Welcome to The Hui ` Maori current affairs for all New Zealanders. E taro ake nei... When her son had toothache, she never imagined he'd be dead just weeks later. - I gave them a boy that was walking and talking, and all he had was a toothache. What did I get back from that? Not fair. - Bryce Rangitaawa's whanau share his story. - You wouldn't want another whanau to go through what you've been through? - No. Never ever. - Then ` what's it like caring for a grandparent with dementia? - Is it a challenge for you? Do you treat it as a job? - As a job? Nah. I'm actually quite honoured and privileged to be here looking after Papa. - We meet the mokopuna showing Aotearoa how it's done. - Bang, eh? Cheee! That's good, mate. - And we speak to Andrew Little about the new Maori Health Authority. Captions by Able. www.able.co.nz Copyright Able 2022 Tahuti mai. When 44-year-old Bryce Rangitaawa told his whanau he was suffering from a toothache, they couldn't fathom the tragic events which would follow. In December 2020, Bryce sought help for a sore tooth and abscess, but less than a month later, he died from a suspected heart attack. His mother, Maria Brown, is sharing Bryce's story to encourage others to get the dental care they need. Kei a John Boynton tenei ripoata. (GENTLE, ETHEREAL MUSIC) JOHN BOYNTON: When Maria Brown visits Onehunga Beach, memories of her son Bryce Rangitaawa come flooding back. - Bryce was very, very special. He was caring, loving, strong, could make you feel like everything was all right, even if it wasn't. - Bryce Rangitaawa died from a heart attack in January 2021, just three weeks after seeking treatment for a sore tooth. 18 months on, Maria still struggles to make sense of the tragic events which unfolded. Did you ever feel that a toothache would lead to your son losing his life? - Never. Never. Never ever. It just doesn't make sense ` how it's all ended, you know? And what we had to go through. (GENTLE, TINKLY MUSIC) - For Maria Brown, Christmas of 2020 was a happy time for her whanau, but it's when Bryce first started complaining of a sore tooth. Maria says Bryce had never had problems with his teeth in the past and didn't have a regular dentist. - Christmas Day, he mentioned it, and then he took some Pamol and something else, and it seemed to have gone away. He seemed to be OK with it. But then it came back. - Struggling to find a dentist which was open, Maria and Bryce went to their local doctors for help. After three visits, Bryce was referred to Auckland Hospital. - My main concern was he hadn't eaten, and then it got to the point where he couldn't even swallow. It just got from bad to worse. - At Auckland Hospital, X-rays were taken, and it was determined Bryce had a right dental abscess and needed to have one tooth taken out. Bryce was then told to immediately book an appointment with a dentist to have this work carried out. He was then sent home from the hospital with pain relief and mouthwash. So when a whanau or someone, you know, feels that pain and can't afford to go to a dentist, and they end up at an emergency department, realistically, what kind of treatment can they expect? - You turn up at A&E. You're often seen by a doctor or a nurse who has little to no dental training, so they're assessing for infection. Often, you'll get some antibiotics to deal with the infection, some pain relief to get you through until the antibiotics start to work but often doesn't resolve the long-term issues, and so people end up back at A&E again. - After visiting Auckland Hospital, Maria had to find the $480 needed to have Bryce's work carried out. Both Maria and Bryce were beneficiaries, and this cost was a major barrier. Bryce had to go to Work and Income for a dental grant. - The mamae of embarrassment and shame of having to ask for help is difficult. And then there's just the barriers of trying to cope with life when you're... living in a low socioeconomic situation. - Bryce secured the $480 dental grant, and Maria was happy he was finally having his dental procedure. - He got the tooth taken out. But when he came home... still very swollen, could barely talk still. But I think` psychologically, you think, 'Great, the tooth's out, and I'm gonna get better.' Unfortunately, that didn't happen. (SOFT, MELANCHOLIC MUSIC) - Just a week later, Bryce's condition deteriorated, and he was referred to Middlemore Hospital. He underwent acute surgery for incision and drainage of a large abscess and to extract another tooth. He spent the night in intensive care, but Maria was able to see him the next day. - I found him downstairs... sucking on a smoothie through a