Te Tiriti o Waitangi and Its Relevance in Emergency Departments
Te Tiriti o Waitangi, signed on 6 February 1840, established a foundational agreement between Māori as tangata whenua (people of the land) and the British Crown. Its significance extends beyond history to contemporary applications, including the design and delivery of equitable healthcare services within emergency departments (EDs). Acknowledging and integrating Te Tiriti principles is critical to ensuring culturally responsive, safe, and effective care for Māori.
Ngā Rerekētanga o ngā Putanga Reo | Differences in Treaty Texts
Te Tiriti exists in two primary versions: te reo Māori and English. The Māori text emphasises tino rangatiratanga (chiefly authority and self-determination), while the English version centres on British sovereignty. These differing interpretations have perpetuated constitutional breaches and systemic inequities, making the partnership promises of Te Tiriti even more vital in today’s health contexts.
- English text: The British sought to protect Māori interests, enable settlement, and establish governance for peace and order.
- Māori text: Māori chiefs understood the Crown’s role as establishing governance while guaranteeing tino rangatiratanga over tribal lands, taonga (treasures), and decision-making.
This enduring misalignment reinforces the need to re-centre Māori voices and frameworks in health services.
The Treaty takes its name ‘Waitangi’ from the place in the Bay of Islands, on the upper North Island, where it was first signed on 6 February. It is regarded as the country’s founding document, establishing relations between the British, their settlers, and Māori tribes (Iwi).
Waitangi Day is officially commemorated each year on 6 February with tribes and Government at Waitangi Tii Marae and Treaty Grounds, Northland. Festival gatherings are held throughout the country. Many make an annual pilgrimage to Waitangi with their families to mark the day and enjoy the festivities.
Ngā Tuhinga o Te Tiriti | The Four Articles of Te Tiriti
The Treaty (te tririti) has four Articles supporting the independence of Māori self-determination within their lands, and this can be translated as the ‘what, how, where and when’ for their whānau (family), Hapu (external whānau defined as bloodline in close geographical boundaries) and iwi (tribe, defined by bloodlines and geographical boundaries).
Below is a description of each of the four Articles, which can be found in the ACEM Health Equity Statement. This is a valuable foundation document when planning, designing, and developing professional skills to increase cultural responsiveness.
The four articles are as follows:
Ko te Tuatahi
Article 1 – Kawanatang |
Ko te Tuarua
Article 2 – Tino Rangatiratang |
|
Article 1 – Kawanatanga supports meaningful Māori representation, kaitiakitanga and participation at all health system levels, including within governance structures and mechanisms, decision-making, prioritisation, purchasing, planning, policy development, implementation and evaluation.
|
Article 2 – Tino Rangatiratanga is about self-determination and addressing institutional racism within the Aotearoa New Zealand health system; actively supporting Māori providers and organisations; applying Māori-centred models of health; using strength-based approaches that engage and involve Māori communities; and recognising that Māori control and authority are critical to successful interventions.
|
Ko te Tuatoru
Article 3 – Ōritetang |
Ko te Tuawha
Article 4 |
|
Article 3 – Ōritetanga addresses equality and guarantees equity between Māori and other Aotearoa, New Zealand citizens. It requires action to improve Māori health intentionally and systematically. This involves considering the broader determinants of health, access to health care, and the quality and appropriateness of services.
|
Article 4 affirms the protection of Māori custom and the position of wairuatanga, te reo and tikanga Māori. These are central to understanding and connecting with Māori culture and worldviews.
|
Ngā Tikanga Hauora i Roto i ngā Tari Whawhati Tata | Applying Te Tiriti in EDs
To uphold the principles of Te Tiriti in ED settings, services must align with Māori methodologies that prioritise equity, cultural safety, and meaningful engagement. This includes:
- Tino Rangatiratanga: Empowering Māori to lead service design and delivery, ensuring that EDs reflect kaupapa Māori values.
- Ōritetanga: Intentionally addressing disparities in ED experiences and outcomes for Māori, focusing on systemic and cultural responsiveness.
- Kaitiakitanga: Actively protecting Māori health through culturally safe environments and partnerships.
- Ngā Kōwhiringa Whaihua: Creating spaces where whānau feel valued and respected, enabling positive healthcare experiences.
- Te Pātuitanga: Strengthening partnerships with Māori, fostering mutual respect and shared decision-making.
Te Tiriti o Waitangi is not merely a historical document but a living covenant that guides the relationship between Māori and health institutions. By embedding its principles within ED practices, we can honour the mana of Māori and contribute to a health system that truly reflects the aspirations of whānau, hapū, and iwi. Māori methodologies remind us that holistic care—addressing hinengaro (mind), tinana (body), wairua (spirit), and whānau—is not only beneficial but essential for achieving health equity.
The intent within the ACEM Health Equity Statement supports the commitment of te Tiriti with the alignment of those of Manatū Hauora Ministry of Health, Aotearoa, New Zealand, which are:
- Tino rangatiratanga – guarantee Māori self-determination in emergency care
- En oho taurite – commit to achieving equity of health outcomes for Māori who use ED services
- Te kaitiakitanga – active protection and to act ensuring equitable health outcomes
- Ngā kōwhiringa whaihua – ensures emergency departments are culturally safe
- Te pātuitanga – partnership, working together with Māori