Barbara Brookes

Health Education Film and the Maori: Tuberculosis and the Maori People of the Wairoa District (1952)

In 1952 Tuberculosis and the Maori People of the Wairoa District was screened for the first time. One of many health education films put into service in the twentieth century, it can be used as a lens through which to explore the way in which film in health education could be used as acculturation to new health norms. Tuberculosis and the Maori People was unique in that it was a cooperative endeavour involving the New Zealand Department of Health, the Ngati Kahungungu Tribal District Committee and the National Film Unit. This educational film acted as a harbinger of modernity in Maori communities as it pointed to the discrepancies between the way things were (poor health) and the way they could be (better health). It sought to increase the allure of engagement with modernity by suggesting that the battle against TB could be won.

In a 1954 memo to Maori Affairs, a Rotorua District Officer pleaded for a mobile plant to show 'talkie' films 'for educational purposes.' 'Films and the film industry,' the officer noted, 'are concerned as much with education as amusement.' ¹ The Officer, working in a district of New Zealand where many Maori lived, could see the advantages film offered in illuminating new ways of living. At a time when tuberculosis (TB) rates amongst Maori were much higher than amongst the Pakeha (New Zealanders of European origin) population, the need for health education was particularly pressing. Dr. Harold Turbott's 1935 study of Maori on the East Coast of New Zealand had revealed that TB was a major problem. 'Health education of the Maori,' he concluded, was 'a paramount need.' ² This concern led to the production, in 1952, of the first locally-produced educational film directly concerned with health problems of the Maori, Tuberculosis and the Maori People of the Wairoa District.

This paper examines the evolution of a unique health education film, one made in cooperation between the New Zealand Department of Health and the Ngati Kahungungu Tribal District Committee. Such cooperation between an indigenous community and a government department was unusual internationally in the 1950s and suggests how prominent Maori, engaged with mainstream New Zealand life, could set an agenda for change. ³ My argument is that educational film acted as a harbinger of modernity in indigenous communities as it was used to point to the discrepancies between the way things were (poor health) and the way they could be (better health). ⁴ Modernity was the message but was also the medium: the modern technology of the moving and talking picture conveyed messages difficult to transmit in words or writing.

Health education films in analytic context

How are we to understand and analyse health education films? They are a different genre to the fictional films that have been the focus of most scholarly work in film studies, hence there has been little interrogation of this important form of health education. Propaganda film has received most attention in studies of Nazi Germany and Ulf Schmidt's fine study Medical Films, Ethics and Euthanasia in Nazi Germany is the only monograph which takes health education film seriously. ⁵ Through an analysis of medical film policy in the National Socialist educational system, Schmidt shows how the centralised state used instructional films to 'communicate ideas of racial science' in the years 1933 to 1945. In doing so, he indicates the role that 'ordinary people'—'medical assistants, doctors and health officials'—played in legitimating state racial policies. ⁶ Schmidt's sobering study of the whole apparatus and production of Nazi medical film indicates the malignant role educational film could play in racial politics.

Tuberculosis and the Maori People of the Wairoa District, made in cooperation between Pakeha health officials, the National Film Unit and Maori community leaders, can be read as a document about racial politics of a very different kind. It indicates a time, in the late 1940s and early 1950s, when leaders in both Maori and Pakeha communities were enthusiastic about the benefits of modern medicine. Here the work of Elizabeth Lebas is suggestive. Lebas' 'When Every Street Became a Cinema' describes how the Bermondsey Borough Council's Public Health Department made some thirty films between 1923 and 1953, with titles such as Where There's Life, There's Soap and Health and Clothing, and showed them in the streets. ⁷ She argues that the films used 'collective health as a means of mediating between the political and a modern meaning of the social.' ⁸ The films represented modern meanings of social life and served as a way to integrate the working class into new urban modes of living. Lebas' insights on class relations in English health education film are particularly useful in understanding the impact of health education film but they do not address questions of cultural difference. Collections that do discuss the framing of indigenous peoples, such as Jane Marcus' Australian collection, Picturing the 'Primitif': Images of Race in Daily Life and Heather Norris Nicholson's Canadian collection Screening Culture are silent on health education film. ⁹ Sam Edwards' discussion of Maori in New Zealand film ignores the work of the National Film Unit and regards film as 'Cinematic Imperialism.' ¹⁰ Because Tuberculosis and the Maori People was a collaborative endeavour between Maori and Pakeha, it cannot be read as a frame imposed on an 'other.' The film was designed to encourage the Maori community into 'hygienic modernity,' ¹¹ a modernity that some sections of the larger community had already embraced.

Film and health education in mid–twentieth century New Zealand

The New Zealand Department of Health expressed great enthusiasm for film as an educational tool in its campaign to raise health standards in outlying Maori communities. Part of an intensification of health education work from the 1940s, the Department was keen to exploit any media to convey health messages. The campaign was driven by an optimism that, with the advent of antibiotics and greater understanding of disease patterns, infectious diseases could be conquered. ¹² Maori leaders shared the enthusiasm of Health Department officials about the potential to improve the health status of their people; they were keen to participate, on an equal footing, in the benefits of the modern nation. 'The objective of modern leaders,' noted one observer, 'is to obtain the full benefits of Modern civilization without sacrificing the major aspects of Maori communal life which involve the land, housing, language, culture and the Meeting House.' ¹³ An enthusiasm for western medicine that flourished in the early twentieth century had seen the direct engagement of Maori in Maori Councils and through training as doctors, as sanitary inspectors, and as district nurses. ¹⁴ This enthusiasm, however, had been short lived. Maori health initiatives were under-resourced and TB seemed to present an intractable problem. By the 1940s, new ways were being sought to overcome the ravages of the disease.

Film offered a means of overcoming the limitations of language in bilingual society; in some districts of New Zealand Maori was still spoken although English was the medium of instruction in schools. Visual representation was a powerful way of displaying domestic arrangements that might be foreign to the viewers. As a popular form of entertainment, film had the power to alter the relationship between the public and the private sphere. The very experience of viewing film, both a private, intimate experience and a public ritual, had an impact on communities. Alison Murray Levine has examined this impact in her study of agricultural films in France, illustrating how the films were used to project a 'modernized vision of rural life.' ¹⁵ Images could exhort and create the desire for change without the didacticism of written instruction. Displaying communities on screen had the power to exhibit their strengths—in the case of Tuberculosis and the Maori People, the pleasure of communal activities—as well as their limitations, such as poor housing.