straw, because he was starving. He was thirsty, you know. But he'd been to surgery. His whole neck was bandaged... and still limited in what he could say, but he was putting his thumbs up to me and saying, 'I'm OK.' - Over the next few days, doctors raised real concerns about Bryce's other health conditions, including diabetes, which he wasn't taking medication for. His elevated blood pressure and blood sugars were of major concern. But Maria says Bryce was active and up and about whenever she saw him at the hospital. - I went up there every day bar one day. He was never lying in bed like how you expect to see sick people. Now I wish I'd never left his side. (BROODING PIANO MUSIC) - If you've got painful, sore, rotten teeth, it doesn't just affect what's going on in your mouth. It has associations with systemic diseases like coronary heart disease, diabetes, low birth weight babies. So there's a whole lot of other things that go with that disease. - When was the last time you talked to Bryce? - Last time I spoke to Bryce was the day before. He'd given me a call. 'Coming home, Mum.' 'Good, Bryce.' Yeah. And then... then I got this phone call from the doctors saying my boy had gone. - Maria says Bryce had been found collapsed on his bed and had died from a suspected heart attack ` just six days after going to hospital and less than a month after first complaining of a sore tooth. - I just... Yeah. I couldn't believe it. Um, it was just... so heartbreaking. Such a shock. That's all I know. It was horrible. I gave them a boy that was walking and talking, and... and all he had was a toothache. What did I get back from that? Not fair. I'm sorry, but just not fair. (BROODING MUSIC) - After Bryce's death, Maria Brown filed a complaint with police and, later, the Health and Disability Commissioner. - I told them, 'I am not happy at all about what has happened here.' - In April this year, Maria received the Health and Disability Commissioner's findings into her complaint. In short, the report found clinicians could not have done anything more to prevent Bryce's death. - I do think more could have been done for my Bryce, whether it be the doctors, the hospitals or any people that need this type of help. People need to recognise and take these things, especially toothaches, seriously. - Bryce's initial coronial autopsy report listed blocked heart arteries and sepsis as direct causes of death. The link to sepsis raised questions about whether Bryce's infection from his operation was managed appropriately. The Counties Manukau District Health Board responded to the Health and Disability Commissioner, saying... Bryce's death is still before the coroner. Where do you go from here? - I think, you know, in all fairness, can I speak to the Commissioner of Health, please? Can you help me here a little bit to... help me get a better understanding of what you're really saying? Cos I just find it so hard... to get my head around all of that. - The debate around oral healthcare continues to be a burning issue in Aotearoa. Karen Turanga says adult dentistry needs to be more integrated into our primary healthcare system. - If we could have better funding, particularly for low-income... individuals ` adults, particularly. Our children are well serviced, but our adults have a real issue. And particularly with Maori and Pasifika, the inequities there are huge as well. If it goes on the way it's going, we're just getting a bigger and bigger avalanche of need. - Maria is now working with a Maori liaison from the HDC to see if some finality can be reached over Bryce's passing. She wants to try and move on with the precious memories she has of her son. - Here's the hard case thing ` I don't normally have photos of people on my walls, but my beautiful niece gave me a photo of me and Bryce that was taken a few years ago. So every morning, I get up, I have a coffee, and I look over by my front door, and there's me and my Bryce. (MELANCHOLIC MUSIC) - Ka aroha hoki. Next, we look at what it's like to care for a kaumatua with dementia. or mate wareware, and this number is rapidly growing as our population ages. Now one Hauraki-based mokopuna is demystifying what it's like to care for a kaumatua with mate wareware, sharing their experiences on social media and gaining a following. Kei a D'Angelo Martin nga taipitopito. (GENTLE, TINKLY MUSIC) D'ANGELO MARTIN: Meet Jim Kingi and his mokopuna James. They've got a very special bond. - Hey, you used to buy me some clothes over there. - Oh, OK. - (CHUCKLES) - This just here? - Yeah, yeah. Just there. - OK. - James is trying to jog his koro's memory who, five years ago, was diagnosed with dementia. - (SPEAKS INDISTINCTLY) - Yeah, yeah. - Bang. - Bang, eh? Cheee! That's good, mate. Out of the blue, sometimes, he comes out with random things ` not whole sentences, though. It'll just be, like, a random word or something, like... 