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Tuatapere has long had to fight for its maternity services, explains former Tuatapere Hospital manager Isabel Fraser.
Tuatapere means over the ridge, or a remote place. It is 90km from Invercargill Hospital, and some patients live up to two hours' travel from Invercargill.
Since 1935, an obstetric service has been available in Tuatapere. Initially this was provided by a midwife, who was partly paid by the mother and subsidised by the base hospital.
In 1938, with the arrival of Dr E. Elder, a full obstetric service was established in the first maternity home in Bridge St, Tuatapere.
In 1953, you may be surprised to read, triplets were delivered and discharged from the Tuatapere Maternity Home.
During the 1950s and 1960s, with the baby boom, many small maternity homes were built in New Zealand. On May 10, 1958, the present maternity home was opened. This is the building used today.
The 1970s saw much new technology developed in obstetric care.
It was suggested that rural hospitals were unsafe and GPs should deliver 50 babies per year to keep up their level of expertise. During this time some small maternity hospitals did close - two being Otautau and Wyndham.
After two contested efforts, the Southland Area Health Board finally closed the Tuatapere Maternity Hospital in 1989.
Following the efforts of some people and the GP at the time, a local health committee was set up and discussed options to retain and reopen maternity services in the hospital.
Some people will remember the lime green bumper sticker "Babies are fun, have one".
The committee conducted feasibility studies, and then drafted a proposal on how local people could run the hospital professionally and efficiently.
A submission was presented to the health board and was successful on a trial basis. A public meeting was called to set up a charitable trust, the purpose being
- To provide local maternity services to suit the district
- To provide some other health services; and,
- To make optimum use of a fairly modern building.
Funding was basically from the board, on a per delivery basis, plus a maintenance fee.
An establishment grant from the local County Council enabled us to carry out minor alterations to the building so that the hospital could run efficiently.
This involved "high use" of only part of the building to save on energy, cleaning and maintenance etc costs.
A contract for funding and support services was formalised in March, 1990, and the hospital reopened on April 10,1990, under the management of the Tuatapere Hospital Trust.
Closure had been for six months. The Trust purchased the building - which had been previously leased from the board - in 1993.
We care for low-risk mothers and normal deliveries. We were able to use the local ambulance service to transfer maternity problems as they occurred to base hospital.
The Nurses Amendment Act 1990 had an impact on the hospital, allowing midwives to practise independently, without a doctor.
The trust later became regarded as a model in New Zealand for rural self-sufficiency.
This would not have happened without a team of dedicated people - 22 years of great service.
In 1992, a recreational centre for seniors was established and continues to operate weekly.
Obstetric services have been available in Tuatapere for 77 years; I consider this to be a considerable milestone for the mothers of Western Southland and their families.
In the 1970s, finance seemed to be the main issue, and the statement "don't ask them the worth of the children in human terms, or the value in human or community terms of the Tuatapere Maternity Home.
They don't seem to have much interest in that sort of thing, only money," was commented on.
Has this attitude come about again in 2012?
I was appalled to read comments from Southern District Health Board deputy chairman Paul Menzies saying service was "clinically unsafe".
The service has existed for 77 years, with safety being the prime consideration.
A high standard of care has been maintained.
The local ambulance service has provided a 24-hour service for many years.
The facility has been upgraded since 1990 to maintain a very comfortable family unit.
There are always challenging times living in a rural area to meet everyone's needs.
The Tuatapere community has always had an attitude to "rally around" to see what we can do, and does it better.
Isabel Fraser was hospital manager from 1989 to 2002.
[The board has been trying to come to an agreement with the Waiau Health Trust for maternity services in Tuatapere. Mr Menzies has said the present arrangements were not clincally safe or financially sustainable.]