Kāeo's decade-long boil-water notice raises health concerns
In July 2015, Northland's Medical Officer of Health issued a boil-water notice because of levels of E. coli bacteria found in the water.
That notice had never been lifted.
Kāeo Water supplies just under 30 customers – a mix of homes, businesses and public facilities such as the toilets and community hall – on State Highway 10, the town's main street.
Rather than face the cost of constantly boiling water, the Valentines have rigged up a tank for catching rainwater and every day they use it to fill up bottles for drinking water.
Valentine said she had organised public meetings and lobbied the council in the past, but little had changed.
'The water needs to be drinkable out of the tap, for the kids that go to the community hall, and the people coming through town. They don't know that it's not drinkable. The businesses in town, a lot of them have installed their own rainwater tanks because they just can't rely on the water.'
Kāeo chef Anna Valentine says her children have never known what it's like to drink out of a tap. Photo / RNZ
Until the year 2000 Kāeo's water supply was owned by the Far North District Council.
The council sold it to Doubtless Bay Water, which quit in 2008, saying it was not economically viable.
It was then taken on by Wai Care Environmental Consultants.
Kāeo Water operator Bryce Aldridge said it was difficult keeping up with ever-changing drinking water standards, especially for a small scheme like Kāeo's.
'And the Government's not assisting with the upgrading that's needed to meet those standards, because of the size of plant that we are.'
Aldridge said he had never put up the price of water, and only a small minority complained about the quality.
'It's actually only one client … I have spoken to the other clients, and this is their fear [if the system is upgraded]: the water price going up, and the battle of having to put fluoride in our water, so a boil water notice actually protects us there.'
The Ministry of Health has recently ordered the Far North District Council to add fluoride to its Kerikeri and Kaitāia town water supplies, but a spokesperson told RNZ the ministry did not order fluoridation of privately-owned water supplies.
Aldridge said the discolouration was caused by iron and manganese naturally present in the source water from the Waikara Stream.
Removing iron and manganese completely was difficult and required multiple treatment stages.
He said the next step for the water scheme would be to move the plant to a new location, and introduce UV treatment.
He told RNZ he had secured a new location just last week, but that had yet to be confirmed.
Kāeo's private water treatment plant, on School Gully Road, draws from the Waikara Stream. Photo / RNZ
Aldridge said he welcomed media scrutiny because it had caught the attention of Taumata Arowai, the national water authority, and had bumped Kāeo's water supply up its priority list.
Taumata Arowai head of operations Steve Taylor said even a small private drinking water supply such as Kāeo's had to meet the requirements of the Water Services Act 2021 and other rules.
The authority had sent a letter outlining its expectations in March, but a meeting scheduled that month had been cancelled by the supplier.
Expectations included boil-water notice communication with consumers, and providing a confirmed, funded plan for achieving compliance with legal requirements.
Taylor said those expectations had not yet been met.
The authority had set a new date of July 23 for meeting the supplier and inspecting the plant.
Taylor said boil water notices were only meant to be a temporary solution, because over time people could forget and risked drinking contaminated water.
The authority could take action if it believed a supplier was not responding adequately to concerns about unsafe drinking water or failed persistently to comply with legal requirements.
That could include requiring the local authority, in this case the Far North District Council, to take over the supply.
All Kāeo Water's customers are based on the Far North town's main street. Photo / RNZ
Te Rūnanga o Whaingaroa pou arahi, or cultural manager, Raniera Kaio said the scheme had suffered from buck-passing between the council and the operator as to who was responsible.
He believed the only way to fix it was by the council, the operator and iwi working together.
'My personal opinion, indeed my professional opinion, is that the operator lacks the resources to fix it. Lacks the resources to fix it alone. It has to be a collaborative solution.'
Kaio said the water plant had been inundated in the 2007 floods and never fully recovered.
The boil-water notice also had a financial effect on the rūnanga, which spent $300-$400 a month on bottled water for staff and manuhiri [visitors].
He said Kāeo's water woes were emblematic of the neglect suffered by many rural, Māori-majority towns.
The effects went well beyond the cost and inconvenience of having to boil water or buy it by the bottle.