'Rotorua'... or 'Kaingaroa' or 'builder' or 'healer' or something like that, you know? - Those words and places are things Jim can sometimes still recall. But when it comes to remembering who his mokopuna James is, it's a different story. - I'd like to think that somewhere deep inside him, eh, he still recognises who I am and... Maybe he doesn't recognise my face, but as the community on TikTok has pointed out, eh, they noticed` they feel that he recognises my wairua. Oi! You unlocked it, man! You bloody clever. This how you been getting out? - Shush, shush, shush. - Shush? - You're snapping me out. (JAMES LAUGHS) - James is Jim's main caregiver. A few months ago, he started a TikTok page to share their experiences,... - So a lot of times during the night, Papa can get up out of bed and take off, but Nan's usually there to cuddle him down to sleep. - ...posting videos on social media showing the ups and downs of living with dementia. # Tonight, I gotta cut loose, footloose. # Kick off your Sunday shoes. - Ah, we initially started it cos we just wanted to capture all the mean memories of our time with Papa. - Moments turned into memories, and memories uploaded online to a following of now over 75,000 people. - Straight away, on the first couple of videos, people were going, 'Oh my God. I'm dealing with this sort of stuff,' or 'blah blah blah blah blah'. 'I love how you're caring for your grandfather, showing care, showing this, showing that.' - In a way, it started a wider conversation about dementia. - Yeah, yeah. Some people have approached me and been like, 'Oh, you know, thank you for what you're doing. 'I'm actually doing this at the moment, and I've been a bit scared. 'I've been a bit quiet, you know? I've never talked about it to anyone. 'But watching your videos, I'm feeling more comfortable to open up and talk to people.' - The unique bond between James and his koro Jimmy has won the hearts of their followers... - ON VIDEO: 'Yeah, nah, we always try and stop him, but this fella's a bit of a machine. 'He can go for ages.' - ...and is helping remove the stigma of dementia, a condition faced by 70,000 people in Aotearoa. - Walking around with an adult that should be looking after you, doing things that what a child or a baby does, and I think, you know, people feel a bit ashamed to deal with that out in public. It doesn't have to be that way. That's what we're out here trying to do is to try and show that... you can just live a normal life. - Prior to Jim being diagnosed with dementia, he was a ringa raupa, a hard-working tradie for many years, and a tohunga, or healer, at Te Korowai Hauora o Hauraki. - He could just diagnose deep, deep problems, you know? Like, things that doctors need... actual machines to pick up on. Papa could do that just by hovering his hand over them, and people used to just be amazed. They'd be like, 'What?!' Nine times out of 10, he could fix the pain, eh. (GENTLE ACOUSTIC GUITAR MUSIC) - Jimmy the healer is now cared for by his whanau in Thames. - OK. - Noho. - (SIGHS) - For Erita Kingi, Jim's wife, the support of her family has been invaluable. - Everyone has a duty care time. We share the cooking,... and then we all do the... the work. - Mm. - The worst thing in the house is the washing. (CHUCKLES) - We make it work. - But we make it` Yeah. - Come dry these dishes, please. - And James's partner, Sharn Phillips, agrees. - In terms of caring for someone with dementia, teamwork definitely makes the dream work. Needs to be a lot of communication, making sure everybody's on the same page. - Jimmy's daughter Misa Kingi says providing around-the-clock care isn't easy. - Not everybody can do it at home, so don't put that expectation on yourself. We're just fortunate cos we've just made that decision and made the call to come and look after him, and it takes a lot of work. - Is it a challenge for you? Do you treat it as a job? - As a job? Nah. I'm actually quite honoured and privileged to be here looking after Papa. I just see it as a bit of a... giving back to those ones before me. - I think this is to keep you in so you don't run away. - Can still get out. - Yeah? (BOTH LAUGH) - Who's that? Mum and Dad? - Oh. - Mate wareware, or dementia, is a part of this whanau's whakapapa. - My mother. My mother had it. Then I had aunties. - That's Jim Kingi. - You. - Yeah. That one. And there's Tom Kingi... and Cobber. - For his older brother Cobber, it's a hard reality to see his teina in this state. - Sad, sad, yeah ` to anybody, really. Yeah. Don't want it on anybody, really, eh. Cancer's another one. Te pukupuku ` ooh. I had it. I had bowel` bowel cancer. - How long did you have your cancer for? - 2007 I had my operation. 