Ka Wai Ola - Office of Hawaiian Affairs, Volume 2, Number 12, 1 December 1985 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Healih Questions by Kekuni Blaisdell, M.D.

Q: E kauka, when your task force eame to Waimanalo in October, you promised to give us a followup report on the November Hawaiian health conference. What happened and what is going to happen, if anything? Or is this just more namunamu (talk)? A: More than 100 confe-

rees attended the first major public all-day halawainui (meeting) on Hawaiian health Nov. 1 at the East West Center to react to five task force report drafts. The Historical and Cultural Task Force reported that medical and spiritual devastation of ka po'e Hawai'i (Hawaiian people) began in 1778 with the fatal impact of foreign infectious epidemics, followed by Western exploitation and progressive deHawaiianization. In the 1950s we were still considered a dying race in spite of a gradual rise in the number of part Hawaiians. The surge of Hawaiian activism in the 1970s resulted in a Congressional Native Hawaiian Claims Settlement bill whieh eventually emerged as the emasculated Native Hawaiians Study Commission of 1980. The Commission's largely-ignored health report reinforced Alu Like's 1977 assessment that we po'e Hawai'i have the worst health profile in our homeland. In 1985, in response to nudging by Sen. Daniel K. Inouye, the federal Department of Health and Human Services (DHHS) provided $30,000 for the currentlyevolving E Ola Mau report on Hawaiian health needs. Like other indigenous people living under a non-indige-nous system, such as the American Indians and our Maori counsins, ill-health is just one dimension of our people who have been dispossessed of our culture, lands, status and power. Three paths are open to us: (1) further assimulation with complete loss of our cultural identity; (2) resistance, passive and or active; or (3) cultural pluralism, with resp>ect and kako'o (support) by non-Hawaiians. and revitalization by us po'e Hawai'i.

The Mental Health Task Force found that we Hawaiians are overrepresented in statistics for suicide, aleohol and drug abuse, assaultive behavior, child abuse, crime, school failure and poverty. Existing mental health services for po'e Hawai'i are inadequate. These adverse findings result from pernicious social circumstances whieh have deprived the native Hawaiian of a positive sense of ethnic identity and self-worth, respect for ancestry and heritage, sense of political and eeonomie empowerment and attachment to the aina (land). ln the past 15 years, Hawaiians have demonstrated a struggle for control, cultural pride, and competence in resolving our own problems that deserve non-Hawaiian social and financial support. The Medical Task Force reported that compared to others, Hawaiians have higher rates of heart disease, hypertension, cancer, accidents, diabetes, infant mortality, birth defects, teen pregnancies, toxemia and urinary infections of pregancy, labor and delivery complications, late or no prenatal care, and cigarette-smoking and alcohol-drinking during pregnancy. For many Hawaiians, medical services are not readily available, health insurance is lacking; and po'e Hawai'i tend to underutilize and resist current health and medical care services and resent meddling outsiders.

Recommendations included reallocating state resources for priority Hawaiian health programs; appointment of more Hawaiians to health boards; education of more Hawaiian health workers; integration of Western and Hawaiian medical care; Hawaiian cultural heahh promotion programs; and research on biological, social and environmental causal factors. The Nutrition and Dental Task Force concluded that the diet of po'e Hawai'i in public heahh is excessive in fat, sugar and salt and tends to be deficient in ealeium and vitamins A, B complex and C. Hawaiians have higher rates of dental maladies. Nutrition and dental education is inadequate and lacks cultural components. Recommendations were for breastfeeding, child nutrition, education, research, surveillance, fluoridation, cultural sensitivity training and adequate dental insurance. The Strategic Planning Task Force called for committment by federal, state and county governments, and eommunity coalitions to make improved Hawaiian heahh a reality; a Native Hawaiian Heahh Planning Advisory Committee of Hawaiian organizations and heahh agencies to deve!op strategies, such as federal and state legislation for planning, research, education, health-promotion, disease-prevention and medical care. Panelists from the neighbor islands, Ilei Beniamina from Ni'ihau, Herbert Yim of Kaua'i, Kauka Blaise Lee Loy from Hawai'i, Leilani Hayes from Maui and Kauka Emmett Aluli of Moloka'i, stressed the need for more time for their island community reactions and input in the conference recommendations, for po'e Hawai'i ourselves to be making the key decisions, for culturally-acceptable heahh programs, for adequate and sustained financial support, for building on existing social and heahh support networks in Hawaiian communities, for direct benefit to needy po'e Hawai'i and for training of loeal Hawaiians for heahh service in their communities. UH Dean Neubauer considered the draft rep>ort to be revolutionary because it boldly links Hawaiian illheahh to social, cultural and historical forces and recommends restoration of Hawaiian cultural identity as a key corrective step. However, he suggested that we distinguish medical care whieh is expensive and relatively less effective, from heahh promotion whieh is less costly and more effective when appropriately applied. For some, he said, lifestyle is created by society, rather than the ehoiee of the individuals. He also warned against excessive dependence on the government whieh tends to depower rather than empower beneficiaries. Dr. Sheridan Weinstein, DHHS administrator from San Francisco, commended the report for correcting nahonai statistics, whieh record more favorable collective heahh indices for "American-Asians and Pacific Islanders" than for Caucasians, by "unmasking" the grave heahh plight of American-Hawaiians. He said the report will not be useful, however, until it acquires community credibility, is translated into "double actions" by both private and government agencies, and is worded to catch the attention and support of top political leaders. No "top polhieal leaders" were present, Hawaiian or nonHawaiian, so E Ola Mau may still be in the "namunamu" stage.

Wendy Roylo Hee, Office of Hawaiian Affairs planning and development officer, center, is shown with former State Sen. Anson Chong, left, and Mike Tweedell, administrator of the Waianae Coast Comprehensive Heakh Center, at one of the panels.

Office of Hawaiian Affairs Trustee Thomas K. Kaulukukui Sr. commends Leeward and Central District kupuna for their Hawaiian Studies work with Hawaii's children in the Department of Education.