Rongoā Māori is the “indigenous way of healing”: a combination of herbal and spiritual medicine used by the Māori of New Zealand. As The Encyclopedia of New Zealand notes, there were both supernatural and human illnesses, with the former treated through spiritual means (e.g., prayers, dunking in water, and other treatments described below), and the latter through herbal remedies. Here, for example, are the supernatural maladies and remedies:
Mate atua – supernatural illnesses
Mate atua were supernatural afflictions, sometimes caused by malevolent spirits when a person had broken a tapu (religious restriction). Dealing with mate atua required a tohunga (priest). His first job was to determine the hara (transgression) committed, and to identify the spirit. The tohunga took a thorough case history of all the patient’s actions before they got ill, sometimes including the patient’s and family’s dreams.
A tohunga’s job
Tohunga were experts in various fields, including the arts, agriculture, fishing, warfare and healing. They were also seen as the earthly medium of the gods, and were intensively trained in whare wānanga (houses of higher learning). Tohunga held a position of authority and respect, but also had the huge responsibility of keeping their people healthy.
Finding the cause was the first stage of treatment, followed by exorcism of the spirit that had possessed the patient. The next stage was a whakahoro (purificatory rite) to remove the effects of the tapu. This usually involved dipping the patient in a stream while the tohunga performed a karakia (prayer) or incantation.
Mariunga
The Ngāti Porou leader Tuta Nihoniho described the mariunga – a wand of wood such as karamū, māpou or maire, which was touched to the body of an invalid and received their essence. It was then taken to a tohunga, who could tell whether the patient would recover.
Takutaku rite
Another rite, the takutaku, involved touching the patient with a karamū leaf, which was then floated downstream. The malevolent spirit would be carried to sea and then to Te Waha o te Parata (a huge whirlpool, caused by a great monster), and finally to the underworld. Freed of the spirit, the patient was then sprinkled with, or immersed in, water.
The site also lists a number of herbal plants used for “human” illnesses, although, as far as I know, none of them have been tested by the gold standard of modern medicine: controlled, randomized, and double-blind testing. I have no doubt that some of these plants do work, but in the absence of testing we won’t really know which ones, and how efficacious they are.
As Wikipedia notes, these forms refer. .
. . . . to the traditional Māori medicinal practices in New Zealand. Rongoā was one of the Māori cultural practices targeted by the Tohunga Suppression Act 1907, until lifted by the Maori Welfare Act 1962. In the later part of the 20th century there was renewed interest in Rongoā as part of a broader Māori renaissance.
Rongoā can involve spiritual, herbal and physical components. Herbal aspects used plants such as harakeke, kawakawa, rātā, koromiko, kōwhai, kūmarahou, mānuka, tētēaweka and rimu.
The practice of Rongoā is only regulated by the Therapeutics Products Bill in the case of commercial or wholesale production so that “Māori will continue using and making rongoā just as they have for generations.”
The Tohunga Suppression Act outlawed traditional medicine in favor of “Western” medicine, but, as the note above shows, the ban lasted just 55 years, and Rongoā Māori is now again legal, though its practitioners often realize that they need to send patients to modern doctors if a traditional cure doesn’t look propitious.
However, there seems to be a move afoot to make Rongoā Māori coequal to modern medicine, if not in curative properties at least in “deep mutual respect.” But, those two items are not independent, for how can a modern physician respect medicines that haven’t been properly tested, much less have any respect for supernatural cures?
What is bad about the attempt to get “deep respect” for indigenous medicine that hasn’t been properly vetted, is that with medicine, unlike with incorporating other indigenous ways of knowing into teaching (e.g., Māātauranga Māori), human lives and health are at stake, so I do have issues with the article below in the ANZ Journal of Surgery (click to read for free).
This study is really an anecdotal one, and with a very small and geographically limited sample, too. The authors recruited four colorectal “Western” surgeons (WS) from the Christchurch region of New Zealand, all of whom had expressed interest in Rongoā Māori (RM). Likewise, the authors recruited seven Rongoā Māori practitioners, four of whom volunteered to be part of the study. Therefore we have a total of eight subjects, all of whom were asked their views about the medicine practiced by the other group. The interviews took place once, and were 30-60 minutes long. The actual study thus lasted a maximum of eight hours.
