Te Tairāwhiti can be represented by three distinct hapori based on geographic location, wellbeing perceptions, and social realities: urban, inland rural, and coastal rural. Tangata whenua make up 56% of the region’s total population, and six of the 11 iwi in the region have primary health organisations that have partnered with local and national research centres to provide equitable initiatives predominantly to the rural populations.
For patients living with cancer in rural areas of Te Tairāwhiti, there is a great need for intermediary health services and clinical technologies that can reduce burdens, particularly of cost and travel. Circulating tumour DNA (ctDNA) is a minimally invasive analytical method that requires only a simple blood draw for the analysis of biomarkers that can determine tumour burden, size, type, prognosis, response to therapy, and risk of recurrence.
Narrative interviews were conducted with Tairāwhiti cancer patients and their healthcare providers to determine their interest in ctDNA technology and to inform the most equitable and appropriate methods of delivery of the technology to the region. A laboratory workflow for detection of tumour-specific structural variants from fresh-frozen tissues was also developed to provide an option for Tairāwhiti-based precision medicine. ‘Māu tēnā kīwai o te kete, māku tēnei’ is a whakataukī that translates to ‘That handle of the basket is for you, this one is for me.’ It articulates the multi-disciplinary approach of this project that integrates both Mātauranga Māori and knowledge of Biomedical Sciences to create tangible research outcomes that can result in an improvement to access and delivery of cancer care services in Te Tairāwhiti.