8 minute read
HELPING HER HAPŪ
We continue our travels around the motu, meeting each region’s Diabetes Community Coordinator. In this issue, we meet Marianne Parker, our Hauora Kaimahi for Northland.
First known as Te Tai Tokerau, the area that Marianne Parker covers is vast. ‘From Whangārei, we go up both coasts, and all the way up. That’s my playground,’ she laughs. She splits her time between roles with Diabetes NZ and Te Hau Ora O Ngāpuhi, the iwi-run community health and social services provider, based in Kaikohe.
When Marianne (Ngāti Korohue/ Te Uri Taniwha) first saw the job of Diabetes Community Coordinator advertised, she knew the role was for her. She had moved from Auckland to live in Kaikohe after her father’s passing in order to pick up on the work he had been doing for their hapū within the Treaty claims area. Her father had wide connections with iwi and hapu, and Marianne has inherited these links. She says this can be a bonus when it comes to approaching those giving and receiving diabetes care.
‘I’m quite fortunate that I whakapapa quite well in the North.’ She says people relax a bit once they realise she has a connection to them.
Working as a bridge between clinical staff and patients, Marianne is passionate about helping her own. She says her concentration is focused on pulling iwi and hapū back to making better decisions for their health.
It’s not a Tribunal thing. It’s not a claimant thing. It’s not a hapū thing. It’s a love for my whenua and our people. That’s why I’m doing this job.
DESIRE TO HELP
Nine years ago, when Marianne lived in Auckland, she found one day that she had lost feeling in her right leg. ‘I rang up my GP and said, “I don’t know what’s wrong with me, but my leg’s not working.”’ She wasn’t able to take any weight on it, and, if she tried, her ankle would give way. The GP sent her to the Emergency Department at Waitakere Hospital, where she was asked if she had any other symptoms.
‘I said I feel drunk all the time.’ Marianne wasn’t a big drinker and certainly wasn’t drunk when she was experiencing the leg weakness, but she still felt weird.
The following day, the ward doctor told her the results of the tests showed she had type 2 diabetes and that this was due to not eating properly, not looking after herself, and not exercising. To top it off, Marianne was accused of having alcohol issues.
‘The only issues I have around alcohol is I can’t afford it!’
This news cut hard. Marianne, who at the time had three tamariki, says she started questioning herself, wondering what sort of mother she was. She was now thinking she had put her children in danger of losing their māmā. ‘I was really down on myself.’
Her HbA1c was 175. (A glucose level above 160-180 mg/dl is considered hyperglycaemia.)
But the hospital’s diabetes team, feeling that something wasn’t right, said they would test her for something else.
Meanwhile, the ward doctor returned, discharged Marianne to the diabetes team, and advised her to get some help for her drinking.
The next day, back at work and feeling glum, Marianne got a call from the team, saying she had been misdiagnosed and could she come back in as it’s urgent they see her. Marianne remembers the diabetes nurse being kind. She was told she wasn’t type 2, but type 1, and that having any kind of diabetes was not her fault.
MEDICAL RECORDS
Fast forward six months after receiving the diagnosis, and a car shunted into the back of Marianne’s. Because she had bruised ribs, she had to get checked out in hospital. Among the questions asked were ‘how’s your diabetes going?’ Marianne told the doctor she was feeling ok and had been taking the medications. Then she was asked if she’d had anything to drink today. She hadn’t but was still asked to do a breath test due to her health records stating she had ‘alcohol issues’.
‘The diabetes team helped me fight to get that taken off my health record. They said every time something takes you to hospital, that will be there.’
Marianne says this is why the role of Hauora Kaimahi stood out for her. ‘I don’t want anyone to feel like I did, sitting in that hospital bed. Type 1, type 2, gestational, any – it’s not their fault. There are other factors, but no-one should ever be told it’s their fault.’
She wants to support whānau so that they never have to feel like that, to be that voice for people who don’t yet have the knowledge to help themselves. ‘I’ll be next to them saying, “stand up and back yourself”.’
MARIANNE PARKER, ADVOCATE AND (ALMOST) LLB
Marianne’s background is in law. She was persuaded into the field by her father, who was keen on one of his five tamariki taking it up in order to help with his hapū Tribunal claim.
All going well, and studying part time, Marianne hopes to graduate by the end of next year. She hasn’t completely settled on which area of law to work in but is considering environmental or within governance.
Having this legal background, as well as lived experience of diabetes, is what makes Marianne a successful Kaimahi Hauora. She has an understanding of receiving a misdiagnosis, a desire to help whānau, and a wish to support those who have mistrust in the ‘system’. ‘The system is a scary thing for them.’ She says some people feel almost like they are being colonised again.
It’s a battle of wills that she’s willing to fight. She’s noticed a resistance to taking medications, due to a misunderstanding of what diabetes is and how it affects the body.
All I’m asking of whānau is to have a bit of a walk around your house. Work in your garden. In your garden have fresh veges. Because of the price of living right now, we can’t afford the veges, the fruit… The exercise of looking after your own garden is going to give you some kind of relief until you have more trust in the system.
‘People think diabetes is just having too much sugar. They don’t realise that carbs is the thing that will spike the blood sugar.’
Marianne works hard to educate whānau on the powers of what makes up our food and how exercise can help.
‘All I’m asking of whānau is to have a bit of a walk around your house. Work in your garden. In your garden have fresh veges. Because of the price of living right now, we can’t afford the veges, the fruit… The exercise of looking after your own garden is going to give you some kind of relief until you have more trust in the system.’
Another challenge is reminding some kaumātua and kuia to keep up with their three-monthly HbA1c test to see how they’re tracking along. ‘A high HbA1c, constantly, is going to open you up to infections. That’s what I’m pushing – that if they don’t have faith in the system, to have faith in that test. Showing that is a good way of starting the conversation.’
It’s not about race, but, to be honest, diabetes is a thing of our DNA rejecting colonisation. Our lives were so different, then we were colonised and our DNA hasn’t been able to handle it. That’s why we have high rates of diabetes and cancer.
Our DNA hasn’t had time to accept that lifestyle change. That’s why Pasifika and some Asians have high diabetes rates. It’s a different life. Europeans have had sugars around for generations, whereas Māori have, at the most, three generations. We lived on vegetables, fruit, tuna, fish. We need a helping hand to be level with other cultures. There isn’t a politically correct way to say this.
DIABETES ACTION PLAN
Earlier this year, Marianne was invited to join others in Wellington to help nut out the refreshed Diabetes Action Plan. The Plan has been developed by Manatū Hauora – the Ministry of Health, along with consumers, Māori, Pacific peoples, and the health sector. We are awaiting the final plan to come out with its recommendations.
Marianne remembers a conversation arising where the suggestion was made to change nurses and doctors to Māori names. She says she appreciates the genuine effort being made to make medical staff more relatable. However, if not properly thought out, with the right people, she says this could end up being a distraction.
‘My recommendation was that when a patient walks into a room and you see their name and you can’t pronounce it, a simple thing would be to ask, “before we get started, how do you pronounce your name?” That makes you more relatable than changing your name to Hone from John. It’s understanding the patient. Changing the system to suit the patient. Not changing the patient’s thinking to suit the system.’
