Episode Transcript
Speaker 1 (Becky) 00:00:02 And welcome to TWT Ao/NZ, the show that is made by oral health professionals for oral health professionals. We will bring you the kaupapa of the oral health profession in Aotearoa to investigate the tooth, the whole tooth, and nothing but the truth.
Speaker 0 (Becky) 00:00:17 Our guest today is Mr. Sam Carrington. He is an Oral health therapist, a lecturer in oral health and associate Dean Māori for dentistry with a passion for hauora Māori, and a mission to implement change, to reduce inequalities in oral healthcare, uh, in our systems in Aotearoa, and particularly for Māori. And I'm super excited to hear what Sam has to say today. And I know that you will be too, listeners.
Speaker 1 00:00:41 The whole tooth NZ is yet to be sponsored by any cutting edge dental company or organization. This could be the opportunity for you. Call us on oh two one oh three five five four five six.
Speaker 0 Becky 00:00:54 Sam , thank you so much for joining us. I'm just going to welcome you with a mihi.
Speaker 2 Sam 00:01:26 Sam's Mihi
Speaker 0 00:01:54 Sam. Oh, it just sounds so beautiful. So ngā mihi on your 10 year anniversary, from graduation as a Bachelor of Oral Health. Mm-hmm, professional and share with our listeners some of that wonderful insight on what's the last 10 years been for, for you like Sam
Speaker 2 00:02:13 <laugh>. Oh, pretty busy. Um, yeah, I, when I graduated, I, um, was very, very conscious of the fact that I wanted to go into the public system. Um, I, for a few reasons, one of them was, uh, during my degree at Otago. I, um, I felt like I needed more experience when it came to, um, restorative work and, and, you know, like looking after the tamariki in, in the, in an area. Um, but I think for me, as a Māori clinician, I felt it sat right in my wider, where I could go and do something at a population health kind of level rather than, um, sitting in a private practice clinic and just taking people's money. Um, I, I liked the idea that I could just do the work and then no money was exchanged. Um, and the work that I was doing was helping people.
Speaker 2 00:03:11 So, I originally went to Wellington, um, and then after about 10 months working fully public, I got the opportunity to come into private. So I just started doing one day a week in private. And, uh, then I whittled and then I went up to two days a week and took three days at the, in the public sector. Uh, and then, yeah, a job came up at Otago to be a professional practice fellow for a clinical tutor. So I took it. And then I think, yeah, ever since then I started that, um, 2015. And then, uh, I was the only person in our team here that had two scopes of practice back then, which was quite interesting. Then I started saying to my head of department, actually, I'm more or less doing the job of lecturer.
Speaker 2 00:04:05 You need to make me one. So he said, yep, all right, let's do it. So, uh, there, yeah, 2019, I think I became, I upgraded, I like to say to lecturer. Uh, and then while I was actually a clinical tutor, I was also doing a postgrad diploma in public health, um, and doing that part-time. So that took a few years. And then, uh, in 2018, I got asked by, um, the director or co-director of the Ngāi Tahu Māori Health Research Unit, by Emma, if I was interested in doing a master's in public health, uh, as part of a bigger project for her and her research team. Uh, so I, I said, yes, I'll do it. Um, and uh, the main thing being, it wasn't dental related. Uh, and because my thinking was, if I get sick of teeth, I can just go into policy or anything like that.
Speaker 2 00:04:57 So yeah. And then finish that master's, uh, started in 2019, I think, and then finished it last year and finally graduated just yeah, uh, last month, which was quite interesting. And at that time, uh, at the faculty here around about 2016, I got, promoted I guess to Deputy Associate Dean of Māori. That was from a, a succession plan point of view. When, Emeritus Professor John Broughton retired in 2020, that's when I got the full upgrade to the Associate Dean Māori. So that's my, uh, one day a week job and my other four day a week job is, um, lecturing and doing clinical teaching.
