Rural Conferences and Kotahitanga

Dr Fiona Bolden

Many of you attended the National Rural Health Conference at the start of May in Christchurch with record numbers of attendees from all parts of the motu. The rural conference has always been a time for us when the rural whānau gather, we have time to meet up with old friends and make new ones, we discuss key issues, reflect, learn, laugh, and some of us even dance! These are the core ingredients, and this conference certainly filled them: Kotahitanga in action.

Key speakers who really made an impression were Carlton Irving with “Empowerment in Māori rural health”. He highlighted key disparities in health for Māori, especially in maternity, infant health and aged care. He also had some recommendations regarding solutions: emphasising Iwi-led and Kaupapa-Māori services, extended teams, mobile and outreach services, rural training pathways, whānau ora models and telehealth services which must be culturally safe and digitally accessible. These will need systems changes to support them, and they will require adequate resourcing, which is a recurrent refrain in all areas of our health services.

Dr Ganesh Nana, an economist, discussed the business of rural primary health care, which is debatably not currently a viable business model. He discussed the difference between financial sense and economic sense. The economy is the responsibility of the Government, and the objective of the economy is to safeguard and nurture the resources that we inherit so that they can be passed, fit for purpose, to future generations.  With the budget yet to be announced, I am wondering how much of it will focus on the objectives of the economy rather than just finances.

More light-hearted keynotes included Matt Chisholm, who entertained us with his anecdotes, but had a more serious underlying message regarding men’s mental health. Our final keynote was Sophie Hart, who is a rural GP and a world-class adventure racer. Her brave and intrepid race down 1000 miles of the Yukon was an incredible feat, especially as she and her teammate not only came 1st but also got the 2nd fastest ever recorded time. They won a T-shirt for their efforts! Her reflection on the importance of being mindful of the journey and totally focused on the present, whilst also having planned for the future goal, seemed extremely apt for the journey we are taking with rural health.

This conference was held shortly after I had attended Bengaluru, India, for the Global Rural Health Summit, which preceded WONCA SAR (World Organisation of Family Doctors South Asia Region). The Summit was led by Dr Pratyush Kumar, who will be President of Rural WONCA when we hold the 21st WONCA World Rural Health Conference here next April. There was a commitment given at this conference by the Minister of Health for India that the Government would support family medicine. This is a major step forward for India, as up to now, all family medicine in India has been privately funded. The rural summit produced the Bengaluru Declaration on Rural Health, which had 4 key calls to action, ones that are very similar to our own. The current president of Rural WONCA, Bruce Chater, was there and attended our conference, coming a few days early to check out our initial plans regarding hosting Rural WONCA next year.

The 21st WONCA World Rural Health Conference will be a conference like no other- building on the success of our conferences to date and spreading the Kotahitanga to all tangata around the globe. So mark the date in your diaries now! Let us use it as a platform to produce an enduring legacy for Rural Health in Aotearoa, New Zealand, putting the solutions for addressing the disparities in the health of rural Māori and other Indigenous peoples at the forefront