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Home / Northern Advocate

The 90% project: Lessons of history key to iwi's vaccination success

By Peter de Graaf
Reporter·Northern Advocate·
29 Oct, 2021 04:00 PM7 mins to read

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A memorial to people who died in the Spanish flu pandemic at Mareitu Urupā, which overlooks Te Hapua and Parengarenga Harbour. Photo / Peter de Graaf

A memorial to people who died in the Spanish flu pandemic at Mareitu Urupā, which overlooks Te Hapua and Parengarenga Harbour. Photo / Peter de Graaf

To understand how people feel about Covid at the very north of Aotearoa you need to take a drive.

A long drive.

First you follow State Highway 1 until you reach New Zealand's northernmost shop.

There you abandon the tarseal and take a winding gravel road through scrubby hills to a small town on the shores of a harbour ringed by silica sand so white it hurts your eyes.

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Then you need to find a steep track to the top of a hill where the clay has been baked white by the sun, and look among the gravestones for a memorial inscribed with a list of names and the dates November 1918-March 1919.

The memorial may be small but the shadow it casts over the town below is long. The Spanish flu hit Te Hapua hard and still haunts the town's memory.

It helps explain why the Aupōuri Peninsula or Te Hiku o te Ika (the tail of Māui's fish) has one of the highest vaccination rates in the Far North.

That's despite national trends which would have you believe any area with high deprivation and a high Maori population — Te Hapua is as good as 100 per cent — should be lagging far behind the average.

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Waitiki Landing store worker Tui Sproats says her family was almost wiped out by the Spanish flu. Photo / Peter de Graaf
Waitiki Landing store worker Tui Sproats says her family was almost wiped out by the Spanish flu. Photo / Peter de Graaf

Tui Sproats, who works at the general store in Waitiki Landing, says everyone in her whānau has been vaccinated.

''Our family was almost wiped out by the Spanish flu. If you want a testament to that just look at the monument on the hill. I did it to protect my family and not let that happen ever again.''

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The need to protect family is echoed by a woman calling into the shop at Te Kao, famous for its huge ice creams and as a rest stop for the bus tours that used to head to Cape Reinga.

She put the area's high vaccination rate down to being a small community with many kuia and kaumātua.

''If Covid goes rampant up here, we're gone. We have to look after each other and, because the majority of us up here are Māori, we need to protect our culture.''

Te Hapua, beside Parengarenga Harbour, is New Zealand's northernmost settlement. Photo / Peter de Graaf
Te Hapua, beside Parengarenga Harbour, is New Zealand's northernmost settlement. Photo / Peter de Graaf

In Te Hapua, a place so remote kids spend more than three hours a day on the high school bus, locals didn't wait for instructions when Covid-19 first arrived in New Zealand.

They called a socially distanced meeting at the marae, set up a road block and a volunteer roster, and shut the town off from the outside world.

The road block is still manned 24 hours a day any time Northland goes into lockdown.

Locals are allowed through on essential business but anyone else — even those with whakapapa or part-time homes in the settlement — can forget it.

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The local iwi, Ngāti Kuri, also swings into action, delivering food and checking vulnerable residents.

Te Hapua resident Eileena Sucich (with Bruno) says a marae-based approach to vaccination works for Māori. Photo / Peter de Graaf
Te Hapua resident Eileena Sucich (with Bruno) says a marae-based approach to vaccination works for Māori. Photo / Peter de Graaf

Eileena Sucich was living near Melbourne when the pandemic first hit.

Her life was soon dominated by masks, distances and separation, but online she saw her family and former neighbours leading normal, joyful lives in the bubble behind the road block.

''I saw how safe they were. I saw my mum was safe.''

She came home to Te Hapua as soon as alert levels allowed and now lives opposite a wharf where kids fossick in the sand and dangle lines into Parengarenga Harbour.

Sucich also points to the Spanish flu as a key factor in the area's Covid vaccination success.

''I remember my nan talking about it. So many people died they just dug a big hole and threw people in it. There's a living memory of it, I think that makes a big difference.''

in the copy

A sign beside SH1 at Ngataki is a reminder that people take Covid seriously up here. Photo / Peter de Graaf
A sign beside SH1 at Ngataki is a reminder that people take Covid seriously up here. Photo / Peter de Graaf

The high jab rate is also driven by locals' desire to protect each other, and the marae-based approach adopted by health provider Whakawhiti Ora Pai.

