I’m finally on annual leave after a rather intense six weeks of my first general surgical rotation as a junior doctor. “How are you going to spend it?” was a question a lot of friends and colleagues asked. I envisioned nine blissful days filled with sleep-ins, siestas, massages, and a trip to somewhere far, far away from the building where I have spent the majority of my waking hours since graduating medical school. This cog is checking out for some much-needed burnout prevention.
For the sake of my sanity, I fully intend to do all the things mentioned above. But these two days I’ve been too busy bingeing the podcast series hosted by Emma Espiner called Getting Better - A Year in the Life of a Māori Medical Student. Emma (Ngāti Tukorehe, Ngāti Porou) is currently a trainee intern at the hospital where I work, and in this series produced for RNZ by Bird of Paradise Productions, she takes us by the hand through the cluster of inequities faced by Māori in Aotearoa’s healthcare system.
“’Unequal outcomes’… that’s jargon for having a better chance of dying if you’re Māori,” says Emma in Episode 1: A Better Chance of Dying. She’s frank about cutting through the politically correct ways (i.e. bullshit) in which our medical system packages the inhumane differences in health outcomes between Māori and non-Māori patients. “Even when the facts are familiar, they are still infuriating. Māori are less likely to receive prescriptions for the same illnesses as non-Māori. Our cancers are diagnosed later and have poorer prognosis. We get sick younger and die earlier.”
What is so compelling and heartbreaking about this series is what Emma does with these too-familiar statistics – she leads us into the lives of the people that these statistics represent. We hear about the discrimination, knee-jerk biases, and cultural barriers that Māori are facing, and the impact this has on their whānau. And we meet a range of inspiring of students and health professionals whose mahi revolves around putting some of the humanity back into a system that Emma shows us is sadly deficient. “We lack humanity when we call Māori statistics for death and disease good enough,” she says in Episode 7: Pandemic. “When we aren’t horrified by the difference in outcomes for Māori babies, Māori whanau, when compared to the Pākehā majority. This system – our system – is rigged.”
It’s a testament to my own privilege that I can, and sometimes do, forget about racial inequalities in the context of healthcare. That these stark injustices aren’t at the forefront of my mind particularly on days when I am completely overwhelmed by the work. In an interview in 2018 discussing her short story ‘Omakase’ published in The New Yorker, Weike Wang told Deborah Treisman “Not having to think about one’s race is, I believe, a privilege.”
But of course it is crucial to think. And thinking about and acting to address these issues is something all New Zealanders need to do together in order to bring about this much-needed change. Emma highlighted in Episode 7 how CoVID “showed beyond any doubt that government can take action and fix – actually fix – problems that were long considered just too big and too knotty before.” So why not fix the problem of the outrageous inequities in our health system?
Getting Better - A Year in the Life of a Māori Medical Student is a beautifully produced, kick-in-the-butt reminder that even within an imperfect system we can commit to doing better for our patients, dream “of something better, and [work] every day to bring that dream closer to reality.” And it highlights just how important it is for our healthcare workforce to have more voices and faces like Emma Espiner’s.Support Villainesse