Meeting the Maori
Katharine Warburton shares her experiences of a clinical elective in paediatrics at Rotorua Hospital, New Zealand
Rotorua Hospital
Rotorua Hospita is a state-funded, 200-bed hospital centrally located on New Zealand’s (NZ) North Island. Along with the nearby and smaller Taupo hospital, it serves a population of 102,000 people, 32% of which are Maori, and 5% Pacific natives. The hospital provides inpatient, outpatient and day-patient services, and a range of community services.
The majority of my work took place in the Paediatric department under lead consultant Dr Stephen Bradley. I was expected to carry out the same work as Trainee Interns (paid NZ medical students in their 6th year of study gaining clinical experience), with the exception of prescribing.
My daily routine involved daily hand-over meetings, at which I was expected to present cases and discuss the events of the previous day. Ward work constituted the majority of my time, where active involvement in ward rounds, administration and clinical skills such as urinalysis and venepuncture allowed significant development of my knowledge and aptitudes. I was able to clerk-in new patients in the Emergency Department, spend time in the special care baby unit and assist SHOs at deliveries. At paediatric outpatient clinics I was given a room to myself to carry out full consultations, including dictating letters. The typically NZ laid-back nature of the staff allowed plenty of opportunity for movement around the hospital. I was welcomed wherever I wandered!
Rotorua Lake and sea-planes
The most interesting aspect of working in Rotorua was the chance to appreciate traditional NZ culture and its impact on modern medicine. Rotorua is renowned in NZ as a cultural centre due to the high proportion of Maori living in the region. Unfortunately unemployment, drug abuse and inadequate education are prevalent within many Maori communities, and consequently poor health is rife amongst the population.
Although only 35% of the hospital catchment population is Maori, I would estimate 70-80% of the ward contained Maori children at any given time. This had interesting public health implications and I noted that most health propaganda and educational initiatives within the hospital was aimed at the Maori. I was able to fully appreciate the socio-economics of the area and their impact on medicine by spending days with the community nursing team visiting some of the most deprived areas of NZ, such as Murupara. Here, some Maori communities live without electricity and basic health knowledge, drug abuse is extensive and traditional medicine is deeply integrated within the culture, opposing the interventions of contemporary medicine. However, it is impossible not to get drawn in by the welcoming nature and interesting culture of the Maori population: one of my most memorable experiences of the elective was sitting on the outdoor platform of the ward, overlooking Lake Rotorua with its regularly arriving and departing sea-planes, whilst a 5-year old inpatient taught me to count to 10 and name simple body parts in Maori!
Of course, being centrally placed in the North Island allows fantastic opportunity for travel around this incredible country. Staff at the hospital are eager for visitors to explore, and even went as far as lending me bikes, offering the use of mountain and lake-side ‘batches’, and giving me lifts around the region en-route to clinics. I felt incredibly welcomed, and there were plenty of other elective students at the hospital to socialize with. I would highly recommend this elective to any students wanting to mix clinical learning opportunities with discovery of new cultures and landscapes. It gave me everything I could have wanted from an elective.
Katharine Warburton
Fifth Year medical student
University of Leeds
ugm3klw@leeds.ac.uk