'It's about the dignity of Kāeo, the mana of Kāeo. And whānau in Kāeo have lived with daily anxiety around whether their water is safe to drink, that really affects not only your health, your hauora [wellbeing], but it sort of affects your own self-worth and your identity as being from Kāeo.'
However, Kaio said he was buoyed by news that Taumata Arowai was about to meet the operator, and hopeful a solution could be found.
Meanwhile, Anna Valentine just hoped one day soon her children would be able to drink water out of the tap.
'I mean, we live in New Zealand, but it feels like we're in a bit of a third world country up here in Kāeo, having to go out every day and fill our plastic bottles from a water container that we collect off the roof. It's just crazy, actually.'
Kāeo's boil-water notice is not the longest-running one in the country.
A 2024 Drinking Water Regulation Report stated 74 long-term 'consumer advisories' – which include boil-water notices – were in place at the end of last year, and 20 council supplies serving a total of 7000 people had advisories in place for three or more years.
'The persistence of long-term consumer advisories represents a significant regulatory and public health challenge,' the report stated.
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NZ Herald
7 hours ago
- NZ Herald
Three staff involved in pharmacy error that led to two-month-old's death
'It just makes no sense that he was left to make up these prescriptions without having someone there with him making sure that he is filling out each one correctly.' RNZ earlier revealed Bellamere Arwyn Duncan died at Starship Hospital on July 19. A Manawatū pharmacy dispensed an adult dosage of phosphate to the 2-month-old's parents. A coroner's preliminary opinion is that she died from phosphate toxicity. The revelations have prompted the Ministry of Health and Health New Zealand to 'urgently' undertake a joint review into the incident with Medsafe visiting the pharmacy to ensure it was safe to continue operating. The Pharmacy Council, which is also investigating, said it was 'clear that an awful error has occurred'. On Friday, the owner of the Manawatū pharmacy emailed Bellamere's parents with a summary of what happened. 'Once again, we recognise the immense impact of our error on you and your family,' the email began. Bellamere Duncan's parents were allegedly given an adult dosage of phosphate by the pharmacy. Photo / Supplied The owner said the pharmacy's standard dispensing process involved intern pharmacists entering each prescription into the dispensary computer. The pharmacy used a dispensing system called Toniq. A technician would then use the information in Toniq and the prescription to identify the medication and put the correct amounts in containers. The labels were then printed out and placed in a basket with the original prescription and the medication. A registered pharmacist would then check the prescription, the labels and the medication itself before it was given to the patient. The owner said the pharmacy received the prescription by email on July 1 from Palmerston North Hospital. The prescription was entered into Toniq by an intern pharmacist. 'This person unfortunately misread the prescribed dosage and entered the prescription dose as '1 tablet twice daily' rather than '1.2 mmol twice daily',' the owner said. The Toniq system then generated an original label for the prescription. 'This includes a warning label with the patient's age, if they are under 18 years old, and if the patient has not been prescribed the medication before. 'The second warning prompts the checking pharmacist to counsel [speak with] the patient or their caregiver about how to take the medication.' The product was supplied in tubes of 20 tablets. The trainee technician printed out three further labels. They were to be placed on the three tubes that were being dispensed. 'This was the trainee technician's first time handling a phosphate product. She was also unfamiliar with the mmol dosage. She did not notice the dosage error as a result. She put the original prescription, labels and the medication in a basket on the dispensing bench for the registered pharmacist to check. 'Unfortunately, the original label and the warning label was not kept with other items.' The registered pharmacist who carried out the final check did not pick up that the medication was for an infant, the owner said. 'In addition, it was not identified that this was a new medication. The fact that the warning label was not retained contributed to this error.' The owner said the intern pharmacist had been suspended by the Pharmacy Council. The registered pharmacist had taken leave and then resigned. 'This person does not intend to return to work in the immediate future,' the owner said. The pharmacy was 'urgently re-evaluating our dispensing and checking protocols and reinforcing safety checks at every stage'. 'We are actively recruiting additional staff to help manage our workloads. In addition, we are engaging an independent pharmacist from outside the Manawatū region to conduct a full review of our dispensing procedures and provide further guidance on system improvements.' The owner said the pharmacy was 'fully co-operating' with investigations being carried out by Medsafe, the Pharmacy Council and the police on behalf of the coroner. The owner signed off the email with 'heartfelt apologies and regret'. 'I don't blame him' Speaking to RNZ on Monday, Bellamere's parents, Tempest Puklowski and Tristan Duncan, said after reading the email they did not blame the intern pharmacist for what happened. 