Speaker 0 00:05:45 Yeah? Kia Ora Sam. So you're now, Sam 2.0 now that you've had a couple of upgrades, <laugh>. Yeah, I know. And you do wear a number of hats and that comes with such, um, responsibility and, you know, you most likely do an extremely, um, enormous amount of mahi and I'm sure your one day, four day split, it's not quite like that. I'm sure you are <laugh> as any passionate oral health professional, you will be doing this in your wairua and in your head all the time. So I'd love to know a bit about each of your roles and, um, we'll just go through those if that's, if that's great. Cause I, I'd love our listeners to hear just the diverse roles that you've got and the mahi and what you bring to each one of those roles. Um, and you know how valuable that is to our profession. Yeah, yeah, sure. Go ahead. So yeah, so for Te Ao Mārama what do you do with that crew? I'm,
Speaker 2 00:06:43 So, I, I started getting involved in Te Ao Mārama, the New Zealand Māori Dental Association when I was an oral health student at faculty. And um, that's where, I guess it kind of sparked in me like a governance kind of fire. Um, I was the bachelor of Oral Health representative on the tu, which are the New Zealand Māori Oral, uh, dental Students Association. Um, and a really good thing about Te Ao Mārama is that every two years we hold our hui back in Rotorua, which is where I'm from. So for me, it's going home, which I love. Um, and back when I was a student, um, you know, 10, 12 years ago, Te Ao Mārama had, they would always put funding aside for their students to attend the hui. So, um, which when you're a poor student, it's like amazing cuz we also got to, um, to meet other Māori oral health professionals.
Speaker 2 00:07:46 Um, and the one, another thing I love about Te Ao Mārama is that you don't have to be an oral health clinician. So we also have oral health promoters who are Māori, managers who are Māori. Um, you don't have to have an annual practising certificate with the dental council. So I liked that side of it. Um, and then, yeah, I think after I graduated I still continue to go to annual hui. And now that I sit on the exec, that's definitely a place where we need to, as an executive, we need to think about strategies and ways where after the students have finished, they kind of dip off a bit for a few years and then they come back. So whereas me, I'm, I'm, I'm a little bit, well I am different cuz I was like, no, I'm still involved, I wanna keep coming. So, um, yeah, I used to, I'd still turn up to the hui every year.
Speaker 2 00:08:33 Um, and then back in, I think we had our 20th anniversary in Dunedin about four or five years ago, and that's where it, um, that's where I got put forward to become an exec member. And, um, I thought, oh, yep, okay. So I said yes and yeah, have been sitting on the exec since then. Um, and at the same time, actually I, uh, same year I also <laugh>, I, I wanna say stupidly, but in hindsight it's not. I also put my hand up to be the secretary of the then New Zealand Dental Hygienists’ Association at that annual hui. Um, I don't know what came over me, but <laugh>, I remember they were calling for people from the floor cuz no one wanted to do it. And I was sitting with the Army girls and I was like, I think one, my, my classmate Kim actually, she was like, you should go for it. And I was like, oh, I don't know. And just her saying that, I was like, all right. So I stood up and yeah, that's, that's an, that started my level of sitting on all these committees, I guess <laugh>.
Speaker 0 Becky 00:09:38 Oh, it's a chance and an opportunity. And look where you've come with this, you know, like the platforms that you can bring your knowledge and expertise and your voice to is, you know, it's fantastic. And so on the exec, uh, the, what do you bring specifically to Te Ao Mārama , can share with us?
Speaker 2 00:09:58 So, um, I, gosh, Te Ao Mārama is a very co Māori organization. Um, so us as an executive, we, over the years actually, we've grown from strength to strength. Um, back when, when I first started out, I, um, I had, I think I'm Leeann Waka, who's our current Tūmuaki. And she has been for quite a while. I wanna say we were the only non-dentist, but I have a feeling there were other people, uh, we had Hatea (sic) there, him and I came on at the same time. And he's an oral health promoter from, from the Bay of Plenty. Um, but I think it's more of a, of a collective strength space, what we all bring to that table at t Maima, um, you know, you've got me and education. You've got Leeann, who's in the public sector. We've, we've got a few private practice practitioners as well.
