Womb-to-the-tomb: The doctor on Great Barrier who does it all

by Peter Malcouronne / 03 February, 2019
An edited extract from Aotea/Great Barrier: Land and People.
ivan howie great barrier island

It’s Ivan Howie’s favourite place in the world: as often as he can (though never as often as he’d like), he heads to Harataonga where he’ll sit under an old pōhutukawa with his book or, if the sun’s out, whip round the rocks for a skinny dip. Photo/Chris Morton

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Ivan Howie is Great Barrier Island’s doctor, emergency dentist, stand-in vet, wedding and funeral celebrant. He’s been hatching, matching, dispatching and patching up fellow Barrierites since 1983 – sometimes for money, often for koha and always in the spirit of egalitarianism and esprit de corps.

Their boat was just over the horizon, about 25 kilometres out, when the CB call came in. “Is there a doctor on the island?” the fisherman asked. He sounded calm, almost bored. Then: “I’ve torn my thumb off in a winch.”

They were two hours away, Dr Ivan Howie reckoned. Not ideal, but you make do out here. You improvise, you have to: you work with what you’ve got. “Get a plastic bag,” Dr Howie says. Put your fragment inside, then stick it in the slurry with the fish. We’ll see if we can patch it up.”

“Can’t. A seagull’s taken it.”

The doctor’s silent for a second. “You can imagine all the other boats listening in… everyone laughing like drains on the bridge,” he continues. “I don’t know… what do you say to that? I just told him he shouldn’t be on his boat with a gull friend.”

Oh, Doctor! Of course, he chortles to himself as dad jokers do, dark eyes dancing behind his specs. And by the way, it’s Ivan, he insists, or Dr Ivan if you must, but not Dr Howie, QSM. That’s not necessary. Not around here.

For three decades, this compact, puckish man has served Great Barrier. Half this time, he’s been its sole doctor. On an island full of stories, he’s snaffled some of the best. Like the night he delivered a baby by torchlight in front of a roaring fire. The bloke who brought his sick wife along in a wheelbarrow. The farmer who got a fishhook caught in a delicate place – and the island-wide quest for a decent set of wire cutters to get it out.

Then there was the time two motorcycles collided head-on in total darkness, an accident that could only happen on the Barrier. “Neither of them had a warrant of fitness – you didn’t have to on the island 30 years ago – and neither had working headlights. One had stopped to try to get his working again: the other was going flat-out.”

Remarkably, the riders – along with a pillion passenger – lived and the story became Barrier legend. Because there’s a lighter side to what could’ve been a horrific accident. “In those days we had no ambulance so the policeman carted them off in his Land Rover. When one of the guys got to the hospital he realised he had a broken toe. Then we remembered how much trouble the policeman had shutting the Land Rover door…”

Ivan’s eyes, twinkling, meet mine as he waits for the punchline to hit. But things can get serious real quick when you’re a hundred kilometres from a hospital. “We had someone pull a foot off in a generator. Another got caught in a windlass and ripped off his arm.” Then there was the local apiarist’s birthday party. Halfway through, with the revellers in rare form, he moved his hive to make more space. The bees swarmed…

“Suddenly there were half a dozen cars roaring down the road and disgorging multiple people onto our front lawn. There were eight people with multiple stings, a few with severe allergic reactions. It was serious and yet hilarious as they were all still in ‘party mode’.”

That was a bit of a bad buzz, Ivan says. But he means it when he says this job has brought him joy. With midwife Adele Robertson, he’s attended the birth of scores of baby Barrierites. “The babies born here belong to the community. There’s something very special about that. Everyone cares for them. Everyone feels personally connected. “We try to look after them, and vaccinate them. We fix all their cuts and bruises.

“When the time comes they may go off to secondary school, but they’ll see us in the holidays. It’s really quite charming: they like to come back later and show you their scars.” Not just kids: recently, Ivan says, a local bailed him up behind the tinned goods aisle at the Tryphena store and insisted on showing him his vasectomy scar.