The upshot:
Western surgeons’ perspectives on RM
The results are no surprise: the doctors didn’t know much about RM. But they were “open to collaboration”, though it wasn’t clear what kind of collaboration. (I can understand that a Māori patient might want a Māori RM practitioner around, at least for solace and cultural comfort.) And of course the doctors thought that, in general, there needs to be better communication between practitioners of modern and of indigenous medicine. Finally, the surgeons cited “systemic barriers, such as bureaucratic hurdles and the absence of clear referral pathways” as impediments to collaboration or “integration”.
Rongoa practitioners’ perspectifes on modern medicine
The indigenous doctors “often feel overlooked within the healthcare system. And this leads to the article’s theme: that modern medicine must be infused in some way with indigenous medicine: a “genuine collaboration”. For instance we read this:
Rongoā practitioners often feel overlooked within the healthcare system. This highlights the need for initiatives that aim to raise the profile of Rongoā Māori within New Zealand’s healthcare system (Table 1). One practitioner mentioned ‘collaboration is minimal, at this stage like the non-Māori community certainly don’t even know that Rongoā exists or anything about it and so that’s not being referred’.
. . . Formulating a genuinely collaborative approach requires recognition of Rongoā Māori as a an option in the patient care journey. ‘Building relationships is key… maybe starting with shared learning experiences,’ one practitioner suggested, proposing foundational steps towards effective collaboration.
. . . . This perspective challenges the healthcare sector to move beyond tokenistic inclusion, advocating for a genuine integration of Rongoā Māori that honours its potential to contribute to improved health outcomes, particularly for Māori patients.
. . . Understanding Rongoā Māori in its full depth requires acknowledging and valuing its comprehensive approach to health, which integrates the spiritual, mental, and physical dimensions of well-being.
The problem here is that we do not know the potential of RM to contributed to improved health outcomes–not without scientific testing of RM remedies, especially the “spiritual” ones. The article refers repeatedly to “mutual respect” of the two types of medicine, as well as the advantage of RM in being “holistic” (presumably meaning it uses spiritual cures as well as medical ones).
The conclusion, which was inevitable, is that modern medicine should collaborate with RM in curing patients. I quote from the paper (bolding is mine):
As identified in the interviews, it is imperative that a curriculum for healthcare professionals encompasses not only the theoretical concepts but also the practical applications of Rongoā Māori. This requires a willingness to move beyond a cursory acknowledgement of Indigenous practices within the medical education system to embedding it as a vital component of healthcare training. It was proposed that an effective educational initiative could take the form of an immersive wānanga on a marae, where tauira (students) and tākuta (doctors) would have the opportunity to learn directly from Rongoā practitioners in a setting that honours the roots of the mātauranga.28–30 In addition to this, incorporating placement based learning would further enable Western practitioners to observe the holistic model of care first hand. This aligns with the insights from the interviews where it was emphasized that Rongoā Māori is dynamic in its practice and does not follow a prescribed regimen.17 By having the opportunity to experience this personalized approach, healthcare professionals can better appreciate the value of nurturing this collaborative relationship.
. . .Recognizing the immense benefits that a holistic model of healthcare offers, there is an unequivocal need to navigate and dismantle the systemic barriers that Rongoā practitioners are faced with. This necessitates a concerted push to ensuring Indigenous healing practices are formally recognized within healthcare frameworks to facilitate a collaborative coexistence with Western medical practices. Moreover, establishing structural support to facilitate funding and infrastructure is an essential component to enhancing the capacity of the current healthcare system to address a diverse range of health needs and allowing this to thrive. It is paramount that this collaboration is guided by Rangatira and Tohunga in this field to ensure the delivery of health services is culturally congruent and responsive. The move towards an inclusive healthcare system that respects the diversity of cultures aligns with Te Tiriti o Waitangi’s principles, honouring Māori sovereignty and self-determination over their health.
