Too Much & Not Enough 

Imagine you are a single mum who has been living in transient housing for almost two years. No security, no community, you can’t call it home. The house might be overcrowded, mouldy or cold. You spend more than 50 % of what little money you have each week on it. After other bills are paid you are often left with just $50 for food. Every day you worry about your children; if they get sick you have to borrow money to get them to the doctor putting you into a debt you cannot repay. 

You have been fighting to exist for so long, you no longer trust the services that have consistently let you down. The social stigma that comes with being an out-of-work single mother brings on mental health issues and the idea of suicide is one that is never far from your mind. You were born into this life and now you are raising your children in it, a cycle that breeds poverty and one that is almost never broken. 

Now imagine that for the past 20 years you have lived in your own home with your husband, raising your children. You have never known what it is like to want for anything, except the want to escape your abusive relationship. So, one night you do leave and almost immediately find yourself in a position you have never been in before – homeless and in need of welfare from a system that makes no sense. Being in your mid-50s you can’t access any senior benefit help and being over 45 years finding work is difficult because society simply does not see a woman your age. You are thankful for charities like the Salvation Army, but you know they can only do so much due to their constrained resources. Missing your kids, you start to think that “sure it wasn’t an ideal living situation, but I had security”. So, you return home to your abusive relationship – because at the end of the day you reason, it is better the devil you know. 

I would like to say the stories of two very different experiences with poverty that women here in the Bay face are just that, stories, but they are not. They might not be about any one woman, but they are unfortunately about many women – whether they are born into poverty or circumstance puts them there. Whatever the reason, no woman should know what it is like to barely exist, especially in a country like ours. But that is not the case. 

Today, because of poverty, women in Hawke’s Bay face a myriad of unseen, never talked about problems. Homelessness, physical and mental health issues and family violence (which while poverty does not cause it, it certainly does not help its prevention). Poverty is a much bigger problem than the choice of whether one pays for food or for electricity – it is what 

being forced to make this choice does to a person. For women in Hawke’s Bay, poverty is a lack of money, lack of stability, lack of choice, lack of understanding, lack of compassion, lack of self-worth.

The facts

“There are still vulnerable people in New Zealand to whom economic benefits have not trickled down. Food banks still exist, as do the diseases of poverty, rising violence, racial tension and homelessness, all of which contribute [to] a worrying under-privileged in our society … Poverty is very disabling for people who experience it. It reduces educational chances, increases health risks and increases the risk of violence.” Kiwi researcher Dorothy Meyer penned this about women in 1997. She could write the same thing about women of today.

In Aotearoa, anyone earning less than 60% of the median wage is deemed poor. But it is a crude figure that is misleading. The Child Poverty Action Group looks at poverty more realistically, by seeing how much people have to meet their basic needs such as utilities, food and healthcare, after housing costs have been paid. With local Salvation Army captain Veronica Rivett pointing out that the government’s Accommodation Supplement falls well short of what was needed for rent, it shows that women are tapping into other basic needs money just to put a roof over their head.

The complexity and interrelationship of these issues born of poverty only cause greater stress for women, says Heretaunga Women’s Centre (HWC) service manager Amanda Meynell. “Women living in poverty often spend long periods of their days just trying to get the basics together to feed their families.”

Issues that are compounded by limited support and structural discrimination, especially in regard to employment and housing for women in the rainbow community. 

When it comes to poverty, it seems all roads lead to home, or rather a lack of one, and have done so for decades.

Over 30 years ago, Meyer reported that “housing adequacy is perhaps the key determinant in the welfare of a family”. Hawke’s Bay District Health Board (DHB) member Ana Apatu agrees. “It is the things that lie outside the clinical sphere such as the housing crisis that determine one’s health. I mean, if you are living out of the boot of your car you are going to be very anxious and stressed and I am not sure what a clinical service can do for you to allay those anxieties.”

Right now, there are 2,818 Kainga Ora managed houses in Hawke’s Bay. Forty-nine of these are vacant with only one in the whole of the Hawke’s Bay ready to let. The Ministry of Social Development (MSD) reports that as of September this year there were 1,644 applicants for public housing – 85% of which were women. According to Kainga Ora, this need has increased 10-fold over the last 5 years from 168 houses needed in June 2016 to 1,644 needed in June this year. 

Meynell says there are hundreds of families in emergency and transition housing living in motels for months and sometimes years on end. She says the transient nature of these environments can create increased stress on women and families who are already buckling under the weight of it. 

Private rentals are just as hard to come by. When they do become available TradeMe reports they now cost on average $550 a week here in the Bay and according to the DHB’s latest Equity Report are often in a substandard condition which only adds to poor health outcomes. 