“For many of our people, for good or ill, I’m the only doctor they’ve ever known,” he continues. But that’s not all: Ivan’s been an emergency dentist, installing temporary fillings, and was a pretty handy stand-in vet. As a trained Baptist pastor, he’s also a wedding and funeral celebrant. Often Ivan will be there at the end, at Tryphena Cemetery, sometimes serving as MC as people get up and tell stories that’ll go on for ages.

“Womb-to-the-tomb” service, the locals call it. “Ivan hatches, matches and dispatches.”

Great Barrier Island

As the Earth tilt changes across the year, so does the sunrise azimuth. This stunning Haratoanga Bay sunrise occurs only around mid-winter, the mist formed by cool air being funnelled down the valley. Photo/Chris Morton

Everyone on the Barrier knows the best spot. Mostly it’s near where they live: those on the island’s eastern side rhapsodise about their beach, whether it’s Medlands, Kaitoke or Whangapoua, while those on the west smile, even snort a little, recognising the subtler charms of their side elude the easily impressed. But push past the parochialism and a consensus quickly firms. Harataonga, they’ll say. You must go to Harataonga Bay.

It’s on the east coast, about halfway up, in the mountainous spine between Awana and Ōkiwi. You turn off Aotea Rd and follow a steep track that wriggles down to the sea. “It used to be awful,” Ivan says. “I remember going down there once to see a terribly burnt toddler who’d been scalded with boiling water. He was camping there with his family – just an awful accident. It was a wet night and the road was pure clay. I had this beat-up HQ Holden and wondered if I was ever going to get back up.”

Perhaps places as heavenly as Harataonga ought to be hard-won or else they’ll be overrun. It was the setting of the 2007 BBC show Castaways. “It’s supposed to be a hardship for participants,” wrote the Guardian’s Simon Mills. “Hardly. Harataonga Bay is the most idyllic, crescent-shaped Robinson Crusoe beach I have ever seen.”

We’ll get to the beach soon enough. But Ivan wants to give the grand tour, which means we start at the Overtons’, the original settler’s house 300 metres inland. “I was at the birth of a baby here once,” he says. “About 20 years ago.” The guy who lives here now looks after a 21-hectare farm with 18 Herefords and around 40 sheep. The front door’s open – there’s a half-drunk mug of tea on the porch – but no one’s home. We’ll try again on our way back.

Down at the base of a valley, walled by regenerating bush, this little homestead is a quaint nod to the motherland. There’s a Norfolk pine, a large oak and a couple of rough-fenced paddocks. “Look at that little lamb!” Ivan says. “Cute wee thing – black legs and black face. Looks like it’s wearing a jacket. Come here, little friend.”

He kneels, holds his hand out. The lamb nuzzles in. More of the menagerie emerge. “Some chooks!” the doctor says. “Why… hello there. Do you speak fowl language?” This man revels in his puns. More sheep – the mums – stroll over. A ram rumbles past. “How… rambunctious!” Ivan says. “You know I’ll never find another ewe!”

Enough! Such excesses could see Ivan, who looks awfully pleased with himself, exiled to Arid Island, the stark, stony Alcatraz that sits a kilometre off the beach. We should press on.

Past a copper-coloured creek, past pōhutukawa and a vertiginous bluff, once a great pā, now cloaked in pūriri. Ivan stops. Smiles. Looks up. Takes another few steps, then stops again. “Isn’t it glorious? You look up at this and you think you’re in the Garden of Eden. Paradise – untouched, unspoilt. But a lot of it – most of it – is recovering what was actually lost. This island was stripped, its kauri forests almost all lost.”

But now, he says, it’s morphing into Arcadia. “The regeneration in the 30-odd years I’ve been coming here has been extraordinary,” he says. “Everything’s doubled in height. Everything’s richer and more varied and we’re getting our birds back.”

