Focus On: Andre Le Geyt, Hawkes Bay

What happens if you mix a passion for Māori health, with a holistic, integrated approach to promoting Healthy Eating and Physical Activity? We talk to Andre Le Geyt, Programme Manager for Kahungunu Hikoi Whenua and find out.

"Kahungunu Hikoi Whenua is an innovative, Kaupapa Māori health promotion programme for the Ngati Kahungunu Iwi rohe, which extends from Mahia to Wairarapa," explains Andre. As Programme Manager, his role encompasses the traditional HEHA Manager role within the role of managing the DHB's new health promotion programme. 

Andre believes the role provides the perfect platform to combine his major interest in Māori Health, with his health sector experience. "I first came into health through workplace accident rehabilitation management, working for a private insurance company."

From here Andre moved to ACC, based at Burwood Hospital in Christchurch, with the Brain and Spinal Injury Specialist Unit.  "I was the representative working with the seriously injured and their whānau to ensure treatment and rehabilitation entitlements were provided, safe reintegration into community life, plus I also worked with administrators to review contracts, policies and programmes to ensure they were effective for patients and their whānau."

It was in this role that Andre ignited his interest in Māori health. "We had a lot of Māori male car crash victims coming through the hospital and I noticed the severity of the impact of the crash on both the patients and their whānau. I observed how the life-changing incapacity impacted both physically and psychologically. For Māori males it affected their mana, and their role within the whānau, as they were often unable to work and provide for their whānau. Even the rehabilitation model itself seemed to disempower Māori males somewhat." 

This observation inspired Andre to develop a Masters thesis proposal focusing on the impact of spinal cord injury on Māori males. However a change within his own whānau brought him back to the Hawkes Bay with ACC. "When I was back in the area, a friend who was aware of my interest in Māori health had heard about the HEHA Manager role and challenged me to go for it," explains Andre. "I'm thankful to her still - especially with the new programmes underway - it's exactly where I want to be!"

Now 20 months into the role, a major highlight for Andre has been the creation of ‘Kahungunu Hikoi Whenua', as he explains. "The programme is Māori-owned and Māori-controlled and creates a holistic focus for the DHB's HEHA and tobacco control efforts through an integrated health promotion programme.  

The programme also represents one of his biggest challenges. "Traditionally there has been a real conflict between funding of clinical versus population health services. So a major challenge for us is getting stakeholders and funders to see the importance of investing in population health, specifically Māori health, and to adopt a holistic approach to funding and working in this area"

When he's not busy working on the new programme, Andre likes to take time out either riding his Harley Davidson motorcycle, playing basketball or doing martial arts, although not right now, as he explains. "I broke my hand at the last karate tournament, which has put me out for six months!" Andre has also been enjoying celebrations in his personal life too - as he was recently married to his partner Kerry, at the end of 2008. Congratulations Andre!

Project Study: Kahungunu Hikoi Whenua

Hawke's Bay DHB's integrated programme for healthy eating, physical activity and tobacco control can trace its origins back to the Ngāti and Healthy project in Gisborne. As Andre Le Geyt explains, "Two of the programme leaders for Ngāti and Healthy, Dr David Tipene Leach and Sally Abel, returned to the Hawke's Bay in 2006. Joined by Kerry Weston, we began talking about how we could develop a similar approach to health promotion in this region."

Discussions evolved into a comprehensive plan, centred on adopting a Kaupapa Māori approach to the delivery of health promotion for healthy eating, physical activity and tobacco control. Through consultation with numerous stakeholders a plan was developed and the local iwi gave it its name - Kahungunu Hikoi Whenua, which is a karanga (call) to Māori to return to Papatuanuku (Mother Earth) and traditional ways of wellbeing. Eighteen months on, the plan has now been accepted and the local iwi have incorporated it into its own annual plan. "It's their health strategy," says Andre.

The project team, joined by Tuakana August, Bayden Barber and Caroline Uttley, are about to enter a dynamic next phase. "It's a really exciting time as the beginning of implementation phase marks our official launch for the programme," explains Andre. The programme has three key components:

1. Community: Working with community-based Māori Health Providers in the development, funding and delivery of healthy lifestyle programmes.

2. Structural: Targeting environmental settings that are supportive for healthy lifestyles, such as schools and workplaces.

3. Social marketing campaign - A Kaupapa Māori approach will be undertaken towards developing and implementing a campaign.

In addition a breastfeeding action plan is going to flow through all the three components.

The Māori Relationship Board has given the programme its full support, and a steering group of representatives consisting of Māori health providers, iwi and independent experts has been established. Andre says there is huge support from all parties, plus a lot of interest! 

"It is major to get something like this through the DHB," explains Andre. "Because is it such a significant programme, the DHB has established a higher level governance and there are a lot of people watching to see what happens!"

The programme is gathering interest from other DHBs keen to see the impact of this innovative approach. "Mid Central DHB have been given the go ahead to start planning with us and a number of other DHBs have also expressed interest in working this way."

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