“Te Teriti,” of course, is the 1840 Treaty of Waitangi, which made England the sovereign government of New Zealand, conferred on the Māori British citizenship with all the attending rights, and allowed Māori to keep their lands and possessions. But there is nothing about health in that treaty at all, though of course anybody can “self determine” whether they get care, and whether they get RM care, modern medicine, or both. But the Treaty of Waitangi has assumed an almost sacred position in New Zealand culture, now viewed as mandating that all aspects of Māori culture and “ways of knowing” must be considered coequal in the country. Right now there’s a big battle about how far Māori “ways of knowing” are taught as coequal to science in schools, and the indigenous people seem to be winning that fight. This article is just a salvo in the battle for medicinal hegemony.
But before they win the Battle of Medicine, any RM-based cures, whether they be based on plants or supernaturalism, must be tested—and tested according to the best procedures of modern medicine, usually double-blind, randomized, and controlled trials. Without those trials, you simply can’t be sure that a treatment works. Saying “our tradition shows that it works” is not sufficient, nor is the claim “well, it worked for me!” We all know the power of confirmation bias and of the placebo effect, and the kind of testing described above is designed to eliminate these effects. (As Richard Feynman famously said, “You must not fool yourself, and you are the easiest person to fool.”)
So no: there cannot be deep mutual respect between indigenous medicine and modern (aka “Western”) medicine until indigenous treatments are tested according to the standards of Western medicine. It will not work the other way around.
I am heartened that some RM practitioners recognize when herbs and superstition won’t work, and summarily hand their patients over to modern doctors. But I don’t think RM should be integrated with modern medicine, or treated with great respect. Until it’s proven efficacious, the null hypothesis should be that the untested treatments of RM comprise quackery
Luckily, we don’t have this sort of problem here in the U.S. After Trump wins, RFK Jr. and his science-based approach to medicine will be in charge of everyone’s health.
Your comment made me picture a Trump-inspired oncologist standing next to the bed of a cancer patient, and the doctor saying, “You’ll see, by April it will miraculously go away.”
Betting it will be the more straightforward approach already now in use:
“Your insurance doesn’t cover that. Sorry.” (And the “Sorry” is optional.)
Doctors know that a lot of what we do is for its placebo effect. We aren’t just treating the patient’s disease. We are hoping he and the family will be satisfied as well. (One very strong predictor of dis-satisfaction with a doctor’s care is when an estranged adult daughter is highly involved with her father’s illness and death.). Our evaluations explicitly turn on this now, sharpened as culturally sensitive care, failure in which can lead to professional discipline.
An anecdote. A friend of mine received palliative care for cancer and died. His widow (B.) was unhappy. Not just grieving but angry. She had decided she wanted to have an array of alternative practitioners, and their remedies, involved in his care. In her telling, the doctor leading her husband’s palliative care was not sufficiently accommodating to whatever incantations and unguents she wanted the alternative practitioners wanted to do. Now, she is as flaky as all get out — as a lot of people our age are, I’m surprised to find out now that we’re getting sick — and my own sphincters were tightening vicariously just listening to her, which seems to be the lot of retired physicians. Not my place to ask probing questions but she didn’t seem to have unrealistic beliefs that these remedies would prolong his life. She just wanted him to have them.
I wasn’t there to overhear any conversations between her and the doctor about these other healers. I’m sure he believed they were hogwash, as we all would. But there must have been something that set her off. Maybe the alt healers wanted to do something that would make side effects of the doctor’s morphine more likely, or increase agitation, which would be good reasons to say no. Indigenous relatives often want to smudge with burning sweet grass, which contravenes smoking prohibitions but she was (Eastern) European, not indigenous. Most of this stuff is harmless mumbo-jumbo, especially in a patient who has no options for active treatment anyway. It offends the doctor’s sense of rationality, is all.
She couldn’t let this go, even months after the fact. This could have been merely the symptom of some other unresolved conflict. I have to wonder, though, if some exposure to Rongoa Maori might have helped this doctor, (whom I never met.). It’s not so very different from how we are taught to deal with harmless woo everywhere, especially when a relative (or the patient) is highly invested in it, as B. so clearly was. It’s their money, their death. Even if it causes them to forgo or delay truly beneficial treatment, that is their choice, not ours.
Even someone as presumably intelligent as Steve Jobs spent months after his cancer diagnosis with “alternative medicine”, likely costing him his life.