The moving picture provided the New Zealand Health Department with a new way to social ends. The country had, in effect, two standards of health: that of the Pakeha and that of the mostly rurally-based Maori. Dr. Sylvester Lambert, the Rockefeller Foundation Representative in the Pacific, was asked to prepare a confidential 'survey of the Maori Situation' for the new Labour government which came into office in 1935. ¹⁶ Labour was committed to radical change in the health sector and keen to improve the health status of the Maori. Lambert concluded that while New Zealand was 'a world leader in controlling environmental hygiene for its European population … it lacked any preparation for dealing with the very specialized field of Maori health.' ¹⁷ The Maori birth rate was booming but this was countered by a high death rate. In 1938, the crude Maori death rate was 24.31 as opposed to a Pakeha rate of 9.71. Infant death rates, at 153.26 per thousand live births, were four times the Pakeha rate of 36.63. The Pakeha improvement in death rates from TB was not apparent amongst Maori. Typhoid fever, dysentery, and diarrhoeal and respiratory diseases also took their toll. ¹⁸ In 1940 Turbott noted that Pakeha were three times more likely than Maori to die from cancer and twice as likely to die from heart disease. 'Maori health troubles,' he noted, were 'due not to failure of physique, stamina or stock,' but arose from 'primitive living conditions' and from 'faulty personal and community hygiene' and therefore were 'happily preventable in nature.' ¹⁹

Prevention was the key to controlling disease and required the inculcation of new standards of hygiene. The Maori Social and Economic Advancement Act of 1945 created the Maori Welfare Division within the Native Department and welfare officers set about trying to improve health conditions in communities through any means at their disposal. Apart from film, both radio and print media were explored as avenues for health education. Sunday Maori news sessions on the radio devoted segments to health in 1949, and in the same year —at the behest of Peter Fraser, native minister and prime minister—tuberculosis advice leaflets were printed in Maori. By the early 1950s, however, many district staff questioned the value of this print form of health education. Deborah Dunsford's study of health education suggests that staff believed Maori speakers did not read Maori and that those who knew English, read in English rather than Maori. These views led to the discontinuation of the Maori language pamphlets. ²⁰ Film, in contrast, was seen to be a successful medium in the campaign to curb illness in Maori communities.

Film, as was well known from the popularity of the cinema, could project another way of living. The government recognised the power of film as a propaganda tool when it created a National Film Unit in 1941. Locally-made film could show the nation to itself and encourage national unity. As Margot Fry has argued, the Labour party in particular was anxious to exploit alternatives to the print media where they had received little support for their health promotion campaigns. ²¹ The Film Unit's Weekly Review, shown in commercial theatres, provided a way of reaching people throughout the country and combining political ends with entertainment. The programme in New Zealand picture houses consisted of a feature film supplemented by 'supports' or 'shorts' that included 'news reels, short comedies, cartoons, and films which describe particular items of interest or study social problems.' ²² It was these 'shorts' that could be directed towards disseminating health education.

Visual representation could act as an important strategy to advance modernisation and government departments wanted to exploit its potential to cross cultural worlds. As one research officer for Maori Affairs put it, 'The use of films for educational purposes is of great value, especially for people who do not have an expert knowledge of subjects such as health and who yet have to try to help backward people overcome their own health problems.' 'Great interest,' he continued, 'is always shown in films and they are the best single medium for reaching a large number of people.' ²³ Animation was regarded as an especially useful way of conveying information, particularly for those whom, like Maori, English was not their first language. While imported films were useful, locally-produced films had the potential to engage communities in new ways. The local people could become the stars of their own show.

As part of both the drive to advance modernisation across New Zealand, and the identified need to improve Maori health, one of the issues targeted was that of introducing medical technology and methods to many who were unfamiliar with such practices. Film was to provide an important medium for this education. Several particular problems were identified as existing in rural Maori communities. Inoculation, for example, was recorded as inducing such terror in some Hawke's Bay Maori children in the interwar period that they jumped out the school window to avoid it. ²⁴ A school medical officer was led to comment that 'one must remember that the Native children are very nervous about any measures of treatment or prophylaxis and I can quite believe that some of the less civilised would run away in terror from strangers armed with medical instruments.' ²⁵ Public health nurses requested film strips to help overcome opposition to their immunisation programme in the 1950s, claiming that 'visual propaganda of the type suggested would undoubtedly make their work easier.' ²⁶

Although postwar urbanisation made medical practices more familiar to Maori, there were still those in isolated settlements who rarely encountered medical services. Film provided an ideal way of making the unfamiliar known and, with the use of cartoons and diagrams, making explicable the process of disease in the body. As one health officer commented in 1948, 'we quite often show health films to Maori settlements re proper care & upbringing of children etc.' ²⁷ A short film on Maori development in the 1930s covered long-drop construction, vaccination, housing, water testing, doing laundry, health examination of school children, and school milk. ²⁸ A Weekly Review item on the work of an East Coast district nurse described her as 'trying to bring the health services of the city to the backblocks.' Although it was 1946, the voice-over commented, 'district nurses in areas such as this have all the spirit that the pioneers ever had.' ²⁹

We have evidence that film was reaching a large audience in Maori communities in the 1930s and 1940s—even earlier than the government's new health campaign. A 1940 study of the Maori community at Ratana revealed that the large communal building built by the community had one of its four rooms dedicated to use as a picture theatre. Films were shown every second week night and 'the majority of the village' attended. ³⁰ Subsequently, the Maori welfare officers found film to be a very useful tool. W. Herewini, the Maori welfare officer for Hamilton, requested films to take to Maori groups in the vicinity. Tuberculosis films, in particular, were important 'to drive home the seriousness of the position' but more importantly, to 'educate them in the various methods of preventing and combating the disease.' Herewini was also anxious to show films on 'the Care of Teeth, diet, personal hygiene etc.' ³¹ The Department of Health used 'a short film on the fly' in its anti-fly campaign in Wairoa in 1948. ³²