So bad is the problem (left to fester by successive governments) that Te Kahu Tika Tangata / Human Rights Commission (HRC) announced earlier this year it would be holding an inquiry into this national disaster.

Salvation Army social worker Susan Searancke says not only has the problem become so bad that it is driving people into poverty, it is separating mothers from their children, with children having to go and live with extended family for their safety.

Clearly, this crisis does not help single mothers on the Sole Parent Benefit (SPB). 

Back in 1997 Meyer reported that “single mothers are currently expected to ‘do it all’. They are expected to engage in full-time work as citizens/workers, to sustain independent households and to raise healthy, well-balanced children, all on their own. These expectations may be unrealistic.”

Sadly, single mothers still face these unrealistic expectations. When I asked the MSD how much one could claim on the SPB, the Ministry’s Karen Bartlett sent through a list of dollar amounts (see table). With a lot of variables at play in how much one could claim, the figures she offered when added up showed the most a single mother could 

receive was $1,061.52 a week. Taking out the $550 cost of private rentals, that leaves the recipient with less than 50% of what they receive to meet their family’s other basic needs.

When I showed the list of MSD figures to Rivett, she said they do not “paint an accurate picture of the situation most of our clients face”, with most living with substantial debt, intergenerational money challenges and addiction which “makes it almost impossible to manage on their benefit.” 

She says the Accommodation Supplement of $305 a week was several hundred dollars short of being able to meet actual rental costs.

What exacerbates the benefit issues is most single parents are unaware of what they are entitled to claim and that the requirement under the SPB to either work or attend courses made life unmanageable for women who had care responsibilities.

Unfortunately, women who can work are seemingly no better off. In 2019 the HRC reported that the in-work poverty rate is substantially higher if the main earner in a household is female, when compared to male, regardless of the household structure. This rate can double for groups like single parent households, which are mostly women. 

Moreover, the Salvation Army is starting to see a new trend developing – older women finding themselves on the breadline for the first time. A problem intensified by things like the gender pay gap which sees more women end up in poverty in their pre-retirement and retirement years. While the reasons for this phenomenon are complex – from gender bias in the workplace to women taking time off for caring responsibilities – the outcome doesn’t change.

Health effects

As you can imagine, being poor and homeless doesn’t lead to great health outcomes for our women in Hawke’s Bay, with the Equity Report showing it’s our least affluent communities who rate their health lower. These are the communities that many of our minorities, our Māori, Pacific Islanders and rainbow women, belong to. 

Apatu says for Māori it is wāhine who hold the whānau together and for this reason when it comes to their health early intervention is absolutely critical. She says while Covid-19 is monopolising the resources at present, which is “absolutely the right thing” to do, she is worried it will only make this “persistent lack of access” wāhine face worse.

Apatu says Māori women are often conflicted about caring for themselves and caring for whānau. “[So] we need to ensure that we don’t take our eye off the ball. Māori women are at the hub of the whānau constantly caring for others.”

Access to our health services is also a problem for the women of the rainbow community, Kirstie O’Riley (she/her) from InsideOUT says, and without it their health problems only get worse. 

Exacerbating women’s physical health problems are their mental health problems. The Equity Report shows that our district has one of Aotearoa’s highest presentation rates of people suffering self-reported psychological distress – most whom are women.

While this may be the case, the DHB’s Dr Frances Oliver says the number of new female clients seen has been relatively stable over the past three years. Whether this plateau is because this is how many women are presenting, or if this is all the patients the DHB take on wasn’t stipulated.

However, Meynell paints a different picture saying during the most recent lockdown the HWC saw a sharp increase in the number of women accessing urgent emotional and counselling support. “Since March this year, we have provided 72 urgent counselling appointments, above and beyond our usual counselling service.”

Apatu says for Māori, health isn’t just about one’s physical wellbeing; one’s emotional and spiritual wellbeing are just as important. As is connectedness – to their whānau and community; as dislocation from it adversely affects their health. “And I am not sure how much we appreciate that. So it is about trying to balance all those things when we know our health services are so constrained at the moment.”

O’Riley echoes this sentiment, voicing her frustration at the lack of reporting done on how these issues impact on the rainbow community as a whole. So, it would be safe to say that even less reporting has been done on women in this community. 

When it comes to the funding of women’s mental health there is not much more information. While Dr Oliver says the DHB has $42 million ringfenced for mental health, how 

much of this figure was spent on women is unclear and women deserve more transparency around this, otherwise accountability suffers. She did say more than $4.4 million had been put aside for Te Ara Manapou – a service for pregnant women and parents with children under three who have addiction problems, and mentioned the free mental health services available in the region. Unfortunately, the Salvation Army says, people can wait up to nine months for the latter.

