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As in 2020, participants were particularly concerned about illnesses related to poor housing with the Raetihi community and general dampness:

"Asthma, emphysema, eczema, and that’s all from those issues of like, our homes. And that’s also the babies, eh. And sicknesses, I heard one was from mosquito bites and they thought that’s what… because these kids were always getting sick and I have heard that this can happen. So just with our dampness of our area, the mosquitoes can make you sick."
"My daughter had problems with the mould growing in our house. And ours is a newer house with double glazing. Very well insulated and we still get the black mould inside. I don’t know what it is, it seems dry inside but condensation forms on the aluminium joinery. Just the condensation at night. Even with double glazed joinery."
"There are a lot of skin complaints, school sores. Often it is hard to get rid of. Definitely the skin."

In terms of roading, one participant noted a problem with dust generated by gravel roads.

"It gets into our water. It also has a lot to do with emphysema. A lot of the old farmers from being in the dust. It’s got a lot to do with it."

Participants were also concerned about mental health. They expressed a perception that there was a lack of services available to support those living with poor mental health or mental illness, although one participant noted that people may be reluctant to seek services due to stigma and fear of discrimination:

"There's a huge problem here with mental health. Ah, we have mental health workers come up from Whanganui once a week and it's just not enough. It's the Whanganui... they come to the health centre here. And if you have someone who is suicidal, they want you to ring the police, not the ambulance service. The ambulance service doesn't have any you know, resources or training to handle that. So, it's really horrible actually. People that are suicidal know those police officers and there's no way they want a police officer at that time. We've rung before through to the help line and once they were really, really good, the other time they were really, really terrible. Made it worse. Yeah. I don't think that whole system of calling the police for a suicide, that just doesn't work. It doesn't make sense to me to call the police. It would make more sense to me that there was a dedicated team or that the ambulance service was trained in that area."
"Yeah, I'd agree with you because I had to call the police for one person. They did, they did end up going to see them, then they came back and I got the third degree! "Why did you ring us? There's nothing wrong!" You know? It just upsets you. But yeah, so, suicide is an issue and that's been brought up in other places I’ve been to."
"There’s nowhere for my mate to get a counsellor. They’ve got to go all the way to Whanganui to get a counsellor. Because there's no support. There's no counselling service."
"And the counselling service in Whanganui was shut down once due to lack of funding. (Redacted, personal name) is a trained psychotherapist and they'd be willing to come here but they can't find suitable premises to actually work out of."
"For a psychiatrist you’ve got to go to Whanganui."
"It’s pretty hard to get referrals."
"It is the naming; a lot of people won't go because of that. Once you've got that name on you, you've got it for life. So you go try to get your gun license, it's on you. Even though you’re not "mental," but you've had things that you've been through."

Primary health care was considered reasonably accessible in Raetihi, with a general practice available in the township. However, concerns were held over wait times for appointments and difficulties recruiting and retaining general practitioners. Nursing services delivered by Ngāti Rangi were considered a welcome addition to health service provision in the community:

"It's three weeks to get an appointment. Not good. I think you really have to fight to get those appointments. You actually have to get on the phone and say, "Something's not right and I’m not going to get off the phone until you either see me or see my children." Usually when you're at that point as a mum, it's because of your children."
"There's Healthline as well, that's amazing. Plus, the local doctor's service, they've got an extra person that does the injections, the vaccinations. And she's available to talk to people and help people and what have you."
"Ngāti Rangi, I've noticed, they’ve been stepping up in the last year. They're stepping up a lot. They're doing checks, all the nurses that left from here when there was a change, they've gone to Ngāti Rangi in Ohakune. They've just got nurses. Check on people, primary health care. It's good but not many people know about that either."
"They have visiting GPs occasionally. "

Concerns were held particularly relating to urgent, emergency, and after-hours access. Elderly people were thought to be particularly vulnerable in this respect:

