Kakahi
The main health concerns for residents of Kakahi related to the lack of locally available services and difficulty accessing services due to geographical barriers, transport and wait times. Residents felt that more and more services were being withdrawn from Taumarunui and the costs and burden of service accessibility was transferred to residents who were forced to travel further to obtain health care. Although a bus was available to transport people to Waikato, service users still had to get to Taumarunui, and for the elderly or unwell it was considered a difficult trip:
"I hurt my hand and I had to go to Waikato to get the MRI, and the radiographer that worked there, she told me she used to come down once a week to Taumarunui but then the funding got cut. So now we all have to drive to her."
"Our mokopuna, when he was born, he was flown up to StarShip and the doctor there said to us, “Don’t bring him back.” He was really good I’ve got to say; saved his life. He got him all prepared for when the helicopter came down to get him, and he said, “Do not bring him back to Taumarunui, there’s nothing here for him.” And he had been sent home from Waikato where they diagnosed him, but he only lasted one night, and he deteriorated. And that doctor, who was only a locum, he was so concerned. He said, “If they discharge you, don’t come back to Taumarunui, refuse to leave.” But as it was, we stayed in StarShip for nearly three months."
"It's actually scary how many resources have been taken out of Taumarunui and the clinics. The staff that work there fight to get the clinics back down here because the patients can't afford to get to Waikato. They can't get there. They've now sorted the hospital bus, but still it's not ideal especially for elderly. They have to wait all day. They get on the bus at eight in the morning and it's a two-hour drive on a not great road, and they've already got health issues. And they have to hang around and I think they don't get back into Taumarunui until six o'clock. And it's big day when you're already sick, and no food, for an appointment for 15 minutes."
"And some of them have a big panic at the hospital about whether they're going to make it back, and if they don't make the bus you're screwed. They have to find a place to spend the night."
"And taking a kid to the Taumarunui Emergency Department, as soon as they see a kid, they say, "No! Off to Waikato!" They just can’t deal with children."
"A lot of the equipment at the hospital was donated by locals, and then all of a sudden, they don’t even have that equipment anymore?"
Accessing primary care was, as in 2020, still considered difficult due to wait times, with some people now accessing primary care by way of telephone or online consultations. Others felt that medical help was available when they needed, though sometimes only after some effort.
"It takes weeks. You’re looking at weeks to see a doctor. It’s hard for new people to enroll."
"We've actually been having a doctor from Northland ringing. He's been ringing my husband weekly, to catch up, make sure he's OK."
"Virtual consultations, online. With what's his name? Lance O'Sullivan."
"I mean it's difficult, but I know when the girls have been sick, they do their triage calls and I've always been able to get them in or done the phone thing if I've just needed, you know, they've had an ear infection and it's continued. I know I’ve been able to get the medicine continued. So um, and like last year (redacted) broke her bones twice and she was seen to straight away for both of those. Well, you'd hope so! But I didn't have to go up north, up to Waikato or anything. But in saying that, when she broke her foot, I was most appalled when the physiotherapist told me that she couldn't have crutches or anything. That she could just crawl around the house. "Throw a bit of cake in the corner and she'll get there if she wants it." Oh my God, I was like, "Excuse me?" I kept at her, and I was able to get a walker for her. It was an effort to get that, and to get a cast on her foot. They were just going to let us leave with nothing."
Some participants were concerned about the fact that older people seemed to be coming to the area for retirement, but had health needs which weren’t necessarily able to be catered for in the community:
"There are so many older people retiring to the area with health issues, retire here, and then there's not the services, the health services can't cope."
"They sell their house in Auckland and come here, but what is there for the older person as far as medical care?"
"Not just that, social stuff, too. There isn't really much for that as well and we see quite a number of elderly men that are recent to the area that'll come in, quite lonely."
Although concerns held in 2020 regarding ante-natal and post-natal care remained, these appeared to be slightly ameliorated due to the employment of a Plunket nurse and midwives in Taumarunui:
"We had no Plunket Nurse for three years. There used to be a Plunket Nurse that came out here. Now there is one in Taumarunui. But there's only one of her. Yeah, they've got one now but for three years we had no Plunket. They've just got one now. But for three years there was nothing."
"I had to go to Tūrangi for a midwife, but there’s now two midwives in Taumarunui. But they will still send you to Hamilton and Taupō."
"The minute there’s any sort of issue, or…. I think they’re just covering their arse."
"They’re maybe not in a position to be able to cope with anything untoward happening."
"It’s so hard when you have to be up there (in Waikato). I got admitted two weeks before for high blood pressure, and I already had a little girl and then you’ve got to pay for accommodation up there, and it’s really hard."
"They’re so over-run, so people will still go away. It’s very large area they cover. They probably go north as well, probably as far as Te Kuiti."
Mental health services were considered to be overstretched or else unavailable:
"Ridiculous. Non-existent. There's nothing."
"There is Kokiri Trust, they provide a lot of services. They provide Whānau Ora which is a help. But they're completely overrun and understaffed. Last time I enquired there was one person trying to manage about three jobs."
"I went to a suicide prevention hui, and they had about twenty participants come and share their stories and it was all about support. The facilitator was from Waikato, there is only one of him. It was an awesome hui, where, where we all got to share stories, but lack of that support was key, you know, in times of darkness they felt unsupported, alone, and that their whānau didn't know how to support them. So, no tools were given to them to be able to manage that. There's just nothing. They just have to cope by themselves and they're not coping."
"The small children too, I've tried for years really to try to get my kids some clinical and social support and I’ve basically been told to go to Tūrangi."
"It's the same postnatally as well, like when you have a baby, there's just no support. They've been so short here on midwives and it's really hard if you're struggling with a baby. "
It was considered that the elderly were most vulnerable in terms of health in Kakahi, particularly those who did not have whānau in the area.
