He aha te Mate Ehlers-Danlos? Tohutohu, Take, me te Maimoatanga

Ko te mate Ehlers-Danlos (EDS) tētahi rōpū o ngā āhuatanga kua oti te whakawhiwhi e pā ana ki ngā kiko hono o tō tinana – ko te ‘kāpia’ e pupuri ana i tō kiri, ngā hononga, ngā oko toto, me ngā whekau. Whakaarohia te kiko hono hei anga o tētahi whare; ki te kore e kaha penei i te mea e tika ana, ka taea e ngā wāhanga rerekē o tō tinana te ngoikore ake, te ngāwari rānei ki te pakaru atu i te mea noa.

He rerekē te pānga o tēnei āhuatanga ki te tangata katoa, ā, he tokomaha ngā tāngata e ora ana i te ora, i te mahi kaha me te tautoko tika me te whakahaere. Ahakoa he iti te maha, e pā ana ki te 1 i roto i ngā 5,000 o te tangata, ko te mārama ki ō tohu ka āhei te awhina i a koe ki te mahi tahi me ngā kaiwhakarato hauora kia kitea te huarahi pai ki mua.

He aha te Mate Ehlers-Danlos?

Ka puta te mate Ehlers-Danlos ina kore tō tinana e hanga pai i te collagen. Ko te collagen te anga e homai ana te hanganga me te kaha ki tō kiri, ngā hononga, me ngā whekau. Ki te kore tenei anga i hanga tika, ka taea e ia te whakahohe i enei kiko kia ngāwari ake te piko, te ngoikore rānei ki te whara atu i te mea e tika ana.

E 13 ngā momo EDS rerekē, ia momo e pā ana ki te tinana i ngā huarahi iti te rerekē. Ko te momo tino noa, ko te hypermobile EDS, e pā ana ki ō hononga, ā, ka whakahohe i a rātou kia piko rawa.

Ko te nuinga o ngā momo EDS ka tukuna i roto i ngā whānau, ahakoa ka puta pea i te wa tuatahi i te tangata kahore he hītori whānau. Ko te āhuatanga e pā ana ki te iwi katoa, ā, ka rereke ngā tohu mai i te ngawari ki te wero ake.

He aha ngā tohu o te Mate Ehlers-Danlos?

Ko ngā tohu ka pā ki a koe e whakawhirinaki ana ki te momo EDS kei a koe, engari he tohu whānui kei te kitea e te tini o te iwi. Ka ngawari pea ō tohu, kāore rānei e kitea, ka nui ake rānei te kitea, ā, ka pā ki tō oranga o ia rā.

Ko ngā tohu tino noa ko:

• Ngā hononga tino piko – Ka taea pea e koe te piko i ō hononga atu i te nuinga o te iwi, ka karangatia pea he ‘rua-hononga’.
• Te mamae o ngā hononga me te ngoikore – Ina koa i muri i te mahi, i te mutunga rānei o te rā.
• Te ngāwari o te wehe atu o ngā hononga – Ngā hononga e ngāwari ana te wehe atu, i te nuinga kahore he whara nui.
• Te kiri ngawari, te piko – Ka ngawari pea tō kiri, ā, ka piko atu i te mea noa.
• Te ngāwari o te whara – Ka taea pea e koe te whara mai i ngā tūkino iti, i etahi wā kahore e mahara ki tetahi whara.
• Ngā whara e whakaora ana i te roa – Ka roa pea te whakaora o ngā kotinga me ngā pakaru atu i te mea e tumanakohia ana.
• Te ngenge – Te ngenge ake i te nuinga, ina koa i muri i te mahi tinana.

He maha ngā tāngata e pā ana ki ngā raruraru o te pūnaha kai, te pupuhi o te ngakau, te māuiui rānei ina tū.

Ka taea e ētahi momo EDS onge te whakahohe i ngā tohu nui ake e pā ana ki tō ngakau, ngā oko toto, ngā whekau rānei. Ki te pāngia koe e te mamae nui o te uma, ngā huringa tirohanga ohorere, ngā tohu rānei e awangawanga ana, he mea nui kia rapu āwhina hauora tonu.

He aha ngā momo o te Mate Ehlers-Danlos?

E 13 ngā momo EDS e mohiotia ana, ia momo he tauira ake o ngā tohu. Ko te mārama ki te momo kei a koe ka āhei te awhina i tō rōpū hauora ki te whakarato i te tiaki me te tirotiro tika.