More deliberating: it takes us half an hour to cover that short walk down to the beach. Here Ivan finds an old, weathered boat plank, just a few flecks of paint left, and decides it might be from the Rose Noelle, the capsized trimaran that washed up on the Barrier in 1989 after being lost for 119 days. Is he serious? It’s unclear, not that it matters: he’s already moved on. “Look at these fabulous pebbles. The shapes, the colours… the way they gleam when they’re wet. And these shells…”

Harataonga is not a large beach, perhaps 400 metres end to end, but Ivan likes to examine everything. Down the far end, just around the rocks, is a cove he often skinny-dips in, but we won’t make it that far today. Instead we’ll stop mid-beach, head up some dunes, and sit for a while under a pōhutukawa. Just contemplate.

“What’s so lovely about being here,” Ivan continues, “is that you’re aware you’re part of a wider world. This is the flight path between Claris and Ōkiwi. They come over and you look up and think ‘I’m glad I’m not going anywhere today. I’m glad I’m right here’. But it’s also nice to feel you’re in touch with the world, whether it’s yachts coming in, or those planes flying overhead.”

He’ll sometimes sit looking up at the sky, or out to sea, and realise half an hour has snuck by. He has fallen asleep here too – never for long though, just a short nap before work intervenes. “I think I like these trees as much as anything. The way they just sit right out on their own like… ‘Here I am’. They’re just massive and go out and out, and up and up. They’re perfect. I’ve taken several weddings under these.”

He reckons this might be his second-favourite tree in the world. But there’s another: a strikingly ordinary pōhutukawa back a little way, just across the bridge, on the other side of the creek. “It’s stunted, bent – it’s been blown over and is now coming away again. While not conventionally handsome, it has a certain bonsai quality. And it represents something quite symbolic to me. Coming back. A rebirth after hard times.”

Great Barrier island

Signs of Aotea’s violent volcanic origins are revealed by this tor lying north of Palmers Track, about two hours along a ridge from Hirakimata/Mt Hobson (621m), the island’s highest point. Whangapoua estuary and beach lie in the distance. Photo/Chris Morton

Ivan has a theory. It’s a tweak of the near-universally accepted maxim that people bewitched by beauty – seduced by solitude – run away to islands. In his experience, people may also have something they’re running away from.

He first came to the Barrier in 1979, invited by the Orama Christian Community. Once a fortnight, he’d fly in for three days and tend to the sick. He remembers that first foray – his plane sweeping in low over the airstrip at Ōkiwi to scatter the sheep, then landing on the second run. And then? “There was an incredible sensation of silence. Not a sound.”

That quickly changed. Ivan roared about the island on a motorbike, a tin satchel at the rear with his instruments, a chilly bag with vaccines and various potions on his back. “Clinics would be held in various halls and behind various bushes. Intravenous drip stands would be fashioned from a mānuka branch. It was all a bit primitive.”

Up until then, Ivan’s career path had been somewhat circuitous. He’d left Auckland with a Dip. Obst. from National Women’s, then studied theology. Moving south, he became a pastor and GP simultaneously in Petone. In 1980, he did a stint on the Thai border working with Cambodian refugees for World Vision. Then back to Auckland, where he was a medical officer on Rotoroa Island for the Salvation Army, while working a day a week at the Christian Care Centre in Mt Eden, and doing public-health work in Pt Chevalier. It was a dizzying range of duties, often exciting, increasingly exhausting. Was he spreading himself too thinly? Certainly Ivan found himself yearning for a community, a wider whānau to belong to. And so in 1983, after staying two months at Orama, he moved permanently to the Barrier.

Typically, he throws himself into his work. More bush clinics, more making do. Ivan’s unflappability and humour found a perfect foil in the islanders’ resourcefulness and resilience. But Ivan felt they needed more. They needed another nurse perhaps even more than a doctor.

