Maria Marama at her home Auckland. Photo:
Waking up to see another day is a gift for Auckland mum-of-three Maria Marama.
Eight years ago she was diagnosed with stage three breast cancer.
Recalling how fit and healthy she was, Marama said her diagnosis came as a major shock.
"Immediately, I thought, 'I'm gonna die', and then I was angry, because I'd done the right things," she said.
"I also thought about, I'm not going to be here for my kids. At that stage I had a child who was just starting intermediate school.
"I had two older ones and I thought, 'I'm not going to be around for my youngest daughter, I'm not going to be here for my mokopuna'.
"So at the age of 49, that what was going through my head. That was pretty devastating."
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What followed was a long journey that saw Marama undergo chemotherapy, radiation, herceptin treatment and reconstruction surgery.
Having gone through the private health system for most of her treatment, Marama said her experience with the public health system was unpleasant.
"I think for Māori and Pacific we kind of heralded in or herded through a pathway that's quick, dirty and nasty, if I can put it that way.
"Because the system is busy, there are a lot of us, but Māori and Pacific have to make their way into the system first. So I think there's some access issues around mammogram and screening, and how Māori women and Pacific women are educated around the need to have those done."
In 2022, the Breast Cancer Foundation published its first and biggest study of it's National Register.
A total of 30,000 patients were covered in the report and the results for Māori and Pasifika women were damning. Māori are 33 percent likely to die within ten years of being diagnosed and Pasifika at 52 percent compared to the wider population.
Olivia Perelini Photo: Supplied
Olivia Perelini is a Breast Cancer Foundation clinical research fellow at the University of Auckland and is one of the few Pasifika medical oncologists in New Zealand.
Dr Perelini said improving the stats requires the public health system to be an accurate reflection of the community it serves.
"My first thought was that representation matters. Who's on the clinical trial leads? Who's on the governance committees, to make sure that the trials are actually going to benefit Māori and Pasifika?" she said.
"I really want to see better outcomes for our people. I want to see more Pasifika in this workplace and I want to see more cancer treatment or services available in the Pacific islands as well."
Family can play a role
Chairman of the Pasifika GP Network Dr Api Talemaitoga said while he has faith in the public health system, it needs to be "culturally safe".
"In my experience as a GP, when people understand what it is about, when you speak to them in their language, when you have a support person that can translate it for them, they will come," he said.
"They will understand how important it is for them not just for their health, but for their family and aiga and the role that they play in that."
Dr Talemaitoga said the approach to boosting covid vaccination numbers among Pasifika people could also be applied to mammograms and clinical trials.
"We learned a lot of lessons from the covid pandemic, when we wanted to vaccinate our Pasifika patients," he said.
"We did not do an appointment system where you come in at this time because they might be caring for children, for grandma or auntie at home.
"So we made it an event where the family could come, the whole aiga could be there to celebrate. Having screening programmes, clinical trials can be run in the same way where you have a Saturday morning or a Sunday afternoon where you're able to come in and have screening done."
Pasifika GP Network chairman Dr Api Talemaitoga says he is worried GPs in south Auckland don’t have the capacity to deal with the predicted surge in demand over winter. Photo: RYAN ANDERSON/STUFF
Step forward
This week Maria Marama will be sharing her story on the Breast Cancer Trials Q and A event at the Auckland Museum.
She said the event is a step in the right direction.
"I'm interested to know what the researchers are going to say in terms of how responsive they are to Pacific and Māori women," Marama said.
"Because when they research us, they research us from their own lens and then they interpret what they say from their perspective so then they dictate the narrative for us as Māori and Pacific people which can be quite harsh.
"So I'd like to see as an outcome to this, more Māori and Pasifika researchers researching breast cancer on our behalf so that there's a culturally responsive system that's informed by research done by Māori and Pasifika."
When asked how she views life now having survived breast cancer, she said she's never going to give up.
"No one's going to tell me that you've only got five years to live I'm going to make sure that I do everything that I can to ensure my longevity so that I am here for my mokopuna.
"It's about your perspective on life, and that life is worth living."