Ronald Iraia and Darrell Henwood are good mates that share a unique bond – they've both received the ultimate gift of life. Reporter Jenny Ling shares their story.
When Northland mates Darrell Henwood and Ronald Iraia catch up for a kōrero these days, their hearts are full of gratitude.
The childhood friends share many similarities; they both grew up in the Hokianga, went to the same school in Opononi, and played rugby for the senior team.
Now in their 50s, the former builders have bonded over another, more momentous milestone – they've both had life-saving heart transplants.
Iraia had his transplant in 2018 and Henwood underwent surgery last year.
Their appreciation of their organ donors and their families, their own whānau, and the specialist doctors and nurses who've been with them every step of the way, runs deep.
Having new hearts has changed them, though they haven't lost their sense of humour.
They joke they've been given women's hearts; Henwood reckons he's more emotional since the transplant and Iraia has started to enjoy the odd glass of wine.
Nowadays their conversations are peppered with comparisons about medications and what foods they're allowed, and not allowed, to eat.
"It's pretty hard case," Henwood said.
"Ronald had his while I was in heart failure."
"It's good to have someone who knows what you're talking about," Iraia said.
"We give ourselves a bit of cheek, we swap notes about what's working and what's not.
"But we're just the same old mates that we were back in the day."
HENWOOD WILL never forget the day he suffered heart failure.
It was November 14, 2016, the day the Kaikōura earthquake rocked the region.
He was at home in Hinds in mid Canterbury struggling to breathe.
The 56-year-old had been having dizzy spells, but like "a typical Kiwi male" shunned the idea of seeing a doctor.
Henwood's wife Deby remembers it vividly.
"I came home on a Wednesday and he said he wasn't feeling well.
"I said don't go to work but he did. On Saturday I woke up and he looked like death; he was yellow."
That's when it started; the countless doctors' appointments and trips to the hospital for tests.
He was transferred from the emergency department to intensive care and coronary care, then from Ashburton to Christchurch hospitals.
The diagnosis was dilated cardiomyopathy, a disease of the heart muscle, where it becomes enlarged and weak and less able to pump blood through the body.
"He was about to die," Deby said.
"They told me it might not end how I wanted it to and I should get the kids up there [to hospital].
"The doctor said the only thing that would make a difference is a heart transplant.
"But it would be difficult because of his size and age [donated organs need to match the size, weight and blood type of the recipient].
"We came out of there feeling like he'd been handed a death sentence."
It was another two years before Henwood was put on the waiting list for a new heart.
Once a heart became available, things moved quickly and he underwent the transplant operation last year.
"I was getting worse every year," Henwood said.
"I would be pretty hammered if I didn't have a heart transplant."
IRAIA'S WAIT was much longer.
Originally from Waimamaku, the 58-year-old has always been active with rugby, tennis and diving.
But during his 30s he'd pass out on the football field or on the street "for some unknown reason".
"No one knew what was going on," Iraia said.
"Over the course of two years doctors found out I had a cardiac arrhythmia. I've had the condition for a long time.
"My heart was racing so fast it wasn't pumping oxygen to my brain."
Over the next two decades he was put on various medications and underwent surgery to try and correct the arrhythmia.
He went from rugby to lawn bowls and golf.
"Over the course of 20 odd years they tried everything they could," he said.
"But my health slowly declined where I got to the point of not being able to walk. I couldn't even walk around the shopping centre."
Iraia made the waiting list for a heart transplant in 2016, though had to wait another two years before he could get one.
"I wasn't sick enough to get one, there were other people on the list in worse condition than I was."
Finally, doctors told him to ready himself, and for three months he stayed at his brother's place in Auckland, waiting.
"You're virtually sitting by the phone waiting for it to ring.
"I got tired of waiting and I thought bugger it, and said to my son 'that's it, we're going home, I'm not going to get one'.
"We went back to Waimamaku and I really thought I'd die there.
"I got home that evening, and the next day I was sitting by the breakfast table and the phone rings and it's Greenlane hospital.
"They said we've finally got a heart for you, and I said you're joking."
For Iraia, having a heart transplant in 2018 was "like a new lease of life".
The father-of-four, who now lives in Whangārei, can't thank the donor family, or the specialist doctors and nurses in Auckland, enough.
"It was a bit weird initially, but I was so grateful more than anything that somebody had done this for me, it was amazing.
"Two years ago, I came home to die, and I'm still here. To be able to be with my kids again ... I'm feeling really great now."
IN NEW ZEALAND, there are many more people waiting for an organ transplant than there are organs available.
More than 550 people are currently on the waiting list, including 52 Northlanders.
Last year there were 74 deceased organ donors, up from 62 the previous year.