Ko ngā momo tino noa ko:

• Hypermobile EDS (hEDS) – Ko te momo tino noa, e pā ana ki ngā hononga me te piko nui me te mamae.
• Classical EDS (cEDS) – E pā ana ki te kiri me ngā hononga, e whakahohe ana i te kiri tino piko me te ngāwari o te tohu.
• Vascular EDS (vEDS) – Ko te momo tino kino, e pā ana ki ngā oko toto me ngā whekau.
• Kyphoscoliotic EDS (kEDS) – E pā ana ki te tuara, e whakahohe ana i te kōwhiu nui me te ngoikore o ngā uaua.
• Arthrochalasia EDS (aEDS) – E whakahohe ana i te hypermobility nui o ngā hononga me te wehe atu o ngā hononga.

He tohu tātai motuhake ia momo, ā, ka taea te whakau i ētahi mā te whakamātautau ira, engari ka taea te whakatau i ētahi atu i runga i ngā tohu hauora. Ka taea e tō tākuta te awhina ki te whakatau i te momo e pai ana ki ō tohu me tō hītori whānau.

Ko ngā momo EDS onge pea ka pā nui ake ki ngā pūnaha tinana motuhake, pēnei i tō whakarongo, ngā niho, te mahi ngakau rānei. Ko ēnei momo e hiahia ana ki te tiaki motuhake mai i ngā tohunga hauora maha.

He aha ngā take o te Mate Ehlers-Danlos?

Ko te EDS te take o ngā huringa (mutations) i roto i ō ira e whakahaere ana i te hanga collagen e tō tinana. Ko ēnei huringa ira e tuku ana i te nuinga mai i tētahi mātua, i ngā mātua rānei, ahakoa ka puta pea i te wa ohorere kahore he hītori whānau.

He ira rerekē te kawenga mō ngā momo EDS rerekē. Hei tauira, ko ngā huringa i roto i ngā ira COL5A1, COL5A2 e whakahohe ana i te classical EDS, ko ngā huringa i roto i te ira COL3A1 e whakahohe ana i te momo vascular tino kino.

Ko te nuinga o ngā momo EDS e whai ana i te tauira e kiia nei he autosomal dominant. Ko te tikanga tenei me whiwhi koe i tētahi ira kua huri mai i tētahi mātua kia whiwhi ai i te āhuatanga. Heoi, ko ētahi momo onge e hiahia ana ki te whiwhi i ngā ira kua huri mai i ngā mātua e rua.

Ki te pāngia koe e te EDS, he 50% pea te tupono o te tuku atu ki ō tamariki, ahakoa ka rerekē tenei e whakawhirinaki ana ki te momo motuhake. Ka taea e te tohutohu ira te awhina i a koe ki te mārama ki tō āhuatanga motuhake me ō kōwhiringa whakatōpū whānau.

Nōhea te haere ki te tākuta mō te Mate Ehlers-Danlos?

Me whakaaro koe ki te kōrero ki tētahi kaiwhakarato hauora ki te kite koe i ngā tohu maha e āhei ana te tohu i te EDS, ina koa ki te pā ana ki tō kounga o te ora. Ko te mohiotanga wawe ka taea te awhina i a koe ki te whiwhi i te tiaki tika me te aukati i ngā raruraru.

Whakahaere he whakatau ki te pāngia koe e:

• Te wehe atu o ngā hononga, te subluxations rānei (ngā wehe atu wāhanga).
• Te mamae o ngā hononga e kore e pai ake me te okioki.
• Te kiri tino piko e kore e hoki mai i te tere.
• Te ngāwari o te whara kahore he take mārama.
• Ngā whara e whakaora ana i te roa, ngā tohu rānei.
• Te hītori whānau o te EDS, ngā tohu rite rānei.

Rapua te awhina hauora tonu ki te pāngia koe e ngā tohu e āhei ana te tohu i te vascular EDS, pēnei i te mamae ohorere nui o te uma, te kopu rānei, ngā huringa tirohanga ohorere, ngā mamae o te mahunga nui rānei. Ahakoa he onge te vascular EDS, e hiahia ana ki te aromatawai tonu.

