This paper describes how Health Hawke’s Bay-Te Oranga Hawke’s Bay (HHB) is successfully working with existing community strengths to influence and build whānau health resilience among Māori in Hawke’s Bay, whose rates of ischaemic heart disease, diabetes and breast cancer are substantially higher than for non-Māori. Due to significant and abiding inequities in the current health system, HHB was failing to reach Māori who most need to access primary care services. This is now changing, with HHB recognising that the makeup and cultural paradigm of Māori whānau, hapū (extended whānau network) and iwi (tribal affiliation) are different systems to those currently being used in our health system. HHB then acknowledged there was a network in place based on whānau and whānaungatanga (system of relational connectedness), and became willing to ask questions rather than focus on fixing problems. The question ‘what can we do to help you do what you need to do?’ reflects HHB’s aim to work with the existing community strengths to influence and build whānau resilience, and support the community to ‘own’ and sustain the activities initiated by HHB. In 2012, HHB embarked on a journey with Waimarama Marae, which is situated 30 kilometres from the closest urban area. Waimarama Marae was in the process of taking ownership and accountability of their health and wellbeing when it first engaged with HHB. The Marae aspirations were to have a nurse clinic, transport to access general practice particularly for the Kaumātua (older people) and more health support from the health clinic sited at the Marae. HHB supported the introduction of the Stanford University Chronic Disease Self-Management Programme (Better Choices, Better Health® Workshop). The Marae health champion and a community member have been trained to deliver this programme, which has resulted in 9 Marae whānau graduating from the first programme with the potential to impact positive effects to a further 72 individuals; these 9 are now equipped to manage their own health and wellbeing better and are actively engaging their whānau in discussions about health and wellbeing. A further 12 from connected Marae in the area are requesting to be trained as lay trainers. As a result of the local community telling others about this programme, other providers and general practice have begun to ask for training. HHB emphasises that a key lesson was to work with the natural rhythms of the community and to take time to know the community aspiration. The key for this community was being on their Tūrangawaewae (a place to stand and be listened to and heard) supported by people from their own community.
