Abstract: This essay explores the social and historical context of the continued incidence of rheumatic fever amongst Maori. This communicable disease is associated with poverty, inadequate housing and overcrowding. These risk factors are all higher for indigenous populations. The article traces the effects of colonisation on Maori health, and presents the Te Whare Tapa Wha health model, which is grounded in a Maori world view, and provides a framework to examine this issue. The implications for nursing practice are explored.