.org.nz/journal/vol-138-no-1627/tutakarerewa-indigenous-advocacy-and-structural-racism-in-bowel-cancer-screening-in-aotearoa-new-zealand” class=”visited:text-foreground-secondary visited:decoration-stroke-link underline-brand-hover hover:visited:text-foreground-primary”>New Zealand Medical Journal, highlighted the government’s failure to fully implement experts’ recommendations to lower the bowel screening age to 50 for Māori and Pasifika people.
Māori are disproportionately affected by cancer at younger ages, are diagnosed at more advanced stages, and while rates of bowel cancer are trending down for non-Māori , they are increasing for Māori . Māori are also more likely to die within two years of a bowel cancer diagnosis.
Kidd is now 62, and her cancer has spread from her bowel to her lungs. She says she was fighting for the right to understand her symptoms but explains: “It’s not a diagnosis that you want.”
Since then, she’s penned a memoir, Ngākaurua: My experience of cancer, identity and racism in Aotearoa , detailing the health inequities Māori experience and advocating for whānau .
She recalls the tough way the diagnosis news was delivered – when a surgeon was confident the tumour had been removed in surgery but hadn’t checked the changed biopsy results – before eventually being told it was terminal by an oncologist.
Her experiences reinforced to her how complex visiting a doctor can be for Māori, especially when factoring in treatment by the healthcare system, potential bias, and survival rates.
Her own grandmother didn’t want to visit the doctor despite noticing changes; she was eventually diagnosed with Parkinson’s after 15 years, Kidd says.
“If you don’t know, you don’t have to accept the treatments. You don’t have to turn yourself into a patient who then is kind of pulled and pushed around by the sector to get to different appointments and take different medications.”
The healthcare sector was never set up to include Māori , she says. A focus on a standard biomedical approach left a gap when it came to Māori ways of being, connection, and hauora , she says.
“When you have that kind of absence, that sometimes is compounded by interpersonal racism … whānau just go, ‘Look, I would rather stay out here where it’s safe in my own community than deal with walking into someone else’s community and being treated poorly’.”
But even those who do seek care often aren’t heard, and their needs for diagnostic tests or referrals aren’t usually met, she says.
“We miss opportunities, and the commercialisation of primary healthcare has really done a disservice to our GPs as well – not giving them the time to understand anybody who doesn’t walk in the door with a list of symptoms and questions.”
She recalls one man who went to the doctor because he said he could no longer ride his horse, and the GP sent him home with painkillers.
“Anybody who’s thinking – and all the nurses who are listening, I can guarantee they’re thinking – ‘Why? Why was that so important that he had to come to the doctor? Has he been to the doctor before?’ And the answer to that was no.
“He had lung cancer that he was experiencing through back pain, and he passed away shortly afterwards.”
Cultural safety education needs to start from within, Kidd says, including challenging our own perspectives and lived experiences.
“What we hear a lot from Pākehā students is, ‘I don’t have a culture,’ and what that really means is because it’s everywhere, you don’t need to see it. Until you go somewhere where you’re the different person and your culture is different, you actually don’t notice the things you take for granted – like the things you celebrate, the way you celebrate, and the way you form relationships and maintain relationships.
“Until you have pride in yourself and your own origins, you can’t develop the humility and empathy that allows you to ask questions about other people’s origins and how they experience the world.
“So it’s not about a tick box thing of needing to be Māori , needing to learn how to be Māori or how Māori think, because we’re all really different.”
For her, she doesn’t see this stage of life as having a “larger purpose” or ticking off bucket lists. Instead, she’s grateful for where she is as she explores a “living-dying” space – a reversal of the stages of enlightenment and birth in te ao Māori .
“I think my legacy isn’t – it’s not life-changing. I’m not somebody who’s gone out and done the kind of research that’s going to result in a miracle drug or anything like that, but my contributions are a small jigsaw piece in the wider puzzle.
“I’m really pleased that instead of feeling frantic about it, I’m able to slow down and, if nothing else, show my kids and my moko – I’ve got five granddaughters – that you don’t have to be frightened and panicky. You can take things at your own pace.
“I do have days when I just kind of go into a spiral where I’m anticipating what it’s going to be like – ‘It’s going to hurt, it’s going to be really undignified, it’s going to be pretty scary’ – but not today. So that’s how I bring myself out of it: it’s not today. Today’s good.”
– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand
