Far from home and all he’s ever known, Mikaere Porē-Tipene faces the unrelenting demands of medical school while striving to honour his whakapapa. Balancing academic pressure with the expectations of his iwi, Mikaere must decide what success truly means – and who he’s doing it for.
From Feilding to Foundations
Mikaere grew up in Feilding, a small North Island town where everyone knows everyone and leaving your front door unlocked is still (mostly) fine. Despite the warmth of a tight-knit community, he often found himself longing for something more. After a gap year spent training and performing with Manawatū’s Te Tū Mataora kapa haka, he knew his journey wasn’t going to be straightforward. Initially unsure whether medicine was really “for him”, Mikaere’s path became clearer when he stepped onto Otago University’s campus for its open day in 2018. "Taking time off allowed me to explore my options a bit more," Mikaere says. "When I came here, it just felt right – like this was where I was meant to be." And so, he followed his gut and enrolled in Otago’s Foundation Studies programme – a decision that laid the groundwork for everything that followed.
Now in his third year of medical school, this move marked the beginning of a journey defined by resilience, but not without its challenges. Mikaere shared that the initial year was rich with lessons, opportunities, and confronting truths. “It didn’t occur to me that I didn’t even know how to study properly,” he says. “But I tried a few things out: learned through trial and error, found my team, and then my grades went up. I knew then that I was doing something right.”
Dubbed by his peers as a ‘haka prodigy’, Mikaere had a later start in both te ao haka and the world of sciences. “I definitely didn’t come from an academic background, and I didn’t get into [kapa] haka until high school,” he recalls. “My mum basically forced me to go to my first practice.” But what began as grudging participation has since evolved into leadership. From his early days with Te Piringa to his role at the University of Otago, Mikaere is popularly known as ‘Uncle Mik’, a tuakana figure and a pillar of constant support and guidance for his peers.
The transformation didn’t happen overnight; Mikaere describes his move from Palmerston North to Dunedin as a turning point. “You get to meet other Māori from all over the motu, and their performing styles eventually rub off on you […] I’ve grown into my own and also gotten to know more about my feminine side, too,” he says. For Mikaere, this step in his journey has not only shaped his identity but also enriched his connection to his cultural roots, despite being so far from home.
Balancing Doubts and Dreams
The demands of medical school and other commitments can be overwhelming, yet Mikaere’s passion for both fuels his resilience. But pursuing a career in the health sector doesn’t mean hanging up the piupiu to wear the stethoscope. While a busy future is certainly on the cards, Mikaere believes he doesn’t have to choose between his passions. Instead, he embraces both, showing that it’s possible to honour his culture while pursuing a demanding career. “I’ve seen people do it before,” he explains. “[Kapa] haka[s] is what keeps them grounded in a system that works against us.”
Looking ahead, Mikaere plans to finish his Postgraduate Years (PGYs) and dedicate time to strengthening his reo Māori at Te Wānanga o Aotearoa – a goal that has been difficult to prioritise amidst the all-consuming nature of study. He hopes to spend a few years specialising in Australia, torn between the technical precision of surgery and the broader impact offered by public health. He jokes about becoming the next Dr Ashley Bloomfield, but his vision is ultimately grounded in his whenua: to build his own medical practice on his papakāinga at Rotoiti, and serving his hapū, Ngāti Rongomai. “Hopefully, I can achieve that later in life,” he says. His vision speaks directly to the systemic barriers that still exist today and the urgent need for transformation, one that centres rongoā Māori, whānau, wairua, and well-being rather than just clinical outcomes.
MAPAS Under the Microscope
The current National government, armed with a barrage of harmful policies, is on a destructive path, systematically targeting Māori and Pasifika communities. From scrapping the Māori Health Authority, repealing smokefree legislation, to now placing the Māori and Pacific Admission Scheme (MAPAS) under review, every move strips power away from Māori and erodes the foundations needed for equitable health outcomes.
These decisions don’t just stall progress made towards improving health equity – they actively reinforce systemic racism. “That's like a step backwards,” Mikaere says. “Smoking is the main cause of most comorbidities, alongside alcohol. [It’s] been there to help people through generational trauma, and those companies are making money off [of] it. So scrapping it was just an embarrassment not only here, but also to the world, because the world looked up to us.”
And while the centre-right coalition government claims to champion equal rights for all New Zealanders, the reality tells a different story. The rhetoric of equality collapses when policies systematically dismantle the very structures designed to uplift Māori and Pasifika communities. Instead of nurturing an environment where these groups can thrive, the government appears more focused on pushing political agendas that ignore the historical and cultural contexts of health inequities. “It's clear that this [is a] very anti-Māori government, even if they’re saying they're not,” Mikaere asserts, highlighting the urgent need for policies that genuinely support Māori health and wellbeing.
When the System Says You’re Not Worth It
For people like Mikaere, it’s personal. After losing a close relative to cancer at the age of 24, the brutal reality of structural bias came into sharp focus. “It’s clear that it’s systemic. They said he wasn’t worth it […] from a doctor's point of view, [he’s] not worth the investment. But that's when you start learning about how the health system works. It’s not designed for us.”
In rooms where the tired mantra of "race doesn’t matter" gets tossed around like a shield, the realities of systemic racism in healthcare speak louder. “We're looking at prevention and intervention, and that's what our current health system doesn't do,” Mikaere shares. The root cause? Colonialism. “The effects of colonisation caused [these] health disparities, and continue to cause negative outcomes today.” Meanwhile, political parties like ACT dress up systemically racist policy changes as “race-neutral,” a move so ironic it’s almost the opposite of acting. In fact, it’s doing nothing at all.
Mixing politics with people’s lives, Mikaere warns, is not just reckless – it’s deadly. “Helping those [who] need help should be the primary goal.” But too often, political gamesmanship wins out.
The National government’s relentless use of benign slogans like “fairness” to distract the public and pit people against one another is more than just troubling – it’s a calculated erasure. Beneath the coded language about “equal rights” and “infrastructure strain” lies a familiar pattern: undermining Māori rights under the guise of equality, and suggesting that Māori enjoy unfair privileges. Mikaere puts it plainly: Te Aka Whai Ora was never about giving Māori special treatment; it was about removing entrenched disadvantages and creating meaningful, overdue change. But how can you erase a century’s worth of damage in just a year?
“The problem is that not many Māori people go and see doctors because of the systemic racism.” Mikaere points out that it’s not just about needing more culturally competent clinicians – it’s about Māori being able to see their own in the health system, people they can trust.
Mikaere shares that it opens the door for Māori to "care for their own." He’s clear about the bigger picture too: “It's for creating a workforce that reflects society, because currently we don't, and we can see how it's creating inequitable health disparities in the health system.” Culturally competent care starts with the basics: pronouncing a patient’s name correctly, recognising the vital role of whānau in decision-making, and respecting cultural practices, like never leaving a tūpāpaku (deceased person) alone and allowing whānau the space to grieve according to tikanga. True care means building systems that honour identity and uphold dignity, especially in life’s most vulnerable moments.
This need for culturally competent care extends into the education system, too. Pathways like MAPAS aren’t just about getting more Māori and Pasifika through the door, but ensuring that patients can one day sit across from someone who understands them. "I don’t know why they’re reviewing it – they see it as racist, but it’s for everyone. What works for Māori, works for everyone,” he says. The evidence backs him up: kaupapa Māori practices, culturally aligned health models, and diverse workforces aren’t just good for Māori – they lift outcomes across the board.
Rongoā Māori (traditional healing practices) is one example of just that. A kaupapa close to Mikaere’s heart, the practice has undergone a remarkable revival in recent years, particularly through the Accident Compensation Corporation (ACC). Since June 2020, client numbers have surged to nearly 9,000. And yet, even with this momentum, the obstacles are real: Māori are 35% less likely to file an ACC claim and often face systemic hurdles when they try, as Eldon Paea, ACC’s head of Māori health partnerships, points out. Of those who embrace rongoā Māori, 59% are Māori, but its holistic approach – addressing physical, mental, whānau, and wairua (spiritual) health – has drawn increasing numbers of non-Māori too. By January 2024, claims for rongoā Māori had nearly doubled, a clear signal that Māori ways of healing have long offered what Western medicine still struggles to provide: care that treats the whole being, not just the symptoms.
