Ka Wai Ola - Office of Hawaiian Affairs, Volume 6, Number 8, 1 August 1989 — He Mau Nīnau Ola [ARTICLE+ILLUSTRATION]

He Mau Nīnau Ola

Some Health Questions by Kekuni Blaisdell, M.D.

Na iwi o ke kino (the bones) Mokuna 'Ekolu (Part III) Na ma'i iwi (hone disease)

Ninau: As a Hawaiian, 1 feel we need to respect the buried remains of our ancestors, such as at Honokahua, Maui. Some scientists say these dug-up bones should be studied instead of reburied, or at least examined before reburial. However, I

heard that the bones of more than 1,000 of our ancient people are already stored in the Bishop Museum. What research, if any. has been done on those already available bones about diseases in old Hawai'i, and why do scientists need more Hawaiian bones to study? Pane: Like you, the general Hawaiian community has expressed a strong public voice for kanu hou (reburial) and malama (protection) of the recently excavated graves of about 1,000 pre-Western kānaka maoli (Hawaiians) at Honokahua, and kekahi ma kahi 'e (others elsewhere). Some po'e Hav.ai'i have even called for kanu hou of the iwi kānaka maoli now at the Museum. Your ninau about the status and research of those previously collected iwi has also been ninau 'ia by kekahi po'e heluhelu (other readers). In 1971, Kulanui o Hawai'i (UH) anthropologist Miehael Pietrusewsky inventoried the human skeletal remains in the Bishop Museum. Included were iwi of 2,912 individuals of Hawai'i, with those of 1,504 kānaka maoli kahiko loa (pre-Western Hawaiians) unearthed at Mokapu, O'ahu, from 1932 to 1957. (Fig. 1 shows a typical example of a distinctive traditional burial exposed in 1957). Pietrusewsky estimated that only "one-half to two-thirds of the eollection had been studied in detail." Publications by Kauka Wamer Bowers and Kauka Ivar Larwen in 1966, and Kentucky anthropologist Charles Snow in 1974 described nā ma 'i iwi (bone disorders) detected in the Mokapu iwi. These maladies may be mahele 'ia (separated) into eight classes and summarized as follows: 1. Birth defects, whieh varied from serious malformations like kuku'e (clubfoot) and spine bifida (spine non-closure), to subluxation (partial dislocation) and fusion, to minor and harmless bone anomalies such as "rocker jaw." 2. Acquired deformities, such as pressure"shaped skull," and nontraumatic asymmetrical deviations. 3. Trauma, such as fracture, dislocation and amputation. 4. Arthropath (arthritis), such as degenerative (Fig. 2), rheumatoid (inflammatory) and gouty (uric acid) forms (e nānā i lalo, see below). 5. Infection, as evident in localized surface uneveness (periosteitis), joint destructive irregularities (septic athritis), small bone cavities (abscess), and irregular deep bone destruction (osteomyelitis). 6. Tumors as single, benign bone replacement lesions, and only one or two examples of probable ma'i 'a'ai (cancer) with mulhple bone destructive sites suggesting cancer origin from soft tissue, such as the lung, breast or gut, with spread to bone. 7. Metabolic disorders, such as osteoporosis (loss of bone density) and gout (bone destruction by urate crystals, e nānā i luna, see above). 8. Dental abnormalities, whieh included malalignment, aries in low frequency until

after age 40 years, absent teeth, bone resorption of periodontal disease, and rare instances of adjacent bone abscess from dental infection (e nānā i luna). The finding of disabling birth defects, such as clubfoot beyond infancy, counter the early missionaryinitiated notion that infanticide of the deformed was a eommon pre-Western practice. Experts' opinions have differed on the evidence for questionable congenital hip dislocation, possible tuberculosis of the spine in one case, postulated scurvy (vitamin C deficiency), and presumed "squatting" bone alterations. No bone evidence has been found in this preWestem series for syphilis, yaws or rickets (vitamin D deficiency). The evidence for Kuku'e and gouty arthritis, both usually hereditary disorders, correlates with the increased occurrence of these afflictions in modem po'e Hawai'i. Of course, bone changes would not be expected to provide direct evidence about the possible occurrence i kahiko loa of the major causes of death in kānaka maoli i kēia wā (today) whieh originate in the soft tissues, 'oia ho'i, coronary atherosclerosis with myocardial infarction (heart attack), stroke with kokopi'i (hypertension), mimikō (diabetes), soft tissue ma'i 'a'ai and ma'i pu'upa'a (renal failure). Researchers such as Pietrusewsky argue that because of the incompleteness and uncertainties in the

previous studies of the Museum iwi, there is need for their further study using new, more advanced techniques, and comparison with other bone series in the past and in the future, such as those recently unearthed on Maui. Scientists also point out that investigation of bones is not confined to detecting disease, but also to other related factors, such as age at death, nutrition, childbirth, physical activity, medical practices, genetics and genetic relationships to other peoples, environment, social structure, and cultural behavior, including burial customs. Some of the findings have application to current health, medical care and education of modem Hawaiians. Retrusewsky also contends that leaming more of the history and culture of ka po'e Hawai'i through study of ancestral skeletal remains could support Native Hawaiian claims for their lands and sovereignty. Because other indigenous people have also protested the disturbance of their ancestral graves, the Association of Physical Anthropologists in 1982 adopted an official policy that respects such human remains in particular ways. These and other aspects of kanu, uses and usefulness of nā iwi kānaka maoli and their significance in the past and future will be further pursued i kēia mahina a'e. 'Oiai, e ho'omau e hā'awi mai nei i he mau ninau ola, ke 'olu'olu.

Figure 1. A female skeleton with the skeletons of several small fish and a fowl. Excavation and

photos by R.N. Bowen. Copyr>ght 1974 by The University Press of Kentucky.