Screening films was often a source of revenue for Maori tribal committees. The 1945 Maori Social and Economic Advancement Act empowered Tribal Committees to make by-laws and impose and collect film licence fees. ³³ At Whirinaki the village hall was used for screenings arranged by an itinerant projectionist, a Mr. McMullien. McMullien came under criticism from the tribal committee since he only paid �5 to the Committee, meanwhile selling ice cream and apples 'and getting all what he can get while the opportunity is offering.' ³⁴ On the other hand, the Pukepoto and Pamapuria district committees in the north supported the application for an itinerant licence for Mr. K. Graham whose application had been opposed by local theatres. Graham took his mobile projection unit to the small settlements of Pukepoto, Pamapuria, and Oturu, saving the people from travelling to town and he paid the respective tribal committees seven shillings in the pound from the box office receipts. His recreational service, the Kaitaia Maori Affairs officer wrote, was 'greatly appreciated and desired by the people' and he had a 'high standard of programmes.' ³⁵ When Mr. G.J. Irvine applied for an Exhibitors Licence to show films in Panguru, the community of approximately a thousand people was described as 'isolated.' 'There is no theatre or other form of amusement, except possibly local dances.' ³⁶ There is thus good reason to believe that health education film would reach a wide audience in Maori settlements, which may have been all the more responsive to locally produced films since little of what they saw contained Maori characters or themes.

In order to create films that spoke specifically to New Zealanders, in 1941 the New Zealand Department of Health began annually allocating budget funds 'for the making of 16mm talkie films for instructional use' by its officers. ³⁷ Since the purchase of its first film in 1919, the Department's film library had steadily increased, containing 276 films by 1949 shown on over 3,500 occasions reaching approximately nine percent of the population. ³⁸ Maori welfare officers found film a 'method of instruction ... far more effective than talks' ³⁹ and tribal committees supported applications for licenses for exhibitors. ⁴⁰ The Health Department, particularly the enthusiast for health education, the deputy director general, Dr. Turbott, recognised that New Zealand-made films would be a particularly 'effective medium of health education' since locally-made films had 'greater audience-appeal.' ⁴¹ In 1937, when still a medical officer of health, Turbott wrote that the 'publicity and propaganda [he longed] for in the future … was visual education through appropriate films.' ⁴²

Cinema, writes Rachel Moore, is 'our one magical tool flush with animistic power to possess, enchant, travel through time and space, and bewitch.' ⁴³ This magical quality had the potential to cross cultural worlds. Traditional Maori beliefs attributed illness to punishment or withdrawal of the gods' protection. '[T]he neglect or violation of the law of tapu, whether by design or accident, caused the atua [god] to send some spirit to invade the body of the offender to a degree equivalent to the error.' ⁴⁴ Such traditional beliefs survived in new Maori religious movements such as the Ringatu faith. The refusal of one Maori community to accept medical attention led a Maori welfare officer to comment:

The belief of the adherents [of the Ringatu faith] that God alone could contribute to the recovery of the sick, was genuinely held by the Waimapu Maoris …. It was not, however a belief that could be corrected by any form of compulsion. We must convince them that there are undoubtedly benefits to be derived by calling in a doctor or a nurse in the case of illness.

The law, the officer explained, was a blunt instrument: '[I]t is necessary to make them want medical attention and want to accept it, rather than threaten them.' ⁴⁵ Welfare officers believed that showing the benefits of modern medicine on screen could promote its acceptance. Visual representation could also play into traditional beliefs in unexpected ways. A Maori elder, after seeing a Disney film flannelgraph in 1955, found validation of his own understanding of disease, commenting that he was 'delighted to see that the Pakeha had at last recognised with the Maori that diseases were caused by spirits and such little folk.' ⁴⁶ Animation clearly opened up a space which allowed his world views to be accommodated alongside those of western medicine.

Those charged with assisting health and welfare in Maori communities were enthusiastic about the potential of film. A district welfare officer wrote, in 1954:

Our tribal committees need in my opinion, more than the spoken word. The word of the preacher or the lecturer is less acceptable to the average human being, than something he can see and which penetrates the mind. This something he can see sometimes and quite often makes the recipient pause and think, and it is from these pauses and moments when men and women stop to think that good springs from. ⁴⁷

Such 'penetration of the mind' was regarded as particularly important to engage Maori people who lived in remote areas. Dr. Manahi Paewai, a Maori medical practitioner in Kaikohe, requested assistance from the minister of Native Affairs to import a film projector in May 1947. ⁴⁸ Such a projector, he claimed, would enable him to work towards 'dispelling much of the ignorance of my own people in matters pertaining to social welfare and hygiene.' Dr. Paewai commented on the success of a technicolor film show, put on by a traveler from Kodak and an American drug house representative. Their film, on 'how local anaesthetic was given in operations,' while 'not the best type of film for beginners,' had proved very useful for a group of young people since it demystified surgical operations. He hoped that obtaining a projector would allow him to show more films along educational lines in hygiene and preventive medicine. ⁴⁹ Similar enthusiasm for the educational potential of film was shown by an Anglican Minister in the King country who sought to purchase a projector to assist with educational efforts in 'such vital subjects as Hygiene, Social Studies, etc.' ⁵⁰

Developing Tuberculosis and the Maori People of the Wairoa District

In 1946, after the lifting of wartime stringencies, the Health Department decided on a policy of producing four films a year on topics ranging from 'The care of the feet' to 'Our daily food' and 'The prevention of dental decay.' ⁵¹ The following year, Cecil Holmes of the National Film Unit wrote to the deputy director of Health, Dr. Turbott, with various questions about the incidence of TB amongst the Maori, of relevance to an instructional film he was making provisionally entitled 'The wise and the unwise.' ⁵² In his reply, Turbott, an expert on the topic having surveyed the incidence of TB in the Wairoa district, pointed out the appalling death rate which was ten times higher amongst Maori compared with the European incidence. The Maori people, he suggested, failed to recognise the disease, and when they did so, failed to obtain early treatment. They also failed to persist with 'curative methods' such as 'rest, sanatorium or hospital treatment ... they get restive and want to go home too soon.' ⁵³ Turbott's 1947 advice as to the importance of fresh air, rest, and good nourishment, became the basis of the script for Tuberculosis and the Maori People of the Wairoa District.

