Driving Health Services Home

Historian Dr Debbie Dunsford draws parallels between New Zealand’s Covid-19 vaccination drive, and a campaign to get mobile x-ray machines to every corner of the country in the search for tuberculosis.

Driving Health Services Home

There are differences and similarities between Covid-19 vaccination efforts and earlier mass x-ray campaigns used to help fight tuberculosis outbreaks in New Zealand.

Science, technology and the disease may be new, but the nature of people has not changed so much. The health promotion techniques learned on the ground in the ‘40s and ‘50s remain relevant today – ‘Shot Bro’ buses, Māori and Pasifika health providers taking vaccinations to the people, health boards competing with each other for the most vaccinations, entertainment and giveaways – these strategies are all part of the country’s 90 percent-plus campaign for vaccination against Covid-19, and they are not new endeavours. There are many parallels with an earlier successful campaign against tuberculosis (TB) in the 1940s and ‘50s.

The New Zealand Health Department’s claim that the country had “one of the lowest rates of tuberculosis in the world” told just part of the story.
Image Description
Innoculation of Māori children whose parents had consumption (tuberculosis). Photograph taken circa 28 Jul 1950 by an Evening Post staff photographer. PAColl-0614-1: Negatives of the Evening Post newspaper, Alexander Turnbull Library.

While this might have been true for the European population, the rate for Māori was estimated to be more than 10 times higher. The Second World War and the successful mass x-ray screening of recruits for the armed forces showed the potential for mass x-ray to detect TB and break chains of transmission.

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Mobile X-Ray Unit for TB Programme stationed at Ohangai Pā, South Taranaki 1946. Collection Puke Ariki

At this time, Taranaki had very high rates of TB, especially among Māori. In 1941, the Hawera Hospital Board visited the Taranaki Māori Trust Board to discuss urgent and co-operative action. They suggested acquiring a mobile x-ray unit to take technology to the kāinga.

Taranaki kaumātua needed little convincing of the gravity of the situation and promised a substantial grant of 2,200 pounds to buy a unit for the use of everyone in Taranaki. The hospital boards funded the operation costs and agreed it was first and foremost “a Māori unit”.

In the first 12 months, the unit x-rayed 2,514 Maori and 3,666 Pakeha, visiting 26 marae and kāinga, as well as hospitals, schools and towns throughout Taranaki. The unit’s staff were eager to foster Māori interest and took on board kaumātua requests that the unit visit marae at weekends when people were not at work. When Māori themselves organised the Whanganui visits in 1948, the unit staff noticed a much higher response.

Mobile x-ray units became familiar sights across New Zealand and it’s easy to recognise promotional parallels with today’s Covid-19 campaign. The ‘shot buses’ of today were then ‘te pahi nui o te eki rei’ (the big bus of the x-ray). Leading citizens lined up to have promotional x-rays taken and units even attended events such as A&P shows. Record numbers of x-rays were proclaimed.

Visits to marae were memorable events with overnight stays, speeches in the wharenui and the sharing of food. At night, staff explained the importance of x-rays and showed films about TB. The Department of Health’s promotion of mass x-rays to the public, both Māori and Pakeha, was an attempt to merge complex information into simple public health messages.

It also seems the visits of the x-ray bus into sparsely populated and seldom visited communities were conducted with a spirt of goodwill that delivered mutual and memorable benefits. While today’s ‘Shot Bro’ buses might be able to navigate rural roads a little easier, the impact and effectiveness of their community outreach, is one learned from epidemics past.

Dr Debbie Dunsford an independent historian, researcher and writer, with experience in the history of health and medicine, oral histories and Auckland social history. A version of this article was first published on Newsroom in November 2021.