to every new positive case that is referred to them until 9pm every night.
She says her small team has big hearts, but the scale of their workload is now entering “new territory”, with about 100 new cases arriving every week for assessment followed by ongoing welfare support and mental health checks.
She says large families are becoming stressed by calls from the coordination centre. Close contacts are called every two days, and positive cases are called daily, but separate calls are being made to every member of the household. As a result, Ms Kupu says some families no longer answer the phone.
More, bigger, faster
Ms Sorensen says the current community care plan does not seem to take into account the living conditions in multigenerational homes where people refuse to go into isolation because it would leave their elderly alone.
“More money and more resources, we just need more, we need bigger, and we need faster,” says Ms Sorensen. “And this situation is only going to get worse, so we also need to show a pathway forward.
“The pressure is only increasing and this experience will take our families a long time, years, to recover from. Right now they need hope and inspiration.”
Source: NZ Doctor