Ivan had briefly met Leonie Taylor back on the mainland at Christian Care. “She was so good with people. Good fun. And a really, really good nurse. She was high-powered, terrifically qualified… and much, much cleverer than me.”

By chance, Leonie visited the island with a friend. Ivan convinced her to return and then asked her to join him, professionally speaking. At some point, work blurred with wooing. “I wanted to show off my island to her. You get proprietorial in some ways: you take people to a place as if it’s your own. So of course I took her to Harataonga.” Ivan and Leonie married in 1986.

At some point, he continues, you become one with the island. “You end up becoming part of it – it becomes a deep part of you. When I used to ride my motorbike, I knew where every pothole was and every rock that could knock me off my bike.”

dr ivan howie

There’s not a lot of money on the island – half its permanent residents get by on less than $18,000 a year. “You set up your practice,” Ivan says, “and charge people what they’d pay in Auckland. Then you get to know them and realise they can’t afford that. So you set up a koha system where you pay the full rate if you can, or make a donation when things are tight.” Photo/Chris Morton

Meanwhile, Ivan and Leonie’s roving clinics found a more permanent home: an old, beat-up caravan previously used for making takeaways. It had a couple of beds in it – it did the job – but it also leaked, and damaged Ivan’s textbooks. “We had it out on the front lawn. We used our lounge as the waiting room. Our kids would get coughed all over but they soon learnt.” There were other quirks with the arrangement. “We had a manual telephone line then,” Ivan remembers, laughing. “We were trying to run a medical practice on a party line that included a public phone box.”

It must’ve been maddening sharing a line with 10 other families, some tempted to hang on for a few more seconds when it wasn’t their call, just in case (and just to keep abreast of the local news). But Ivan reckons the comedic aspects of the exercise far outweighed any frustration. And there were advantages to the arrangement: the islanders would let the exchange know that Ivan had just left so and so’s house in Claris and would be home in 10 minutes. Try back then!

Still, by the mid-1980s, it was clear the island needed more. Aotea’s health-centre dream was gestating, driven by a “determined” group of islanders – that included the indefatigable Helen O’Shea. The locals raised $30,000 themselves, a serious sum then, especially on the Barrier, and the ASB Trust gave $130,000. The then-Auckland Area Health Board donated an old state house which was refurbished with the funds. Meanwhile, Ivan and Helen worked the local body politicians. Ivan recalls bailing up then-Mayor Dame Cath Tizard: “I said we were building the real Aotea Centre. She said: ‘Invite me to the opening and I’ll invite you to mine.’” This Aotea, the Community Health Centre, opened in 1990. Talk to anyone on island and it’s clear it’s still one of their great achievements. Curiously, it’s also something they talk about in the present, although it was almost three decades ago. Situated in Claris, the centre of the island, it’s the core of this community. Step inside its utilitarian walls and you see why the islanders were so proud.

Down one end is “Marie’s shop”, named after former community worker Marie Henson. There you’ll find several large boxes with second-hand clothes that everyone picks through. There are also household goods, knick-knacks, an egg beater, a saucepan. And books. It’s like a continuous garage sale, Ivan reckons. “Except there’s no charge for it, you just make a donation. It’s quite wonderful.”

Depending on the season, you’ll also find boxes of grapefruit and vegetables. Help yourself. Cut flowers just pop up on the bench.

There’s not a lot of money around here. Never has been. “You set up your practice,” Ivan says, “and charge people what they’d pay in Auckland. Then you get to know them and realise they can’t afford that. So you set up a koha system where you pay the full rate if you can, or make a donation when things are tight.” It was a very Barrier arrangement: several islanders regularly paid a little extra, effectively subsidising their less-fortunate neighbours.

“People are so generous. They’re very kind to us. They start to bring things, not so much as payment but as a kind of contribution. Marmalade, cakes, scones… smoked snapper, cabbages, wild pork or some kūmara they’ve grown. Farmers might fix my car or pull it out of the ditch with their tractors.”