Kaua e manukanuka ki te ngawari o ō tohu – he tokomaha ngā tāngata e ora ana i te ora noa me te whakahaere tika. Ko te whiwhi i te whakatau ka taea te whakamarie me te awhina i a koe ki te whiwhi i te tautoko me te maimoatanga tika.

He aha ngā take morearea mō te Mate Ehlers-Danlos?

Ko te take morearea matua mō te EDS ko te whai i te hītori whānau o te āhuatanga. Mai i te nuinga o ngā momo e tukuna ana, ko te whai i tētahi mātua me te EDS e nui ake ai ō tupono ki te whiwhi i te āhuatanga.

Heoi, he maha ngā take ka pā ki te pānga o te EDS ki a koe:

• Te hītori whānau – Te whai i tētahi mātua, te teina rānei me te EDS, ngā tohu rite rānei.
• Te ira tangata – Ko ētahi tohu, ina koa te hypermobility o ngā hononga, ka kitea pea i roto i ngā wāhine.
• Te tau – Ka kitea pea ngā tohu i te wa o te taitamariki, te pakeketanga rānei.
• Te taumata mahi tinana – Ko te nui rawa, te iti rawa rānei o te mahi ka taea te whakaiti i ngā tohu.
• Ngā huringa homoni – Ko te hapu, te taiohi, te menopause rānei ka pā pea ki te kaha o ngā tohu.

He mea nui te mahara kahore te whai i ngā take morearea e tikanga ana ka whanake koe i ngā raruraru. He tokomaha ngā tāngata me te EDS e ora ana i te ora kaha, i te whakaoti pai rānei mā te ako ki te whakahaere i ō rātou tohu.

I etahi wā ka puta te EDS i roto i ngā whānau kahore he tangata atu e pā ana. Ka puta pea tenei nā te mea he ngawari ake ngā tohu o ngā whakatupuranga o mua kahore i kitea, i ngā huringa ira hou rānei.

He aha ngā raruraru pea o te Mate Ehlers-Danlos?

Ahakoa he tokomaha ngā tāngata me te EDS e whakahaere pai ana i tō rātou āhuatanga, he mea whai hua te mārama ki ngā raruraru pea kia taea ai te mahi tahi me tō rōpū hauora ki te aukati i a rātou. Ko te nuinga o ngā raruraru ka taea te whakahaere ina kitea wawe.

Ko ngā raruraru whānui ka pā atu ki a koe ko:

• Te mamae o ngā hononga – Te kore e mutu te mamae e pā ana ki ngā mahi o ia rā.
• Ngā whara maha – Ngā pakaru, ngā kī, me ngā wehe atu mai i ngā mahi noa.
• Te osteoarthritis – Te kakahu me te pakaru wawe ake o ngā hononga nā te kore e pumau.
• Te ngenge roa – Te ngenge tonu e kore e pai ake me te okioki.
• Ngā raruraru o te pūnaha kai – Ngā raruraru me te pūnaha kai, tae atu ki te gastroparesis, te reflux rānei.
• Ngā raruraru niho – Te mate ngutu, te whānuitanga o ngā niho, ngā raruraru kauae rānei.

He raruraru nui ake pea, engari he iti rawa te maha. Ka uru pea ēnei ki ngā raruraru o te waahanga ngakau, te whānui o te aorta, te pakaru whekau rānei i roto i ētahi momo EDS, ina koa te vascular EDS.

Ko te rongo pai ko te tirotiro auau me te tiaki aukati ka taea te awhina i te kite i ngā raruraru pea wawe. Ko te mahi tata atu ki tō rōpū hauora ka taea te awhina i a koe ki te whakarite i ngā raruraru me te pupuri i tō kounga o te ora.

Me pēhea te aukati i te Mate Ehlers-Danlos?

Mai i te mea he āhuatanga ira te EDS, kaore e taea te aukati i te puta. Heoi, ka taea e koe te mahi i ngā mahi maha ki te aukati i ngā raruraru me te whakahaere i ō tohu, ka taea te whakarereke nui i te pānga o te āhuatanga ki tō ora.

