Immersed in Culture
It was freezing outside. The chill in the air was biting, and the ocean roared as waves crashed on the long, sandy beach. A gentle breeze blew as the sea mist coated our faces. Though it was August, it was mid-winter in New Zealand. And my family and I, including a 5-month-old and a 2-year-old, were about to ditch our warm clothes for swimsuits. And dig in, literally, at Hot Water Beach hot springs.
Hot Water Beach is on the East Coast of the Coromandel Peninsula on the North Island of Aotearoa, also known as New Zealand. The natural hot spring river becomes accessible for a soak two hours either side of low tide, when visitors come armed with a spade or small shovel and dig their own spa pool in the beach sand. The Pacific Ocean provides a scenic backdrop and cold water to temper the heat of the spring, which can reach 147 degrees Fahrenheit. Our family found ourselves in this extraordinary place over a long weekend after moving to New Zealand for a year-long work holiday in 2017.
Geothermal activity in New Zealand is responsible for a number of natural hot pools on the island nation, which is located just off the coast of Australia. New Zealand formed when the sunken continent of Zealandia was pushed up from the ocean floor when the Indo-Australian and Pacific plates collided about 25 million years ago. Since then, resultant volcanic and geothermal activity has shaped many of the nation’s geographical features and has caused major and minor eruptions, as well as earthquakes which continue to plague the country. However, the native people, the Maori, have a slightly different take on the creation of the beautiful country.
The Maori people descend from Polynesians who settled on the island approximately 700 years ago. As legend has it, Maui, a demigod, hid on his brother’s canoe, or waka, when they left to go fishing. Maui brought along an ancestral fish hook, and when the brothers were far from land, Maui jumped out and began to fish. He got a large fish on, and with the help of his brothers, hauled the fish to the surface. The brothers began to carve out portions of the fish, which created the mountains, valleys, lakes and shoreline of the North Island of New Zealand. The canoe that held Maui and his brothers formed the South Island, and the anchor, Stewart Island.
The influence of the Pacific Islands and its nations is prevalent in the North Island, and Auckland, the largest city in NZ, has the largest population of Polynesians than any other city in the world. Maori make up approximately 15 percent of the population, but Te Reo Maori, the Maori language, is one of the national languages of New Zealand, along with English and NZ Sign Language. Upon arrival to Auckland last year, our small family was greeted with “Kia Ora,” which translates to mean “Hello” or “Be well and healthy.” Our children were delighted to learn “Hongi,” the traditional Maori greeting in which people press their noses together and touch foreheads. My daughter, Greta, was entranced by a performance of a “Haka” at the Auckland museum, a traditional Maori war dance that has evolved into a demonstration of community and strength. If you have ever seen the All Blacks rugby team play, you may have seen the “Ka Mate” haka enacted by the team at the start of the game. At our children’s daycare, they were taught to count and sing in Te Reo Maori. At the library, entire sections were devoted to cultural preservation of the Maori people.
As newcomers to New Zealand, we learned to use the Maori language daily. Many place names were Maori, and we often drove along Tamaki drive in Auckland, viewed Rangitoto or Waiheke Islands across the Waitemata harbor, and we lived in the Eastern suburb Kohimarama. We began to pronounce “wh” as a “f” sound, such as “Whangamata” as “Fang-ga-ma-tah.” Our lexicon was also influenced by commonwealth nations, such as the U.K. and Australia. We have habitually changed our vocabulary and now say nappy, rubbish, jumper (for sweater), petrol, wee and pram despite returning to the U.S. One of my son’s first words was “Ta,” which is a common way to say “Thank you.”
