Wiki Mulholland was a mother and wife whose breast cancer diagnosis was catalyst to a movement for reform of the state's drug-buying agency Pharmac.
Mulholland, 43, died early this morning, surrounded by whānau and friends at home in Palmerston North.
As the sun rose on Manawatū, Mulholland's husband Malcolm letthe world know through social media. Dawn came with tributes for the struggle they had shared - a struggle that had turned into a campaign drawing focus to others who shared the same or similar plight.
"The end was quite sudden," he told the Herald today. "We thought we had more time. That was the thing that really affected us and something we are struggling with."
When the diagnosis came in 2018, it was terminal. For the Mulhollands, the disease certain to take Wiki lit up inequity and tragedy known intimately by those walking the same road.
There were drugs that would extend her life but the best were not supported with taxpayer funding. There was the opaque process to determine that funding. There was the personal cost which saw the family robbing financial future security to buy months, weeks, days in the present.
There were statistical anomalies particular to Māori - not truly anomalies but the consequence of a health system that systemically delivered worse outcomes to one specific part of our community.
Mulholland had lived for 40 years with what it means to be a Māori woman in Aotearoa.
With terminal breast cancer, she was now confronted what it meant to die as a Māori woman.
From the point of diagnosis, those sharing Mulholland's diagnosis live an average of three years - 1095 days.
"From statistical information, it's about 12 months for Māori women living in New Zealand," she told the Herald last year. "Statistically, I shouldn't be here. That's a real hard-out thing. It's confronting to think I actually should be dead."
Wiki Mulholland, 43, died early this morning, surrounded by whanau and friends at home in Palmerston North. Photo / Mike Scott
Mulholland beat those odds and, in the end, hit that statistical average life expectancy. She did so - they did so - by fighting against the constraints of the public health system.
In 2018, the couple and their three children were life complete. For what they received, they gave back through service on school boards, coaching sport and other contributions to the community in which they lived.
When the diagnosis came, it was shattering. More so the discovery there were two tiers of healthcare available - one for those who could afford it and one for those who could not.
The public system offered chemotherapy for free. For the cost of $5800 a month, they could access a drug called Ibrance, which slows cell growth and inhibits the scale and spread of cancer.
"There was no way that we could afford that," Mulholland told the Herald. They cashed in KiwiSaver and used what was possible through trauma insurance then set about fundraising.
Every dollar had the potential to prolong life. It was a money scramble the Mulhollands knew was embedded with an inherent wrongness - they knew others were in the same situation and less able to find the opportunity to extend life.
Mulholland's primary battle was internal. She carried the cancer and wrestled with the disease and its cost daily. Malcolm found a different fight - the academic turned his keen research skills on Pharmac and became convinced the system in which it operated failed to meet the needs of those for which it was created.
Historian Malcolm Mulholland at the Palmerston North family home. Photo / Mike Scott
These weren't separate paths. Wiki and Malcolm - as with life and children - were intertwined, sharing each other's load where they could as they used their experience to push back boundaries for others in a similar struggle.
They heard their stories, studied the issues, organised resistance, marched on Parliament, met with and told their story - and those of others - to senior politicians. It didn't see Pharmac reviewed at the time but - two years in - it did see Ibrance funded.
It was a victory that seemed hollow, a battle won in a war that wouldn't end. Along the way were casualties as other women they met along the way succumbed to that which would eventually take Mulholland.
By then, the struggle had expanded well beyond Ibrance. Malcolm had become the spokesman for a group he helped establish - Patient Voice Aotearoa- which sought Pharmac's reform and a doubling of its drug-buying budget.
The interim report of a review into Pharmac is due within days. It could be released today. The review studies how Pharmac meets its objectives, what scope exists for improvement, the timeliness and transparency of its decisions and if there is equitable access to medicines for Māori and Pacific peoples.
Wiki Mulholland during her appearance at the Health select committee at Parliament, Wellington. Photo / File
Malcolm, who is surrounded today by whanau and friends, says: "If there was one thing to have a part of Wiki's legacy, it would be to bring about a change to Pharmac."
At the time Mulholland spoke to the Herald, it had been two years since her diagnosis. "I used to reflect on 'what does two years mean to me?'
"It's seeing my son become a teenager, it's seeing my daughter graduate, it might be mokopuna, grandchildren arriving … birthdays or these special milestones that you take for granted in your life."
Their sons, Ihaia and Patrick, are both teenagers now. In August, their daughter Molly became mother to Manaia Glenn and wrote: "Nan is looking forward to being best friends with you."
