But what you don’t want when indigenising your space, he stresses, is cultural appropriation.
“Seeking advice from local iwi or kaumātua is the first step, but at the same time, it has got to be genuine.”
“If you’re going to do it, you have to be genuine about the intentions – it’s not something to make more sales.”
Mary Roberts, a former Ngāruawāhia pharmacy owner who has worked in the Waikato town for the past 35 years, agrees, adding that indigenising your pharmacy space has to be done with great care. “An indigenised space that is full of stuff and health professionals who aren’t culturally safe is cultural appropriation or tokenism,” she explains.
“You can’t indigenise a space or have a culturally safe space without involvement of your hapū and iwi and your whānau. As a Pākehā person, it can’t be one sided.”
When creating her pharmacy, Mrs Roberts worked with local hapū and iwi throughout the process and had “lots of discussions” about what would be appropriate.
“It wasn’t a quick process. And it’s not about loading the responsibility onto Māori staff members either, which some people tend to want to do. It’s about finding the right person within the rohe to point you in the right direction,” she says.
“We’ve got an awful lot of trust to rebuild...Why should they trust you and Pākehā medicine? The outcomes still aren’t where they should be.”
One of their “greatest successes” she explains, was the patient counselling area, which featured giant frosted glass panels adorned with kowhaiwhai and rongoā patterns that were gifted by the local hapū.
“It’s about creating private spaces in public – banks do it quite well. You want to be able to have conversations that are private, but you don’t want them to feel like you’re talking at them. People didn’t feel trapped or like they had been dragged into an office and it created this space which had special ambience, particularly for our Māori patients. Everybody respected that space,” she says.
It’s also important to have a space that is big enough for patients to bring support people with them if they wish, she adds, noting they also opted for a circular table in the counselling area.
“There’s more equity in [a circular table], there’s more sitting alongside each other and being supported than what comes with a squarish table. It’s about thinking what’s going to make people feel safe, comfortable and equal.
“It was really amazing, patients would just walk in there and sit down. They wouldn’t come up to us and say ‘can I talk to you’ but the fact they just went in there and sat down – you knew they were waiting for you to come and talk to them. It is creating that safe space.”
Considering simple details such as the style of chair can make a big difference too, she says. Chairs need to be not too low or too soft for patients to get out of, and expansive enough to comfortably accommodate larger people.
“In a number of pharmacies, particularly the corporate models, they have the belief that you don’t have lots of seating because you want people to be up, moving and shopping the shelves so they’ll buy more.
“But if you’re an older person or you’re unwell, quite often you want to sit down comfortably. We also wanted to create an area where people can talk and connect with each other, because at the end of the day, the thing that is most health-giving is to ensure that they have connections with people and there’s no reason why that can’t happen in a pharmacy.”
Another hit at her pharmacy was the safe space created for tamariki to play in, with a selection of children’s books in te reo and jigsaw puzzles that reflected te ao Māori.
You could also incorporate te reo in your signs but be sure to check with your local hapū as the choice of what is appropriate may vary from area to area, she says.
“When we did ours there were several choices that were distinctive to our area and which, to a fluent te reo speaker, would have signalled that we had taken care and respect. Then the final choice was decided by our kaumātua.”
“Wherever possible we also tried to source patient material in te reo – there are a lot of great resources out there.”
Former Pharmaceutical Society president and pharmacist Ian McMichael has also taken steps to create a culturally safe pharmacy environment and says it is an ongoing, ever-evolving process.
“One of the major things for me, for all cultures, is asking yourself how you would like to be treated. Then you look at the way your pharmacies operate for anyone, and then treat them in the way you would like to be treated,” says the Hamilton pharmacy owner.
“If you relate well to people, if you treat them with respect, they’ll be responsive to you in the same way.”
For pharmacies that don’t have a seating area, Mr McMichael believes offering patients a comfortable place to sit down is a great place to start.