Ka Wai Ola - Office of Hawaiian Affairs, Volume 1, Number 8, 1 October 1984 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Health Questions by Kekuni Blaisdell, M.D.

This month's eolumn continues with additional pane (answers) to he mau ninau submitted last month, for whieh mahalo hou to you po'e heluhelu 'imi (inquiring readers). Q: Why were our people of old, before the haole eame, so healthy, whereas even now we Hawaiians have moresickness, in spite of modern haole medicine? Maybe we should go back to Hawaiian medicine. Pehea la?

A: Last month l provided evidence to support your premise that ka po'e kahiko (pre-haole Hawaiians) were indeed a generally healthy people, although they were not entirely free of ma'i (disease) as some writers, such as Kamakau and Halford, have claimed. The reasons for the relative ola of ka po'e kahiko and the unhealthy profile of us modern po'e Hawai'i are complex, but we need to understand them if we are to remedy the situation and acquire the selfdetermination and self-sufficiency we seek in our native islands. The muhiple factors affecting ke ola are conveniently considered in three main groups. First are genes, perhaps 10,000 of them, that eaeh of us inherits from our kupuna (ancestors). At present, wecannot readily control our own genes without our bodv cells, but we ean influence their assortment in our kamali'i (children) by our nrating choices. The second and most important group of heahh factors eoneem "life style," whieh we as indi\iduals do control through our personal choices and habits. These include the food we eat, body hygiene, self-abuse with harmful substances. phvsical fitness, rest, stresscoping, and the medical care we obtain. Let us focus on some of these in more detail.

Too mueh dietary fat and cholesterol, such as in bacon, "french fries," butter, eggs, and milk shakes, are majordeterminants in the wide prevalence of atherothrombotic ma'i pu'uwai (heart disease), stroke, ma'i 'a'ai (cancer), mimiko ;diabetes), and obesity among us modern po'e Hawai'i. In ka wa kahiko, na maka'ainana (commoners) ate mainly i'a (fish), kalo, 'uala (sweet potato), uhi (yam), ulu (breadfruit), mai'a (banana), ho'i'o (fern), occasionally moa(fowl), and only rarely pua'a (pig) and 'ilio (dog), whieh were usually reserved for ali'i. Because of this high-fibre, low-fat diet and other factors described below, our kupuna maka'ainana probably had mueh lower frequencies of the dominant "western" diseases cited above. Excessive intake of pa'akai (salt) increases the risk of kokopi'i (high blood pressure) and worsens ka pehu (swelling) of pu'uwai (heart), pu'upa'a (kidney) and ake (liver) failure, so we may assume that ka po'e kahiko, who relished pa'akai as mueh as we do today, probably were familiar with these maladies, just as we are. Abundant sweets were unknown in old Hawai'i where munching on ko (sugar eane) was almost the only source of kopa'a (sugar). Keia wa (today), beginning in childhood, readily accessible candy, pastry and "soft drinks" are main

contributors to our fatness, mimiko and dental caries. Self-abuse with puhi paka (cigarettesmoking), whieh was unknown in H awai'i kahiko, is a leading cause of ma'i 'a'ai (cancer), of chronic bronchitis, emphysema and hano (asthma), and is a major risk factor in heart attacks and gangrene of the limbs in us po'e Hawai'i keia wa. Aleohol, also absent in our islands before Capt. Cook's men introduced beer, contributes to liver, throat and esophageal cancer, cirrhosis, stomach bleeding, suicide and auto injuries. Drug abuse, known only in the form of "kava debauchery" among a few ali'i to Capt. Cook's journalists, is now epidemic among our 'opio (youth) causing brain, lung, kidney, liver and gut damage, infections and suicide. Regular, rigorous physical activity in hana (work) and pleasurable sports were integral to the life style of our kupuna. Contrast that robust past with our eontemporary high-tech society in whieh after a sedentary day's "work," we "exercise" by watching wrestling on TV. Physical fitness improves our blood circulation, and the efficiency of heart, lung and muscle function; it prevents surfeit body fat; it ean control kokopi'i (high blood pressure) and body metabolism of sugar and fat, relieve stress, and promote restful sleep and a feeling of well-being.

Contrary to popular belief, professional medical care has only a secondary role in preventing ma'i and restoring ola. This topic will be explored further in next month's eolumn on the applicability of Hawaiian medicine today. The third main group of health factors are environmental. Although they are usually beyond individual control, they may be amenable to group action. They include climate, natural resources, public sanitation, population density, public behavior, and specific disease agents. This group of factors will also be discussed in a future article. Some have suggested that our ill health results from the stress of cultural conflict and collective despair. Despair of our people over loss of our lands and our cultural identity. No longer do we eommune regularly with our 'aumakua and with the great forces of nature. Many of us po'e Hawai'i have failed to adapt to the dominant haole eeonomie, social, political and educational system in our homeland. Yet, ironically, we have too rapidly acquired some harmful western ways — overeating malnutrients, puhi paka (cigarette-smoking), ona mau (aleoholism), drug addiction, reckless automobiling, physical inactivity without meaningful recreation, urban psychosocial stress, overcrowding and destruction of our environment by commercial exploitation. While this account may seem to be a dismal assessment, we shall be considering upbeat ways to lift ourselves and our kamali'i (children) into a more promising, wholesome future in columns to eome. Meanwhile, e mau ha'awi mai i mau ninau ola, ke 'olu'olu (please continue to send in your heahh questions).