In March 1948, Cabinet gave approval for an educational film on tuberculosis, intended for 'general distribution through New Zealand theatres for general adult education.' The estimated cost was £1,000. ⁵⁴ Turbott was 'enthusiastic' about general distribution. ⁵⁵ To tap into the nation's network of cinemas would indeed provide the Health Department with a wide audience for its health messages. Health education films were to 'be made in such as way as to permit their being included in the national Weekly Review either as whole items or as excerpts.' ⁵⁶ Such general distribution would not, however, reach those isolated Maori districts that were seen as so much in need of advice. The tuberculosis film was, therefore, to meet two needs: first, to contain a general instructional segment on TB and how it spread suitable for general distribution, and second, to specifically instruct Maori on how to prevent the disease. This dual purpose confused one Departmental officer so much that he announced to the South Island Tuberculosis Association that in fact two films were being commissioned, for separate Maori and European audiences. ⁵⁷

The dual purpose became central to the structure of the film which was planned and scripted in collaboration with Dr. R.S. Francis of Napier hospital, an 'energetic' doctor, well known for his radio broadcasts in Maori and his health talks to groups throughout the East Coast region. ⁵⁸ Francis was also the author of a booklet entitled The Control and Treatment of Tuberculosis which contained a section entitled 'The Maori and Tuberculosis.' 'Overcrowding,' 'sick cases in the home,' 'Insufficient care in hygiene,' 'Failure to Seek medical Advice,' and 'Failure to Co-operate with Chest Clinics,' 'Diet,' and 'Unwise Spending' were singled out as the causes of the high Maori TB rates. ⁵⁹ Maori were thought to have developed a 'fatalistic outlook' with regard to TB. They refused hospitalization because they regarded hospitals as 'a place to die in' and they avoided appointments for chest x-rays. ⁶⁰ Dr. Francis urged the Maori community to develop 'a real desire for improvement' ⁶¹ and the film was structured to promote such change.

Dr. Francis contributed ideas for the content of Tuberculosis and the Maori People of the Wairoa District, oblivious of cost, with the support of the Ngati Kahungunu Tribal District Executive Committee and the Taranaki Mobile X-ray Unit. Dr. Francis and C.A. Taylor, director of the Health Department's Tuberculosis Division, addressed a public meeting in Wairoa in 1949 which resulted in the formation of a Tuberculosis Association. ⁶² The cooperation of the Tribal Executive based in Wairoa was a critical move ensuring the success of the film and signifying the importance of a Maori political voice. ⁶³ Turi Carroll, a respected Ngati Kahungunu leader and a founder of the Wairoa Tuberculosis Association, narrated much of the film and, in doing so, acted as a mediator of modernity.

The film opens by introducing the ten tribal areas making up the relatively isolated district centred on Wairoa in the Hawke's Bay of the Eastern North Island. Long panning shots show the district to the people. The audience then sees the Ngati Kahungunu Tribal Executive Committee, together with the local district nurses, some of whom are Maori, assembling for the monthly Committee meeting where they view the film, 'Tuberculosis. How it spreads.' This film within the film contained the cartoon segment originally intended for general distribution. The segment insists verbally and visually that TB is not a Maori disease but rather a disease of all mankind that exists wherever overcrowding and poor living standards are found. It is humorous and instructive and it was the first cartoon ever done for the Health Department. Bob Morrow, the animator, had been trained by Disney in England and came to New Zealand in the late 1940s. ⁶⁴

Image 1: District nurses and members of the Ngati Kahungunu Tribal District Committee gather to watch a film about tuberculosis (Source: Tuberculosis and the Maori People of the Wairoa District, Archives New Zealand /Te Rua Mahara o Te K�wanatanga, Wellington).

Tuberculosis and the Maori People of the Wairoa District carried messages about healthy as opposed to unhealthy Maori lifestyles. The audience are introduced by Turi Carroll to 'Our Wairoa': the centre of ten tribal districts and also the centre for the Health Department's activity in the area. The audience are assumed to be participants as well as spectators; they are to feel ownership of what they see because they know the land, the respected elder, and possibly the patients, nurses, and doctor who appear on screen. They are appealed to as individuals who are responsible for their own living conditions.

Although the community is shown to be almost half and half Maori and Pakeha who meet and mingle at the races, it is the centres of importance to Maori that are shown: the meeting house Takitimu and the Mahia Peninsula, birth place of the Ngati Kahungunu people. As a Maori waiata (song) is chanted, the tribal districts are shown and the outlying areas are described as almost purely Maori. Viewers visit these districts with district nurses who give their side of the story of caring for TB patients. The nurses stress the importance of fresh air, plenty of fruit and vegetables, and rest. They point out the importance of isolating infectious family members in TB huts supplied by the Department of Health.

Image 2: The district nurse visits a family, where the father is living in a TB hut supplied by the government (Source: Tuberculosis and the Maori People of the Wairoa District, Archives New Zealand / Te Rua Mahara o Te K�wanatanga, Wellington).

'Poor feeding and poor housing' are identified as the main causes of TB. A Pakeha is also shown living in poor housing but, the narrator comments, 'he never stays there long. He keeps on searching until he finds a better house, somewhere his wife and children may live in healthier surroundings.' The Pakeha is at less risk of TB because he lives in less crowded conditions and 'because his wife usually feeds him pretty well.' The camera focuses on the greens, wholemeal bread, milk, liver, eggs, cheese, and 'any amount of fruit' that the Pakeha family enjoys in their modern home.

Viewers are then asked to share the doctor's point of view. Early detection of the disease, the doctor stresses, is vitally important as early detection leads to early cure. The Taranaki Mobile X-ray Unit is shown at a Marae, with Maori lining up to enter for the free service. 'Every body,' the doctor exhorts, 'should be looked into.' The x-ray procedure is demystified and described as straightforward as 'an ordinary snapshot' but more important since it revealed the state of the lungs. The camera follows all the procedures, from taking and reading the x-ray film to writing the subsequent report.

