Planting Seeds for Reflection


This research tested the effectiveness of using a design methodology for reflecting on the meaning of health equity. The investigation involved engaging keen members of a quality improvement and innovation unit situated within a large public hospital. To assist this organisation with recognising their responsibility and capability for honouring te Tiriti o Waitangi. The findings from this study revealed that personal transformation was more significant than using design methods to enhance reflection with others. However, this research aspired to be just one of many seeds planted for imagining and transforming towards an equitable healthcare system.

Poor health is often perceived as the outcome of individual behaviour and is not attributed to the wider social determinants of health. For Māori, these social determinants are inextricably linked to the ongoing impacts of colonisation. It is undeniable that colonial structures have perpetuated health inequity since the 19th century. As such, healthcare institutions have made public declarations to honour te Tiriti o Waitangi by endeavouring to eliminate health inequity.  

The pandemic has amplified the evolution and the role of design in healthcare to mainstream attention. Like our healthcare system, design cannot cure the world of wicked problems. But design can facilitate us to imagine a world without them. Design offers the ability to rapidly prototype and user test solutions. In contrast to the risk-averse health profession. Instead of fragmented and siloed education systems like healthcare institutions, we should apply design to health thinking and vice versa. By utilising design thinking “not just to design a new leaflet” but using radical imagination to redesign a new healthcare system. Clever design has assisted with better healthcare delivery. But it has also exposed how systems do not meet equitable health outcomes. How might we redesign the future of healthcare by blending a creative pedagogy and scientific method? We can use design to plan, prepare, and produce the next generation of healthcare professionals. To resource and equip a workforce who care deeply about health equity.

My journey to pursue research into racial health equity emerged as a pathway to reconcile with my experience as a Korean person living in Aotearoa. I have since learned that anti-Asian racism moreover racial justice cannot be achieved without tino rangatiratanga. Te Tiriti o Waitangi is an integral constitution to the formation of this nation. Fundamental to this contract is the agreement that those who wish to call Aotearoa their home must be in partnership with tangata whenua. As tangata Tiriti, it is our responsibility to honour te Tiriti in congruity with our entrance onto this motu.  

I spent a decade in my healthcare career before pursuing design. Since embarking on this adventure, my worldview exploded in ways I never imagined were possible. It was through my design studies (and not my healthcare education), that I sharply discerned this nation’s history. I grappled with my intentions and positioning throughout the research journey. I also felt overwhelmed by the entrenchment of injustice, rendering myself desolate and despairing. Paradoxically, the privilege of having this consciousness compelled me to continue. A personal goal from undertaking my master’s was navigating how to manage my commitment to a responsible learning journey in a thriving yet sustainable manner.

There has been a type of paralysis described by non-Māori when learning about structural and institutional racism. A questioning of how non-Māori can conduct meaningful research without being offensive or tokenistic. In tandem with this, Māori should not be expected to carry the mental and spiritual burden of educating others. We, as tauiwi or Pākehā, must educate ourselves and converse with fellow tauiwi or Pākehā. We must recognise that pathways to multiculturalism cannot occur without a commitment to biculturalism.  

I feel my studies have irrevocably altered my way of seeing and thinking about the world and myself. I acknowledge that learning and growing never cease. However, by undertaking my Master of Design, I would define my ‘outcome’ as a consolidation of my positioning as a tangata Tiriti. I have developed an increased sense of clarity, confidence, and commitment for social justice. At the beginning of my master’s journey, I had wished for increased confidence in speaking about equity, anti-racism, and decolonisation. But I am since realising that perhaps the opposite is required. I must continuously and consistently practice humility. We are always learning, unlearning, and relearning.  

Read more about Phoebe's Masters project here:

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