Speaker 2 00:10:56 Um, we've got Hatea who's from the, um, from the oral health promotions space. And actually prior, we also had a few other oral health promoters who also sat on our exec. Um, yeah, we all, it's not like a normal executive where you have specified, you know, you're gonna be the treasurer, you're gonna be the vice or anything. It's, we recognize that Leeann is our Tūmuaki, but we all just get on with the work and we all bring our own individual strengths and, and to make, to make Te Ao Mārama as successful, and the only actually Māori Oral Health Association in the world.
Speaker 0 00:11:33 Yeah. Oh, amazing. Now tell us now about you also the Vice President of NZ Oral Health Association. So tell us a bit about that role, like being a, being in all these seats, you know, you're able to have a bit more of a global perspective of what's going on. Do you think you bring a bit of unity there too? A bit of, um, connectivity between all these things? <laugh>? Or are we still as siloed as ever?
Speaker 2 00:11:57 <laugh>? Um, I think now that we have our own oral health association representing, uh, dental therapists, dental hygienists, and oral health therapists, I think, um, it's a lot better now. Um, it's interesting you bring that up. Cause we started having conversations, back in 2016. And the Old New Zealand Dental Hygienists’ Association and the New Zealand Dental and Oral Health Therapists Association, and it was only until last year actually that we finally got, um, everything over the line to create one organisation. Um, and I guess you could say, there's a few of us that have been a constant during that process. So, um, I do want to acknowledge Anna Holyoke, who's our interim, or our inaugural president, and also Erin Campbell Day, who was our treasurer for the New Zealand Dental Hygienist Association and was the interim treasurer when we started, when we got everything, you know, legally done with the lawyers and, and the New Zealand societies and everything rubber stamped and signed off.
Speaker 2 00:13:00 She, she was, um, well both of them were integral in, ensuring that we brought that history from back in 2016. Um, but we've, we've always had our eye firmly on the goal that we need to stop being so, so siloed, like you said, you know mm-hmm. <affirmative>. Um, but also it was a, um, it was a strategic move particularly, uh, since oral health therapy was a brand new profession back in 2017, I think in 2016 we knew it was coming and that's why we started this conversations. Um, and now we've finally, we've, well we've had our, our scope for, I don't know, five years now. I, I don't say it's new anymore cuz it's been around for a while. Um, but yeah, I guess sitting, sitting in throughout that whole process as well as sitting on Te Ao Mārama at the same time, as well as working at the university, I does, like you said, gives me a global perspective about what was happening.
Speaker 2 00:13:57 And I think eventually all the, all the ducks were lined up in a row and, and we, yeah, we finally got it over the line. And, you know, thanks to the membership as well. Cause, you know, disbanding two associations, which were very, very, um, you know, fierce and strong advocates for their professions at the time. Um, and I do want to kind of thank the, the life members of those two, um, old associations too. They had foresight to kind of see, you know, why they needed an association when they did. Um, particularly the New Zealand Dental Therapist Association, which started in 1935. Um, you know, having, having that history and, you know, sitting back when we started this or when we got our current N Z O H A across the line, uh, I did think, you know, far out, it's been going on for nearly a hundred years.
Speaker 2 00:14:45 The, the history of the NZ, I can't remember what they were called, Institute of Dental Nurses or something back in the thirties, um, even right down to the New Zealand Dental Hygienists’ Association, which started in 1993. Um, and just taking all that history and then now making, making history, you know, we're the only, um, organization in in the world that represents all three professions to the point actually where we've got our colleagues in Australia who have been trying to do the same thing and they just can't. So hearing their struggles and, and, you know, wanting advice from us, it's quite, quite interesting too. I mean, New Zealand and us as Kiwis, we are, uh, movers and shakers and you know, when we, when we want to get something done, we get it done. Not to say that Australia doesn't, I mean, they are a bigger country, let's be honest. But yeah. And that's also not to acknowledge that there were a lot of, a lot of barriers getting to this point. Um, some very frustrating. But, um, you know, you just learn from from from what happens and, and acknowledge it and continue on <laugh>.
Speaker 0 00:15:53 Yeah. Well, congratulations for also being part of the, the success of getting, N Z O H A over the line as well, because it is momentous for us to be together because as we are all trying to pursue improving oral health, our working conditions and our professions as a whole, uh, it's, it's imperative that we're all together in the same waka <laugh>, paddling, the same way. <laugh>.
