‘There are still nurses who remember going by horseback to these houses’

Sunday, 14 June 2026

Clare Ward is a country doctor living and working in the far north of Aotearoa New Zealand in the Hokianga Harbour, an area sparsely populated with many health challenges. This thoughtful memoir tells the story of her 30-year working life, the people she works with and the remote and isolated landscape in which she practises. A Place to Stand introduces us to a world very different from city life, sharing what it means to work as a country doctor with the challenges and rewards inherent in that.

In A Place to Stand, country doctor Clare Ward explores what it means to be Pākehā in a deeply Māori part of the world, writing about this with respect, while also acknowledging her standing as an outsider. She says she has become immersed in the rural Māori world view, and this has profoundly changed the way she views concepts of health, medicine and life in general.

Roads

Iwitaua Road meets Ōtangaroa Road to wind its long way from west to east. At its beginning, it follows Opurehu Awa. As evening comes it becomes more mysterious and you might imagine that it leads to other times, gone now, and to dreams that blow through the grass as dandelion parachutes or the pollen of poplars. Under the shelter of darkness Hongi Hika touches his torn flesh and calculates the route that will lead him home.

Roads and pathways, like doorways, have physical and metaphorical realities. You can look at them as simply a way of getting from one place to another. But you can also notice they take you from one reality to something else. Where you are at the end of your travels is not the same as where you were at the beginning; even a short distance carries you to some new destination and to some other way of being. Roads carry the imprints of the people who have travelled on them. They take you past places you have never been and past places that are more than familiar.

There is a house on a hill. A year, maybe two years ago, two sisters lived there. One was dying, the other was looking after her. The one who was strong buried her sister and then got sick herself. Now others live in the rooms that were theirs. When you go past that hill and that house, you think of them. You think of the times you sat beside them, when your eyes saw what their parents had seen before their daughters were even thought of.

Another road follows the harbour’s edge past a culvert. It was here that a car with two women in it did not make the bend. It was not found until daylight. The road takes you into the past and carries you into a new present. It is filled with memories. It is filled with impressions.

Clare Ward peppers her writing with her photography. This is titled “Rawene spoonbills”.

The community health nurse and I used to visit an old man who lived on the other side of a river. We went by a farm road and then down to a river crossing, up on to the other side of the bank and over paddocks to where his home was. In those days the nurses all had four- wheel-drive vehicles. This was because country roads are often rugged and because access to patients’ houses can be even more furrowed. There are still nurses who remember going by horseback to these houses.

Rivers are chameleon beings. Some days there will be a sparkle of light on shallow water that runs over stones. If it has been dry for a while there will be mostly shingle. On another day the bottom will not be quite as easy to see through water that is now brown and opaque. Yet another time there will be a huge ocean-like expanse that flows over banks, paddocks, fences, roads and sometimes bridges, carrying with it all the detritus that has accumulated since the last flood.

If the river looked at all questionable, the nurse would drive her station wagon down to the edge. Then she would advance a few metres. If the water did not reach the lower door frame she kept on going, all the while testing the river’s depth and with a mind to the sogginess of the grass we were now about to cross. If the water came up to the lower door frame she would back away.

On the days when the nurse and I were not able to take the car to the house, we would cross by a swing bridge. This bridge was a few planks joined end on end with number eight wire and tied to a tree on either side. There were two other strands of wire for handholds but each plank moved independently of the next one and the bridge lurched as you crossed it. The old man’s grandchildren never gave a moment’s thought to using it, but if you were new to it or if you were nervous, it was daunting.

I remember another nurse on another bridge who would cross on hands and knees. She was a tough and experienced rural nurse, but she was unable to trust the bridge. It was a tribute to her sense of vocation that she would cross it at all; the person on the other side had no way of getting to her clinic and this was the only way they were going to get the attention they needed.

Once we were over the bridge, we crossed a paddock to get to the old man’s house. The paddock was wet and it was boggy. If we had not brought gumboots this meant carrying our shoes in our hands as well as whatever else we were going to need. It meant arriving with very dirty feet.

Not only do rural roads wind their narrow ways but they also carry traffic you would not see in urbania. In Hokianga these will be stock trucks, milk tankers, log trucks and trailers, trucks carting lime, quad bikes and sundry other vehicles. For the most part people treat other drivers with respect and speeding is not a major issue. But not always. As one man put it, “I would not like to meet myself coming up the other side of the hill.”’ At the time he was commenting on his temptation to bypass the road island at one particular T-junction.

There will be school buses and tractors to think about. There will also be the red rural delivery van, which is just as likely to be coming toward you on your side of the road as it delivers mail along both sides of the road at once.

