In the 20th century, Māori population numbers increased considerably. This was an impressive demographic recuperation. In addition to an increasing resistance to common introduced infections, an important factor in recuperation was a vigorous health campaign mounted by Māori and by the government in the early decades of the 20th century.
Māori health development
Young Māori activists, many of them graduates of Te Aute College in Hawke’s Bay, pushed for improved health practices in Māori settlements around the country, and advocated greater use of the available health-care services and facilities. From the late 1890s they worked through the Te Aute College Students Association (later known as the Young Maori Party), led by Āpirana Ngata and others. Many influential chiefs and elders lent their support.
Soon this movement became closely associated with innovative Māori health measures adopted by the government. The new Public Health Department established in 1900 included a Māori section headed by Dr Māui Pōmare, who was appointed native health officer. Until he resigned in 1911 to enter Parliament, Pōmare travelled around the country, inspecting Māori settlements, and giving advice, instruction and encouragement to local leaders to improve sanitary and public-health conditions. For some years he had the help of an assistant native health officer, Dr Te Rangi Hīroa (Peter Buck).
Māori Councils Act
Under the Māori Councils Act 1900 Māori councils and local marae committees were elected in almost every Māori district. Health improvement was one of their most important functions. A number of influential Māori were appointed to government positions as native sanitary inspectors, to assist the health work of the councils. The Māori councils did their best work in their first decade, after which most struggled to continue, largely due to inadequate financial resources.
Native health nurses
Native health nurses, both Pākehā and Māori, were appointed to the Māori nursing service set up by the government in 1911. A precursor of the public health nursing service of later times, this branch of the Health Department had the strong support of Māori health advocates such as Pōmare, Te Rangi Hīroa and Ngata. The service concentrated on community health work in Māori settlements, many of them remote and without easy access to doctors.
Government health support
During this period the government continued to subsidise doctors as native medical officers in Māori districts, and to supply native school teachers with medicines for their pupils.
More and more hospitals were built. They were only partially government-funded, and because of a perception that Māori land-owners did not contribute their fair share of rates, there was a tendency for hospital administrators to resent having to admit Māori patients.
Many Māori were suspicious of hospitals, and found them unsympathetic to Māori cultural practices and values. A move at this time to establish Māori hospitals was unsuccessful.
Continuing ill health
Although levels of immunity to new diseases had increased, and death rates were dropping, poor economic circumstances and unsatisfactory living conditions still made many Māori susceptible to ill health.
There were still frequent local typhoid outbreaks, and tuberculosis continued to ravage Māori communities. In 1913 there was a widespread smallpox epidemic which resulted in some Māori deaths. Many Pākehā died in the influenza pandemic of 1918, in which millions of people died all over the world, but Māori were even worse hit. It is estimated that 5% of the Māori population died, a death rate more than eight times that of Pākehā.
Survival of traditional healing practices
Traditional health practices were still very common in all Māori areas. In some districts people were reluctant to participate in any modern health programmes, particularly programmes that were associated with the government. This was the case in Taranaki and the Waikato, following land confiscations after the 19th-century wars. In the Urewera, too, the prophet Rua Kēnana chose to work for health improvement independently of the government and the Māori councils.
Tohunga Suppression Act
Complaints were often made by health officials and others that tohunga were endangering rather than enhancing Māori health. In 1907 the Tohunga Suppression Act was passed, with the support of several Māori leaders and politicians. It was intended to counter what was regarded as the harmful side of the tohunga’s work. Although this legislation was not an outright assault on all aspects of traditional healing practices, it strongly confirmed the idea that ‘tohungaism’ was an undesirable activity. Not many prosecutions were made under the act, however, and tohunga continued to practise.