This leaves private mental health services which, at up to at least $175 an hour, are well out of reach for many women here. Searancke says so little of the population is receiving any form of mental health care that many women fall through the cracks, leaving social workers to pick up the pieces. “Social work is working with the remaining walking wounded who are anxious, who are in poverty, who are frightened and afraid, who have their mental health damaged by the situation.”

Violent results 

When all these problems come to a head, family violence is often the result. Dr Oliver says the correlation between social determinants, such as poverty, and gender-based violence with mental health issues is well known. Despite this, the DHB says there is no straightforward way of measuring the prevalence of such violence in our community as there is no monitoring framework. Which is a real problem as health services could play a vital role in effective screening and early intervention.

This lack of framework also leaves other organisations like the HWC grappling to change Hawke’s Bay’s family violence statistics. Meynell says at least one-third of the women who visit the centre do so because of violence, a figure exacerbated by emergencies like Covid-19. “What is important to remember though is that lockdowns don’t cause violence – rather the conditions of lockdown can intensify already existing issues.”

It is not any easier for rainbow women, O’Riley says, as they face even more barriers to receiving the help they need to heal from domestic violence such as poor experiences with support services.

What doesn’t help is that violence in the home is taking other forms and becoming harder to spot. For example, Auckland University Professor Dr Janet Fanslow reports an increase in the rates of controlling behaviours and economic abuse. Such forms of violence are still being conflated with psychological abuse making it harder to confront them.

A possible reason for these increases, she says, is that societal work such as the It’s Not OK campaign have increased the recognition that physical and sexual violence are not on. “If men have taken these messages on board, and possibly perceive that their greater risk of consequences for the use of physical and sexual violence, they may have shifted their use of violence to controlling behaviours and economic abuse,” she says. 

Several local family violence services were approached for comment.

Just not enough

So, what have I learnt researching and writing this story? That the problems facing many women in Hawke’s Bay are both enormous and unending and that there is no magic bullet to help them heal. There are programmes, services and organisations out there doing their best to right these wrongs, however it is a piecemeal and ad hoc approach providing answers that often only lead to more questions.

One solution offered up is Te Tawharau, a public-private collaborative mental health crisis hub announced earlier this year by Health Minister Andrew Little. Expected to open early next year, Dr Oliver says once operational it will provide specialist care alongside input from social services with the needs of the patient (no matter their gender) at the centre. 

Moreover, Apatu says the DHB is trying hard to recruit more Māori into our health services in an effort to make sure that wāhine feel safe and cared for in our health facilities. “So we see ourselves when we walk into a health institution, that we feel part of it, that we feel engaged, that we feel listened to,” she says. 

Perhaps Te Ara Manapou could address some of Apatu’s concerns through its work with Hawke’s Bay women. Te Ara Manapou is an intensive family/whānau focused, wraparound outreach service for pregnant women and parents with children under three years of age who experience problems with alcohol and other drugs. Programme spokesperson DHB health practitioner Haami Harmer says they are trying something different by building their capacity to apply matauranga – karakia, pūrākau, whakataukī, te reo me ona tikanga and exploring who we are as practitioners, and as a service – so maybe it is the start of turning things around.

And there may be some hope in this area for women in the rainbow community. Dr Oliver says the DHB acknowledges that fear of social stigma and discrimination can be barriers to accessing health services, including mental health services. It hopes to address some of these issues through its new Rainbow/Takatapui Advisory Roopu/Group with Panu Ti Whaiti. “The DHB remains committed to further work in this space, alongside community and primary care supports, to improve the accessibility and reach of rainbow services,” says Dr Oliver. 

And then there are the countless charities and organisations that fill the gaps wherever they can. Despite this though, Searancke says, “It is just bandaid upon bandaid.”

Rivett agrees with her, going further to say, while certain government initiatives are great most of the time – like the Ministry of Education’s (MoE) Ka Ora Ka Ako free kai for kids programme – they also have downsides. She said parents coped when their kids were at school, but during lockdown, all of a sudden they had to find food to replace this and just couldn’t make ends meet. “Sometimes handouts aren’t actually fixing the problem, but rather they are creating another problem,” she says. In this case, perhaps extending dependency. Tipene Chrisp from the MoE responded, saying “providing food outside of school is outside of the scope of the programme.” Correct, but not an answer to confused children.

Rivett says ultimately there is not enough of any service. “I have talked to everyone, even our government services, there is just not enough. I mean, what do we do about that?” 

Photo: Florence Charvin