If the weather is bad then as well as floods there will likely be slips on the road or trees will have fallen across it. Hokianga land is made of clay. It is made of clay that wants to creep its way downward. There will never be a time when there are no road works. You need to factor this in when you are deciding when to leave to catch a ferry. You also need to factor in the farmer who is taking their stock across the road at quarter to the hour when there is just quarter of an hour before the ferry is due to leave. The road is like a lumpy mattress. Or it has holes in it. Something underneath has fallen away and the tarseal is not strong enough to bridge it. If you drive too quickly you will be jolted back into caution. Today there is a place on the Mangataipā gorge road where the tarseal on one half of the road has fallen down the bank. To the north the road across the Mangamuka ranges is impassable. For as long as the work takes - in this case, over two years - it means an extra half an hour to get to Kaitāia.

Clare Ward’s photo of Otangaroa Road, where this chapter opens.

I sometimes reflect that if the world of people stopped for a year, when it woke up again most of the roads in the north would be blocked off, not by the orange road cones that are an absolute fact of life today, but by the unabated forces of nature.

If you see a road sign with a picture of a cow and the words “wandering stock”, it behoves you to slow down, especially at night when a black cow facing the other way is impossible to see until you are right on top of it. Some parts of Hokianga have more fences than others where the long acre is part of the normal grazing. Cows, horses and pigs all use the road, as do turkeys and pūkeko. And also possums, which drivers either try to avoid or try to aim for. When you hit a possum, it is a bit like hitting a brick. It is always surprising that their small soft bodies create as much of an impact as they do. When there are possums on the road, there will also be hawks that scavenge the corpses. They often seem to wait until your car is on top of one of them before they rise slowly and fly across the windscreen either with or without the possum in their grasp.

A long time ago a car hit a horse at night. The night was moonless. The driver was not thinking about what else might be on the road, like the horse that was in the middle of it. The driver and front-seat passenger were both injured. At first, the car seemed to be more badly injured than the people. But afterward the car could still drive, while the front-seat passenger died within a week or two.

Clare Ward works as a rural doctor in the Hokianga Harbour area in the far north of Aotearoa New Zealand. A Place to Stand is her first book and the photos from it are from her own collection.

When there is a lot of rain, access to the hospital can be cut off in every direction as floods block roads at Whirinaki, at Taheke and Waimā, at Te Karae and Mangamuka, at Rangiāhua and at Kaeo to the far east.

I remember one night a young woman came into the hospital with stomach cramps. She had managed to get across the harbour from Panguru. She was pregnant. There were still three months to go before her baby was due to be born. Her cramps came and went about every fifteen minutes. The night was dark but more importantly, it was windy. Not only were the roads closed but the weather was too dangerous for the helicopter to take a chance. Her baby would have weighed about a pound, or as much as a 500g block of butter. In a big-city hospital the baby might have lived, but in this place, with just elementary ways of keeping a tiny baby alive, its survival would have been fraught. The young woman’s pains subsided. The storm subsided. The baby waited for another three months before it decided on a better day to greet its new world.

A Place to Stand by Clare Ward, published by Allen and Unwin Aotearoa New Zealand, RRP $37.99. Out 16 June.

The harbour is the road between north and south Hokianga. There is a car ferry that links the two and for about thirteen hours of the day it is possible to get backward and forward. When the winds are strong and coming from the wrong direction, the ferry will close its services. People who live on the north side of the harbour will either have a very long drive around to the hospital or will need to go north to Kaitāia if they are sick or need urgent medical care. Out of hours, an ambulance or a woman in labour will get the ferry crew out of bed.

The harbour is the road of old Hokianga. Lots of people still remember going to movies or dances or school or to church by launch or small boat. Those people are old now and those little boats have their place in history.

Today the old man on the other side of the swing bridge is dead and his house has fallen down. The land stays the same. Sometimes his grandchildren come back to the places they remember and to the urupā where he lies. The poplars that anchored the swing bridge on either side have fallen into the river. Fence posts connected to other fence posts by number eight wire stand in the air above a bank that has fallen away. Even the river has changed. It takes a different course to make its way down to the harbour.

Limestone and light have turned Iwitaua Road into a ribbon of silver. From up on the hill you can see the way it snakes through paddocks and trees and disappears somewhere over there. Along its length there are gates. Gates made of wood, gates made of steel, gates that lead into grazing land, gates that lead to forest, gates that take the visitor to another doorway. When you look at the way the road shines in the light you see those who turn into familiar faces as you come close, and you see the ones that disappear into the brightness - they are the ones who were here before.

Extracted from A Place to Stand by Clare Ward, published by Allen and Unwin Aotearoa New Zealand, RRP $37.99. Out 16 June.