A new study has revealed Māori liver cancer patients travelled twice as far as their Pākehā counterparts for access to primary surgeries. Photo / Stock
A new study has revealed Māori liver cancer patients travelled twice as far as their Pākehā counterparts for access to primary surgeries. Photo / Stock
A new study has revealed travel costs are a likely barrier for Māori needing surgery for liver cancer.
And one Māori health advocate says for some patients, sometimes it is a choice between travelling to get treatment, or putting food on the table.
Bay of Plenty man Mana Ruru wasdiagnosed seven years ago with liver cancer as a result of hepatitis B.
Ruru travelled to Auckland Hospital from his farm in Waimana, in the Eastern Bay of Plenty, five or six times over two years before he received his life-saving transplant surgery.
The study has found 36 per cent of Māori are more than 200km away from access to primary liver cancer surgery.
For Ruru, the burden of travelling to receive his treatment was made easier through vouchers.
"I was lucky that they allowed me some travel vouchers for those drives," Ruru said.
"Previous to all of that I drove to Whakatāne heaps and heaps for different appointments. I paid for those [trips] out of my own pocket."
Ruru said the drive to Auckland from his farm was about three-and-a-half hours long, while the drive to Whakatāne measured about half an hour one way.
Seven years ago, Mana Ruru was diagnosed with liver cancer as a result of hepatitis B. Photo / Supplied
If he hadn't received travel vouchers, Ruru said something would have had to give.
"I would have had to sacrifice paying a few bills. I would have had to catch up with the payments later and had to explain myself and my situation to everyone."
However, Ruru said there was financial aid available through different foundations and he believed the Government would come to the table to support those in need.
"There is help out there. You just have to walk your fingers over the numbers on the telephone and keep going until a door opens."
Ruru said he would be forever grateful for the support and care he received from his liver transplant team, headed by Dr Ed Gane.
"They supported me before, during and after," Ruru said.
Ruru spent three months in Auckland recovering from his liver transplant procedure.
Māori were found to be 31 per cent more likely to die from liver cancer than non-Māori with the same diagnosis, the study said.
According to the Hepatitis Foundation New Zealand, about 60 Māori are diagnosed with liver cancer each year.
The study was conducted by researchers from the Cancer and Chronic Conditions Research Group, the University of Otago, University of Waikato, Te Aho o Te Kahu Cancer Control Agency and Te Whatu Ora Waikato and Waitemata.
The group linked the data of 3326 liver cancer patients from the New Zealand Cancer Registry with hospitalisation data.
At the conclusion of the study, researchers found that 288 Māori liver cancer patients who received treatment for their condition needed to travel further for longer in order to access care.
University of Otago Department of Public Health associate professor Jason Gurney. Photo / Supplied
One of the study's authors, University of Otago Department of Public Health associate professor Jason Gurney said the contrast in travel distances was driven by the proportion of Māori who lived rurally and the centralisation of treatment.
"But you wouldn't say Whāngarei or Tauranga are 'rural' but people who live there would still need to travel to Auckland, depending on the procedure."
Gurney hoped the research findings would help Te Whatu Ora and Te Aka Whai Ora - Māori Health Authority in their work to provide equitable healthcare.
"It's always complicated to make change," Gurney said.
"But there are some quick wins here that I can see."
Gurney said the study recommended financial support and for more treatments to be provided locally.
"At the moment patients can apply for National Travel Assistance," Gurney explained.
"But that financial support comes as a reimbursement. So patients still need to pay for travel expenses up front."
Gurney recommended flipping the National Travel Assistance pay structure around so patients could get financial support without first going out of pocket.
Aroha Mai Cancer Support founder and manager Bubsie MacFarlane. Photo / NZME
Aroha Mai Cancer Support founder and manager Bubsie MacFarlane said barriers for Māori to access treatment were not limited to liver cancer patients.
"It's not the diagnosis that's the problem. It's all the outlying issues that can go with the diagnosis."
MacFarlane, who founded Aroha Mai to support Māori cancer patients in 2006, said often the choice could be between getting treatment and putting food on the table.
"They can go from a one-income household to a no-income household. There are people out there trying to help but it's not enough."
MacFarlane said the last time she had helped a patient apply for the National Travel Assistance, the fee did not account for changes in petrol prices.
"And when they need money, they need it on the spot, not weeks or a month or two months from now."
A Te Whatu Ora Lakes spokeswoman said patients who needed one of the primary surgeries listed in the study would be referred to either Waikato or Auckland hospital.
Liver transplants were only provided at Auckland Hospital.
"Dependent on the situation we may do percutaneous drainage for some patients but others would be referred to a tertiary provider."
The spokeswoman said there were a number of services providing transport for patients to attend health-related appointments.
A Te Whatu Ora - Health New Zealand spokesperson said Te Aka Whai Ora - Māori Health Authority, and Te Aho o Te Kahu, the Cancer Control Agency were committed to building an equitable national health system.
"We are committed to working closely with our Māori health providers, partners, and stakeholders to fund health services that work for whānau Māori and have created flexible funding arrangements to enable providers to deliver services in their rohe as they see fit.
"For more patients, this may mean we offer them to go to a provider outside their normal district or in a private hospital to get their specialist care sooner. Providers will also experience more flexibility in funding and/or changes in regulations to allow them to grow more workforce and shift tasks to other professions so their clinical skills can focus on those who need it most. This increases access for patients."
Te Whatu Ora Hauora a Toi Bay of Plenty was contacted for comment but was unable to respond before the deadline.
