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Booster shot: Tuhoe on verge of opening ‘blueprint’ Ruatahuna clinic
23 July 2020

The first of the Tūhoe iwi’s two new medical clinics serving people “in the middle of nowhere” is ready for its formal opening, despite COVID-19 disruptions.

The clinic is nearly two hours’ drive from the nearest major centre, Rotorua, and the rural iwi’s main Kawerau clinic.

Iwi clinical director and GP Emily McNicholas tells New Zealand Doctor the Ruatahuna clinic is a test-bed for embracing telehealth.

The iwi’s 1700 patients, enrolled across its three existing clinics, took to teleconsults during COVID-19 lockdown, and the network is looking to exceed the then RNZCGP-mandated 70 per cent target and achieve 80 per cent, Dr McNicholas says.

“The patients love it, they can stay at home or stay at work if they’re not too unwell.”

Rolling out the blueprint
Lessons from the COVID-19-delayed Ruatahana clinic will be applied to Tūhoe’s fifth clinic at even more remote Lake Waikaremoana, which is also expected to open this year, Dr McNicholas says. Ruatahuna will be “a blueprint”.
Tūhoe is considering developing patient self-management programmes and evening classes for conditions like diabetes at its Ruatahuna and Taneatua clinics.
The Ruatahuna clinic was scheduled to open in March but COVID-19’s appearance forced work stoppages. Now complete, all that remains is to have a formal opening, Dr McNicholas says.

Iwi tackles COVID
Tūhoe’s three COVID-19 swabbing clinics at Ruatahuna, Waikaremoana and Waimana which Dr McNicholas describes as “in the middle of nowhere”, swabbed 80 per cent of the iwi’s approximately 12,000 population inside its rohe, or tribal boundaries.
In its entirety, Bay of Plenty DHB, which covers Tūhoe, has so far swabbed more than 17,500 people, Ministry of Health data show. The iwi opened its swabbing clinics because the Whakatāne community-based assessment centre was too far away.
“At Waikaremoana, 50 people turned up, which is a massive result for such a small population,” Dr McNicholas says.
“By demand, we probably had the most successful CBAC clinics in the country.” These have since been wound down.

Drive-through flu vax
Immunisation was also a success story during the height of pandemic restrictions. A drive-through seasonal influenza vaccination clinic saw all 400 enrolled patients eligible for early access to free shots get vaccinated, and then some, Dr McNicholas says.
Historically, the iwi has suffered low child immunisation rates, but an outreach service is making inroads, Dr McNicholas says.
With many people in small, isolated communities without landline, cell phone coverage, or even transport, it has been difficult arranging child vaccination booster shots.

Moving closer to target
“Typically, our immunisation rates have been really low, around 52 per cent, when the national target is 95 per cent.
“Six months ago, we were at 54 per cent; we’re almost at 70 per cent now.”
Now the clinicians come to the patients, she says.
“And our patients seem to be more open to immunisation at home being surrounded by people they are familiar with.”

NZ Doctor

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