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ABSTRACT
Prior to colonisation, Māori had a well-developed holistic health system based on maintaining balance between people, place and spirit. The colonial imposition of British economic, religious, educational, legal, health and governance, through warfare, immigration, legislation and social coercion had a devastating effect on Māori health outcomes. With the release of the WAI 2575 Waitangi Tribunal report exposing the failings of our health system in relation to Māori health, the need to decolonise our health system becomes more pressing. A key difficulty in this work is the poverty of transformative language, concepts and frameworks in our workforce. This paper is the product of an anti-racism think tank that occurred in April 2019. While working through a system change analysis on our colonial health system, Māori and Tauiwi activists and scholars created an allegory-from gorse to ngahere. The allegory depicts the ongoing impact of the colonial health system as represented by gorse, and the possibilities of a decolonised health system represented by ngahere-a self-sustaining and flourishing native forest. Racism has a geographic specificity. The allegory we developed is a mechanism for conceptualising decolonisation for the context of Aotearoa. It serves to reinforce the different roles and responsibilities of the descendants of the colonisers and the colonised in the pursuit of decolonisation.
The colonial health system in Aotearoa is failing Maori. This is evident through the findings of the landmark WAI 2575 report of the Waitangi Tribunal that found institutional racism and systemic breaches of Te Tiriti o Waitangi across the infrastructure of the health system, including in health legislation, policy, contracting, governance and investment practices of the Crown.1 Ultimately the failings manifest as enduring ethnic health inequities.2 This complex problem is not unique to Aotearoa- rather, it is a global challenge3'4 facing colonial health systems and nation states committed to equity and social justice. Evidence shows political processes of colonisation and forced assimilation have devastated Indigenous health.5'6 For example, dispossession and forceful detachment from ancestral lands, shifted access to healthy food and water, while diminishing cultural identity that was tied to the whenua where whānau had lived for many generations. The challenge before us now is how to reconfigure colonial power relations and to decolonise health systems.
There are loose parallels with the challenges facing...