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The indigenous people of Hawaii are reported to
have some of the highest mortality rates
for virtually all major chronic
diseases. Obesity is also higher in Hawaiians than in non-Hawaiians, as is
diabetes. Statistics like these have prompted health researchers to
identify native Hawaiians as a vulnerable
population.
Hawaiians
relied on a myriad of natural substances for healing purposes, including
plants widely available today, like kukui, the state tree of Hawaii. Its
nutmeats were used as a purgative while the flowers and sap were used to
cure mouth sores. Noni, a type of mulberry
, is
still used as a tonic and has become the subject of clinical research for possible anti-cancer properties.
Creating connections between traditional healing and contemporary
medical practice opens a door into indigenous communities, according to
Kaloa Robinson. He heads Hui Malama Ola Na Oiwi , which provides medical
services to the native Hawaiian community on the state's largest island.
"I
guess the question is, what is the role of traditional medicine in
today's society?" he muses. "We've found that even though they [native Hawaiians]
go to see a physician, there's just something that's missing, the
spiritual aspect that's missing. And practices like ho'oponopono is something
that we refer some of our clients to."
Ho'oponopono means 'to make things right,' according to Kaohu Chang
Monfort, a nurse known for her healing expertise. She says her family
routinely practiced this kind of group mediation and prayer when she was a
child. "Ho'oponopono was number one. We never let the day go by, before
the sun goes down, without ho'oponopono. You talk about what's bothering
you. Nobody leaves until everything comes out." She recalls they could
spend hours talking. "And when whatever's troubling you comes out, that's
what the prayer is about, to help you heal."
Spending time with patients is an important part of health care, says
Edna Baldado, a caseworker with Hui Malama who sees clients with
diabetes. "Then they feel like you really care about them. Allowing them
to have that space and that time, helping them feel like they're somebody
worthwhile and important. That's a Hawaiian kind of value."
While ho'oponopono and spending time help heal the spirit, traditional
healer Mary Fragas points out that nourishing food is essential for a
healthy body. "The Hawaiians used to eat fish, poi, taro, potato, uloo
[breadfruit]," she points out. Recognizing that, Hui Malama has hosted
fish and poi gatherings around the Big Island, demonstrating healthy
cooking techniques to encourage healthy eating.
Baldado says sharing food and conversation has been an effective way to
expand Hui Malama's reach into the community, making more people aware of
their range of services. "We want to promote eating our traditional foods,
because that's the healthiest food," she tells the crowd at one of the
gatherings. "If we eat that kind of stuff, we'll be like the Hawaiians of
old." To scattered laughter, she adds, "They were slim, they could run for
miles and not get tired!"
The fate of those 'Hawaiians of old' is
similar to that of indigenous people across the globe. Less than a century
after the first Europeans arrived in the islands in 1778, disease, war and
famine had claimed over 80% of the native population. Disease is still
taking a disproportionately high toll of Native Hawaiians, who die at
greater rates from cancer, heart conditions and diabetes -- chronic
diseases that afflict all ethnic groups.
In searching for the reasons why, state health official Kim Birnie
notes that some of the research points to genetic causes. "But other
[causes] are accessibility," she adds. "Are Hawaiians not getting care
early enough? And if they're not, why not?"
Birnie is Communications Director for the agency that oversees the
state's Native Hawaiian health care system. She says individual wellness
is intertwined with social and economic conditions. "A lot of [our
clients] are the working poor. They're working but they can't afford the
rent. Or they want to work, but they have bad teeth. Having their teeth
worked on gives them some confidence to be able to go out and apply for a
job so they can pull themselves out of the homelessness. So it's all tied
in."
Providing effective health care for Hawaiians requires bridging
cultural, historical and social divides, according to caseworker Edna
Baldado. "We have to kind of be innovative sometimes, but if it works [why
not try it?]," she asks. "We're not doing anything that's going to be
detrimental to us as individuals, or us as a people or to our
organization. As long as we're not doing something that's going to be
hurtful, we can do things a little more creatively."
One innovation that works is the Native Hawaiian
Health Scholarship Program. Recipients - like Allison Grace - specialize
in needed health professions, and after graduation, are placed in underserved
areas. Grace
says, "Being in the community is so different from being a doctor in the
hospital, 'cause you get to talk to [patients] one on one, you get to
spend time with them."
She has been assisting Dr. Joycelyn Jurik, who says their practice is
truly outreach. "If there are individuals that we hear about that are
having problems at the beach, we'll go to their van, we'll go walk the
beach, find them in their tents, we'll walk the bushes, find them in the
bushes, and that's where we'll see them!"
Grace says being Hawaiian themselves makes their relationship with
their patients closer: "We live through it," she explains. "We see that
diabetes runs rampant in our families, I think all our patients become
Auntie and Uncle anyway."
Jurik agrees. "I don't think I call anyone Mister and Missus! So it's
like, 'Auntie, when do you want to come see me again?' For them it's so
comforting, they feel like family now. And we feel like they're family,
too."
Improving the health of Hawaiians has meant acknowledging connection
between past and present, between social customs and medical
knowledge,and most importantly,between patient and health care
provider.
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