Arotakehia ēnei rautaki aukati:

• Te whakakori ngawari, auau – Te hanga i te kaha o ngā uaua hei tautoko i ngā hononga kore e pumau.
• Te rongoā tinana – Te ako i ngā tauira nekehanga tika me ngā tikanga tiaki hononga.
• Te kai pai – Te tautoko i ngā huringa whakaora me ngā hiahia kaha o tō tinana.
• Te moe tika – Te awhina i tō tinana ki te whakaora me te whakahaere i te mamae.
• Te whakahaere ahotea – Te whakaiti i ngā take ka taea te whakaiti i ngā tohu.
• Te tiaki rā – Te tiaki i te kiri ngoikore mai i te kino.

Ki te whakatōpū koe i tētahi whānau, ā, kei a koe te EDS, ka taea e te tohutohu ira te awhina i a koe ki te mārama ki ngā morearea me ngā kōwhiringa e wātea ana. Kāore tenei e tikanga me kore koe e whānau – he tokomaha ngā tāngata me te EDS he mātua whakamiharo e whakahaere pai ana i tō rātou āhuatanga me te ora whānau.

Ko te mohiotanga wawe me te whakauru i te nuinga ka āhei te whakaputa i ngā hua pai ake. Ki te rere te EDS i roto i tō whānau, ko te noho mataara ki ngā tohu i roto i ngā tamariki ka taea te awhina i a rātou ki te whiwhi tautoko i mua atu i te muri.

Me pēhea te whakatau i te Mate Ehlers-Danlos?

Ko te whakatau i te EDS e hiahia ana ki te aromatawai tika i ō tohu, tō hītori whānau, me te whakamātautau tinana. Kāhore he whakamātautau kotahi e taea te whakatau i ngā momo EDS katoa, no reira ka whakamahi tō tākuta i ngā tohu motuhake i whakawhanakehia e ngā tohunga i roto i te mara.

Ko tō kaiwhakarato hauora ka tīmata i te nuinga mā te:

• Te arotake i tō hītori hauora – Tae atu ki te hītori whānau me ngā tauira tohu.
• Te whakamātautau tinana – Te tirotiro i te piko o ngā hononga, te āhua o te kiri, me te tohu.
• Te whakamātautau hypermobility – Te whakamahi i ngā tauine whaimana hei ine i te piko o ngā hononga.
• Te aromatawai tohu – Te aromatawai i ngā tauira mamae, te ngenge, me ētahi atu tohu.

Mō ētahi momo EDS, ka taea e te whakamātautau ira te whakau i te whakatau. Heoi, mō te hypermobile EDS (te momo tino noa), ko te whakatau i runga i ngā tohu hauora no te mea kāore ano kia mohiotia te take ira.

Ka tuku pea tō tākuta ki ngā tohunga pēnei i ngā tohunga ira, ngā tohunga rheumatologists, ngā tohunga ngakau rānei mō te aromatawai atu. Ko tēnei huarahi whānui e whakarite ana ka whiwhi koe i te whakatau tika me te tirotiro tika mō tō momo EDS motuhake.

He aha te maimoatanga mō te Mate Ehlers-Danlos?

Ahakoa kāhore he rongoā mō te EDS, he maha ngā maimoatanga whai hua e taea te awhina i a koe ki te whakahaere i ngā tohu me te aukati i ngā raruraru. Ko te matua ko te kimi i te huinga tika o ngā huarahi e mahi ana mō tō āhuatanga motuhake.

Ko te maimoatanga e arotahi ana ki te nuinga ki te:

• Te rongoā tinana – Te whakakaha i ngā uaua i ngā hononga me te ako i ngā tauira nekehanga haumaru.
• Te whakahaere mamae – Te whakamahi i ngā rongoā, te wera, te makariri, ngā tikanga rānei hei whakahaere i te kore e pai.
• Te tiaki hononga – Ngā taonga tautoko, ngā tautoko, ngā papa rānei hei aukati i ngā whara.
• Ngā kaupapa whakakori – Ngā mahi iti te pānga pēnei i te kauhoe, te yoga ngawari rānei.
• Te rongoā mahi – Te ako ki te whakarereke i ngā mahi o ia rā hei whakaiti i te ahotea.
• Ngā rongoā – Mō te mamae, te mumura, ngā tohu motuhake pēnei i ngā raruraru ngakau rānei.

Ka uru pea tō rōpū maimoatanga ki ngā tohunga rongoā tinana, ngā tohunga rheumatologists, ngā tohunga ngakau, me ētahi atu tohunga e whakawhirinaki ana ki ō tohu. Ko tēnei huarahi rōpū e whakarite ana ka whakautuhia ngā āhuatanga katoa o tō āhuatanga.

