Ka Wai Ola - Office of Hawaiian Affairs, Volume 21, Number 5, 1 May 2004 — Dialysis treatment returns to Kalaupapa [ARTICLE+ILLUSTRATION]

Dialysis treatment returns to Kalaupapa

It's been more than 30 years since the first dialysis machines were established in Kalaupapa. In 1974, four Kalaupapa residents were receiving dialysis treatments from their homes. As patients got older it heeame more and more difficult for helpers to run around to the homes to give service. In 1979 the loeal hospital was able to install two units. Eventually the hospital gave way to the Care Home where dialysis treatments continued and were successful. In 1996 renovations began at the Care Home whieh prompted the eventual closing of the dialysis unit. Longtime resident and former patient chairman, Ku'ulei Bell recalls Unele Johnny Nākoa to be the last person to use the Care Home's dialysis maehine in 1998. Aunty Ku'ulei Bell remembers helping her husband with his dialysis treatments until his passing. After his passing, she continued helping other patients with their weekly treatments, going to their homes three times a week. "At that

time, there weren't very many people to help," said Bell. Most of those she assisted have long since passed, but Aunty Ku'ulei has been a strong proponent to bringing dialysis back. Since the last dialysis treatment given in 1998, the community of Kalaupapa and many supporters have been discussing the possibility of bringing it back to Kalaupapa. A workshop titled "Together Our Voices are Strong," in August 2003 gave new life to the discussion. Ka 'Ohana o Kalaupapa, the eommunity group sponsoring these discussions found the issue important enough to form a committee specifically for dialysis in Kalaupapa. The quest to bring dialysis back to Kalaupapa was further fueled by an impassionate plea from Unele Henry Nāla'i'elua. A resident of Kalaupapa since he was 16, Unele Henry started dialysis treatment in 2003 and tried traveling between Honolulu and Kalaupapa. The arduous trips back and forth took a toll on him and eventually he gave

in to a life in Honolulu where he had easier access to dialysis treatments. "I want to eome home, why can't I do this back home?," he asked community supporters in an October 2003 meeting. He's accepted the lifestyle of a diabetic but finds it even harder to adapt to life away from home. After many months of meetings and updates, a collaborated effort was confirmed and commitments from different partners were realized. Concerns over liability issues and maehine maintenance have been weighed in heavily by all parties, but in end all the details were worked out and the joint efforts a success. Similar to the process that brought dialysis to Moloka'i residents living "top side" in 2003, the project was facilitated by Moloka'i's Nā Pu'uwai Native Hawaiian Health Care System. Contributors to the project include the State Department of Health, St. Francis Medical Center, Moloka'i Rural Development Project, Ke Aupuni Lōkahi - Moloka'i

Enterprise Community Governance Board and the Office of Hawaiian Affairs. OHA approved funding the purchase of two dialysis machines and related equipment including a sophisticated water filtration system. On April 29, 2004, project organizers will celebrate with the Community a blessing for the return of dialysis to Kalaupapa. Representatives from the joint partnerships will be on hand to celebrate with residents and Unele Henry Nāla'i'elua as the first recipient of on-site dialysis. I asked Aunty Ku'ulei Bell what it meant to them that dialysis was returning to Kalaupapa. She replied, "We are so happy I can't express enough gratitude to everyone who did this. Not only for Henry, but a lot of us are diabetics and will be candidates soon. Just knowing that the machines are here for us, gives us relief and peaee of mind that we ean stay here even if things turn out that way." ■

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Colette Machado Trustee, Moloka'i and Lāna'i