As my husband and children and I soaked in the thermal pools at Hot Water Beach, my mind drifted to what the NZ and the Coromandel peninsula may have once been. Though still rural, I imagined the towering Kauri forests, which are large trees similar in size to the Redwoods of California, filled with large Moa (a now extinct giant flightless bird, larger than the ostrich), and traveled by kiwi birds, who crept under the silver and black ferns. In part of learning about NZ through the eyes of a child, my 3-year-old would often report back to me about flightless birds, the presence of penguins on the South Island and other animal facts after a trip to the library. Many of the species that evolved on the isolated island nation are now extinct, but one may still see Pukekos, a large swamp bird, or hear the beautiful sound of the Tui, which has a call full of complicated notes and tones. Our first month in Auckland, a lovely Tui became our alarm clock at 4:30am and reminded us that we were in a new place.
In contrast to the tranquility of natural hot pools, the urban scene in Auckland also took some adaptation. Many of the homes in the city are placed two per lot, with a “front house” and “back house.” Each plot may have room for a small yard or garden (often teeming with tomatoes, silver beet and herbs) or citrus or feijoa trees. The homes were smaller, built for warm weather, and lacked insulation. Without central heat, homes were warmed with a heat pump or heater in each room, to be turned on only when the room was occupied. Economy cars were the standard, and work fleets were made up of vans, rather than pickup trucks, to save on fuel, which could cost up to $3.80 NZ per liter (or about $9.90 USD per gallon).
While in Auckland, my husband and I both worked in health care. Jonathan had contracted to complete pediatric and sports orthopedic fellowships, and I planned to work as a general practitioner, or GP, in a clinic in the Mission Bay suburb. The practice in which I worked was staffed at any one time by a practice nurse and three physicians and was just big enough for each one of us to have a combined office/exam room. When a patient arrived for a visit, physicians would room the patient, take all vitals needed and limit each consultation to one health concern or 15 minutes maximum, whichever came first. That may mean that a patient was seen once or twice a week, or booked a longer visit if more time was needed, and it helped that GP practices and the health-care system are subsidized by the NZ government.
Patients are not required to have insurance and only pay small fees to see physicians. More complicated health concerns can be addressed in the specialist realm, but wait times for covered care can be up to four to six months to see a specialist or a few weeks to months to complete routine imaging such as ultrasound. In NZ, 100 percent of all medical care is covered for children under age 13. For anyone in New Zealand, whether permanent resident or visitor, any accident, such as a broken bone or getting the wrong vaccination or an infected bug bite, is covered under the ACC, or Accident Compensation Corporation. As a GP, government-funded services resulted in access to resources needed to solve a difficult problem or make a diagnosis, but I found that New Zealanders in general were self-reliant and realistic about outcomes and utilization of such resources which helps keep funding in place.
The socialized system in New Zealand has other programs to help allay medical costs. Children are entitled to free dental care, and there is a national support network of nurses for health and well-being through the Plunket program for all children, with additional education for parents, breastfeeding and lactation counseling, and other social services. My son had all of his well child checkups covered through this program, and our Plunket nurse, Charlotte, was available for office visits and would readily answer texts. As a GP, we worked closely with the Plunket care team, especially when a discrepancy with growth or development was noted and children were referred to our offices for evaluation. Unlike a typical pediatric practice in the U.S., where care is centralized, GPs were utilized for sick child visits or immunizations. As a doctor, I would get to see families with common conditions, like colds or strep throats, or help coordinate care for a child with other needs or who required a more specialized approach to their well-being. In the latter case, I used the public specialist system to then refer to a pediatrician. None of this would cost the patient or their family.
I often had travel consultations during my sessions with patients. Because NZ is so close to the Pacific Islands, families would come in to discuss pre-travel vaccinations or return to report tropical illness or other travel medical concerns. Many NZ residents are foreign nationals and have connections to their home countries. This made our visits quite interesting, as I would have to translate a prescription from Chinese, or French, or read doctor’s notes from Chile or Argentina (with the help of a translator). Auckland is a very international city, and I had many unforgettable interactions. For example, one morning I had a family come in with their 5-month-old baby, who was born in the Netherlands. I was glad we had booked for a half hour (extra-long) visit, because we had to translate their medical and immunization records, which were in Dutch, to determine what the child needed for vaccines and medications. Both New Zealand and the Netherlands utilized the metric system, so there was no need to translate height or weight to kilos or meters, respectively, but it was fascinating to me to interact as an American doctor with Dutch nationals in a New Zealand medical practice. This scenario was not uncommon throughout a day of consultations.