Viewers see a smiling Maori woman patient in a sanatorium which might be one outcome of the visit to the clinic, but they were reassured that a few minutes spent getting an x-ray 'may save years of suffering later on.' If a TB sufferer was cared for at home, all the family was exhorted to have regular three-monthly checks to ensure that the infection had not spread. A family is shown attending the mobile clinic with the kindly doctor carrying out the chest examination of one of the boys while the others watch. 'These parents are wise,' the doctor pronounces, because they have brought their children to be checked and are willing to follow advice. If advice was ignored, he continued, 'and the enemy TB wins, it means certain death after years of illness.'

The film explains that disease is 'a certainty in certain conditions': in overcrowded and poorly-designed housing. An important segment of the film contrasts poor makeshift housing in one settlement, Te Reinga, to the modern homes and abundant vegetable gardens in the soldier settlement of Huramua. Here the audience are shown inside a modern home and various health messages are implicit in the scenes. The kitchen is supplied with hot water and a woman is shown carefully putting a milk jug in the kitchen safe. A young girl is shown flushing the toilet cistern and carefully washing and drying her hands. The house is well-ventilated with open windows, and a woman is shown making the bed. The new houses, Turi Carroll notes, are paid for out of wages, land rents, and family benefits. Not only are the houses new and some have specially built TB porches, the people spend time growing fresh vegetables, another important health asset.

Image 3: A doctor carries out chest examinations for a family (Source: Tuberculosis and the Maori People of the Wairoa District, Archives New Zealand / Te Rua Mahara o Te K�wanatanga, Wellington)

Image 4: Correct hand washing technique on display (Source: Tuberculosis and the Maori People of the Wairoa District, Archives New Zealand / Te Rua Mahara o Te K�wanatanga, Wellington).

While the camera pans over a settlement of small and flimsy corrugated iron houses, Turi Carroll warns that the people from poorly housed areas are 'a danger to everybody since the people who live in them travel about.' He goes on to suggest that since these people owned land, there was 'no need' for them to live like that. The verbal admonition is undercut by a scene of cheerful children having great fun sliding into a river pool. 'Children,' Turi Carroll notes, 'lead the way to better health.'

Scenes with children provide joy in the film. Whether swimming, eeling, washing their hands, or awkwardly eating eel with a knife and fork, one senses their pleasure at being filmed and the desire to do as instructed even if it did not come naturally. Maori children are said to be very fortunate for unlike Pakeha children who have to take cod liver oil, Maori children can eat eel regularly 'which is nicer and cheaper.' Iwitea, famous for its eels, is said to combine 'a Maori level of community life with a Pakeha level of good health.'

Success in conquering TB depends 'on individual conduct,' viewers are told next. Sufferers were not to be blamed for having the disease, but they could be blamed for passing it on. They were to keep way from young people and children should, if possible, be given bedrooms of their own. A young boy is shown carefully washing his hands, reinforcing the earlier hand washing message. A family is pictured at breakfast, eating the important recommended variety of foods including fruit, milk, and cheese. Another message is conveyed: that children should go to school 'with a good breakfast inside.'

The enjoyment of young people playing and watching tennis provides an opportunity to reinforce messages about the necessity for sleep: 'life can be enjoyed without late nights.' Against the background of workers in a modern canning factory, young people are exhorted to seek employment in light, clean work places. 'This TB is an enemy that kills too many of our young people,' Turi Carroll concludes, 'but it is not an enemy we need fear since we know we can defeat it by better housing, better feeding, and personal care.'

There is little in the official files to suggest how the film was received apart from one report of the screening of an unspecified tuberculosis film in the Whangarei Ambulance Hall to 20 local residents which noted that the film was 'of extreme educational value to the Maori people.' ⁶⁵ The document's author reports that it was likely to have been the film that 'led to discussion for weeks afterwards' in Maori communities, confirming views that 'no other medium of education is as effective as suitable motion pictures.' ⁶⁶ The Wanganui Tuberculosis Association reported that the successful showing of health films to Maori groups in the district had 'surprised even Maori Welfare workers.' ⁶⁷

An extended production and the health education agenda

Tuberculosis and the Maori People showed Maori communities to themselves, as did the film Broken Barrier—a feature film about a romance between a Pakeha man and a Maori woman—made in the same year. There had been very few films on Maori life and those that existed, the national film library commented, were 'chiefly for tourists.' ⁶⁸ By involving the Ngati Kahungungu Tribal committee the Film Unit ensured that the health messages were presented in a format that was both accessible and entertaining. The message conveyed clearly was that individuals had to take responsibility for their bodies, hygiene, housing, and even employment conditions yet, paradoxically, the ultimate control of health lay in other hands: those of medical professionals. At the same time as validating Maori community life, the film used representation to project new ways of living that suggested greater individualisation.

Planned in 1947, Tuberculosis and the Maori People, twenty-seven minutes in length, was not completed until 1952 partly because of a shake up to the National Film Unit caused by the election of a National government in 1949 and also because of the expense entailed in making the film. Turbott had greeted the suggestion that a section of the film be in cartoon with enthusiasm: animation provided a unique tool to simplify complex ideas about disease. It also blurred the line between instruction and entertainment, using the powerful weapon of humour through the cartoon characters employed. He had not, however, been made aware of the cost. By 1950, considerable cost overruns dogged the film as the original coloured cartoon sequence was expensive. The estimated total cost of the film rose to �4,000, three times more than the original estimate. In the face of this excessive cost, Dr. Turbott decided that the film should not be completed.

The National government which came to power in 1949 shook up the government information services and transferred the National Film Unit (some members of whom were thought to have communist party affiliations) from the Prime Minister's Department to the Tourist and Publicity Department. ⁶⁹ In 1950 the National Film Unit was told to become a 'self-contained trading unit' competitive with private enterprise. The Weekly Review was to be discontinued and the animation department of the Unit closed down as soon as current work was completed. The Treasury was not prepared to support the Health Department's order for cartoons, since it understood that 'the National Film Studios are not at present in a position to undertake such work without expansion of staff and equipment.' ⁷⁰ The Health Department was frustrated by the slow progress and irregular charges from the National Film Unit and sought freedom to approach outside firms who could possibly 'give a more efficient service at less cost.' ⁷¹ The Pacific Film Unit and Neuline Film Studios were both eager to carry out work for the Department. ⁷² Soon the National Film Unit's animator, Bob Morrow, was to leave to set up Morrow Productions and join the ranks of the independents soliciting for business.

