Tere Piua (second from right) says having asthma means having to worry about things many people take for granted. Photo / Supplied
For Tere Piua, breathing is anything but easy.
The busy mother of four, whaea whāngai (foster mother) of two and grandmother of three already juggles looking after her large family, managing a child care service
in Murupara and leadership responsibilities in the Cook Island community.
Due to her chronic asthma, she also has to worry about each breath she takes.
Piua hoped sharing her experiences with asthma would help change common public perceptions of people with the condition.
"They believe that you're a smoker, you're a drinker," Piua said.
"The first question I get asked is if I smoke. That really annoys me.
"I've never smoked in my entire life."
According to information from Asthma and Respiratory Foundation NZ, people with asthma have sensitive airways in their lungs.
The airways may tighten, partially close up, swell inside, and make more mucus when faced with certain triggers.
This makes it hard to breathe in, and even harder to breathe out. There is no cure.
For Piua and her children, asthma attacks have been "uncomfortable, unbearable and frightening".
"It feels like someone is stomping on your chest and squeezing your lungs.
"When I know that I'm going into an attack, I crouch in like I'm going into a fetal position."
Piua said having asthma meant worrying about "everyday things people take for granted".
"I'm very worried about the cold, changes in weather, changes in pollen.
"All of it affects my breathing. I live with this 24 hours a day."
According to the Asthma and Respiratory Foundation NZ's most recent impact report, Pacific peoples are 3.2 times and Māori are almost three times more likely to be hospitalised because of asthma than Pākehā or other New Zealanders.
Asthma mortality rates are more than three times higher for Māori and 2.7 times higher for Pacific peoples compared to other New Zealanders.
An article by Medical Research Institute of New Zealand professor Richard Beasley stated that these rates, particularly in Māori and Pacific adults, are among the highest in the world.
The statistics did not come as a surprise to Piua, whose family all suffer from serious forms of asthma, allergies, eczema and hay fever.
"I've been to hospital quite a few times," Piua said.
"The attacks always come just on the brink of winter. Right now, just talking to you I'm out of breath."
Piua said she and many of the children in her family had been prescribed "the whole traffic light" of asthma medication.
"Sometimes we fight over the ventolin [quick relief medication].
"My son's an athlete but he runs out of breath and he can't find his inhaler so he uses mine."
Piua believed asthma treatment could benefit from natural and culturally sensitive approaches which focused on the whole person.
"If we look back to our tupuna, before we even had asthma pumps, our health back then was very good.
"We were eating off the land. There were no poisons, no fizzy drink. It was all healthy.
"If it worked back then in our ancestors' days then we should be embracing that."
Piua's focus in her family is on healthy and clean eating, exercise and spiritual nourishment.
"I also try to make sure everyone remembers their medications."
Asthma and Respiratory Foundation NZ medical adviser Dr James Fingleton said Asthma Awareness Month was an opportunity to call for investment and change.
"Historic and institutional racism has affected the way services are delivered and also [patients'] willingness and ability to access support."
Fingleton also said financial difficulties could lead to people living in damp and mouldy homes and not being able to afford medical appointments and prescriptions.
The situation will not change, Fingleton said, without significant investment and focus.
"[We need] general investment in building a good severe asthma network across the country because one does not currently exist.
"That should be paired with culturally appropriate services embedded in communities with higher respiratory needs."
A Ministry of Health spokesperson said the ministry recognised asthma could have a severe impact on the quality of life of many New Zealanders.
The spokesperson said several strategies were in place to improve the health outcomes of people with asthma.
"One key element is the Healthy Homes Initiative which aims to increase the number of whānau living in warm, dry and healthy homes.
"Another important approach has been the ministry's commitment to Smokefree Aotearoa Action Plan."
The spokesperson said the ministry worked closely with community health providers to improve equity outcomes.
"Creating clinical health networks to manage long-term conditions like asthma will be fundamental to this work and to the operational structure of Health New Zealand."