Many of the families that we met, either professionally, or socially, in New Zealand were pleased with the infrastructure. Aside from medical coverage, public works kept the country tidy and functioning. We potty trained our eldest in NZ, and I was thankful for the ubiquitous, clean public toilets available in every town. On rubbish receptacles, slogans for “Be a Tidy Kiwi” or “Take three” were posted to encourage everyone to pick up extra litter and keep NZ neat. Museums were free for NZ residents, and the library system could obtain any book available in the world on request. Most communities had a post office that also functioned as a bank, with a national “KiwiSaver” pension program partially funded by the government for retirement. Roads were well maintained, and I got used to navigating rotaries, or roundabouts, while driving on the left side of the road (thus clockwise). We saw few stop signs but rather obeyed “give way” or yield signs that helped keep busy Auckland traffic moving. When we headed to the country, national roadways were two lane only, and, depending on the geography, bridges would condense down to one lane and vehicles forced to stop to wait for others coming in the opposite direction on a major highway. Though it was a bit different than what we are used to (no super highways), the pace was a bit slower, which made sightseeing that much easier. However, in the city, vehicles only had to stop for pedestrians if they were in a designated crosswalk, so walking traffic rarely had the right of way.
Our family not only got used to driving on the left side of the road, but we also got used to a change in diet. We learned quickly to shop for seasonal fruits and veggies after our first grocery bill neared $1,000 NZD for a family of four. In the off-season, courgettes (zucchini) could cost $19 NZD/kilo, capsicums (peppers) would be $5 NZD each, and avocados up to $7 NZD each. Berries were only available in the summer, and “pumpkin” (generic for any type of squash) was only available in the fall. Tomatoes were really only affordable if they came from your own garden. These same prices were also reflected at restaurants.
Our kids thrived in our new locale, trying new foods and learning new habits. One of my favorite memories was of my daughter, who saw live New Zealand green-lipped mussels in the grocery store water tank. The mussel is a traditional Maori staple and is very affordable. While seated in the cart, she asked me, “Mummy, can we get mussels please?” And I, pleased with Greta’s willingness to try new foods, exuberantly packed up a kilo into the shopping “trolley.” When we were at home, after steaming them with lemon and garlic, we sat down to eat. As my husband and I savored the flavor, we didn’t expect our daughter to eat her mussels and then resolutely ask for more, more, more! Greta and her brother adapted easily to the kiwi lifestyle. Soon after arrival, Greta ceased wearing shoes, like most of the children in Auckland, and no longer fussed when applying sunscreen, happy to oblige with the Slip! Slop! Slap! Campaign. Due to ozone losses over the country, UV rays from the sun are not filtered as well when they hit NZ, and sunburns and sun cancers result. In fact, according to Melanoma NZ, approximately 13 people are diagnosed with melanoma in situ or melanoma every day in New Zealand. Burn time can be as short 12 minutes in the summer.
On Hot Water Beach that afternoon, we were lucky that burn time is a bit longer in the winter, but despite, we lathered up in sunscreen before taking a dip into the pools. As the sea roared over our shoulders and we felt the warm water of the pools, my husband and I looked at each other, nodded and knew that we were fortunate to have the opportunity to call New Zealand home, if only briefly. After 14 months in an amazing country, it’s nice to be home in the U.S, but we also miss the community that we were a part of in Auckland and the stunning beauty around every turn as we traveled in New Zealand. We would love to return, but, as it’s said in Te Reo Maori, “Ma Te Wa” or time will tell (and hope to see you soon).
Jillian Verby Klaucke, MD, is a family physician who now resides in Sandpoint, Idaho. She has lived and worked in New Zealand on three separate occasions since 2001 and was recently there for 14 months with her family over 2017-2018. For more information or if you have questions for Jillian, please email firstname.lastname@example.org or visit SandpointDPC.com. Ka Kite!