Located in the upper reaches of the Makakaho Stream is the locality of Makakaho. The upper valley localities are particularly isolated, Ngamatapouri Primary School being  from Waitōtara village.
Makakaho is located at the source of the Makakaho Stream. The upper valley areas are quite isolated from one another, with Ngamatapouri Primary School being a notable example of this remoteness, situated as it is away from the town of Waitōtara.