'My first initial reaction after reading it was I felt really bad for the intern,' Puklowski said. 'I don't blame him for the mistakes. I blame whoever was meant to be looking over his shoulder, whoever put him in that responsibility and just left him to it.' Puklowski said it should have been picked up that the medication was for a baby. 'It just seems like there's something lacking there that could have avoided it being missed or messed up.' Duncan said the system 'needs to be better'. Tempest said she remained 'frustrated and angry' about her daughter's death. 'It's just an endless sort of questioning of how and where it went wrong, to the point of, yeah, how could it have been avoided? 'Obviously, those questions don't do much now, which then brings on the sadness of just knowing that she could still be here if these things were pulled up on initially, if maybe the intern wasn't left just to do the job by themselves. Or if you know something else is put in place, we would've never even gotten it and then we wouldn't be beating ourselves up for giving it to her.' Duncan said the past two weeks since Bellamere's death had been 'really hard'. 'Just empty is the only word that really comes to mind,' he said. 'It's unfair. Just stolen away by a singular document. That's what it comes down to.' Puklowski said the couple 'don't really know what to do with ourselves really'. They were now waiting to see what happened with the multiple investigations that are under way. 'I want things to change,' Duncan said. In a statement to RNZ on Friday, Pharmacy Council chief executive Michael Pead said whenever the Pharmacy Council received a notification of an incident, it began an 'initial inquiry' to assess the situation. 'At the start of any inquiry, our focus is on ensuring there is no further risk to public safety. There are many ways to achieve this, including suspension of the pharmacist or pharmacists involved or a voluntary agreement that the individual/s will stop working.' In order to ensure the inquiry into Bellamere's death was 'fair and thorough', and to avoid pre-empting any findings, the council could not provide any further details. 'We can confirm that the Pharmacy Council is comfortable that immediate steps have been taken to prevent the risk of further harm while the enquiry is ongoing.' The medication While in hospital, Puklowski gave Bellamere her drops for Vitamin D. Nurses also administered her phosphate. When they left hospital, they were given some Vitamin D in a little bottle, and a prescription for iron and Vitamin D. The following day, Duncan went to a Manawatū pharmacy with the prescriptions. He was given the iron, but said the pharmacy refused to give the Vitamin D as the staff thought the dosage was 'too high for her age and her weight'. The staff said they would call the neonatal unit and follow up. A few days later, Puklowski received a call from the unit to organise a home care visit. During the call, she was asked if she had any concerns, and Puklowski asked if they had been contacted about the Vitamin D. They had not, and said they would follow up and rewrite the prescription along with a prescription for phosphate. A day after the phone call, on July 2, Duncan went to the pharmacy to collect the medication and came home with just the phosphate. Unbeknown to the parents they had been given an adult dosage of phosphate. The label on the medication directed them to dissolve one 500mg tablet of phosphate twice daily in a glass of water. That evening, they gave Bellamere her first dose of the medicine in her formula water. They would give her three bottles in 24 hours as was recommended. The couple noticed in that period that her eating was off, and thought she was 'extra gassy', Puklowski said. 'She was still feeding fine. She just wasn't maybe going through a whole bottle compared to what she was,' she recalled. Then, the day after she got her first dosage, Bellamere suddenly stopped breathing. Bellamere was taken to hospital and rushed to the emergency department. Once she was stabilised, she was taken to the neonatal unit where she stayed overnight before she was flown to Starship Hospital. The couple had taken a bottle of the medicine with them to Starship Hospital. She gave it to the staff who saw that they had been given an adult dose. The staff then requested the original prescription which confirmed the script had been written with the correct dosage, but somehow the pharmacy had given the wrong dosage, Puklowski said. 'I keep thinking about how much she ended up having and it just makes me feel sick.' Tragically, Bellamere died at Starship Hospital on July 19. On Wednesday, a Ministry of Health spokesperson told RNZ there were a number of investigations under way. 'Medsafe has completed an urgent assessment and is comfortable there is no immediate patient safety issue at the pharmacy. Medsafe will continue to work with Health New Zealand and these findings which will inform the information provided to the coroner. Medsafe is also sharing information with the Pharmacy Council. 'Once these reviews are completed, we will be able to look at next steps.' Health Minister Simeon Brown earlier told RNZ he raised the incident with the Director-General of Health as soon as he was made aware. 'She assured me that there would be an investigation undertaken by both the Ministry of Health and Health New Zealand. That investigation is under way. 'I am advised that this incident has led to Medsafe undertaking an urgent assessment of the pharmacy. A further investigation is being undertaken by the Pharmacy Council, and the death is also the subject of a Coroner's inquest.' Health agencies would provide information to the coroner as needed to support the inquest. 'It is important that the reviews are undertaken, and that the circumstances that led to this incident are understood. I expect that these investigations may propose recommendations, and that these will be reviewed once reports are complete.' - RNZ
