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 (spiritual health) 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 housen (1). This was published in the 1980ies and
generally welcomed and supported by Maori.
These are the four
components (taha) of the house (whare):
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 anchoring
within whanau, ancestry and personal experience and inclination. (1) It
may be worthwhile to raise the topic, though - and to reflect on our own concepts.
(Reflection 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
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