Foundations of equitable speech-language therapy for all: The Treaty of Waitangi and Māori health

Abstract

The delivery of health services, including speech-language therapy (SLT), is influenced by the culture of the healthcare discipline and the unique cultural, social and political history of the country. Among the multitude of terms referring to cultural competence and related concepts, it is timely for the SLT profession in Aotearoa (New Zealand) to determine a unified and strategic approach to cross-cultural service delivery. This article examines foundational issues to consider before establishing that approach. The Aotearoa context is strongly influenced by colonization, te Tiriti o Waitangi (the Treaty of Waitangi), immigration and questions of biculturalism and multiculturalism. Within this, issues arise because the Aotearoa SLT workforce is not representative of the population it serves. Because of te Tiriti, it is necessary to begin by addressing issues facing Māori, the indigenous peoples of Aotearoa. These include health inequities, racism, color-blindness and white privilege. The Hauora Māori (Māori health) approach taken by medical schools in Aotearoa might be a suitable medium for SLT to address these issues. Ultimately the SLT profession, and individuals within it, need to develop a ‘critical consciousness’ through which they recognize the cultural, social and political context and search for innovative solutions.

Keywords:

• Speech-language therapy
• Cultural competence
• Health inequities
• Indigenous
• Treaty of Waitangi/te Tiriti o Waitangi
• Māori

Acknowledgments

We are grateful to two anonymous reviewers for their helpful suggestions to improve this article.

Disclaimer statements

Contributors All authors had equal contribution in designing the study and carrying out data analysis and preparation of the manuscript.

Funding The first author was funded by a Health Research Council of New Zealand Eru Pōmare Postdoctoral Fellowship.

Conflict of interest None.

Ethics approval Not required.

Glossary

Aotearoa	=	New Zealand
Hapū	=	Sub-tribe
Hauora Māori	=	Māori health
Kāwanatanga	=	Government
Māori	=	The Indigenous peoples of Aotearoa
Pākehā	=	Non-Māori, usually used to refer to New Zealand Europeans
Rangatira	=	Chief or chiefs
Tangata whenua	=	The people of the land, refers to the Indigenous status of Māori in Aotearoa
Taonga	=	Property, treasure
Tauiwi	=	People who are not Māori
Te Ara	=	The path, track or course
Te reo Māori, te reo	=	The Māori language
Te reo me ona tikanga	=	The Māori language and its customs
Te Tiriti o Waitangi	=	The Treaty of Waitangi. Usually used to refer to the Māori language version of the Treaty
Tino rangatiratanga	=	Absolute sovereignty, self-determination
Whānau	=	(Extended) family