Otago Daily Times
7 hours ago
- Otago Daily Times
Three pharmacy staff involved in error that led to baby's death
By Sam Sherwood of RNZ An intern pharmacist misread the prescribed dosage of medication for a two-month-old baby who later died from an overdose, RNZ can reveal. Afterwards, a trainee technician, who was handling a phosphate product for the first time, did not notice the dosage error. Then a registered pharmacist who carried out the final check did not pick up that the prescription was for an infant and that it was new medication. The intern pharmacist has since been suspended, and the registered pharmacist has resigned. The baby's parents say they do not blame the intern pharmacist for their daughter's death, and say he should have had more support. "It just makes no sense that he was left to make up these prescriptions without having someone there with him making sure that he is filling out each one correctly." RNZ earlier revealed Bellamere Arwyn Duncan died at Starship Hospital on July 19. A Manawatū pharmacy dispensed an adult dosage of phosphate to the two-month-old's parents. A coroner's preliminary opinion is she died from phosphate toxicity. The revelations have prompted the Ministry of Health and Health New Zealand to "urgently" undertake a joint review into the incident, with Medsafe visiting the pharmacy to ensure it was safe to continue operating. The Pharmacy Council, which is also investigating, said it was "clear that an awful error has occurred". On Friday, the owner of the Manawatū Pharmacy emailed Bellamere's parents with a summary of what happened. "Once again, we recognise the immense impact of our error on you and your family," the email began. The owner said the pharmacy's standard dispensing process involved intern pharmacists entering each prescription into the dispensary computer. The pharmacy used a dispensing system called Toniq. A technician would then use the information in Toniq and the prescription to identify the medication and put the correct amounts in containers. The labels were then printed out and placed in a basket with the original prescription and the medication. A registered pharmacist would then check the prescription, the labels and the medication itself before it was given to the patient. The owner said the pharmacy received the prescription by email on July 1 from Palmerston North Hospital. The prescription was entered into Toniq by an intern pharmacist. "This person unfortunately misread the prescribed dosage and entered the prescription dose as '1 tablet twice daily' rather than '1.2 mmol twice daily'," the owner said. The Toniq system then generated an original label for the prescription. "This includes a warning label with the patient's age, if they are under 18 years old, and if the patient has not been prescribed the medication before. "The second warning prompts the checking pharmacist to counsel (speak with) the patient or their caregiver about how to take the medication." The product was supplied in tubes of 20 tablets. The trainee technician printed out three further labels. They were to be placed on the three tubes that were being dispensed. "This was the trainee technician's first time handling a phosphate product. She was also unfamiliar with the mmol dosage. She did not notice the dosage error as a result. She put the original prescription, labels and the medication in a basket on the dispensing bench for the registered pharmacist to check. "Unfortunately, the original label and the warning label was not kept with other items." The registered pharmacist who carried out the final check did not pick up that the medication was for an infant, the owner said. "In addition, it was not identified that this was a new medication. The fact that the warning label was not retained contributed to this error." The owner said the intern pharmacist had been suspended by the Pharmacy Council. The registered pharmacist had taken leave and then resigned. "This person does not intend to return to work in the immediate future," the owner said. The pharmacy was "urgently re-evaluating our dispensing and checking protocols and reinforcing safety checks at every stage". "We are actively recruiting additional staff to help manage our workloads. In addition, we are engaging an independent pharmacist from outside the Manawatū region to conduct a full review of our dispensing procedures and provide further guidance on system improvements." The owner said the pharmacy was "fully co-operating" with investigations being carried out by Medsafe, the Pharmacy Council and the police on behalf of the coroner. The owner signed off the email with "heartfelt apologies and regret". 