Clinical nurse and social workers tackle unmet health needs

Published: June 7, 2023

As the first clinical nurse specialist working alongside Oranga Tamariki in South Auckland, Fonoifafo (Fono) McFarland-Seumanu has a big job on her hands.

Fono photo cropped
Fonoifafo (Fono) McFarland-Seumanu, a South Auckland nurse making a difference in her community, interviewed by RNZ Pacific/Lydia Lewis.

Fono describes her job as a 'health brokering role'. She endeavours to make the health system more accessible for vulnerable tamariki and rangatahi.

'There’s a really high number of kids who come to the attention of Oranga Tamariki and who have unmet health issues,' she says.

Fono says there are a number of barriers to whānau getting the medical help that their moko need.

'Whānau may not have a car, or shift work means they can’t make medical appointments, a baby might not be registered with a birth certificate which means they can’t register with a GP, or no phone credit means they can’t phone to book an appointment,' Fono says.

Fono works out of the Oranga Tamariki Otara site and alongside social workers.

'It means we can identify health issues earlier,' she says. 

Some of these issues include neglect, malnutrition, ADHD and poor hearing and eye-sight that affect learning, re-occurring eczema infections, scabies, and lice.

Fono acts as a short-cut to get urgent medical issues treated by professionals.

She drops prescriptions off to homes, re-arranges specialist appointments to suit a whānau, helps with transport to get them to an appointment, registers babies with GPs and Plunket and even makes sure babies have a birth certificate.

Fono says unmet health issues are often linked to other issues that social workers come across such as truancy.

'There was a young person who hadn’t been to school for months and months because they were being bullied. It turns out the bullying was down to the young person having infected eczema. I dropped a script off that same day and the young person was back at school as soon as the infection cleared.'

Fono’s own history with Oranga Tamariki

Fono comes to the job with valuable knowledge and first-hand experience of being a whānau caregiver.  

At just 21-years-old and studying nursing, Fono took on the care of her 5 nieces and nephews.

'When I turned up, the children were at the Oranga Tamariki site with their bags, waiting to be picked up.'

'The only thing that I sort of had ... was the willingness to just step forward and take them home with me, which I was able to that day.

'The understanding was it would be for 3 weeks, but the weeks turned into months and eventually became 2 years.'

While it was tough, that time was invaluable in hindsight, she says.

'If I had had somebody in this [nursing] role 5 years ago, while I had the 5 children, that would have made a world of difference because somebody would have been there alongside me saying: "Hey, actually, that child is not purposely misbehaving, he just cannot hear you". Or, "he cannot actually see".

'It would have been super helpful to have a health professional beside me to say actually: "You just take them to this place - you provide him with the letter, it's all funded".

'A lot of that stuff we don't know - our families don't know. So it's real frontline primary care health issues that we can make a difference in,' she says.

Fono’s positive impact

Oranga Tamariki in-take and assessment social worker Scott Matapakia says having a nurse based at the Otara site means on-the-spot, tangible support for families.

'Having Fono alongside me and having consults and stuff can actually readily prepare families for instant care, she can do those direct referrals without the usual wait times.'

Scott says that he and Fono work closely to trouble shoot issues that families may be experiencing.

Fono is currently the only nurse in this role in South Auckland, working across multiple sites.

Her role is an example of the Government’s new way of working under the Oranga Tamariki Action Plan.

The Oranga Tamariki Action Plan intends to make it easier for social workers to get support from other agencies and refer children, young people and their families to essential health, education, and youth justice services and alert other agencies to issues that need to be addressed.