"It's improved but it has been very difficult. They brought back one of the doctors who's nearly 80. Well into retirement and he's been brought out of retirement. There was a long period where we didn't actually have a GP in Raetihi. It's been problematic, it's improving. Triage system doesn't always work, it sort of, it's a filtering system and um, sometimes people can slip through the cracks. My daughter-in-law needed to see a GP urgently and she was kept waiting in the waiting room for a couple of hours and she did see a GP but it was established that (redacted, diagnosis). It just wasn't satisfactory."
"And the elders, from what I’ve seen, all of our elders don't want to cause an ambulance, they don't want to feel like a nuisance. We try to tell them as younger people, you're not being a nuisance. Elderly don't think like that, they’ve been taught, don't fuss about me, but it's those ones that need it."
"It's difficult in the weekends. We've had people that have had accidents. There was one occasion when I was working at the (redacted) and this woman was beside herself [...] she said, "What do I do?" because she couldn't get satisfaction from anywhere. And I said to (redacted, personal name) that they needed to sort all this out and make sure someone was available on a Saturday because we're so far away... the person could have flippin' died. If an ambulance is out on call or taking someone to Whanganui, then... there's no way. "
"The fire brigade is available in Raetihi, they're first responders, but basically if you have an accident and you are seriously injured then you should dial 111. Not try to get to the GP."
"They tend to third degree you if you’re ringing emergency and this is what happened. They third degree you as to exactly how bad it is. That's why she was put off a bit."
"But I think a lot of people worry about the money for an ambulance. They don't know that if you pay $80 a year you can get the ambulance as much as you like. We got that, having kids. They come to you, comfort you and it's somebody to tell you, especially as a young mum or with your elders, it's good to know that you've got them there. For me, I have St Johns."
"Most call outs are for heart attacks around this area, so the fire brigade are the ones that often have to go there and keep those ones alive. They do a lot. It’s quite hard on them. They have to support the ambulance and there’s only one or two in Ohakune."
"Some of them go to Taumarunui (for after-hours care) now, that's the word on the street. They've got the hospital in Taumarunui open 24/7, not nearly as busy as Whanganui, so they’d rather go there for after hours. It's closer, an easier drive."

Participants felt that there was good availability and accessibility of maternity services in Raetihi, although it was noted that many women did not birth in Raetihi due to the risks of being so far from specialist or emergency care:

"There’s two (midwives) now. But to have your baby, you can't stay here. You go to Whanganui, or wherever. You can birth here but you've got to be out. So if you've got complications a lot of people would rather have a baby in Whanganui."
"There is a birthing unit at the Waimarino Health Centre. It's only if it's, you've had no complications or if there isn't enough time. But your partner can't stay. I think they rather like to take you to Whanganui in case there is a complication."
"We still have Raetihi born babies but you can't stay here and for a first time mum it's not as... Whanganui's the best place. If you have your baby here you ring your midwife, you meet her down there and then you go home."
"They do a lot of home births too. A lot of home births, it's very common here."
"A lot of the time too, Whanganui is our closet hospital and that road to Whanganui is not the greatest. Sometimes there are airlifts."
"Sometimes women have to hold the baby, hold the baby inside while you're getting to Whanganui on the Parapara, which isn't the nicest road."
"It's closed a lot in winter especially. There are slips. It's quite scary to be pregnant, there's no cell phone reception."
"I booked a motel in Whanganui in the end. At our cost, we booked a motel rather than come back over and have a two-hour drive."
"We're lucky we haven't lost more babies than we have. I’ve talked about it with others that the ambo's aren't taught how to deliver a baby. They don't have anything on that ambulance, enough to keep that baby OK. It's quite scary. It's not the ambos’ fault but I think in a rural area, they don't get training so that's another thing that could change. "

Access to other secondary health services was accessed in some cases when specialists visited Raetihi, but mainly by travelling to Whanganui. In this case, there were public transport options available to assist:

"There's other form of transport of course is the Waimarino Health Shuttle and that will take patients to Whanganui for specialist appointments. That's a booking service, it will go every day if there's patients needing to travel. And it won't just take you to the hospital, it will take you for an eye appointment or dental. "

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