In order to save all the work that had gone into Tuberculosis and the Maori People, a thirty-five millimeter black and white film of 1600 feet, the Film Unit and the Health Department entered a series of negotiations which resulted in the Studio agreeing to compromise on �2,400 for the whole film, writing off �1,100. ⁷³ The compromises made unfortunately included replacing the animation with nonanimated drawings which, in effect, put an end to the dual purpose of the film. 'It would of course,' wrote J. Harris of the National Film Unit, 'be too crude to allow what would then become a diagram sequence to have any separate existence of its own for instruction of Pakeha audiences.' ⁷⁴ However, without animation, the drawings were necessary, as the cartoon had carried arguments 'difficult or uneconomical' to convey by direct photography yet they were essential to the film.

But loss of the film's suitability for general distribution was perhaps not such a major concession if we consider the likelihood that there was in fact a more important, yet less overt, goal in mind that would still be met. The new chemotherapy which was available for TB in the 1950s is not mentioned in Tuberculosis and the Maori People, an omission which might simply be explained by the length of time between the conception and scripting of the film and its completion. This omission may, however, have a more complex explanation in that health education messages were ultimately concerned with lifestyle issues and it was these that took precedence in the minds of the makers rather than a simple cure. In this light the film might be seen as originally having a triple purpose: straight description of the disease, the particular measures Maori could take to combat it, and Maori indoctrination into Pakeha domestic arrangements. Although the third purpose was one advocated by Maori leaders, such as Turi Carroll, at the time, the way in which it was woven into the film was necessarily covert as was the very existence of this indoctrination goal. The persuasive power of film lay in part in its entertainment value, not didacticism. Poverty lay at the heart of Maori susceptibility to TB but poverty made for depressing cinema. Health messages ultimately had to be optimistic; to succeed they needed to convince people that their destiny lay in their own hands. The film, generated by a government department, presented a carefully constructed and optimistic vision of the future.

Finally, we can gain yet further insight into the impetus behind Tuberculosis and the Maori People by considering a turn of events not long after the release of this film. By 1954 the Health Department was looking for the production of an animated cartoon sequence 'TB: how it spreads' of the kind originally envisaged for the Wairoa film for public education and they were referred to Morrow Productions. Morrow had recently completed a cartoon entitled 'A Good Lunch' for the Health Department. This message about healthy eating was intended for general distribution in the same way as the Health Department's 'How's your Smile,' shown by Kerridge Odeon Theatres in 1953. Unfortunately Kerridge Odeon and Twentieth Century Fox were not interested in distributing 'A Good Lunch' without payment. The public service which the theatre chains had performed by showing government film free of charge was being undermined by paid advertising shorts. In a letter to the Department, Bob Morrow noted: 'It is obvious we are caught between the tides.' ⁷⁵

Despite this setback, and his parlous financial state (at one point the company did not even own its principle piece of equipment, namely the camera ⁷⁶ ) Morrow produced a technicolour animated film, TB: How It Spreads and How to Prevent It, using much of the original Health Department script. In this instance the audience addressed was young Pakeha. They were exhorted to eat properly, get adequate sleep, and avoid close contact with old people who might cough over them. They too were to visit the doctor and follow his advice. Advice about housing, however, is notably absent. It is uncertain what distribution this film had but the National Film Unit once more found a national audience for TB with the 1957 Pictorial Parade feature 'Health - Success Story' conveying the news that early detection, mass x-ray, chemical drugs, and antibiotics had emptied beds of TB sufferers. For this national success story, they felt no need to display the conditions of poverty that continued to make TB, and other diseases, pressing problems for Maori.

Conclusion

Film was used extensively for health education over the second half of the twentieth century. In New Zealand and elsewhere the power of film to literally frame disease was taken up and exploited by those at the forefront of health education and it was used as a form of acculturation to new health norms. Film held out the promise of transforming individual health practices with the result that the individual body would be integrated into a wider health transformation of the social body. Tuberculosis and the Maori People was a unique attempt to incorporate the indigenous community into a film about their major health problem.

Film, as Walter Benjamin observed, extended the viewer's 'comprehension of the necessities which rule [their] lives,' in this case, the didactic messages which projected new necessities in terms of housing and good food in particular. On the other hand, film 'manages to assure us of an immense and unexpected field of action.' ⁷⁷ That field of action here was an engagement with modernity. Maori leaders such as Turi Carroll regretted that some Maori were happy living in what, by the 1950s, were regarded as substandard conditions. Maori Affairs officers were concerned that refusal to engage with modernity, as was the case with isolated Maori at Waimapu Pa, could lead to unnecessary deaths. 'We must convince them' said Mr. Rewiti, 'that there are undoubtedly benefits to be derived by calling a doctor or a nurse in case of illness.' ⁷⁸ The modern technology of film became an important means of conveying the benefits of western medicine in traditional communities.

Tuberculosis and the Maori People, in trying to enact change in the Maori lifestyle in order to combat TB, utilised a strategy which, ironically, constituted the exact conditions which would interfere with the success of this public health initiative. It attempted to smooth over the disjunction between the traditional (Maori life) and the modern (European civilisation) through Turi Carroll's narration, suggesting what was thought would be an appealing goal of 'a Maori level of community life with a Pakeha level of good health.' However, creating this ideal required an assumption of the existence of one 'Maori level of community life,' which was visually belied by the film itself in conveying very different conditions in various Maori communities. Furthermore, not everyone within Maoridom shared Turi Carroll's enthusiasm for engagement with Pakeha modernity. ⁷⁹ Despite these misunderstandings, however, Tuberculosis and the Maori People did have some success in increasing the allure of modern engagement through its more simple and direct message—by suggesting that the battle with TB, which wrought such destruction on Maori communities, could be won.

