Ka Wai Ola - Office of Hawaiian Affairs, Volume 6, Number 5, 1 May 1989 — He Mau Nīnau Ola [ARTICLE+ILLUSTRATION]

He Mau Nīnau Ola

Some Health Questions by Kekuni Blaisdell, M.D.

Ka Poi A Me Na Mu Ma Ka Pu'a: Mokuna 'Elima (Part V)

Ninau: Since the old Hawaiians ate poi from eommon 'umeke, and Hawaiian parents pū'ā food for their babies, isn't this proof that contaminated food was the main way infections spread in old Hawai'i? Pane: Your ninau requires several ex-

pianations ana pane. If by "old Hawai'i" you mean pre-1778 when the first haole eame, then the available evidence indicates that contagious infections, whieh were the scourge of the continents at that time, were not present in preWestern Hawai'i. With the arrival of Capt. James Cook and his crewmen in 1778 and other foreigners subsequently, epidemic infections, such as gonorrhea, syphilis, ma'i 'aiake (tuberculosis), infectious diarrheas, pneumonias, influenza, measles, whooping cough, mumps, leprosy, smallpox, diphtheria, scarlet fever and plague, decimated our native island kūpuna. A recent book by UH professor David Stannard blames these foreign diseases for the rapid 'aui (decline) in heluna kānaka maoli (Hawaiian populahon) from circa 1,000,000 at the time of Cook to a low of about 40,000 in 1893 at the time of the U.S. armed invasion. Akā, only some infections are transmitted by ka mea 'ai (food) or water in ka mea 'ai. These include the following whieh have been known in Hawai'i: infectious hi (diarrheas), such as cholera, typhoid, salmonellosis, shigellosis and rarely tuberculosis. In modern times, we have had sporadic instances of viral hepatitis A, "traveler's diarrhea" (from enteropathogenic E. eoli), and varieties of food poisoning, such as botulism, staphylococcal toxicity and fish poisoning. Sharing poi from eommon 'umeke (calabash), as described i kēlā mahina aku nei (last month), was a welll-established custom among maka'āinana kahiko loa (preWestern native commoners). This practice was an expression of the sharing nature of traditional Hawaiian culture. Later, this custom was the basis for the term "calabash 'ohana," referring to a family-like relationship based on eating poi from the same 'umeke. Fig. 1 shows that even as late as 1898 at the Iwilei prison in Honolulu, inmates ate poi from a eommon central pahu (barrel or tub), although their other foods were in separate individual plates. Pū'ā, meaning softening food by donor mastication for an infant or the elderly, who might have difficulty chewing the morsel, was a sign of special

affection for the recipient. Mikanele (missionaries) and later stern sanita-tion-conscious kumu kula (school teachers) decried such practices as promoting the transmission of harmful mū (germs). Whieh illness-producing mū? Ka ma'i 'Oku'u, the acute squatting diarrhea of 1804 that demolished Kamehameha's army and navy encamped on the Wai'anae beaches on the eve of the scheduled invasion of Kaumuali'i's Kaua'i, is now thought to have been cholera, or perhaps typhoid_. Both of these infections are acquired by mu-containing kukae (fecal) eontamination of nā lima (hands), ka wai (water) or ka mea 'ai (food). So poi could have played a role in the spread of that catastrophic illness. However, if the infected person were overtly ma'i (ill), such as with hi, piwa (fever), lua'i (vomiting) and 'eha'opū (abdominal pain), one would not expect the patient's mū-containing food to be knowingly shared with others, unless the persons concerned did not know better. No laila, what infections might a nonsymptomatic "carrier" unknowing!y transmit by sharing his poi 'umeke? Typhoid and related na'au (gut) carrier infections, as well as vital hepatitis A, might be so transmitted. Pehea o ka ma'i 'aiake (tuberculosis)? Tuberculous infection usually affects the akemāmā (lungs) and is acquired by inhaling the causative mu in ea (air) droplets from sputum coughed up by atuberculous patient. Tubercle mū in ka mea 'ai would not be expected to cause akemāmā infection, and would only rarely cause na'au tuberculosis, such as occurs-in pipi (cattle) tuberculosis in kānaka (human beings), or in patients with advanced akemāmā infection. The possibility that poi might be a suitable medium for the growth of the mū of tuberculosis and other disease-causing mū na'au, and thus might transmit such infections, was studied by UH professor O.A. Bushnell and his colleague Edwin Ichiru in 1950. They showed that the survival time of tubercle mū in poi at room temperature was only three days, because of rapid growth of "normal" contaminating mū, whieh sour the poi

and also somehow inhibit the tubercle mū. These results are similar to those reported i kēlā mahina aku nei. In contrast, refrigeration, by inhibiting the growth of "normal" mū, permitted the tubercle mū to survive for as long as 11 days. Here again, the. more sour the poi is, and the sooner it gets sour, the safer it is to eat! The two UH researchers then examined 141 samples of refrigerated poi, from various restaurants in Honolulu, for disease-causing mū. None of the samples contained usual disease-causing mū (such as salmonella and shigella), although smeill numbers of unusual infection-causing mū (like E. eoli and Proteus) were found, as expected. No laila, it would appear that poi has the potential to transmit some infections; akā, definite evidences of such spread of infections, from sputum or fecal contamination, have not as yet been demonstrated for poi. Poi, the main food staple of kānaka maoli for 2,000 years. Poi derived from taro, kinolau of Kāne _and hiapo of Hāloa, the eommon ancestor of all kanaka maoli.

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Fig. 1 . Prisoners eat poi with their fingers f rom a eommon central pahu (tub or barrel), although their other foods are in separate, individual plates, in this scene from Iwilei in Honolulu of 1898.