Demystifying Rongoā Māori: Traditional Māorihealing

History of Rongoā Māori

Rongoā Māori is the traditional healing system of Māori. It focuses on the oral transmission of knowledge, diversity of practice and the spiritual dimension of health. Rongoā Māori encompasses herbal remedies, physical therapies and spiritual healing.

Tohunga is the discipline of traditional healing and its practitioners. In early Māori history Tohunga were seen as the earthly medium of the controlling spirits and influenced all aspects of life. Illness was viewed as a symptom of disharmony with nature. If a person was sick, the Tohunga would first determine what imbalance had occurred, before the illness could then be treated both spiritually and physically.

When European settlers came to New Zealand, they brought with them new diseases, modifying the environment and changing the disease ecology of the country. This caused significant mortality among Māori from influenza, measles, whooping cough and dysentery. The Māori population continued to decline into the early 1900s until the situation was reversed partly due to health reforms including building latrines, destroying unsanitary dwellings and establishing Māori health nurses.

The Tohunga Suppression Act 1907 grew out of concern of the practice of "rogue" Tohunga who lacked the training and integrity of traditional Tohunga. Rongoā Māori was seen as unsafe and an impediment to Māori progress by the medical fraternity. A conventional western medical system was desired for New Zealand. At this time, the activity of "quack" doctors was also suppressed with the Quackery Prevention Act 1908.

The Tohunga Suppression Act was passed with support from the four Māori members of Parliament, but only Tohunga whose activities were seen as harmful, were suppressed. The legislation was never really enforced with very few Tohunga prosecuted. However the main consequence of the Act was that it pushed the practice of Rongoā Māori underground. Identities of Tohunga were kept secret and matters of Rongoā were never discussed outside of Māori communities.

Rongoā Māori today

Despite the Suppression Act, training of Tohunga continued over the years and knowledge was passed on and developed. In 1962, as a result of a review of legislation that differentiated between Māori and Europeans, the Tohunga Suppression Act was repealed. With the resurgence of Māori culture in the past few decades Rongoā Māori has once again become prominent.

Māori view health in a holistic way, incorporating spiritual, psychological, physical and family aspects. It is perceived that conventional health services are focused on treating a person's physical health but may not always address other aspects. Some Māori may feel that their needs are better met by engaging with their traditional healers. There may also be geographical, financial or cultural barriers to accessing mainstream healthcare for some people.

The World Health Organisation advocates the inclusion of traditional healers in national health systems. There is a call for Rongoā Māori to be formalised within the public health system in New Zealand and to exist in synergy with conventional medical systems. The following steps have been made to this effect:

• In 1993 the National Organisation of Māori Traditional Practitioners (Ngā Ringa Whakahaere O te Iwi Māori) was established.
• In 1995 regional health authorities were able to purchase aspects of Rongoā Māori. The Ministry of Health has continued to fund services.
• In 1999 the Ministry of Health published a set of standards for traditional Māori healing.
• In 2006 the Ministry of Health released a Rongoā development plan outlining how Māori traditional healing practices will be supported within the health and disability sector. The aims of this plan are to improve the quality of Rongoā services, create leadership roles within Rongoā, increase the capacity and capability of services and develop research and evaluation activities.
• In 2007 Lake Taupo PHO signed a contract for services with the National Organisation of Traditional Healers, setting a benchmark for bridging the divide between Māori and mainstream services. The two organisations now work together to promote the benefits of Rongoā Māori.

The practice of Rongoā Māori

Rongoā is an important aspect of health care to many Māori people despite their concurrent use of western medicine. It represents the passing on of culture and history. Traditional treatment may be sought for a variety of reasons including illness that is atypical or not responding to conventional treatment, mental illness and chronic "lifestyle" conditions such as type II diabetes.

Tohunga do not have a specific training programme or institution but are recognised experts in their field by their communities. Many learn their craft through the passing on of knowledge from elders or through apprenticeships with practising Tohunga. Knowledge and practice borrowed from western medicine may be incorporated into treatment.

Tohunga may work alone or within a clinic (Whare Oranga) and generally do not actively advertise for patients. There is considerable variation in practice and treatment protocols and no standard consensus on diagnosis or prescription. Treatment is individualised to tribes, areas, local plant material and specific needs. Healers are thought to be more prevalent in rural areas and in the North Island.

Treatment includes plant remedies from native flora (Rongoā rākau), massage (mirimiri) and prayer (karakia). Illness is treated by addressing aspects of health including spiritual, psychological, emotional, cultural, social, environmental, family and physical health.

As part of the Ministry of Health standards for traditional healing, Tohunga must ensure that:

• Patients are aware of any follow-up treatment or consultation required
• Patients are referred to other services where appropriate, especially for emergency or acute needs
• Co-operation with other health professionals according to the wishes or needs of the patient takes place

Whare Oranga, like general practices, are required to keep records for patients they treat. These records must contain details of treatment objectives and outcomes.

Some Māori patients may be unwilling to admit to their doctor that they are using traditional healing methods. However GPs should feel comfortable asking their patients about Rongoā Māori. As for any patient, it is important to be aware of any alternative remedies that a patient is taking, to assess any possible conflict with conventional medicine or treatment.