''For Māori the marae is everything. Also, their staff are well known. They aren't new people coming in and telling us what to do. We know all the nurses — they are family — and the doctor has been here forever, so there's already that basis of trust.''

Some young people were swayed initially by social media misinformation but Te Hapua is the kind of place where the old ways, including respect for elders, hold strong.

Youngsters still listen to their grandparents and seek out people who have made an effort to find the truth, Sucich says.

It was also mostly young people who volunteered at the road block, two at a time in six-hour shifts in any weather.

''People just put their hands up. It was beautiful.''

The gate to Te Hapua is guarded 24/7 during Covid alert levels 3 and 4. Photo / Peter de Graaf
The gate to Te Hapua is guarded 24/7 during Covid alert levels 3 and 4. Photo / Peter de Graaf

Whakawhiti Ora Pai ("The Bridge to Good Health") is based at Te Kao, between the shop with the big ice creams and Pōtahi Marae.

It has so far delivered more than 2000 vaccines in an area which includes Te Hapua, Te Kao, Ngataki, Pukenui, Waiharara and Kaimaumau.

Latest figures show 64 per cent of eligible people in the area have had both doses of the Pfizer vaccine and 77 per cent have had at least one.

In the Far North those results are beaten only by prosperous east coast towns such as Kerikeri and Russell.

The slowest areas, such as Waima and Horeke, have first-dose rates of barely over 55 per cent.

A vaccination map of Northland contrasting areas with high (blue) and low (orange) fully-vaxxed rates. Image / supplied
A vaccination map of Northland contrasting areas with high (blue) and low (orange) fully-vaxxed rates. Image / supplied

Errol Murray, general manager of Whakawhiti Ora Pai, says the organisation's philosophy is to take the service to the people rather than waiting for people to come to the service.

That also ensures equity because if people have to travel to Kaitaia to get the jab, for example, that excludes anyone who doesn't have money for petrol.

''We took it to the people, on the marae, because we knew our people would be most comfortable there.''

Another reason for Whakawhiti Ora Pai's success is, unlike the national rollout, it didn't deliver jabs by age bands.

Māori like to do things together, as a whānau, Murray says.

''We just opened it up — Māori, non-Māori, any age. Sometimes kuia won't get a vaccination before their mokopuna because they believe the next generation is more important.''

Another factor in the organisation's favour is that its staff are local, almost all Māori, and are known and trusted by the community.

Whakawhiti Ora Pai general manager Errol Murray and clinical manager Maureen Allan at their headquarters in Te Kao. Photo / Peter de Graaf
Whakawhiti Ora Pai general manager Errol Murray and clinical manager Maureen Allan at their headquarters in Te Kao. Photo / Peter de Graaf

Clinical manager Maureen Allan says staff held community meetings at each location beforehand to answer questions and address any concerns early on.

They also set up their own booking system, avoiding the problems that dogged the national booking system early in the rollout.

A lot of work is needed to check out and prepare every marae, set up, then dismantle everything two days later and start again in another location, she says.

Their systems have to be paper-based because there isn't enough connectivity to run the kind of online record-keeping systems used elsewhere.

Misinformation hasn't been a big issue but, for some, hesitancy or needle phobia is.

The solution, Allan says, is to sit the person down, talk them through it, and provide good information.

The organisation has also tried new approaches such as making Tik Tok videos to reach young people.

A memorial to people who died in the Spanish flu pandemic at Mareitu Urupā, which overlooks Te Hapua and Parengarenga Harbour. Photo / Peter de Graaf
A memorial to people who died in the Spanish flu pandemic at Mareitu Urupā, which overlooks Te Hapua and Parengarenga Harbour. Photo / Peter de Graaf

Ultimately it's the memorial on the hill overlooking Te Hapua — and many other stones marking mass graves scattered around the tail of Māui's fish — that drive them to vaccinate as many of their people as they can.

''We have the historical information to really go hard out. At one stage the Māori population dropped to 40,000 people. We thought we were out the door,'' she says.

''We don't want that happening again.''

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