Dr Jonni Koia, Research Fellow at Waikato University, is blending traditional Māori methodologies with scientific molecular cell approaches, in an exciting project to find new treatments for diabetes and other metabolic disorders. Johanna Knox finds out more.

For centuries, Māori have made medicines – for numerous ailments – from the unique native plants of Aotearoa. This mātauranga (knowledge) has been passed down through generations.

Various native trees and plants have long been known by Māori to have anti-diabetic properties – whether they help to prevent it or ease its progression or symptoms.

Dr Jonni Koia (Waikato-Tainui) is working to support and verify mātauranga surrounding rongoā (healing) from a biomedical molecular scientific point of view. Alongside this, she’s developing systems to try to ensure that mātauranga passed down, and the people who hold it, are protected from exploitation.

Anti-diabetic rākau rongoā

Dr Koia is working in collaboration with a team at the University of Auckland, led by Professor Peter Shepherd, that specialises in biomedical research on diabetes and cancer. This year, with the team, she published The Potential of Anti-Diabetic Rākau Rongoā (Māori Herbal Medicine) to Treat Type 2 Diabetes Mellitus (T2DM) Mate Huka: A Review.*

The review points out that, before European settlement, the prevalence of diabetes among Māori was low. Today, rates of type 2 among Māori are three times higher than for other New Zealanders, and the age of onset is significantly earlier. Type 2 prevalence among Māori children under the age of 15 is also increasing: “Adaptation to a western-style diet and lifestyles is thought to have contributed towards high rates of diabetes among Māori. A case study has indeed confirmed T2DM can be improved by lifestyle changes, with Māori reverting to traditional food intake and physical activity.”

The research looks closely at the anti-diabetes potentials of three taonga plants: kūmarahou, karamū, and kawakawa. Dr Koia says “Preliminary evidence is already showing us rongoā like kūmarahou and kawakawa may play a role in glucose uptake within adipocyte fat cells. That is encouraging. I am yet to test the same effects in beta islet cells, intestinal gut, and skeletal muscle.

Restoring rongoā to its place

Dr Koia says, “The kaupapa of my research is to support the work of kairongoā (rongoā Māori practitioners) and the knowledge they hold. For many reasons, but mainly political, the availability of rongoā Māori services has been a long-term issue for many.

“Rongoā Māori services ought to hold an equal place alongside western medicine in terms of funding, particularly with Te Tiriti o Waitangi obligations.”

She outlines numerous reasons for this need. “The development of western medicines has often not taken into account differences between individuals, such as genetic variance. There is growing evidence that there are genetic factors unique to Māori patients that could impact on treatment strategies. Together with anecdotal reports that Māori and Pasifika respond worse to metformin, this raises the possibility of unique genetic factors regulating these responses to medications.

“Given that Māori have been using rongoā for hundreds of years with good effect, it is possible there are gene variants or clusters of gene families common among Māori and Pasifika to enable them to process natural rākau rongoā more effectively than synthetic drugs like metformin. This is why I also believe rongoā Māori ought to be equally funded by our country’s health system: because it is what our people need in order to be well.

“I’d like to see the work conducted by our kairongoā (rongoā practitioners) accepted in mainstream health systems. Further, I’d like to see their work valued in terms of meeting present-day health needs.I would also like to see less resistance towards the acceptance of rongoā rākau in the community. Traditional Chinese medicine is more accepted in Aotearoa than our own rongoā Māori practice.

“Rongoā Māori is not an alternative therapy. It is a therapy practice that stands on its own merit, based on traditional, evidence-based knowledge systems and tikanga Māori.”

Te Reo Tipu

Alongside her research into rākau rongoā , Dr Koia has developed Te Reo Tipu, a framework for undertaking research into biomedical and bioheritage research on taonga native plants. It’s attracting interest from other researchers – and industry – already.

She says the framework safeguards mātauranga Māori and its custodians through meaningful engagement with Māori communities and by ensuring that protocols associated with kaitiakitanga, mana motuhake (self-determination), and rangatiratanga are followed.

“Te Reo Tipu is intended as a guide for kaupapa Māori biomedical and molecular cell research on rongoā Māori … It’s important that the mātauranga Māori of our taonga species is sought first-hand from Māori and not bioprospected or exploited.

“What I find the most frustrating is that there are researchers who criticise or disregard the work of our kairongoā, while at the same time conducting scientific and clinical research on our rongoā in secret.”

She says that, before doing research into the medicinal properties of native plants, “tauiwi (non-Māori) need to make the effort to find out who their local kaumātua are in the area and approach them about their research to seek consent. It is important tauiwi seek to actively and meaningfully engage with the Māori community at the whānau and marae level.

“Being Māori myself, if it’s good enough for me to ask my kaumātua about doing this research, then it should be good enough for tauiwi to ask too.”

Ka ora te whenau, ka ora te tangata

Dr Koia says her current research is based around this whakataukī, which can be translated as “if you heal the land, you heal the people”. She says, “I view health and wellbeing as an intrinsic and intimate connection between the whenua and the people of the land. If the land is healthy, the people will be healthy. If the land is sick, the people will be sick. As such, I not only seek to develop traditional kaupapa Māori biomedical research projects that address human metabolic disease using traditional rongoā Māori but I also develop kaupapa Māori molecular bioheritage research that addresses native plant disease and the potential role other rongoā taonga species may have on diseased plants.”

* https://doi.org/10.3389/fphar.2020.00935

This article first appeared in the Summer 2020 issue of Diabetes Wellness.

Captions: Kawakawa Karamū Kūmarahou PHOTOS: PHIL BENDLE COLLECTION