Ka Wai Ola - Office of Hawaiian Affairs, Volume 20, Number 05, 1 May 2003 — Cancer studies focus on women and 'ohana [ARTICLE+ILLUSTRATION]

Cancer studies focus on women and 'ohana

By Naomi Sodetani Ola na 'ilima wa 'ole i ke ao 'opua The hardy 'ilima of waterless places is healed by the rain cloud. — Mary Kawena Puku 'i Cancer is not a distant issue to heahh educators Noreen Mokuau and Lana Ka'opua. Too many women in their own homes have lived with, and been taken by, the disease Mokuau's aunt died from cancer and her mother, after battling breast cancer years ago, is now undergoing treatment for ovarian cancer. After this interview, Mokuau sped off to relieve her sibling, and begin her "shift" of caregiving. Both women have had their own close scares with lumps later diagnosed as benign. And both had unpleasant dealings with a Westem-based health care system that doesn't know how to care for Hawaiian women, Mokuau says. Propelled by their concerns, the two friends, both social researchers with the University of Hawai'i School of Social Work, decided to initiate two studies to find ways to promote the wellbeing of families of other Native Hawaiian women with cancer.

Ka'opua and Mokuau are now looking for Native Hawaiian women newly-diagnosed with cancer and their 'ohana to participate in the oneyear studies. Ka'opua, an assistant professor and researcher with the Cancer Research Center of Hawai'i, eonceived a study to explore the use of traditional healing practices like ho'oponopono in cancer care. Na Lei Pūlama (cherish our beloved) offers participating families ho'oponopono training to strengthen their coping and communication skills. Mokuau's 'Ohana Intervention study offers 'ohana knowledge and skills to manage the daily burdens of care, including negotiating household See 'OHANA on page 13

Noreon Mokuau 0) and Lana Ko opua.

'OHANA from page 9 chores and communicating with health care providers to ensure that patients' and caregivers' needs are met. Native Hawaiians have the second highest overall incidence of cancer in the United States, among all ethnic groups. Native Hawaiian women have a mortality rate 2.6 times higher than the general population in Hawai'i. "You hear aU this talk of self-determination these days," Mokua says. "But what's the use of getting it if our people don't stay alive?" A cancer diagnosis, "like a stone thrown into a pond, causes a ripple effect within families that eontinues through treatment and recovery," Ka'opua says. Routines and roles are disrupted. The cancer patient often worries about not fulfilling her kuleana as a caregiver — while grappling with the discomforting awareness that she herself now needs care.

Eaeh family has unique needs and strengths taxed to the limits when cancer strikes. "And although many of us are hardy and have loving family relations, there are still these challenges," Ka'opua says. The two studies are among seven pilot studies focused on creating better ways to address cancer through awareness, prevention and research in the Hawaiian community underway as part of the 'Imi Hale Native Hawaiian heakh initiative, whieh is a five-year project of Papa Ola Lōkahi, funded by the National Cancer Institute of the National Institute of Health. Even with 'alternative medicine' on the rise, the Western-oriented health care system still largely focuses on the physical symptoms of the disease, ignoring its cultural and spiritual aspects. But for Hawaiians, Mokuau says, spirituality "undergirds everything" as an essential component in one's daily well-being and healing.

W31 The 'Ohana lntervention study looks at the importance of the involvement of family members, Mokuau explains. The Na Lei Pulama study teaches families to use ho'oponopono, as taught by the late revered scholar Mary Kawena Puku'i, as a method of family discussion to achieve lōkahi (unity, harmony) within the 'ohana. Ka'opua and Mokuau say that participants wiU not only learn skills to help them eope today — they will contribute to a healing legacy that will help others tomorrow. Research gathered from these studies will be used to mainstream culture-based care into Hawai'i's health care system for future generations. 'Ohana members are involved because, for Native Hawaiian women, the challenges of cancer are not a solo matter. "Cancer is a family disease," Ka'opua says. "It affects everyone." ■

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