University of Otago

Acknowledgements

My thanks to those who commented on versions of this paper at the New Zealand Historical Association conference, at the Centre for the Study of Health and Society, University of Melbourne, at the Otago University 'Health and Hybridity' seminar and, in particular, to my colleagues at the University of Otago. Many thanks also to the anonymous reviewers for their helpful suggestions.

Notes

^1.Memo from the assistant district officer, Rotorua to the secretary, Deptartment of Maori Affairs, 25 February 1954, AA MK 869 660a 19/1/81, Archives New Zealand, Wellington (hereafter ANZ).

^2. H.B. Turbott, Tuberculosis in the Maori, East Coast, New Zealand (Wellington: Government Printer, 1935), 21.

^3. Turi Carroll, who played a large part in Tuberculosis and the Maori People of the Wairoa District, strongly believed that he should 'use skills and knowledge gained in the Pakeha world for the benefit of the Maori.' He was active in a number of community associations including the Wairoa Hospital Board. A leader in the Ngati Kahungunu community, in 1962 he was elected president of the New Zealand Maori Council of Tribal Executives. Turi Carroll was knighted in 1962. (Jinty Rorke, "Carroll, Turi, 1890–1920,"The Dictionary of New Zealand Biography, vol. 4 (Auckland: Auckland University Press/ Bridget Williams Books, 1998): 91–2.)

^4. My thanks to my colleague, Mark Seymour, for this observation.

^5. Ulf Schmidt, Medical Films, Ethics and Euthanasia in Nazi Germany: The History of Medical Research and Teaching Films of the Reich Office for Educational Films/Reich Institute for Films in Science and Education, 1933–1945 (Husum, Germany: Matthiesen Verlag, 2002).

^6. Ibid., 23.

^7. Elizabeth Lebas, "'When Every Street Became a Cinema': The Film Work of Bermondsey Borough Council's Public Health Department, 1923–1953," History Workshop Journal 39 (1995): 42–66.

^8. Ibid., 45.

^9. Jane Marcus, Picturing the 'Primitif': Images of Race in Daily Life (Canada Bay, NSW: LhR Press, 2000); Heather Norris Nicholson, Screening Culture: Constructing Image and Identity (Lanham: Lexington Books, 2003).

^10. Sam Edwards, "Cinematic Imperialism and Maori Cultural Identity," Illusions 10 (1989):17–21.

^11. ThissuggestivephrasecomefromRuthRogarski, This suggestive phrase come from Ruth Rogarski, Hygienic Modernity: Meanings of Health and Disease in Treaty-Port China (Berkeley: University of California Press, 2004).

^12. Deborah Dunsford, "Don't spit! The New Health Education in Post-war New Zealand" (paper presented at New Zealand Historical Association Conference, Auckland, December 2005), courtesy of the author/presenter.

^13. D.I. Sinclair, "The Problem of tuberculosis in the Maori," (Preventive Medicine Research Essay, University of Otago, 1948), 77.

^14. Maui Pomare graduated in Medicine from the American Missionary College in Chicago in 1899 followed by the New Zealand-trained Peter Buck (Te Rangi Hiroa) who graduated from Otago in 1904 and Tutere Wi Repa (Otago, 1908). The careers of these men and other initiatives in Maori health are discussed in Derek Dow, Maori Health & Government Policy (Wellington: Victoria University Press/Historical Branch Dept. of Internal Affairs, 1999), chapters 3 & 4.

^15. Alison Murray Levine, "Projections of Rural Life: The Agricultural Film Initiative in France, 1919–1939," Cinema Journal 43, no.4 (2004): 76–95, 90.

^16. Dow, Maori Health and Government Policy, 157.

^17. Ibid., 161.

^18. H.B. Turbott, "Health and Social Welfare," in The Maori People Today: A General Survey, edited by I.L.G. Sutherland (Wellington: New Zealand Institute of International Affairs & the New Zealand Council for Educational Research, 1940), 230–31.

^19. Turbott, "Health and Social Welfare," 233.

^20. Dunsford, 3.

^21. Margot Fry, "Servant of Many Masters: A History of the National Film Unit of New Zealand, 1941–1976," (MA thesis, Victoria University of Wellington, 1996).

^22. "Report of the Motion-Picture Industry Committee," Appendices to the Journals of the House of Representatives, I-17, 1950, 6.

^23. Memo for chief clerk, 12 October 1955, "Use of films in health education," AAMIC 869 660a 19/1/81, ANZ.

^24. A.G. Paterson, director, Division of School Hygiene to Dr Larke, school medical officer, 24 September 1924, "Medical Inspection of Schools, Hawkes Bay 1921–1938," H1 8813 35/40/1, ANZ. My thanks to Jennifer Halder for drawing this and the following reference to my attention.

^25. School medical officer to the director of school hygiene, 26 September 1924, "Medical Inspection of School, Hawkes Bay 1921–1938," H1 8813 35/40/1, ANZ.

^26. Public Health nurses from Whangarei, 8 July 1955, "Health Education Film Strips," H1 box 2220 34/3/6 32907, ANZ.

^27. Memo, Maori Affairs, AA MK 869 660a 19/1/81, ANZ.

^28. Maori Development in the 1930s, no. 27702, New Zealand Film Archive, Te Anakura Whitiahua, Wellington [hereafter NZFA].

^29. 'East Coast District Nurse,' Weekly Review 257, 1946, no. 747, NZFA.

^30. J.P. Broad and J.S. Steven, "A General Survey of Ratana," (Fifth Year Preventive Medicine Research Essay, University of Otago, 1940), 49.

^31. W. Herewini to the controller, Maori social and economic advancement, 9 August 1948, MA Acc 2490 Box 74 36/3, pt 1 health/hygiene 1932–1956, ANZ.

^32. Health Department Memo, MC Acc W2490 Box 74 36/3, part 1 health/hygiene 1932–1956, ANZ.

^33. Maori Affairs Memo, AA MK 869 660a 19/1/81, ANZ.

^34. The Committee wanted to increase their charge to �15. See Maori Affairs Memo, 2 June 1949, AA MK 869 660a 19/1/81, ANZ.