Speaker 2 00:16:17 Exactly. And that was the reason why we, you know, and, and someone who used to sit on both associations. I used, I, this was part of the reason why we started their conversation. It was one association is doing one thing, another association doing exactly the same time. It just makes sense to just merge them together so that we're all, like you said, paddling the same, boarding the same, getting to the same destination. So, um, that was definitely one of the, one of the strategic ways why we decided to, to do what we did.
Speaker 0 00:16:47 Yeah. Oh, number three, you are on the advisory board of OHCAN So tell us a bit about OCHAN for those of us that don't know what it is and what do you do in that space?
Speaker 2 00:17:01 Yeah, so the Oral Health Clinical Advisory Network, they, um, it is, I better get this right, otherwise I'll get in trouble. <laugh>, it advises the minister and the ministry on oral health services, particularly focused on publicly funded ones. So, um, the interesting thing about OHCAN is, um, I, I got nominated to that, to that. I did have one of the exec members prior to me getting nominated approach me and say, you know, you're being nominated, are you okay with us putting you forward? And at the time I was like, oh gee not another committee. <laugh> I talked to my partner and he said, oh, not another committee, you say no, but hearing what their kaupapa was, I was like, actually I think it would be, um, quite good to have have someone like myself or to not say no more or less purely because I looked at who had their names down and if you weren't in government, you were a dentist.
Speaker 2 00:18:02 And I thought, well, where's, where's us? Where's, those that are at the coalface, those that are , working within the community oral health service, not that I do anymore, but, um, you know, I, I have an under an awareness of it having worked in it. Um, so yeah, I said to Moira Smith, I was like, sure, keep my name down. And then got voted in and thought, oh great. So we meet quarterly and it can range on issues from writing guidelines for, for the public service. So, uh, they've done, uh, like fissure sealant guidelines, um, kind of looked at, um, I think they've, they were part of the fluoride guidelines or have summarised it for practitioners. They make whatever guidelines we need, oral health for older care for older peoples is another one that they're working on at the moment.
Speaker 2 00:18:55 Um, but I, I do want to kind of point out that the latest executive, um, it's myself and Pauline Koopu, who's a public health dental specialist up in Auckland. Um, we are the only Māori, and actually I'm pretty sure we are the first Māori to sit on, so that was quite, quite momentous too, in our hui that we have at OHCAN it's wonderful cuz everyone there works in public dental, in the public dental space. So they know the struggles. Um, and they also know why we need to be, you know, um, adhering to things like ** decisions that we make. So it's quite, it's quite good that, um, people like Pauline and myself are not sitting there banging our heads against the table going, they don't understand, you know, dental health. Um, they do. And it's, um, quite good because Pauline and I, we do have our side bars and, you know, have chats about, you know, decisions that are being made.
Speaker 2 00:19:52 And yeah, I think, um, yeah, I can, it's, it's been interesting times as well cuz Covid kind of hit when I got on that, that exec. So, um, I'm, I'm also a firm believer too that kind of take a year or two to kind of get a feel for what's happening in, in a group. And I think I've now got to a place with O A N that I'm like, I, I gotta, I understand it and, and I get the sense that Pauline is the same cause we're both first timers on their group as well, which is quite, quite interesting.
Speaker 0 00:20:22 Yeah. And on just something that popped into my head as you were speaking about OHCAN and, um, the mandate that you are set by the ministry, so to tell us, do you think, do you think there's some exciting work coming up for OHCAN? Um, you know, since we're becoming standardized, nationalised, you know, all in from one point, uh, well two points, if that, that makes sense. Yeah. That, that we're gonna have something that just seems far more, um, oh, just far more in line with best practice quality, appropriate accessible care kind of thing.