From each according to their ability; to each according to their need. And that’s exactly how it should be, Ivan reckons. He says he’s in lifelong debt to the country that trained him to be a doctor and gave him these opportunities. One day he might need a little back, but for now, he’ll keep paying in.

Isn’t this Marxism writ small? Perhaps, though you suspect the contrarianism within every Barrierite’s DNA would resist any attempt to organise or formalise what they have. On this island, it just happens. It can’t be imposed or enforced – that would never work, not here.

It’s simple, Ivan says. No need to over-complicate. “I’ve always felt that people shouldn’t have to pay when they’re sick. I’d love to see this as a place where you didn’t have to have dollars – you just did things for people when they needed things.”

dr ivan howie great barrier island

Ivan’s an inveterate beachcomber. He’ll find an old plank, tell you with a smirk it’s from the Rose Noelle, the famous trimaran that washed up nearly 30 years ago, then start studying stones intently. “You look at things with new eyes,” he says. “You see the texture on that leaf. You see the pebbles on the beach: see when you put them in the water, how they shine. Their colours, their shapes…” Photo/Chris Morton

We’ve returned to his beach. Back to Harataonga – to his special place, his second-favourite tree – where he comes to read, recharge and ruminate. And, occasionally, reflect on a life that’s rarely been straightforward.

Right from the cot, Ivan’s done things differently. The child of New Zealand medical missionaries, he was born in Chefoo (now Yantai) in Shandong Province, China in 1941. When he was 18 months, his family was interned in a Japanese prison camp. It’d be a thousand days before they stepped outside its walls. Ivan’s youngest sister, Margie, was born in the camp. He remembers other things – the searchlights, sirens and dogs, being dragged outside in the middle of the night for another roll call. Counting in Japanese and bowing for the emperor.

His parents had Old Testament-levels of commitment, and the family returned to China in 1948. Ivan and his two siblings were packed off to a boarding school in Guling, Jiangxi Province and didn’t see their parents for three years. Then the Communists took power and foreigners, especially missionaries, weren’t wanted.

Ivan, 10, returned “home” to a country he hardly knew. The family settled in Epsom, Auckland, and Ivan’s dad set up a general practice on Queen St. He went to Auckland Grammar School before attending Otago Medical School in 1961.

Our narrator is keen to press on to more interesting subjects than himself. It’s not only humility: he’d much prefer to stay in the here and now and look forward than reminisce. As retirement looms, he’s contemplating the next act. He’ll be busier than ever but he can’t wait.

He’s actually been thinking about this for a while. Back in 2002 he won the Norman Mathias Prize for an exuberant essay, “Rural General Practice – A Pathway to Eldership.” “Exciting and original,” averred the Royal New Zealand College of General Practitioners’ judges. “Engagingly hypomanic yet scholarly and apt.”

Hypomanic? “A person who’s hypomanic – in this context at least – is a bit out there,” Ivan deadpans. “And it’s true I was unduly excited: I was raving on about the Barrier and its people. I find that comes very easily to me.”

The essay, just over 2000 words long, is an ebullient manifesto for a kinder, better New Zealand, one based on the Barrier. Where everyone has a part to play. Everyone helps hold the wall up. No one’s left out, no one’s left behind.

Think of the Harbour Bridge, he says. “You have two sides which frame it. Arches supporting it from above. And down below, out of sight, are the under-girders. Your elders. They’re down there quietly holding everything together.”

And “down there” is where Ivan’s heading. “In Western society we retire and we’re finished. But when you’ve grown up in a community like this, I like to think you’ve still got something to offer. The Māori are good with this – they value and honour wisdom.”

It’s a well-visited idea, one that regularly rests on the fallacy that age equals wisdom. So often it comes with the tiresome in-my-day harrumphing of the curmudgeon, the grump the world has left behind. Our doctor is not this man. “I fear I may have become a romantic anachronism,” he says, laughing.

