'The Māori problem’? : a political ecology of tuberculosis among Māori in Aotearoa/New Zealand between 1918 and 1945

Abstract

The rate of tuberculosis among Maori (the indigenous people of Aotearoa New Zealand) has historically been ten times that of Pakeha (New Zealanders of European descent). The current rate of tuberculosis among Maori, rooted in this historical pattern, is between eight and ten times that of Pakeha. It is well established that social inequality and high rates of tuberculosis are linked, and tuberculosis can be viewed as the corporeal manifestation of social inequalities. This historical and anthropological research investigates the pathways that create and maintain this relationship. Of interest is the specific ways in which these pathways occurred among Maori between 1918 and 1945. Published works, archived government records, unpublished dissertations and other documents and manuscripts, are analysed as texts with both historical and historiographical importance. The focus is upon the three areas of economic hardship, housing conditions, and access to health care. These can be seen as sets of pathways through which social inequality and tuberculosis interact, and are well documented in both current literature surrounding the social origins of infectious diseases and in the historical sources of data. These sets ofpathways link macrosocial and microsocial levels, and interact at the biological level with the life cycle of the tuberculosis bacillus. Each of these three areas is investigated in tum, followed by an investigation of their specific workings among Maori communities in one region in New Zealand, Rotorua. Political ecology and the notion of structural violence are used to inform and structure the analysis. The bacillus is seen as a necessary, but not sufficient, cause of tuberculosis, and the notion of a 'Maori problem', and the use of race as an explanatory variable, is critiqued. It is argued that issues of class and marginalisation are of paramount importance in explanations of the high rates of tuberculosis among Maori.