He tokomaha ngā tāngata e kite ana ko te whakakotahi i ngā maimoatanga hauora me ngā whakarereketanga oranga e homai ana te hua pai rawa. Ko te mea e mahi ana ka rerekē mai i te tangata ki te tangata, no reira kaua e pouri ki te roa te kimi i tō mahere maimoatanga pai.

Me pēhea te whakahaere i te Mate Ehlers-Danlos i te kāinga?

Ko te whakahaere kāinga he wāhanga nui o te ora pai me te EDS. Ko ngā whiringa o ia rā e mahi ana koe ka taea te pānga nui ki te āhua o tō ngakau me tō mahi, ā, he tokomaha ngā tāngata e kite ana i te angitu nui me ngā rautaki tiaki whaiaro auau.

Ko te whakahaere kāinga whai hua e whakauru ana ki te:

• Te nekehanga ngawari o ia rā – Āhei te awhina i ngā meneti 10-15 o te whakakori tika.
• Te rongoā wera me te makariri – Te whakamahi i ngā kaukau wera, ngā putea huka rānei mō te whakaora mamae.
• Te moe hauora pai – Te hanga i tētahi taiao moe ngāwari me ngā urunga tautoko.
• Ngā tikanga whakaiti ahotea – Pēnei i te whakaaroaro, te manawa hohonu, ngā mahi ngāwari rānei.
• Te inu wai tika me te kai – Te tautoko i ngā tukanga whakaora o tō tinana.
• Te whakarite mahi – Te whakarite i te mahi me te okioki hei aukati i ngā pupuhi.

Ko te ako ki te whakarongo ki tō tinana he mea nui. I ētahi rā ka pai pea koe, ka hiahia rānei koe ki te mahi atu, i ētahi atu rā pea ka hiahia koe ki te okioki atu. E rua ngā mea noa me te EDS.

Whakaarohia te pupuri i tētahi tātai tohu hei kimi i ngā tauira i roto i te mea e awhina ana, e whakaiti ana rānei i ō tohu. Ka taea te whakamahi i tēnei mōhiohio ina mahi tahi me tō rōpū hauora hei whakarereke i tō mahere maimoatanga.

Me pēhea te whakarite mō tō whakatau tākuta?

Ko te whakarite mō tō whakatau ka taea te awhina i a koe ki te whakamahi pai i tō wā me tō kaiwhakarato hauora. Ko te whakarite pai i te nuinga ka āhei te whakaputa i ngā kōrero hua ake me te tiaki pai ake.

I mua i tō whakatau:

• Tātaihia ō tohu – Whakauruhia te wā i tīmata ai rātou, te mea e pai ake ana, e kino ake ana rānei.
• Kohikohia te hītori whānau – Ngā mōhiohio mō ngā whānau me ngā tohu rite, te EDS rānei.
• Mau mai ngā rongoā o nāianei – Tae atu ki ngā taapiri me ngā maimoatanga kore-whakahaunga.
• Whakaritehia ngā pūrongo – Tuhia te mea e hiahia ana koe ki te mohio, ki te kōrero rānei.
• Tuhinga pānga – Me pēhea te pānga o ngā tohu ki tō oranga o ia rā, ki te mahi, ki ngā mahi rānei.
• Mau mai ngā tūtohu o mua – Ngā hua whakamātautau, ngā whakaahua, ngā pūrongo rānei mai i ētahi atu tākuta.

Kaua e manukanuka ki te whai i ngā whakautu katoa, ki te whakamārama pai rānei i ngā mea katoa. Kei reira tō tākuta hei awhina i te whakakotahi i te mīharo me te arataki i a koe ki te whakahaere pai ake i ō tohu.

Whakaarohia te kawe mai i tētahi hoa whakawhirinaki, tētahi mema whānau rānei ki te whakaaro koe he mea whai hua. Ka mahara pea rātou ki ngā mōhiohio, ka whakarato rānei i te tautoko ngakau i te whakatau.

He aha te mea nui mō te Mate Ehlers-Danlos?

Ko te mate Ehlers-Danlos he āhuatanga e taea te whakahaere e pā ana ki te tangata katoa i ngā huarahi rerekē. Ahakoa ka whakaputa pea i ngā wero, he tokomaha ngā tāngata me te EDS e ora ana i te ora, i te mahi kaha rānei me te tautoko tika me te huarahi maimoatanga.