Speaker 2 00:21:02 Yeah, I think now that we are, I think it's from, from what I am hearing and seeing on the ground with the health reforms, um, are still very early days to kind of figure out what direction we're going. But the, the pathway has been set through legislation. So, um, the Pae Ora Healthy Futures bill, um, which passed in June and then obviously got implemented 1st July, 2022. Um, yeah, it's quite an interesting time where a lot of people don't really know what's going on. Um, but I think give it time and people will, people will know. I know from an OHCAN perspective, um, the ministry had been doing things to kind of lead up to, to when we were coming into one, one, well, one, I don't know, healthcare, um, entity mm-hmm. <affirmative>. Um, so for example, um, the National Oral Health electronic records, uh, work. So that's where if you had a child who was in Gisborne and then they moved to **, say Dunedin, um, their records wouldn't followed them.
Speaker 2 00:22:06 So the ministry was kind of like, well, we should just make it one kind of thing. One, one titanium, I guess. Yeah. Where, um, the records do follow them. Um, some other work that I'm aware of that we're doing at OHCAN level is, um, well the, a ACC legislation is coming up and, um, you know, you have dental therapists and oral health therapists who work in these community clinics who, if a child had an accident, uh, they would go to them first. But because our profession is not legislated, under a ACC legislation, um, to provide, to give us like a, a ACC number so that we can kind of treat and recommend or, you know, refer when necessary. Um, I just an example, we had, a representative from a ACC at an OHCAN hui and being the only non-dentist on OHCAN I kind of said, well, why is it that OHTs and DTs aren't able to be registered with a ACC ? And she more or less said, well, what are you, what do you learn as an O H T? So it was one, it was great, quite fulfilling for me to go back through our course in Otago and literally list out what we teach and then send that in an email, just very brief points and having the dentist email back going, oh my goodness, this is, why aren't you listed as an ACC provider? This is very comprehensive what you learned. So, um, I think watch this space.
Speaker 0 00:23:35 You're also on the member of the National Oral Health Equity Clinical Group. Give us a quick overview of that little, um, that little role <laugh>.
Speaker 2 00:23:44 Yeah, so that one, is more or less kind of bringing into light exactly what kind of services, or health services are out there, and how we approach, dental care in using an equity link. Mm-hmm. <affirmative>. So, um, I sit on the clinical group, there's also a Māori rōpū, and then represented us from both those groups said at the governance level and a governance group. And in the governance group you have represented us from Te Aka Whaiora so the Māori Health Authority, um, it's all about commissioning and, and, um, I mean, I, when I put my hand in the ring for that one, I didn't really know what I was getting into. But, um, it's quite interesting to sit back and learn how that high level kind of work happens. Um, I'm hopeful that with Te Aka Whai Ora or the Māori Health Authority, which is, um, for those people who don't know, it's when, you know, iwi and Hapu can determine what they want for their own people, um, and how that, how that healthcare service is delivered for their own people.
Speaker 2 00:24:56 So, um, part of my, my, um, whaakaro around that I guess is how do we make oral health front and centre for Iwi and Hapū who haven't really, or don't really know about it. Um, I'm very fortunate that I come from Te Arawa where, um, you know, we've had a lot of kuia who have always said, if you have a paru (dirty/unwell) mouth, you have a paru body. And we were one of the first in Aotearoa to set up a dental kaupapa, Māori specific dental service, which is Tipu Ora. Um, and I do want to acknowledge, Inez and Pihopa Kingi who helped set that up, my rohe (area). Um, and I don't know, maybe that's why I'm kind of sitting on these levels cause it's in my blood, I guess <laugh> sitting on the committees.
Speaker 2 00:25:45 But I think from, as a Māori clinician who's kind of sitting at that level listening to all this kōrero happening, I'm kind of in the back of my mind thinking, okay, in Aotearoa we have eight oral health providers, none of them are in the South island. So how do we, how do we get that message out there to, to our South island iwi and hapū? Um, how do we get that message out to the Iwi and hapū who, who don't have an oral health provider in the North island, um, a Māori oral health provider. So it's, it's other things like making sure that they're funded properly, that what they're using, so their clinics and their caravans or their mobile units are, you know, properly up and running. And then they have the funding to maintain that. Looking at Māori oral health providers versus the, you know, normal public sector, the standardised what one, um, Māori health providers for years were scrimping and saving to deliver the service that they do for whanau.