^35. Kaitaia Department of Maori Affairs to Controller Social and Economic Advancement, 31 May 1948, AA MK 869 660a 19/1/81, ANZ.

^36. Letter from T. Ropiha, Under Secretary Maori Affairs to Director of Explosives, re application for an Exhibitor's License, 13 January 1949, AA MK 869 660a 19/1/81, ANZ.

^37. Turbott to Information Section, Prime Minister's Department, 2 November 1948, H1 25860 34/3/7, ANZ.

^38. Derek Dow, Safeguarding the Public Health: A History of the New Zealand Department of Health (Wellington: Victoria University Press, 1995), 168.

^39. Mrs T. Trotman, welfare officer, Memo, AA MK 869 660a 19/1/81, Part 2, ANZ.

^40. For example, letters from the Pukepoto and Pamapuria Committees, Kaitaia Department of Maori Affairs to controller, social and economic advancement, 31 May 1948, AA MK 869 660a 19/1/81, ANZ.

^41. Memo from Health Department to minister of Finance, 24 May 1950, H1 25860 34/3/7, ANZ.

^42. Memo from Dr H.B. Turbott to the director-general of Health, 24 December 1939, 88/95-2/pt. 1, Alexander Turnbull Library, Wellington.

^43. Rachel O. Moore, Cinema as Modern Magic (Durham: Duke University Press, 2000), 163.

^44. Bronwyn Elsmore, Mana from Heaven. A Century of Maori Prophets in New Zealand (Auckland: Reed Books, 1999), 81.

^45. Report of Maori Welfare Officer, 18 January 1950, MC Acc W2490 Box 74 36/3, part 1 health/hygiene 1932–56, ANZ.

^46. Report of speech of Manu Winiata speaking at a nurses conference, H1 25860 34/3/7, ANZ.

^47. Memo from the assistant district officer, Rotorua to the secretary, Department of Maori Affairs, 25 February 1954, AA MK 869 660a 19/1/81, ANZ.

^48. Manahi Nitama Paewai, of Rangitane and Ngati Kahungunu descent, graduated MBChB from Otago University in 1945. Following graduation he worked for two years at Auckland Hospital. In 1947 he briefly worked as a locum for Dr. G.M. Smith in the Hokianga before he moved to Kaikohe to begin general practice. Manahi Paewai, "Paewai, Manahi Nitama,1920–1990," Dictionary of New Zealand Biography, vol. 5 (Auckland: Auckland University Press/Department of Internal Affairs, 2000): 385–6.

^49. Dr. M.N. Paewai to minister of Native Affairs, 15 May 1947, AA MK 869 660a 19/1/81,ANZ.

^50. L.F. Allison to Peter Fraser, 16 September 1938, AA MK 869 660a 19/1/81, ANZ.

^51. Turbott to Information Section, Prime Minister's Department, 2 November 1948, H1 25860 34/3/7, ANZ.

^52. Ibid.

^53. Ibid.

^54. Ibid.

^55. Prime Minister's Office to the National Film Unit, 13 December 1948, AA PG Acc W3435 3/3/4, part 1, ANZ.

^56. Ibid.

^57. Report of Meeting of South Island Tuberculosis Association, Christchurch Press, 6 December 1948, H1 25860 34/3/7, ANZ.

^58. Athol Wells, 'Tuberculosis in New Zealand Maoris,' in History of Tuberculosis in Australia, New Zealand and Papua New Guinea, edited by A.J. Proust (Canberra: Brolga Press, 1991), 101.

^59. R.S.R. Francis, The Control and Treatment of Tuberculosis (Wellington: Government Printer, Wellington, 1949, reprint 1955).

^60. Broad and Steven, 78–9.

^61. Francis, 45.

^62. Report of a Public Meeting, H1 45424 64/15/1, Wairoa Hospital 1927–1964, ANZ.

^63. Involvement of the indigenous community in this was unlikely to have taken place in Australia in the 1950s. (Comment by Ian Anderson when I gave a version of this paper to the Centre for the Study of Health and Society, University of Melbourne, 2002.)

^64. Michael Walker, Levin, telephone interview with author, Dunedin, 26 October, 2001.

^65. Report from the Tokerau District, April 1956, AA MK 869 660a 19/1/81, part 2, ANZ.

^66. Memo from the Auckland Office of Maori Affairs, AA MK 869 660a 19/1/81, ANZ.

^67. 6^th Meeting of the New Zealand Federation of TB Associations,18 October 1955, AA MK 869 660a 91/1/81, ANZ.

^68. National Film Library to secretary, Maori Purposes Board Fund, 16 March 1953, AA MK 869 660a 19/1/81, ANZ.

^69. Geoffrey Churchman, ed., Celluloid Dreams, A Century of Film in New Zealand (Wellington: IPL Books, 1997), 57.

^70. Memo for minister of Finance, 24 May 1950, H1 25860 34/3/7, ANZ.

^71. Memo to director general of Health, H1 25860 34/3/7, ANZ.

^72. Roger Mirams to the Health Department, 4 February 1948; J.N. Kirk and Selwyn Toogood to the Health Department, 23 February 1949, H1 25860 34/3/7, ANZ.

^73. Memo for director general of Health, 28 November 1950, H1 28560 34/3/7 films, ANZ.

^74. J. Harris, Memo on Production History of TB and the Maori People, AA PG Acc W3435 3/3/4, part 1, ANZ.

^75. Morrow to W.I. Walter, Health Education Committee, Department of Health, H1 28560 34/3/7, ANZ.

^76. Memo for deputy director from Department of Health, 21 December 1951, H1 25860 34/3/7, ANZ.

^77. Harry Zohn, trans., Illuminations by Walter Benjamin (New York: Schocken, 1969), 236, cited in Rachel Moore, Savage Theory: Cinema as modern magic (Durham: Duke University Press), 42.

^78. Report by Maori Welfare Officer, 18 January 1950, Acc W2490 Box 74 36/3, part 1 health/hygiene 1932–1956, ANZ.

^79. By the mid-1960s, Turi Carroll's leadership of the New Zealand Maori Council was seen by younger urban Maori leaders as 'increasingly problematic and overly accepting of Pakeha goals' (Rorke, 92).

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