But as you say, it was his life.
My good friend’s sister recently died of ovarian cancer after spending years with symptoms and refusing to go to a doctor. She kept saying that God was telling her not to see a doctor (very sad but she wouldn’t listen to anyone.)
Maybe yes, maybe no. Mr. Jobs’s had a rare form of pancreatic cancer, a neuroendocrine tumour for which the best treatment is unknown. His survival of 7 years after he eventually decided to have surgery is about par for this disease. He might have done as well without any treatment at all, alternative or conventional. I don’t know what surgery he had but I, too, would have put off pancreatic resection for as long as I could if it wasn’t going to be clearly curative. (I wouldn’t have used to woo stuff, either.)
“What can we learn from Steve Jobs about complementary and alternative therapies?”
https://pmc.ncbi.nlm.nih.gov/articles/PMC4924574/#:~:text=The%20untimely%20death%20of%20Steve,NETs%20have%20not%20been%20identified.
Thanks for the info. His records aren’t public so we don’t know what advice he got.
I’d say your friend’s sister made a good choice. Ovarian cancer is usually fatal, even when diagnosed early, and if she had had an earlier diagnosis it is likely she would have been more miserable during the bit of time she still had before her symptoms became extreme.
Maybe so. I hadn’t thought of that.
Not an MD – but I would also want to know about the interactions between herbal remedies and ‘western’ drugs.
Herbal remedies or herbs per se are also regularly consumed in the West, and I doubt that there are a lot of systematic studies about interactions, or sometimes even toxicity. Arctostaphylos uva-ursi was used for years as a I believe somehwat effective traditional adjuvant medicine in urinary tract infections before someone took a closer look and decided it was a carcinogen. Grapefruit juice, while not being a remedy, has lots of strong interactions with all kinds of drugs. https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix
On the one hand, I think it’s sad that these indigenous “medical” practices are becoming normalized, a trend which, in the long run, can only hurt the people who believe in them, literally by not actually helping, but also financially (wait, do the shamans take Blue Cross?).
On the other hand, is it so much different from chiropractry? Or homeopathy? Anyone who buys Airborne at CVS for a cold or has some klutz twist them into a pretzel is engaging in this woo. And yet millions of otherwise educated people do it. Maybe we should let the Kiwis have their fun and let Darwin and/or a series of wrongful death lawsuits sort things out.
Chiropractors have killed people, both by hurting their necks and spines or ignoring serious medical problems and imputing them to spine issues. I would say (and readers can weigh in here) that an entire medical system based on untested herbal cures and spiritual remedies is bloody dangerous.
Would you send you sick kid to a NZ indigenous medicine doctor? If not, why not. And really, do you want Māori to die just to get rid of this medical system?
Why I use a medically qualified physiotherapist that my doctor approved of.
Ok, she did stick needles in me but fully agreed the Chi/Qi stuff was rubbish. All it does is stimulate the muscles and nerves.
Would I send my kids to a Maori shaman? No. I also wouldn’t send my kids to a Voodoo witch doctor or a Pentecostal faith healer. I would, in fact prohibit it. In the words of Homer Simpson, “their my kids, I own ’em.”
I don’t believe that these practices work, but there are variants all over the world, East and West, and the people who DO believe in them, wherever they are, have to learn on their own (or not) that they’re bunk, while we provide a logical, fact-based alternative. Sometimes this means not getting well in spite of what the chicken claw in the bowl says.
Do I WANT Maori to die? Not at all, but it isn’t up to me. It’s up to them. They’re adults and they have a choice: do I treat an illness with chants or do I go to a hospital? (Ironically, when you think about it, this is more of a choice than they’d have if the evil settlers never showed up.)
Umm. . . . I don’t think that Māori kids have a choice; they go where their parents tell them. How are kids going to learn on their own if it is bunk if they are indoctrinated. It is better to ban medicine that makes false claims.
You do not want kids to die because their parents believe in bunk, do you?
The Maori who believe in it would argue that no false claims are being made, merely that, as with all medicine, sometimes things work out and sometimes they don’t. NZ is a democracy and its voters/legislature can either mandate that medical practitioners (however they define them) meet minimum standards of actual care, or they can accept that there is a level of harm that will occur to certain groups that is an acceptable trade-off for assuaging their crippling Colonial Guilt.