Speaker 2 00:26:46 Um, and it just, it still blows my mind that they're not given the same weight as the mainstream service. So now that we have Te Aka Whai Ora, it's kind of like, okay, well now we have to start, the Māori health providers need to hold the government to account and ensure that they're funded correctly. Um, you know, right down to even staffing, uh, how is it that I can go to a Māori health provider but get, you know, 10% less pay if I went to the, to the mainstream public sector, which is still not very good pay compared to when I went to the private sector. So, um, I'm seeing initiatives like the voluntary bonding scheme coming out, particularly for oral health therapists. I think that's a great initiative. But we do need to see more resourcing into, into this area. And, you know, we're getting way more Māori oral health, you know, dental, oral health, dental technology coming through here.
Speaker 2 00:27:38 if I was probably a little bit older, I reckon that I'll slowly phase out retirement in my iwi area. But we need to make that, that an attractive option for, for new graduates. Cause you know, they get outta university and they have often great big student loans. The first thing they're obviously gonna go for is a job which pays them the most money they can get. And unfortunately at the moment it's private practice. So, um, yeah, compared to the public sector and who loses out in that public sector, it's obviously, you know, Tamariki and Whānau. Uh, so I think there needs to be a real rewiring of how everyone views it and how, um, how we continue on moving forward.
Speaker 0 00:28:23 Yeah. Oh, Amen Samuel, amen to that <laugh>. Um, yeah, I love these, these conversations are, are so necessary to make these changes sustainable. The advocacy that, um, we must have to see improvements in health, uh, are just that need to be had on continual <laugh> continual levels to be able to, um, you know, be be in those, be in those ears that need to hear this. Right. Sam, I'd love to, um, briefly talk about your master's. So congratulations on doing your master's of public health. Um, that that must have been a massively proud day for your yourself and your whānau. And I looked at your research topic, you were investigating the Māori views of antibiotic resistance using a one health approach and a kaupapa Māori methodology. Can you give us a quick, um, run through of like what that was about and some of your recommendations or your findings and um, how you might use that going forward in your oral health mahi?
Speaker 2 00:29:26 Yeah. Well, considering it's not really oral health related, but it kind of is, um, <laugh>. Yeah. So it was an interesting journey. Uh, my masters', um, it was a full-on thesis, so, um, cuz you can do a dissertation, but this was, um, straight thesis, which again, was also quite interesting to do. Yeah, what did I do? So one health, a one health approach, it's recognizing that, um, human health, animal health and environmental health or intrinsically related and that if one of them is outta whack, then all the other two are outta whack as well. It was, there was no research out there really about Māori expert views on antimicrobial resistance. There's little bit of research about indigenous views, but nothing our specific. Um, and so that was our gap in, in the research. So my literature review was, um, a little bit all over the show.
Speaker 2 00:30:21 I kind of had to, um, obviously split it down into the three silos that are one health. Um, but from the outset it was a very kaupapa Māori methodology. Like we use kaupapa Māori methodologies throughout the whole thing. So, um, I think it was important to recognize that I am a very early career researcher. My primary supervisor, she is Māori as well. And then we had, I had two others. So Emma, was my primary supervisor. I had Pauline Norris, uh, who was in pharmacy, but then during the time of my thesis she moved over to the Center for Pacific Health at Otago University. Um, and she was our, qualitative expert. And then, um, I also had, um, Professor Patricia Priest. He is a, um, infectious diseases specialist. Uh, so she brought around the whole, um, antimicrobial resistance kind of lens to that and also, um, the one health lens too.
Speaker 2 00:31:18 Cause she's involved quite heavily into that. So yeah, just long story short, um, ended up me interviewing nine Māori experts, whether they were, human animal or environmental health. So I actually people who, put like Māori doctors, a few Māori dentists, um, anyone who could prescribe a Māori pharmacist as well. Um, which was, which was awesome. Uh, and then right down to a Māori farmer, and a Māori environmental scientists too. So did my interviews, did my thematic analysis and lots of findings. For example, there were quite a few who worked in the human health domain, um, who were talking about how, you know, colonisation has had such devastating impacts for Māori, for whānau and Māori you know, they were experiencing racism themselves within their own work. Um, and, and how, you know, just the trickle down effect of things like, their own whānau or they know people who can't afford things like basic antibiotics to treat basic infections.
