A seminar day of Maori Health, held in a marae

A "Wharehui", assembly hall

Here some important aspects of Maori health concepts:

Te Whare Tapa Wha - The Principle Understanding of Health in Maori Culture

In traditional Western understanding, health is in first place a physical entity, which then allows for emotional well-being and mental health (mens sana in corpore sano). In modern medicine, an effect in the other direction (emotional distress → damage to the body) is recognised, although health is still most commonly measured in physical parameters (BP, BG, Lipids, cardiovascular events). (Reflections of the author)

In Maori understanding, health consists of a system of interrelated components. The primary perspective is rather a spiritual than a physical one. „Taha wairua is generally felt by Mäori to be the most essential requirement for health. It implies a capacity to have faith and to be able to understand the links between the human situation and the environment. Without a spiritual awareness and a mauri (spirit or vitality, sometimes called the life-force) an individual cannot be healthy and is more prone to illness or misfortune”. (1)

Dr Mason Durie has framed this perspective into the concept of the four essential components of a house. This was published in the 1980ies and generally welcomed and supported by Maori.

These are the four components (taha) of the house (whare) of health:

Te taha wairua – Spiritual Health

As spirituality is not a part of the common Western understanding of health, this area remains unattended if not specifically and individually adressed. There are no own consentive concepts of spiritual health the Western society has to offer. It can be assumed that the perception and conceptualisation of spiritual health will vary widely between Maori individuals, depending on their anchouring within whanau, ancestry and personal experience and inclination. It may be wothwhile o ask, though, and to reflect on our own concepts. (Reflections of the author).

Te taha hinengaro – Psychological Health (Health of Thoughts and Feelings)

While Western thinking distinguishes between the spoken word and emotions (and generally encourages the word more than the feeling), Mäori do nor draw such a sharp distinction. Communication, especially face-to-face, depends on more than overt messages. Mäori may be more impressed by the unspoken signals conveyed through subtle gesture, eye movement, or bland expression, and in some situations regard words as superfluous, even demeaning. ... Health is viewed as an interrelated phenomenon rather than an intra-personal one, ...and poor health is typically regarded as a manifestation of a breakdown in harmony between the individual and the wider environment. (1)

Te taha tinana – Bodily Health

Taha tinana (bodily health) is a more familiar health dimension though the Mäori emphasis is different in that there is the clear separation of tapu and noa. Certain parts of the body and the head in particular, are regarded as special (tapu), and bodily functions such as sleeping, eating, drinking, and defecating are imbued with their own significance, reflecting various levels of importance and requiring quite different rituals. Food, for example, is a leveller which removes any vestige of sacredness or distance (as between people). ...

Slender body forms are not necessarily prized more than well-rounded shapes, nor does obesity provoke the same sense of disapproval encountered in society generally. Health workers report difficulties in trying to convince Mäori patients that they should lose weight. Their efforts might be better spent in appealing to health risks, especially for future generations, rather than to personal vanity. (1)

Te taha whanau – Family Health

Taha whanau acknowledges the relevance of the extended family to health. The family is the prime support system for Maori, providing care and nuturance, not only in physical terms but culturally and emotionally. Reported rises in the prevalence of family dysfunction including signs of abuse, do not lessen the point but underline its significance. Mäori still maintain that ill health in an individual is a reflection on the family and may well blame a family for allowing a person to become ill or to die, even when there is no direct causal link.

Taha whanau relates to identity and sense of purpose. The much-lauded state of self-sufficiency or self-realisation does not convey a sense of health to Maori. Inter-dependence rather than independence is the healthier goal. … Underlying the whare tapa wha model is the consistent theme of integration. Individual health is built into a wider system, the boundary between personal and family identity being frequently blurred. Similarly the divisions between temporal and spiritual, thoughts and feelings, mental and physical are not as clear-cut as they are have been in Western thinking.... Despite a century and a half of colonization, Mäori remained convinced that good health could not be gauged by simple measures such as weight or blood pressure... (1)

Source: (1) Mason Durie: Whaiora - Chapter Five TIROHANGA MAORI -MÄORI HEALTH PERSPECTIVES