'I don't blame him' Speaking to RNZ on Monday, Bellamere's parents Tempest Puklowski and Tristan Duncan said after reading the email they did not blame the intern pharmacist for what happened. "My first initial reaction after reading it was I felt really bad for the intern," Puklowski said. "I don't blame him for the mistakes. I blame whoever was meant to be looking over his shoulder, whoever put him in that responsibility and just left him to it." Puklowski said it should have been picked up that the medication was for a baby. "It just seems like there's something lacking there that could have avoided it being missed or messed up," she said. Duncan said the system "needs to be better". Tempest said she remained "frustrated and angry" about her daughter's death. "It's just an endless sort of questioning of how and where it went wrong, to the point of, yeah, how could it have been avoided? "Obviously, those questions don't do much now, which then brings on the sadness of just knowing that she could still be here if these things were pulled up on initially, if maybe the intern wasn't left just to do the job by themselves. Or if you know something else is put in place, we would've never even gotten it and then we wouldn't be beating ourselves up for giving it to her." Duncan said the past two weeks since Bellamere's death had been "really hard". "Just empty is the only word that really comes to mind," he said. "It's unfair. Just stolen away by a singular document. That's what it comes down to." Puklowski said the couple "don't really know what to do with ourselves really". They were now waiting to see what happened with the multiple investigations that are under way. "I want things to change," Duncan said. In a statement to RNZ on Friday Pharmacy Council chief executive Michael Pead said whenever the Pharmacy Council received a notification of an incident, it began an "initial enquiry" to assess the situation. "At the start of any enquiry, our focus is on ensuring there is no further risk to public safety. There are many ways to achieve this, including suspension of the pharmacist or pharmacists involved or a voluntary agreement that the individual/s will stop working." In order to ensure the inquiry into Bellamere's death was "fair and thorough", and to avoid pre-empting any findings, the council could not provide any further details. "We can confirm that the Pharmacy Council is comfortable that immediate steps have been taken to prevent the risk of further harm while the enquiry is ongoing." The medication While in hospital Puklowski gave Bellamere her drops for Vitamin D. Nurses also administered her phosphate. When they left hospital they were given some Vitamin D in a little bottle, and a prescription for iron and Vitamin D. The following day Duncan went to a Manawatū pharmacy with the prescriptions. He was given the iron, but said the pharmacy refused to give the Vitamin D as the staff thought the dosage was "too high for her age and her weight". The staff said they would call the neonatal unit and follow-up. A few days later Puklowski received a call from the unit to organise a home care visit. During the call she was asked if she had any concerns, and Puklowski asked if they had been contacted about the Vitamin D. They had not, and said they would follow up and rewrite the prescription along with a prescription for phosphate. A day after the phone call, on July 2, Duncan went to the pharmacy to collect the medication and came home with just the phosphate. Unbeknown to the parents they had been given an adult dosage of phosphate. The label on the medication directed them to dissolve one 500mg tablet of phosphate twice daily in a glass of water. That evening they gave Bellamere her first dose of the medicine in her formula water. They would give her three bottles in 24 hours as was recommended. The couple noticed in that period that her eating was off, and thought she was "extra gassy," Puklowski said. "She was still feeding fine. She just wasn't maybe going through a whole bottle compared to what she was," she recalled. Then, the day after she got her first dosage Bellamere suddenly stopped breathing. Bellamere was taken to hospital and rushed to the emergency department. Once she was stabilised she was taken to the neonatal unit where she stayed overnight before she was flown to Starship Hospital. The couple had taken a bottle of the medicine with them to Starship Hospital. She gave it to the staff who saw that they had been given an adult dose. The staff then requested the original prescription which confirmed the script had been written with the correct dosage, but somehow the pharmacy had given the wrong dosage Puklowski said. "I keep thinking about how much she ended up having and it just makes me feel sick." Bellamere died at Starship Hospital on July 19. On Wednesday, a Ministry of Health spokesperson told RNZ there were a number of investigations under way. "Medsafe has completed an urgent assessment and is comfortable there is no immediate patient safety issue at the pharmacy. Medsafe will continue to work with Health New Zealand and these findings which will inform the information provided to the coroner. Medsafe is also sharing information with the Pharmacy Council. "Once these reviews are completed, we will be able to look at next steps." Health Minister Simeon Brown earlier told RNZ he raised the incident with the Director-General of Health as soon as he was made aware. "She assured me that there would be an investigation undertaken by both the Ministry of Health and Health New Zealand. That investigation is under way. "I am advised that this incident has led to Medsafe undertaking an urgent assessment of the pharmacy. A further investigation is being undertaken by the Pharmacy Council, and the death is also the subject of a Coroner's inquest." Health agencies would provide information to the coroner as needed to support the inquest. "It is important that the reviews are undertaken, and that the circumstances that led to this incident are understood. I expect that these investigations may propose recommendations, and that these will be reviewed once reports are complete."