Speaker 2 00:32:26 Um, access, you know, being an issue for, for whānau to get to a, a doctor or a GP to get a prescription for a common infection. Um, right to how, um, a lot of people it's quite interesting that as Māori, when we work in our own fields, we, we sit in two lanes. One being, um, things that we're taught in university, um, things that we know from a scientific perspective, I guess you could say, but also drawing on our Te Ao Māori perspective too. So, um, I often find myself doing it as a clinician. Um, but it was really wonderful hearing how, um, the, the environmental scientists do that. Um, how they apply Te Ao Māori to their worldview, um, through their own mahi as well as outside of that. For example, I had one, one participant who was talking about how there's a whakapapa for antibiotics and a whakapapa for the environment and everything has a whakapapa, and I've kind of thought about it in my own kind of work, but hearing him talk about it and talking about it so well, I was like, well this is really, really cool stuff.
Speaker 2 00:33:37 Um, right down to things like, Māori perceptions of medicines, equity for Māori around education for things like antimicrobial resistance, it's just not there. Um, things like, um, you know, applying a wha water policy approach to healthcare cause or, or things like anti antimicrobial, antibiotic resistant infections. Cause what's out there around education for an, an, um, an well antibiotic resistance. It's very pākeha-ified. It doesn't, it's not very, um, you know, it's quite confusing. Um, doing my literature review and and research on it, I was like, even I don't really get this. So, um, but then also another, another I guess finding was that within One Health, cause I did ask the interviewers, you know, were they aware of what One Health was and if they didn't, I had like a bit of a spiel I gave them. And then we kind of probed that even more.
Speaker 2 00:34:33 And a lot of them were, um, you know, One Health is kind of like a, um, it gives you, if you, if you're collaborating amongst the three silos of One Health, it's, it's a very multicentric kind of thing to do. You know, we don't hold things in silos as people we, we think of, of the bigger picture. So, you know, um, integration, collaboration, partnering, all of that, um, came through quite strongly. Um, but I guess if I'm gonna talk about findings, um, so one of the findings we had was that obviously there needs to be culturally safe and culturally competent people at work. Um, particularly if you're a healthcare professional working, uh, in a pākeha organisation. If you're a Māori healthcare professional working in a pākeha organisation that pākeha organisation needs to, um, really look at themselves and, and think about how and what they're saying and what they're doing could impact on Māori staff or just Māori overall, um, kind of really know about how colonisation for Māori, um, particularly around antimicrobial resistance.
Speaker 2 00:35:43 So how did we get to where we are, since the Pākeha arrived here around antibiotic resistance. Um, and, and actually another interesting finding we found was that, um, particularly everyone kind of talked about how when they go to the doctor, some doctors are very, um, aware and understanding and some are as racist as. But how if you're sick, um, the chances of you getting a back pocket prescription, um, and actually filling that back pocket prescription and then using it, um, how there were inequities there as well. So we were finding that if you were Māori and you went to a GP or a doctor that prescribed antibiotics, they're more likely to tell you, oh, just go home. You'll be fine. Uh, versus if you were pākeha it was like, oh, well I'll give you a back pocket prescription and, you know, if your symptoms get worse over the weekend, then you can start taking these antibiotics.
Speaker 2 00:36:39 But yeah, it's, um, and this actually happened to me, it happened to me quite recently. Um, I had a doctor kind of try to school me about how um, uh, you know, how do you know what a back pocket prescription is? It's just contributing to antimicrobial resistance. And I kind of, without being a smart ass, had to say, well, like, I do know <laugh>. I did my thesis on it. But, I was fitting all the, all the criteria for antibiotic. And to be fair, like my throat did get better over the weekend. Cause it was Friday afternoon typical Sam. Um, and, and I did not use an antibiotic. I took them back to the pharmacy and they disposed of them. So, um, it's also having that kind of education too. Not many people knew that you can actually take unused medicine, uh, or expired medicine back to a pharmacist. So.
