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As the voices of the world’s First Peoples are beginning to be heard internationally this thesis adds another voice to the global debate on the current status of indigenous peoples, the historical and socio-economic processes which brought about those human states and the way in which such issues are approached by people in power. Irihapeti Ramsden, who belonged to the people of Ngai Tahupotiki and Rangitane, opened her PhD thesis with those words. Her doctorate, Cultural Safety and Nursing Education in Aotearoa and Te Waipounamu, was completed just months prior to her death in April of 2003. Irihapeti trained as a registered general and obstetric nurse at Wellington Hospital. She worked in a range of areas including general nursing, respiratory medicine and public health before moving into nursing education. She is perhaps best known in Aotearoa and internationally for the development of Cultural Safety – an educational framework for the analysis of power relationships between health professionals and those they serve. Cultural Safety has been part of the New Zealand nursing and midwifery curriculum since 1992 and comprises 20% of the state registration examination for all nurses and midwives. Irihapeti negotiated the foundations for developing a process of ownership of the Cultural Safety curriculum between Otago Polytechnic and Ngai Tahupotiki iwi, an early example of exercising intellectual property rights. The International Council of Nurses, the oldest and largest international professional organization in the health field, representing nurses and nursing in 118 countries, recommended in 1995 that Cultural Safety be included in the education programmes of all national nurses associations. Many times, Irihapeti was working in comparative intellectual and emotional isolation which could be a lonely place. She was an expert at seeing the 'big picture’. She linked Cultural Safety with wider aspirations and contexts common to indigenous peoples including notions of citizenship and sovereignty issues. Her later work developed these ideas further in recognising and drawing on the commonality between the experience of colonisation amongst indigenous peoples and the resultant cultural poverty and very real economic poverty which she was witnessing both here and overseas. A few of her other contemporaries also recognised the potential legacy of Cultural Safety early on. Irihapeti’s long time friend, lawyer and expert in the area of legal work on Maori rights, Moana Jackson, said in his interview with her: Its [Cultural Safety] broadest strength I think … is that it is a political idea and in the end remedying the ills of our people is a political and a constitutional issue, not in terms of the Beehive and Parliament, but in terms of changing the mindset of our people about our power and our powerlessness and so on. Irihapeti was diagnosed with cancer eight years ago but continued to work at an astounding pace. She found it difficult to say no to any request to speak as she believed it was an opportunity to increase people’s knowledge and understanding of the Treaty of Waitangi and New Zealand history and the resultant consequences on Maori. Irihapeti was scathing of the fact that a comprehensive teaching approach regarding the treaty has never been an integral part of the mainstream New Zealand education curriculum. Irihapeti’s ideas were both challenging and threatening to many pakeha New Zealanders who were, and are, often ignorant of the country’s history and fearful of difference. She maintained it was impossible to understand or reverse the poor physical and mental health of Maori until the historical, social and political injustices faced by Maori were understood and addressed. The introduction of Cultural Safety was met with a barrage of negative, and sometimes vicious, media coverage, culminating in the threat of an inquiry into Cultural Safety by the Government’s Education and Science Select Committee in 1995. Throughout this period Irihapeti not only calmly and eloquently responded to misrepresentations and accusations about the aims of Cultural Safety but continued to teach and work towards developing a robust education approach to the Treaty of Waitangi for tutors and student nurses and midwives which would facilitate opportunities for skilled analyses and an informed debate. Her views were often as unpredictable as they were original. During the 150th commemorations of the Treaty of Waitangi in 1990 she was dismissive of the building of waka (war canoes) that were being hailed by Maori and Pakeha alike as an exciting rebirth of Maori tradition. They are nothing more than Maori frigates, she said, and simply reinforce the tired cliché of Maori as warriors. "Once were gardeners, once were astronomers, once were philosophers, once were lovers," she declared in reference to the bestselling novel 'Once Were Warriors’ by Maori novelist Alan Duff. She viewed a "check list" approach to cultural understanding as not only misguided but dangerous and was sceptical of much of what passed for biculturalism in Aotearoa. Irihapeti was particularly impatient with the type of cultural window-dressing that has seen, for example, the saying of, usually Christian prayers in the Maori language at the start and finish of many public meetings. On more than one occasion she invited anyone attending the meeting who wanted to say a karakia (prayer) to leave the room "and get it over and done with". Irihapeti had far too much respect for Maori tikanga to want to see it plastered over a Pakeha framework in a vain attempt to give it credibility. There was no need to take on or assume the culture of others, she wanted people to be proud of and be true to themselves and where they had come from. Irihapeti had many skills and interests. She was a writer and contributed extensively in terms of essays and co-authorship of books on a range of subjects including biographies, history and politics. She was a member of the Spiral Collective that published the novel 'the bone people’ which went on to win the 1985 Booker prize and Pegasus Prize for Maori literature. She had a fascination with the Russian Tzars and their families. She enjoyed food and fine wines and hosted many planned and impromptu lunches and dinners. In her home she surrounded herself with things she loved; paintings, pounamu, books, silks, family photos. There was always at least one bunch of perfect flowers and frequently several in each room. Many of them had come from her own garden which she enjoyed immensely and was a source of inspiration and creativity. She was a Council member of Lincoln University and sat on a number of other committees including the Health Sponsorship Council, the Ethics Committee and Maori Health Committee of the Health Research Council of New Zealand, the executive committee of the National Heart Foundation of New Zealand and the New Zealand Council for Educational Research. Irihapeti had a long standing interest and involvement in asthma research and asthma service development. She was a member of the Ministerial Maori Asthma Review Team in 1991, and a member of the Maori Committee of the Asthma and Respiratory Foundation of New Zealand. Another area of interest was bioethics. Irihapeti was a Teaching Fellow in Bioethics at the Otago Medical School, Bioethics Research Centre and in 1997 she was appointed as the New Zealand representative to the International Board of Bioethics. Just weeks before her death Irihapeti was awarded the New Zealand Order of Merit for her services to nursing and Maori health. Irihapeti’s wicked sense of humour and fun was widely enjoyed. She could tell extremely good and extremely bad jokes and laugh just as much at either. Her own upbringing, through her father and within her mother’s extended family, had exposed her to a very wide range of ideas, discussion, encouragement of opinion and analysis of thought. It was those skills which she brought to all situations. Her favourite questions were: What do you think? What would you do? Why do you say that? She would address these questions to anyone, including young people. Irihapeti loved children and was always genuinely interested in what they thought about the world and how things were going for them. My children loved her, as did many others. There was much to look forward to. Sharing in the life and success of
her daughter and son, watching her grand-daughter grow up, hoping for
more grandchildren . . . Irihapeti had been awarded a post-doctoral fellowship
by the HRC to continue her work in Cultural Safety which she hoped would
lead to the development of an international network and research environment
for indigenous people who could comment upon and influence the development
of health policy in their countries. With love and thanks. Lis Ellison-Loschmann and CPHR
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Irihapeti Merenia Ramsden