The state/universities should not pretend that untested, improbable or magical practices are an equivalent to and of equal worth as evidence based medicine, nor should physicians or the state pretend that all current medical practices or advice are strongly evidence based (many aren’t, or the evidence base is very weak). The Maori woo like lots of other woos have a place where people just need a placebo effect, but should not be state-sponsored, or taught as part of medicine. I assume that there are Maori/Polynesian traditional practices and remedies that are effective, just like some traditional European ones were, and NZ medical research universities could make it their job to study this.
No one wants to see Māori die but the activists are so determined it may take that for them to realize how wrong they are.
Certainly every attempt to resist it should be tried, but I’m not very optimistic.
Ironically, the whole paragraph “[I]t is imperative that a curriculum…appreciate the value of nurturing this collaborative relationship” could be written the other way around: Maori healers must be encouraged to embed medicine in their spiritual practices, and must be trained in medicine so that they can offer more inclusive health care to Maori citizens. And medical doctors can carry on doing what they already do sans mumbo jumbo.
The fact that the whole idea is not developed this way tells us a lot. The program is not about respecting diversity of cultures or honouring Māori sovereignty and self-determination. It’s about bullying the medical establishment and shaming the descendants of settler colonizers.
Reconciliation is a one-way street, yes. Perpetual atonement is more accurate. See you in Court.
Ha yes reparations are like Spuddies: enough just isn’t enough.
https://www.imdb.com/title/tt0327084/quotes/?item=qt0432584
Jeez I joke but this new truth-and-reconciliation report is not funny.
https://nationalpost.com/opinion/jamie-sarkonak-the-special-interlocutors-plan-for-abolishing-canada
This is where it’s at in Canada, Mike. Mystical properties of forest plants and invoking water spirits as therapeutic agents to compete with scientific medicine are pretty small potatoes. The Indian Industry is trying to promote indigenization of the medical school curriculum, yes, but it’s not so much to convince medical students that indigenous shamanism should be given weight in treatment decisions. (Even the natives don’t want that. They want insulin for their diabetes and naloxone when they overdose on fentanyl just like everyone else does. They were first in line demanding Covid vaccines on remote Reserves before anyone else got them.* They just like to carp after the fact about culturally incompetent care.)
Rather it’s a power dynamic of extracting fealty to the idea that the Canadian state is illegitimate. Every portion of Canadian society has to be de-stabilized and de-colonized, from each according to its capturability and to each according to its compliance. They sense the hour is late. There are 700,000 registered “status Indians” in Canada. 500,000 new Canadians immigrate legally every year — that would be the equivalent of 4,500,000 new Americans — who don’t give a rat’s ass about native issues and resent being made to pay guilt-reparations once they figure out just how much of their taxes go there. (South Asian immigrants might argue the British Crown owes them, too, not the other way round!) White people might not be facing the Great Replacement. But aboriginals are, despite their high birth rate.
Maybe it’s the same in New Zealand. Do Maori parents really want to give their children incantations for meningitis instead of antibiotics? I doubt it. It’s more likely about political power. If we get you to acknowledge the truth of what we say about magic, we can get you to say yes about other things that are more strategically important and lucrative to us.
This all might collapse once someone like Alice tells the Queen of Hearts NO!, that her minions and mouthpieces are nothing but a pack of playing cards. Or it may be too far gone to turn back. All an insurrection needs is a large pool of poorly educated young men with few prospects for gainful employment, a charismatic leader, ….and money. It doesn’t even need a cause.
—————–
* During the Trucker Occupation in Ottawa, a Toronto native woman was quoted by media as saying the vaccines must be crap. “They gave them to us first. When have Indians in Canada ever been first in line for anything?!”
This is yet another example of what I’ll call the Smorgasbord Theory of Science, in which science isn’t seen as a cohesive series of methods which test claims by eliminating bias but a cultural smorgasbord of different approaches and flavors which is improved by including more varieties for people to pick from.
Excluding Rongoā Māori from the table is like refusing to put out an offering of tacos or goulash in an all-you-can-eat potluck buffet intended for everyone. There are no “wrong” dishes: the only sin is keeping folks from a seat at the table where they can use the kind of knowing they prefer.