Building a medical workforce that reflects the people it serves shouldn’t be a radical idea. It’s common sense. Right now, we don’t have that, and we are living with the consequences.
Statistically Speaking, We’re Dying
In this ongoing 'med school showdown,' the numbers tell a brutal story. As of 2023, Māori doctors represent only 4.7% of New Zealand’s medical workforce, according to a University of Auckland study. Even more damning, the same research indicates that Māori patients are 43% more likely than their non-Māori counterparts to be hospitalised due to healthcare complications. These overwhelming disparities don’t just hint at a problem – they scream the urgent need for systemic change in our healthcare system.
But these figures reflect something deeper: a system that not only fails to represent a growing Māori population but actively worsens the inequities it was supposed to heal. As the current coalition government continues to fan the flames of divisive rhetoric, the impact on Māori health outcomes becomes even more pronounced. The stats reveal a pattern not of progress, but of systemic discrimination and neglect, giving rise to the necessity for pathways like MAPAS that aim to create a more equitable healthcare workforce. Without these targeted pathways, the health gap for Māori and Pasifika will only continue to widen, locking inequality even deeper into the foundations of the system.
Addressing these brutal disparities is not just about tweaking policies; it demands reform – investing in culturally competent care, and building health initiatives that are actually accessible, not just in name. Otherwise, the cycle of disadvantage will tighten its grip, shutting more whānau out of accessing quality healthcare, among other things.
“When you look at it, most of our whānau aren’t [of] high socioeconomic status. Not everyone has transport – [so] how can they afford to get into these areas?” Mikaere points out. The barriers aren’t just bureaucratic; they’re baked into daily life. “Some of our own doctors tend to perpetuate those stereotypes in clinics, which makes whānau feel a bit whakamā [shy, ashamed]. And I think this is why Māori are reluctant to seek help, because why would they seek help from somewhere they are not going to be treated fairly? They've not seen a familiar face that they connect to.”
Unseen in the System, Unwell by Design
The gruelling reality of healthcare access endures: a system so invasive, so alienating, that it leaves many Māori feeling isolated, and untrusting of the very thing that is supposed to care for them. General health practices aren’t just daunting — they’re a hostile experience for those forced to navigate spaces stripped of cultural awareness and basic respect. Mikaere knows this truth firsthand. “A biomedical lens only focuses on treating that person, an individual. When the individual basis has changed, that model cannot reflect on everyone – we're looking at the wider picture,” he explains. Without cultural understanding, the system builds walls instead of bridges.
Culture, however, offers what medicine alone cannot. Beyond rongoā Māori, kapa haka also stands as a living form of rehabilitation and healing; a lifeline for many, including those the system tried to erase. Culture isn't just complementary to healing – it is the healing. What’s clear is this: true well-being will never be achieved through clinical solutions alone. The revival of rongoā Māori, the transformative power of kapa haka – these are not "alternative therapies" to be tacked onto a Western framework. They must stand at the centre of any healthcare system that claims to serve all New Zealanders. Cultural identity and health are inextricably linked, and the future of healthcare in Aotearoa depends on whether we’re willing to acknowledge that truth.
For Mikaere, whānau remains his compass. Though the journey can be “challenging at times”, he always comes back to his purpose: “How am I going to give back to them? They gave me the privilege to study medicine. That keeps me up.”
If we are serious about health equity, we must invest not just in systems, but in the next generation of healers like Mikaere – those who know that the fight for well-being starts with restoring mana, identity, and trust. Those who will lead our communities into a future where our people are no longer unseen, no longer unheard, and no longer unwell by design.