Speaker 0 00:37:29 Oh, so Sam, we've discussed earlier your passion for Māori and <inaudible> and reducing these oral health inequalities. Um, and thank you for sharing such a fantastic, um, overview of like all the things you get up to. I think that we could probably talk for three hours more <laugh>. Um, and you know, the things that you've shared with us today, it's such an important conversation to be had. What should our listeners know, um, from your perspective for them to be able to feel empowered in their journey of Te Ao Māori or Te Reo Māori or any aspect of just becoming more culturally safe?
Speaker 2 00:38:07 That's a big question.
Speaker 0 00:38:11 Well even one thing, one step forward specifically because when I listened to your presentation a while back, uh, two days ago, that it made me think, like you said, wonderful things like advocacy and, um, you know, embracing Te Ao Māori as a, as a non-Māori person, you know, for my own experiences where I've gone and sought out that information and spoken to people and said, well, what should I learn? What should I do? Um, am I on the right track? What if you're right at the beginning of that journey mm-hmm. <affirmative>, what's that first step forward? what do you think?
Speaker 2 00:38:47 I think, and this is kind of what I was talking about the other day, it's understanding why we are at where we are at today. Um, a lot of people, like, I think I, I kind of put it a little bit confronting in my, in my kōrero I had, it was, you know, the effects of colonisation and what it has done to Māori. And, and not only Māori, but you know, Pacifica people, refugees that come here, low socioeconomic people. Um, it's understanding the broader picture that, you know, what what has been done here has caused what's happening for Māori. So, um, it's acknowledging that and um, and, and reflecting on it. Cause a lot of people just refuse to acknowledge the fact that colonisation has done what it's done to our people here. Um, and obviously you've done that yourself, so I'll give you a big mihi to that.
Speaker 2 00:39:44 But there's people out there who are just like, who, who won't acknowledge, you know, and I think I used the analogy of, of Moana Jackson's houses, you know, um, how would you feel if people started building houses around you and enforcing what they think is right. Um, and you know, throwing in systems that, that uh, completely go against what you know, uh, and making you do it. Um, and, and, and then just expecting you to just live like them. It's just, it doesn't work like that. So, um, yeah, I think acknowledging colonisation, understanding He WHakaputanga and Te Tiriti and the Treaty and I, I often, I do have to differentiate the two cuz like I said in my corridor, one is Māori and one is not as English and they mean completely different things. So understanding what the articles of both mean and understanding why we got to where we are today. I think, uh, through, through uh, He Whakaputanga, Te Tiriti and the treaty and also other things like talking the Tohunga Suppression Act. Um, you know how my grandmother's generation and her parents' generation, they had the, the crap beaten out them if they spoke Te Reo, up until look at today, you know, this year we're celebrating 50 years of Te Reo Māori being, um, an official. And I say that loosely language in Aotearoa, it's always been the language, um, here. Um, yeah, just understanding that and acknowledging it and and reflecting on that, I think is the first step.
Speaker 0 00:41:11 Yes. As we celebrate, uh, Te Wiki o Te Reo Māori this week, which is pretty exciting this week. This week I said it twice, but yeah, Sam, on that ngā mihi nui, I just would like to thank you because you've just done so much, um, in your short 10 years as an oral health professional and um, we definitely will talk again because there's just so much more that our listeners could gain from that great understanding you have as a Māori or health professional as we look to create more, um, equitable and um, fair services for, um, our tamariki and rangatahi. And you know, even in our private practice space as well, just being able to really know that, um, we're all culturally safe in our space. Mm-hmm. <affirmative>, so Kia ora, Sam
Speaker 3 00:42:02 Kia ora Becky <laugh>
Speaker 1 00:42:05 Kia Ora for making it all the way to the end of our longest podcast yet. Sam Carrington was an absolute gem to have a kōrero with. I give him a massive thank you for all the hard mahi he does for us as oral health professionals in Ao/NZ and also for the people that we serve.
Next week I'll be speaking to Dusty Pearson. Dusty brings his unique worldview as an oral health therapist practising in Palmy North. Be sure to tune in next week so you can hear all what Dusty has to say. So go well, my oral health professional colleagues and peers from Diane and I at The Whole Tooth Ao/NZ Noho Ora Mai.
