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Four dimensions of holistic wellbeing:
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1.
Hinengaro (mental health)—the power of knowledge and positive thinking.
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2.
Tinana (physical health)—integration of traditional and complementary treatments.
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3.
Wairua (spiritual health)—faith and trust in phenomena (tangible and intangible).
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4.
Whānau (family)—the importance of close relationships.
The Māori world is rich in metaphor where deep understanding of one phenomenon or concept can be usefully applied to make meaning of many things that seem inexplicable. Developed by Sir Mason Durie in 1984, Te Whare Tapa Whā (the four-sided house) is a traditional Māori model of holistic wellness [1]. The model is premised on a wharenui (meeting house) structure, requiring all four sides to be of equal dimension and strength in order to stand strong. This model is applied ubiquitously throughout Aotearoa New Zealand, and it was this model that I turned to following my diagnosis of cancer to make meaning of the inexplicable: the news that I have breast cancer. As frightening a prospect as that was, I knew that if I was going to survive, I needed to draw on the knowledge, resilience, and fortitude of my tūpuna (ancestors) and my mana motuhake (self-agency) to have rangatiratanga (self-determination) over my own healing journey.
Hinengaro: Knowledge Is Power
A critical component of my journey has been learning. In my roles as a mother, advocate, and research evaluator, I critically understood the value of arming myself with as much information as I could to inform my thinking and decision-making. I found that our people, like other Indigenous people, do not fare well within the Western cancer-care system [2]. I was not prepared to wager my life on one treatment pathway. In reviewing the use of complementary medicine (CM) and traditional medicine (TM), I discovered that systemic racism and discrimination impacted levels of access to medical treatment to CM and TM for Indigenous peoples [3]. I grew a heightened awareness about the potential of Te Ao Māori (the Māori world) for my healing journey. I met with tohunga (Māori experts) to access mātauranga Māori (traditional knowledge), rongoā Māori (traditional medicines), and tikanga (traditional practice). I immersed myself in research and participated in alternative treatments including vitamin C and mineral infusions, cannabis oil, Chinese medicines, and kinesthesiology.
Tinana: The Capacity for Physical Healing and Wellbeing
Exercising mana motuhake (self-agency) over my breast cancer was literally a contest of my mind over matter. While I was fortunate to have private medical insurance, the Western treatment pathway was nothing short of intensively grueling. It included a mastectomy, chemotherapy, radiotherapy, Herceptin, heart checks, weekly blood tests, and meetings with the surgeon and oncologist. Despite the physical toll, my research led me to lifestyle changes, including rongoā maori (Māori medicines), eating a wholesome diet, decreasing stress levels, and making natural products for my body and home. I continued to work and coach netball teams, and I completed an adult teaching diploma. These activities kept me physically connected to life and I made a conscious decision not to simply give up but to be an active participant in my own recovery.
Wairua: The Capacity for Faith and Wider Communication
I connected with my cultural spirituality through the guidance of tohunga (Māori experts), friends and whānau (family), and embracing the holistic approaches to wellness of my tupuna (ancestors). This spiritual journey enriched my soul and reinforced my resolve to overcome the physical challenges. I never lost faith that I would survive and move beyond breast cancer to a place of sustained health and wellbeing. Reaching a place of “tau” or being settled and calm was important for my wairua (spiritual health).
Whanaungatanga: The Importance of Support Networks
Whanaungatanga (family connection) is foundational to the centrality of being Māori. As a collective culture, our identity is inextricably linked to our kin—past, present, and future. So, it was natural that my diagnosis saw me immediately drawing on these links as my primary support system. From providing meals, being chauffeured to appointments and advocating for my needs, to gifting encouraging words that uplifted my spirit, the support of my whānau (family) and friends was essential to my healing. Their physical and practical support was something I couldn’t have done without, and their unwavering presence gave me the courage to face each day with resilience and hope.
Conclusion
My journey through breast cancer has been one of challenges and triumphs. I am conscious of the toll taken on my whānau—my partner and our tamariki (children)—and my relatives and friends and the impact my breast cancer diagnosis had on their own “Te Whare Tapa Whā” (dimensions of wellbeing). We must be cognizant that their lives are affected as much as ours, and, as they watch and observe our struggles, they are struggling too. My experience has taught me that drawing on collective support, traditional healing practices, and our Indigenous knowledge, medicines, and stories of resilience and determination can overcome most challenges. It is my hope that sharing my story inspires others to exercise their mana motuhake (self-agency), trust in their own Indigeneity, and find their own healing pathway. Further, I hope that we, as Indigenous peoples, can collectively challenge Western-centric cancer-care approaches and improve access for our people to holistic, culturally responsive, cancer treatment options.
References
Durie M. Te Whare Tapa Whā: A Māori model of a unified theory of health. In: Meijl H, editor. Proceedings of the National Māori Graduates of Nursing Conference. Victoria University of Wellington; 1984.
Seneviratne S, Campbell I, Scott N, Coles C, Lawrenson R. Treatment delay for Māori women with breast cancer in New Zealand. Ethn Health. 2015;20(2):178–193. https://doi.org/10.1080/13557858.2014.895976
Gall A, Leske S, Adams J, Matthews V, Anderson K, Lawler S, Garvey G. Traditional and complementary medicine use among Indigenous cancer patients in Australia, Canada, New Zealand, and the United States: A systematic review. Integr Cancer Ther. 2018;17(3):568–581. https://doi.org/10.1177/1534735418775821
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Marama, M. (2024). Expression of My Mana Motuhake (Self-Agency) to Guide Breast Cancer Recovery. In: Garvey, G. (eds) Indigenous and Tribal Peoples and Cancer. Springer, Cham. https://doi.org/10.1007/978-3-031-56806-0_23
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