Otago Daily Times
7 hours ago
- Otago Daily Times
Wood smoke, traffic fumes polluting Christchurch air
The air quality in parts of Canterbury has recently been rated 'unhealthy' using the air quality index, which measures the levels of particulate matter in the air. But what does poor air quality actually mean for our health? University of Otago environmental epidemiologist Professor Simon Hales told RNZ's Nights the source of the pollution, particularly in winter, is generally home heating. "The reason why it's a problem in winter is because in Christchurch ... the city is somewhat bowl-shaped with the Port Hills on one side, and there tends to be sort of a very calm night with the temperature inversion, which is a bit like having a lid on the city. So all the smoke that comes out of people's chimneys is trapped, and that's what leads to the very high level." Hales said Christchurch's air quality had improved since he lived there 30 years ago, but still needed to improve further. "The World Health Organisation has a guideline level for the daily level of PM2.5 fine particle pollution, and that's 15 micrograms per cubic metre," he said. "About 15 percent of the days over the past five years have been over that guideline level. And in the last three months, about 43 days." That means, in the last three months, Christchurch's air has had over the WHO-recommended daily level of particle matter in its air about 47 percent of the time. "There is also an annual guideline which is five micrograms per cubic metre. And in fact the annual average PM 2.5 in Christchurch has been about nine micrograms per cubic metre, so nearly double the WHO guidelines," Hales said. While polluted air was unlikely to noticeably affect young and fit people, those with chronic diseases, particularly heart and lung related, might notice their symptoms getting worse temporarily. However, the short-term effects were only part of health impact, he said. "Over weeks and months of exposure, it's making people who are currently healthy gradually less healthy. So it's actually inducing disease or worsening disease in people who otherwise would have been healthy. And this relates particularly to heart disease and lung disease, but there's an increasing number of different diseases that we're realising are related to air pollution exposure." And it's not just woodsmoke leading to the poor air quality. Nitrogen dioxide (NO₂), which comes mainly from road traffic, is also a big issue, Hales said. "In fact, we recently did a study which suggested that the NO₂ was actually more of a problem in terms of its overall health impact, causing over 2000 premature deaths per year." The same study, published in 2021, revealed that particles mainly from home heating contributed to about 1000 deaths. The main solution was to switch to cleaner fuels, Hales said. That should not be a problem for a wealthy country like New Zealand, which had abundant hydropower resources, he said. A similar shift was needed in regards to transport. "We need to change the modes by which we get about mostly. "We still use personal cars, mostly fossil fuel-powered cars, and we need to switch both to clean vehicles, EVs for example, but also we need to switch the mode so that people are not relying so much on personal cars, but also using public transport and active transport, so walking and cycling." New Zealand had mixed results when it came to the WHO's guidelines, Hales said. "If you look in global terms, then New Zealand is doing pretty well. We're not meeting all of the guidelines all of the time, but we are getting close and in many places we do meet the guidelines for most of the time, so that's something that many countries can't say. "On the other hand, I think we need to be doing more. We need to have more incentives for the kind of policies that I was suggesting before."