A recent report by Organ Donation New Zealand shows the number of deceased organ donors has slowly increased over the past decade.
However, the country's rate of deceased organ donation is still relatively low compared with other countries.
ODNZ clinical director Dr Stephen Streat encourages people to have a conversation about organ and tissue donation with their families.
"The reality is that organ donors come from human tragedy," he said.
"The person who is in the intensive care unit with irreversible brain damage, was most likely alive and well the day before.
"By having a conversation with your family or whānau now, you can share your thoughts regarding donation and also find out theirs.
"That way if you or someone in your family are ever in a situation where donation is possible, you/they will know what to do."
FOR HENWOOD and Iraia, having the heart transplants was just the beginning.
They have a lot of medication to take including immunosuppressant drugs to help prevent the immune system from rejecting the donor organ.
They have to watch what they eat; food must be super fresh, and runny eggs, raw seafood, alcohol and reheated meals are all out.
Henwood's body has rejected the new heart six times, and each time his medication has been adjusted.
He can't work too much and has to watch he doesn't overdo it.
"There are some downsides but they're nothing compared to the alternative," Henwood said.
"I'm happy as. Someone's given you a new lease on life. You don't want to wreak it or be disrespectful to the donor or their family."
Henwood still requires four-monthly check-ups in Auckland, but they're getting fewer as he gets stronger.
He hopes next year he can get back to work, and in the meantime is getting his fitness up by helping his parents around their Hokianga property.
Both men gave permission for their heart valves to be donated to another family.
They plan to write letters to their donor families to thank them, once they've found the right words.
Their ordeal has impacted those closest to them.
"Having been through it, it's made us more aware of helping others, Deby said.
"Our three boys, each one when they got their licence made the decision to be donors. You don't want to think something will happen to your family, but how can we not give back?
"We are lucky to still have him with us and not a day goes by where we are not grateful to his donor and family for their selfless act of generosity while going through such a loss."
Māori organ donation rates - are they really that low?
Ronald Iraia is so grateful for the new heart that's given him a second chance at life, he is now an active organ donation advocate.
The 58-year-old knows he wouldn't be here today if it wasn't for the person who gave the ultimate gift of life and their family who went along with their wishes.
Iraia, who is of Ngāpuhi descent, said Māori have "a lot of cultural issues around donation".
Some are hesitant because of cultural beliefs around the need for completeness when a dead person is buried.
Iraia has attended three seminars at hospitals in Auckland and Whangārei to talk about his experience with a focus on being a Māori recipient.
"I talk to Māori people to try and change their way of thinking," he said.
"My hope is that I can change the way people think about being donors.
"The fact that we can help, not only our people but others, and help to save lives, it's a great thing to be part of that."
Out of the 74 deceased donors last year, six were Māori, according to Organ Donation New Zealand's 2019 annual report.
The other donors included 62 European, three Pacific and three 'other'.
Former Northland GP Dr Lance O'Sullivan said Māori are underrepresented as donors but overrepresented in their need for organ transplants.
The biggest concern is cultural concerns of tapu, he said.
Organ donation needs to be discussed within communities to overcome this, he said.
"The flipside to that is the Māori belief system of koha and manaaki [showing respect, generosity and care for others].
"That fits very comfortably with organ donation, so it can fit within our culture and Māori leaders need to promote this more.
"Yes, you are giving up part of your body but actually it's the ultimate in manaaki."
Organ Donation New Zealand clinical director Dr Stephen Streat said the notion that cultural concerns are a barrier preventing Māori from donating aren't true.
About 10 per cent of donors are Māori, "slightly less than the population percentage, but not much".
"There's a lot of myth about what Māori want and don't want," Dr Streat said.
"Māori, like everybody else, do donate.
"It's about giving everybody the same opportunity, regardless of ethnicity. Every family should have the same opportunity to have this discussion."
Dr Streat said reluctance to donate due to wanting to be buried whole are not unique to Māori.
"Half of this country does not wish to donate; only 50 per cent do want to be donors.
"If you ask people who don't want to, that reason that they 'want to be buried whole' is common in all groups of people.
"The most powerful determinant in willingness to donate is income and wealth and in this country income and wealth are strongly related to race and ethnicity.
"Willingness to donate has to do with socio-economic factors like marginalisation, the education you've had, the degree to which you believe society treats you fairly."
How to be a donor
* Select 'donor' when applying for or renewing your driver licence. This will be printed on your licence.
* However, this is an expression of your interest only, not an official organ donation register.
* The most important step is making sure your family, whānau or friends know whether or not you want to be a donor. They have the final say.
*If you've already had a discussion with them, there's nothing else you need to do.