But it’s not going to stop him. “I can assure you: I am ready to pontificate!” But he doesn’t need to: he makes a compelling case for eldership in the essay. “Instead of being cast on the scrapheap as a dependent superannuitant, as dead wood, there can be heard a ‘voice’ or ‘word’ calling each of us to be heart kauri timber instead.

“To be loved and appreciated among our people allows us each to abandon ‘peace of mind’ sought in wealth and insurances for the true ‘social security’ of our own folk among whom we have shared a lifetime. They will bury me here with my gumboots on. Rich compost I am sure.”

Read this essay – so generous, so playful, so alive – and you can’t help but smile. For it’s also a paean to people and to place: to this island and this beach perhaps most of all.

“When you bring someone to Harataonga for the first time,” he says, “it helps you see things again. It’s exciting, it’s stimulating, it’s beautiful. Picasso said, ‘Art washes away the dust from our everyday lives.’ And sometimes you need your windscreen cleared so you can look again at it.

“You see artists painting the local scenes, something you see every day. And that’s nice. But then you go along to an exhibition and you think, ‘Oooh, that’s a pretty colour.’ So you come back to the beach and you look at things with new eyes. You see the texture on that leaf. The striations in the sand. You see the pebbles on the beach: see when you put them in the water, how they shine. Their colours, their shapes. I remember finding a pebble that had a hole in it. My daughter was just starting med school. So I put a string through it and gave it to her for her birthday.”

Such a simple gesture: something a child might do. Except there’s something else going on. The Barrier diaspora is sizeable – perhaps five times its resident population have been forced to leave for work or study. So many take a part of the island and hold it close until they can return. Come home.

And this is where our host defaults back to his engagingly hypomanic self. We revisit his notion of the Barrier as “a social laboratory”.

Could you somehow organise this? I wonder. Define it. Map the DNA of the island. “Why would you want to?” he says. “It’s an informal thing. It’s clannish and it transcends money and office.”

It’s what the Greeks called koinōnia, he explains. It’s the communion of the island – and your contribution to the community. “Everyone has their part to play and at any moment, somebody is helping somebody else. But more important, they’re being helped.

“I go round to somebody’s place where mum is sick, and someone from next door or down the road is cooking a meal and looking after the kids. People identify with each other here – they merge families.”

I’d heard this next story several times before. The story of the old Claris Club. It was a crumbling, wooden building with a floor that would visibly move up and down when people danced. “We used to watch All Blacks tests there,” Ivan explains. “We’d see all this happening. And you’d see how everyone watched out for everyone’s kids. There were bunks down one end so you could put the kids to bed.” Then hit that wobbling dance floor again.

“Our patients become our friends,” he writes in the essay. “Growing up into this blurs the distinction of doctoring and healing as well as that of patient-doctor versus family relationships.”

“The Barrier is a levelling place; homo genius I call it,” he writes. The wordplay is so daggy, so Ivan, but also entirely apt. The island’s stubborn egalitarianism remains among its most enduring and endearing traits.

Writing back in 2002, he observed: “The chairwoman of our community board became the cleaner of the council chambers. The present chairman drives the rubbish truck. We happily wear each other’s cast-off clothing.”

The essay ends: “I want to build up our ecosystem here where small is still beautiful, market forces are almost unknown, competition in health care is unthinkable and esprit de corps is universal.”

Meanwhile, here on Harataonga, the sun’s sliding away. We pack up and make our way back, along the creek, over the bridge, past the favoured pōhutukawa. One more question – where does he see the Barrier in a decade’s time? “At the heart of it, there’ll be a community that’s gotten deeper and richer, and more beautifully human. So that’s my ambition. To make a contribution to that, wherever it ends up.”

An edited extract from Aotea/Great Barrier: Land and People, words by Peter Malcouronne, photography by Chris Morton (Potton & Burton, $70).

This was first published in the January 2019 issue of North & South.

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