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

He Mau Ninau Ola

•••lllllllllllllllllllllll||||l||||||l|IIIIIHIIIIIIIIIIIIIIIIIHIIIIIIIIIIIIIa Some Health Questions

by Kekuni Blaisdell, M.D.

Q: I understand that the Hawaiian Civic Clubs, at their 1983 Convention, voted to provide medical care for us Hawaiians. Did anything eome of that idea? A: Claire Hughes-Ho, chairperson of the Health Issues Subcommittee of the Hawaiian Civic Clubs Politi-

eal Action (HACPAC) lobbying committee, informs me that her group is following through on these three resolutions adopted at the 1983 Convention: ( 1) Urge OHA to establish an Advisory Board of Hawaiian medical professionals; urge OHA, the Department of Health (DOH) and the Department of Education (DOE) to develop a TV health education program for ka po'e Hawai'i (Hawaiian people); direct OHA to work with the Hawai'i Dental Association, DOH and DOE to develop a dental program for kamali'i Hawai'i (Hawaiian children). (2) Work closely with the Cancer Center of Hawai'i in research, information, and treatment of ma'i 'a'ai (cancer) in ka po'e Hawai'i.

(3) Cooperate with the Pacific Health Research Institute in study, information and treatment of kokopi'i (high blood pressure) in elderly po'e Hawai'i. In August, 1984, nutritionist Hughes-Ho organized her Health Issues Subcommittee to include these additional po'e Hawai'i health professionals: William Ahuna, M.D., Noelani Apau, M.D. , Chiyome Fukino, M.D., Nanette Judd, R.N., June Oda, M.S.W., and Nathan Wong, M.D.

The subcommittee considered the formentioned resolutions and examined the serious health plight of us po'e Hawai'i — the shortest life-expectancy, the greatest overall mortality; the highest rates of infant deaths, ma'i pu'uwai (heart disease), stroke, ma'i 'a'ai, accidents, kokopi'i, mimiko (diabetes), kidney failure, hano (asthma), chronic bronchitis, suicide, some mental illnesses, teenage pregnancies, and pukaniho (dental caries) compared to the other lahui (races); that we po'e Hawai'i underutilize health care resources; and that while we p>o'e Hawai'i comprise 18 p>ercent of our state population, less than five p>ercent of health professionals in our homeland are po'e Hawai'i. Auwe. Aloha 'ino i na pua o Hawai'i.

After reviewing all of these health pilikia, conferring with community resource persons, and realizing that funds need to be sought now for a health project with measurable results within three years, the Heahh Subcommittee prepared a modest, but culture-oriented, inter-agency denta) health proposal. Called Ho'ola Niho (Make Healthy Teeth),

the pilot project would supplement an already-established Headstart dental program. A tentative outline was approved at the November, 1984, Civic Clubs Convention in Hilo. Following are the main features of the program with asterisks indicating the proposed Ho'ola Niho components whieh will require additional funding for kamali'i Hawai'i:

• Objective: To decrease pukaniho rates and thereby reduce subsequent dental-repair costs and loss of niho, through culture-specific preventive dental hygiene practices. • Target group: About 100 kamali'i Hawaii'i, ages 3 to 5 years, in the O'ahu Headstart (preschool) Program. • Approach: (Mechanisms for these methods were explained in last month's eolumn) • Dental health education by network of Kupunalike in Hawaiian homes: (1) Reduce dietary refined ko (sugar) by avoiding snacks of candy , pastry and soft-drinks, thus decreasing bacterial formation of decay-causing acid.

(2) Toothbrush and floss removal of dental plaque after meals at least onee daily. • Dental intervention: (1) Annual examination of niho for pukaniho. (2) Fluoride tablet supplement daily, with parents' approval, to increase tooth enamel resistance to decay. (3) Topical fluoride application, with parents' approval, for remineralization of tooth enamel and to reduce bacterial acid formation. (4) Sealant (plastic coating) treatment of deeply-fissured, non-carious niho, as barrier against plaque bacterial acid.

(5) Referral for dental repair. • Evaluation to include comparison of pukaniho of Hawaiian vs. non-Hawaiian kamali'i, and treated vs. nontreated kamali'i Hawai'i, with appropriate controls. Since planning is still in process, readers with ninau and or comments are invited to contact the following responsible po'e: Claire Hughes-Ho, DOH nutritionist; Hardy Spoehr, Department of Hawaiian Home Lands planning specialist; Corrine Lee, Headstart dental hygienist; Yoshi Koga, UH Department of Dental Hygiene chairperson; Manuel Kau, D.D.S., DOH Dental Heakh chief; and Haunani Apoliona, M.S.W., Alu Like administrator. Our mahalo a nui for their dedication to Ho'ola Niho no kamali'i Hawai'i.