Ko ngā mea tino nui hei mahara ko te mohiotanga wawe e āhei ana te whakaputa i ngā hua pai ake, ā, he maha ngā maimoatanga whai hua e wātea ana. Ko te mahi tahi me ngā kaiwhakarato hauora mohio me te ako ki te whakahaere i ō tohu ka taea te whakarereke nui ki tō kounga o te ora.

Kāore koe i te kotahi anake i te whakahaere i te EDS. He hapori tautoko, ngā rauemi whai hua, me ngā tohunga hauora e mārama ana ki te āhuatanga. Me te manawanui, te whakatairanga i a koe, me te pūnaha tautoko tika, ka taea e koe te whakahaere pai i te ora me te EDS.

Ngā pūrongo e ui ana i te nuinga mō te Mate Ehlers-Danlos

U1: He mate kino te mate Ehlers-Danlos?

Ko te nuinga o ngā momo EDS ehara i te mate kino, ā, e ora ana te iwi i ngā oranga noa. Heoi, ko te vascular EDS (te momo onge rawa) ka nui ake te kino nā te mea e pā ana ki ngā oko toto me ngā whekau. Ahakoa me te vascular EDS, he tokomaha ngā tāngata e ora ana me te tirotiro tika me te tiaki. Ka awhina tō rōpū hauora i a koe ki te mārama ki tō āhuatanga motuhake me ētahi atu whakatūpato pea ka hiahia koe ki te tango.

U2: Ka taea te whakakori me te mate Ehlers-Danlos?

Ae, he tino whai hua te whakakori mō te nuinga o ngā tāngata me te EDS. Ko te matua ko te whiriwhiri i ngā momo whakakori tika me te mahi haumaru. Ko ngā mahi iti te pānga pēnei i te kauhoe, te yoga ngawari, te whakakori kaha rānei ka taea te awhina i te pumau i ō hononga me te whakaiti i te mamae. Ka taea e tō tohunga rongoā tinana te awhina i a koe ki te whakawhanake i tētahi kaupapa whakakori e haumaru ana, e whai hua ana hoki mō ō hiahia motuhake.

U3: Ka kino ake te mate Ehlers-Danlos i te pakeke?

E pā ana te EDS ki te iwi i ngā huarahi rerekē puta noa i ō rātou oranga. He tokomaha ngā tāngata e kite ana i ō rātou tohu e pai ake ana i te ako i ngā rautaki whakahaere pai ake, i ētahi atu pea ka kite i te nui ake o te ngoikore o ngā hononga, te mate rānei i te wā. Ko te rongo pai ko te whakahaere tika, he tokomaha ngā tāngata e pupuri ana i tō rātou kounga o te ora tae noa ki ō rātou tau maha. Ko te tiaki hauora auau me te noho kaha ka taea te awhina i te aukati i ngā raruraru.

U4: Ka haumaru te hapu me te mate Ehlers-Danlos?

He tokomaha ngā tāngata me te EDS e whai ana i ngā haputanga angitu, ahakoa he mea nui te mahi tata atu ki ngā kaiwhakarato hauora e mārama ana ki te āhuatanga. Ka taea e ētahi tohu te kino ake i te wā hapu nā ngā huringa homoni, ā, pea ka hiahiatia ētahi atu whakatūpato e whakawhirinaki ana ki tō momo EDS. Ko te kōrero ki tō tākuta me tētahi tohunga hauora whaea-pēpi ka taea te awhina i te whakarite i te haputanga haumaru rawa.

U5: Me pēhea te mohio ki te pāngia pea taku tamaiti e te mate Ehlers-Danlos?

Ka taea e ngā tamariki me te EDS te whakaatu i ngā tohu pēnei i te piko o ngā hononga, ngā whara maha, te kiri ngawari, te whara ngāwari rānei. Ka amuamu pea rātou ki te mamae o ngā hononga, ka ngenge rānei. Heoi, he maha ngā tamariki e piko ana, no reira he mea nui te titiro ki ngā tauira me te kōrero i ngā awangawanga ki tō tākuta tamariki. Ko te mohiotanga wawe ka taea te awhina i ngā tamariki ki te whiwhi tautoko tika me te ako ki te whakahaere i ō rātou tohu mai i te tamarikitanga.