2007. He flew down to Christchurch, did all the healing. And I felt a big difference. Mm. Like, a lot of people say, 'Oh, lucky your brother was there.' (DELICATE, POIGNANT MUSIC) - The Kingi whanau says there's no denying Jim's ability to heal those with chronic illnesses, but now it's time to return the favour. - We always remember who he was, what sort of person he was, and that helps you care for him and give him the love and support that he needs. - Being able to care for Jimmy at home can be tough on the Kingi whanau, but James says the mahi is worth it, and he wouldn't have it any other way. - I appreciate him still being here. Nah, I love the fact that I can still touch him. I can still kiss him. I can still smell him, can still hug him and everything, you know? That's me every morning, every night, eh. When I wake up, I'll go and give him some cuddles and just embrace that he's here. You know? 'Hello, Jim Kingi. Hey, Jim Kingi.' And he's just... Every morning, every night, you know? Never fail. - E iti noa ana na te aroha ki to ratou koroua ki a Jim Kingi. - Rawe. Akuanei, ka korero ahau ki te Minita take Hauora, ki a Andrew Little. and Health New Zealand were officially launched. The restructure of our health services aims to improve health outcomes for New Zealanders and address inequity experienced by Maori in the health system. Hei matapaki i tenei take kua hono mai te Minita Hauora a Andrew Little. Tena koe. - Tena koe. - Kia ora. Well, we started off this show with a story around dental care, so can we just touch on that? Bryce Rangitaawa's death may have been rare, but the circumstances surrounding it aren't, because a recent report by the Journal of the Royal Society of New Zealand found every part of our oral health system is stressed, long waiting lists, inconsistent collaboration across practitioners and inconsistent access. So for people like Bryce Rangitaawa, it's, you know... the outcome is death for him. Is the dental healthcare system broken? - I'm not sure that it's broken. I think it certainly can be improved. I think we put a lot of resources into dental care for children and adolescents, make sure that people kind of get that start, although I acknowledge that, as a consequence of COVID, there's a big backlog in catching up with some of that care. I think when it comes to adult dental care, look, we haven't had a lot of support for that. Recently ` in fact, in this year's budget ` this government's increased the grant that is available to people, not just for beneficiaries but for low-income people, to get urgent dental care. So $1000... now for that. I think when I looked at Bryce's story ` and it is tragic, and my heart goes out to his whanau ` is that I think one of the other things that I expect the reforms to really work on is that general primary care and so that, you know, people get all the various health issues they've got picked up as early as possible in their lives so that that can be part of their known health profile. So whatever health service they're getting access to, all of their health profile is known. - But even people on six figures can't afford to go to the dentist in this country. Is that because we've got a private system with no public system, so you can charge what you want on that side? And it's a false economy, because they turn up in the A&E. - Yeah, as I said, we put a lot of resources into dental care for children and adolescents ` less for adults. If you've got dental problems as a consequence of an accident, you'll get covered by ACC. But for pretty much anything else, it's what the dental profession will charge you and if you... if you make arrangements with them. I think... But, as I say, I think our dental care stands alongside the rest of our health and our well-being, and we've gotta make sure that our full health services, particularly primary care, helps cover those issues. - But don't we, as taxpayers, rely on you guys to make arrangement with the private sector to regulate it in some way so that it's actually achievable and affordable? Because, you know, yeah, of course, you have an accident, ACC covers you. But just things like crowns and fillings and, you know, keeping your teeth clean ` it's just unachievable for... you know, I don't know how many, but I'd say, you know, the