Ka Wai Ola - Office of Hawaiian Affairs, Volume 2, Number 7, 1 July 1985 — He Man Ninau Old [ARTICLE+ILLUSTRATION]

He Man Ninau Old

Some Health Questioris by Kekuni Blaisdell, M.D.

Q: E kauka, since the big health problem of us Hawaiians are due to haole diseases, why not forget the old Hawaiian superstitions that you have been writing about, and get on with hightech modern medicine? A: Your mana'o (opinion) seems to be shared by many, esp>ecially non-po'e Hawai'i, in our island eom-

munity. However, before we "get on with high-tech medieine," perhaps we should clarify some points you raise. While we po'e Hawai'i do indeed have the worst hea!th profile in our own nativeland, such as the highest rates for ma'i pu'uwai (heart disease), ma'i 'a'ai (cancer), stroke, kokopi'i (high blood pressure), mimiko (diabetes), and ulia (aeeidents), rather than labeling these "haole diseases," it may be more helpful to identify the responsible factors. They appear to be mainly matters of lifestyle, 'oia ho'i: • Misnutrition, with consumption of high-tech fast-foods containing excess calories, fat, sugar, sodium, and inadequate fibre. • Self-abuse with cigarette-smoking, aleohol, and other harmful chemicals. • Laek of physical fitness. • Malcoping with stress. • Reckless automobiling. Current evidence suggests that these behavorial traits, whieh seem to depend largely on individual ehoiee, are widely prevalent among us po'e Hawai'i. No ke aha mai (why )? There are certainly not traits characteristic of our pre-haole Polynesia ancestors. Js this self-destruction as some would assert? Can high-tech modern medicine be expected to rescue us? We po'e Hawai'i have yet to ninau (ask) and attempt to pane (answer) these ninau in open and extended kukakuka (discussion) with the best-informed and wisest na'au (bowels) among us.

Contrast our inaction with our Maori kaukini (cousins) in Aotearoa (New Zealand) whom I recently maka'ika'i ia (visited). In 1980, faced with a malhealth profile similar to ours, as reported by Maon physician Dr. Eru Pomare and nationally televised, the Maori community organized for action. Maori kaumatua (elders), the Maori Women's Welfare League, takuta (physicians), tohunga (kahuna lapa'au) and other health professionals, Maori political leaders and other government officials, Maon academicians, and young Maori activists joined in a series of hui (meetings) on marae (Maon meeting places) with the following results: 1. Maori traditional concepts of health were affirmed, not rejected as "superstitions." Ora (health) springs from te wairua (spirit) interacting with te hinengaro (mental and emotional), te tinana (body), te whanau (extended 'ohana and ever-present tupuna (ancestors), in maintaining harmony with te ao (environment) and te atua (gods), and preserving mana through proper balance of tapu (sacred) and noa (non-sacred). 2. Erosion of such Maori concepts, so vital to Maon cultural identity and self-esteem, by loss of political self-determina-tion and eeonomie self-sufficiency, loss of Maon lands and fishing waters, urbanization, polluhon of natural resources, negative depiction of Maori in communication media, narrow Pakeha (haole) medical practices, and suppression of holistic Maori health practices, were considered basic causes of Maori ill health and related social maladies of school failure, unemployment, crime, homelessness and poverty. Accordingly, all Maon health services must be sensitive to and incorporate unique Maori concepts of health in fostering strong sense of self-esteem and Maori cultural security, with emphasis on promoting wellness, rather than merely disease therapy. 3. As official policy, Maon tangata (people) must be involved in all planning and implementing of Maori health programs integrated with all aspects of Maori life. Further, the limited resources of the Maori must be supported by the financial resources of the nation as a whole whieh lie mainly in govemment budgets and allotments.