It’s five in the morning. The first place in the country to see the sun and it’s still pitch black.
Joseph Moana and his whānau are getting ready to drive to Gisborne Hospital. A 90-minute journey from their home in Tokomaru Bay so Joseph can receive lifesaving dialysis treatment for renal failure.
“Winters are the hardest; dark early and dark when we leave,” Joseph says.
Late last month, the Coast was hit by a huge storm. It’s unexpected moments like these which mean Joseph often worries about the road being open. Missing a treatment results in him struggling to do daily tasks.
It's not just the weather conditions that make the commute to the hospital hard for Joseph, the condition of the roads to Gisborne are often unsafe.
“Shocking. Logging trucks don’t help,” says Joseph.
The 50-year-old father of four makes the trip so he can be hooked up to a dialysis machine for five hours. A three-hour round trip, three days a week and he’s been doing it for the last three years.
The type of dialysis Joseph has chosen isn’t available at Te Puia Springs Hospital, just a 15 minute drive from his home.
“I got to do it... it’s more or less keeping me alive.”
Joseph and his whānau live in Te Tairāwhiti region, home of Ngāti Porou.
It is made up of scattered coastline communities stretching from Te Toka a Taiau in Tūranga/Gisborne to Pōtikirua past East Cape.
The coastal population is 4400, 85 per cent are Māori. The main health provider here is Ngāti Porou Hauora.
“Ngāti Porou...we are loud and proud,” says Rose Kahaki, chief executive of Ngāti Porou Hauora.
Te Puia Springs Hospital is the main health hub on the East Coast, although every township has its own clinic. It’s the only Māori-owned and run hospital in the world.
See the full story on Sunday, TVNZ1 at 7.30pm, and then on TVNZ OnDemand.
Hospital services are limited and if anything goes wrong or if locals need to see a specialist, it means travelling hours on State Highway 35 to Gisborne or Whakatāne.
Built in 1903, the last upgrade of the hospital was when the maternity ward was added back in the 1960s.
“Te Puia Hospital has been here for many years,” says Rose.
“The pipes are old, they’re rusting. We need to get that changed.”
Large infrastructure failings have caused major issues for the hospital, with a burst pipe cutting off water supplies until it was replaced.
The hospital is also in desperate need of rewiring, so power isn’t constantly lost to the building.
Dr Helen Gardyne, one of only two doctors at the hospital, says the roof needs replacing.
With a scattered population along the coastline, Ngāti Porou Hauora hasn’t received any substantial funding increases in decades, outside of DHB contracts.
“The system is failing,” says Rose.
“To date New Zealand has funded health through the population. Iif you have a large area in which to service and your population is low then yes, it can be disadvantaged, and it is.
“Do we get enough money for the actual services to be delivered? I think we are a little stretched.”
The hospital’s maternity ward was where 52 babies were delivered last year, but minimal funding means facilities and equipment are sparse.
“We have three bedded birthing units,” Corrina Parata, the region’s only full-time midwife says.
Ngāti Porou whānau want to birth at Te Puia and Corrina goes above and beyond to make that happen.
However, due to a lack of resources and facilities, whānau sometimes have to be sent to Gisborne.
“I've been contending with complicated pregnancies around gestational diabetes, type two diabetes, hypertension in pregnancy potentially leading to pre-eclampsia, or eclampsia.”
As the sole midwife, Corrina looks after the entire East Cape. She drives around 4000 kilometres a month along rugged coastal roads to tend to families sometimes living without power or running water.
Corrina is an example of how skeletal the staff is at the hospital in Ngāti Porou, despite it being one of the biggest employers in the area.
Similarly, Dr Helen Gardyne and one other doctor are the only doctors working fulltime to manage all cases, from cancer to serious injuries.
“It can be stretched at times,” says Helen.
“So, we would like to get more doctors here and another couple of full-time people to stay for two to five years.”
She says the remoteness of the area has been one of the challenges which has kept many doctors and nurses from coming to work in the area.
The remoteness is also difficult for those living in the community - scattered population and limited job opportunities have resulted in low incomes for many families. This has left 90 per cent of the community living in deprivation.
Life expectancy for locals in the region is also much lower than anywhere else in New Zealand, with the life expectancy of the average man being 69 years, says Rose.
This is in contrast to a life expectancy for the average New Zealander of 81.
“My father died at 69,” says Peter Matahiki from Tokomaru.
“He went through a lot of struggles with his health. Diabetes, high blood pressure, cholesterol. A lot of services that he needed were not available for him here.”
Peter says, like most men in the area, his father was “hard-headed” and wouldn’t get help for his health issues.
“There’s many like him. If there’s something wrong with them they wait for two months before they actually go to the doctor.”
Peter says he knows that he needs to change his lifestyle and his approach to healthcare if he wants to live longer than his father.
“Hopefully I can adapt and make the changes that I need to make.”
Peter’s health has become a priority after he and his partner found out they were expecting a baby, who was born in late June.
“I’d like to try and be there for as long as I can for our new baby, and our kids that we have with us now,” he says.
As a doctor in the region for 12 years now, Helen knows first-hand the health struggles locals have battled.
“We have a new cancer every two weeks,” she says.
“We have every chronic disease you can think of. Heart disease, asthma, diabetes, gout, renal disease, so all those can combine in one patient. Blood pressures are quite high too.
The rates for comorbidities are high – patients coming in with more than one chronic disease.
Helen says some locals have accepted that they won’t live a long life.
“Some people said I live to 65, that’s a good life, that’s long enough, I’ve lived a good life,” says Helen.
“I was quite shocked because most other areas you’d say, 'oh I’ll live to 75, 85, 95,' you know.
“But they’re happy to live just that long.”
Corina says Ngāti Porou Hauora have presented reports to the Government about the poor life expectancy in the region and lack of access to healthcare.
So far there hasn’t been any action taken by the Government.
In a statement, Associate Minister of Health Peeni Henare says he knows there is mahi to be done to address the issues in Ngāti Porou district and “acknowledges the health difficulties facing the people on the East Coast”.
The minister says once the Māori Health Authority has been created it will work with iwi to address the “needs and priorities of Māori from a local whānau perspective”.
It’s 3pm. Joseph and his whānau are back home in Tokomaru after spending five hours hooked up to his dialysis machine.
In two days, he’ll be up again before the sun and on the road to Gisborne.
See the full story on Sunday, TVNZ1 at 7.30pm, and then on TVNZ OnDemand.