large majority of New Zealanders. - So, we provide support for those who are on benefits and on low incomes, and we've expanded access to grants for that care in this year's budget. But when we look at all the health issues and healthcare that the state provides and the additional funding that we put into it ` literally billions of dollars of extra that we've put in over the last five years ` we are constantly gauging ` where is the next best place to put the next dollar? And we've put some additional assistance into adult dental care for those on lower incomes, but we certainly don't have a fully state-subsidised service. That is true. - Do you think it's working? I know that it's successive governments, obviously. Do you think it's working, though, in child dental care? You've got 60% of Maori, 70% of Pasifika tamariki,... you know, with tooth decay by 5 years old. Is it time to bring back the school dental nurse? - Yeah, I think, certainly the last couple of years, the school dental services have struggled to keep up, because we've had lockdowns, and, you know, kids haven't been at school, the places where they would go to get their appointment. So there is a big catch-up job going on in that respect. I know that some of the` previously, the DHBs put in place mobile dental vans, were keen to fund a few more of those so that we can actually get out into communities to get that support, even for kids. So, look, that's an ongoing challenge that we have. We know that oral healthcare is important. - Are they being monopolised by richer areas, though? You know, because... School dental nurse was great, because you just took` your child walked across the court to the dental nurse. Now you've got to rely on parents who, sometimes, are working double shifts, to get in a car, to get to the school to take their kid to the dentist, and the dentist sometimes isn't even in their rohe. - Yeah. It wasn't every school that had a dental nurse, so kids always had to travel. Some kids always had to travel. I think the benefit of the mobile dental clinics is that they turn up at the school, get through that bunch of kids, go on to the next one. That's the way that programme is meant to work. It's fallen over a bit, because, as I say, we had so many disruptions, particularly in the Auckland region in the last couple of years, that a whole bunch of kids didn't get their regular check-ups that they should've got. - Ka pai. We've just had the launch of the new authorities last week, so, yeah, tell me what the priority for the new Maori Health Authority is. - Well, they were very much said, but I think the main thing is for them to get their commissioning services up. They will take responsibility for commissioning the Kaupapa Maori health services. But actually, what they bring is not just the support for Kaupapa Maori health services; it's actually their involvement in all health services and the advocacy that they bring to make sure that the needs of Maori are elevated within the rest of the health system. When we look at some of the big challenges we've got that really affect Maori, things like rheumatic fever, actually, the role that the Maori Health Authority will play will be` will be hugely significant, because we've gotta get better traction in terms of dealing with that issue, which we know is an issue of poverty and afflicts people in isolated communities who struggle to get access to basic healthcare. - We've got, you know, COVID cases at the moment up about` you know, over 10,000 a day. What is the advice that you're getting from your officials about what we should be expecting over the next couple of weeks, months? - They're still gauging what they think that the trajectory might be. It's pretty clear that we are now in sort of a second wind, if you like, of COVID infection. The numbers are going back up. I think one of the critical things is to make sure that, again, our hospital system isn't overwhelmed, and that's why we're seeing some hospitals, again, deferring the planned care so that beds are available. But also, I know that both the Maori Health Authority and Health New Zealand are working to make sure that primary care is supported so that people who are feeling really, really unwell don't all turn up to ED when they don't need to but can get access to healthcare in their community. - Kia ora. And masks, of course. So tena koe. - And masks ` all those things. - Thank you for your time today. Tena koe. Kua hikina Te Hui, e hoa ma. Noho ora mai ra. Captions by Able. Captions were made with the support of NZ On Air. www.able.co.nz Copyright Able 2022 - Ko te reo te take.