ALL dishes (forms of medicine) deserve to be on the Smorgasbord of Science. They’re equally valid. In fact, neglected dishes of ancient origin have the best flavors, honed over time and without all those nasty artificial ingredients of the modern world.
I’d say let a few people die, then have the coroner have their say.
Usually about 70-80 of these systems are BS.
But yeah, I’m saying it, it may be against medical ethics but let some fools die, give them the Darwin Award and shame the RM fools who basically committed manslaughter.
Even if they are kids????
Blame the parents or simply go over them. A doctor can if they are convinced the parents are endangering the child.
I meant it as an adult patient. Also include a great deal of cynical sarcasm as well.
Also, if they insist on such treatment over modern medicine and they die, there is little I can do despite being distraught over it.
I very much doubt that it’s normal Maori patients who are clamouring for traditional medicines in cases where a proven modern remedy exists. This fish is rotting from the head, and when it’s universities and activists that pretend that Maori trad medicine in cases of diabetes are just as good as Metformin and insulin, it is they, the people in the higher echelons, who are responsible when less educated people are mislead to believe their woke pretenses are the truth.
Our host asserts: “… any RM-based cures, whether they be based on plants or supernaturalism, must be tested—and tested according to the best procedures of modern medicine, usually double-blind, randomized, and controlled trials.” Devotees of the Maori way of knowing will, of course, protest that double-blind etc. etc. test protocols are colonialist impositions of Western cultural hegemony, and imposing them violates the sacred word of te tiriti o Waitangi.
Let me offer a modest proposal: turn te tiriti o Waitangi in the opposite direction. If it means that everything> has to be done 50% Maori and only 50% pakeha, then apply that to everything. If our smartphone needs recharging, we can use electricity only half the time, and the other half must recharge it with mauri by the appropriate incantations. Same division of methods when repair is needed on automobiles, trains, aircraft, refrigerators, home plumbing, wheelchairs, eyeglasses, dental fillings, pacemakers, and so on.
John, I like that answer. It’s a judo way for handling idiocy. Accept the claim at face value and do what it says. Wave herbs over that dead cell phone, and if it doesn’t charge, then that obviously means that the great spirit doesn’t want you to use it.
In terms of medicine, allow this type of healing but also allow malpractice cases, just as any medical doctor would be faced with in a similar circumstance. And make it known in advance that this is the way it works. We accept your right to practice this, and you accept the consequences of doing so because you’re an equal member of society.
No, I don’t want kids to die because of bad decisions by parents, but they can still choose to apply Rongoā Māori “medicine” whether or not it’s accepted by the government. So if we’re going to allow it, make practitioners fully accountable for the results.
I had an intussusception & volvulus last year that caused a great deal of pain. I had emergency surgery as the surgeons were concerned about a bowel rupture & subsequent peritonitis. Given the direction of the NZ medical system as you described, I would have had to undergo a trial of witchcraft, that would have only delayed the operation, & likely complicated recovery. Somehow, bent over in agony, despite Morphine, I doubt I would have been appreciative of having someone in native dress dancing around my bed, & waving leaves with incense.
As I was being wheeled into surgery for a cataract removal, the physician asked me if I would like to pray with him. I told him that if he had so little confidence in his ability, I wanted another physician. He stammered about some of his patients wanted blah, blah, blah and it wasn’t necessary. We got on with it.
I’d report him to his licensing body for that. It is intrusive and threatening to someone in as vulnerable a position as being wheeled into surgery.
BTW, I can’t imagine any group of physicians less likely to get on with woo than a bunch of general surgeons. Their psychology does not allow for it. An illustration—watch a long hospital corridor and you’ll see the surgeons striding down the centre, whilst the internists walk along the edges, probably with a hand on the rail.
Has anyone run an AI over Rongoā Māori? Would we get a summary of what works or a mish mash of folk tales?
Or would we get a new assertion that AI only works on written works and Rongoā Māori is primarily a spoken set of wisdom?
Even when we’re being sold toothpaste, there’s always that *one* voice of dissent. Where is that voice in this study ? Bullcrap !