Ka Wai Ola - Office of Hawaiian Affairs, Volume 7, Number 9, 1 September 1990 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

by Kekuni Blaisdell, M.D.

Ho'oulu a ho'ola lahui - Mokuna 'elua (Propagate and make healthy the race - Part II)

Ninau: Since, as you point out, Hawaiians have the most teen-age pregnancies, eomplieations of pregnancyand infant mortality, wasn't Kapi'olani Maternity Hospital founded to save the Hawaiian race?

Pane: I kēlā mahina aku nei (last month), we listed ten indicators of the worst or near-worst plight of us kānaka maoli (indigenous Hawaiians) in hāpai (pregnancy)-related pilikia, such as the highest infant mortality and birth defects rates. Such findings are not new. They continue trends evident since the fatal impact of the first foreigners in the form of Capt. James Cook and his crewmen in 1778, who brought gonorrhea, syphillis, probably tuberculosis, aleohol, tobacco, firearms, and disdain for our spiritual forces and nature about us. There followed other contagious infections, the high-fat and cholesterol western diet, exploitation of our people and ravaging of our forests in the sandalwood trade, whaling, cattleranching; suppression of our religion, culture and language; alienation of our people from their 'āina, and disruption of the ahupua'a 'ohana-sharing and educational learn-by-doing systems. All of the above events, whieh eonhnue in modified ways today, are among the responsible factors for makuahine (maternal) and kamaiki (infant) loss. These factors are generally considered to be low standards of living, poor habits and inadequate medical care. By 1855, with the native population down to about 70,000 from perhaps a thriving 1,000,000 at the time of Cook 77 years previously, Kamehameha IV lamented to the legislature: "The decrease of our population . . . is a subject in comparison with whieh all others sink into insignificance; for our first and great duty is that of selfpreservation. Our acts are in vain unless we ean stay the wasting hand that is destroying our people. 1 feel a heavy and special responsibility . . . one whieh you all must share; nor shall we be aequitted . . . of a neglect of duty, if we fail to act speedily and effectively . . . in the cause of those who are every day dying before our eyes." During those long painful years of the kingdom, rura) kānaka maoli, who survived from self-reli-anee on resources from the land and sea in the traditional ways of thier ancestors, fared better than their urban hoahānau (cousins) who, crowded in insanitary hovels of the seaport towns, succumbed from dependence on menial-wage jobs, contaminated food and water, recurring epidemics of infectious diarrheas, measles, influenza, mumps, whooping cough, small-pox, and later leprosy, plague, scarlet fever, diphtheria and rheumatic fever. lt was to meet the dire medical needs of these ailing and poor town natives that, in 1859, the King and his Queen Emma assumed the leadership in founding the Queen's Hospital as a government institution supported by a hospital tax. (More about this in a future eolumn). Thirty-one years and three kings later in 1891, the "Kapi'olani Home of the Ho'oūlu a Ho'ōla Society," a private non-profit institution, was chartered "for the purpose of establishing and maintaining a Maternify Home for the care and treatment of Hawaiian women during the period of childbirth and for such other benevolent and charitable purposes as may be consistent with the maintenance of such Maternify Home. " This passage from the English version of the original charter, now findable in the state archives, is emphasized here because it is not shown in the publications of the present Kapi'olani Medical Center for reasons, perhaps, that will become apparent as this

mo'olelo (story) unfolds. The 1894 deed officially transferring ownership of Ululani, Princess Kekaulike's formercottage on Beretania and Makiki Streets, to the Maternity Home where it first opened its doors in 1890, eonfirms that free maternal and newborn care were provided to Native Hawaiian women and their kamaiki, as related i kēlā mahina aku nei. The December 1, 1891 petition for a charter stated that the majority of the seven to nine members of the board of trustees would be of Hawaiian or part-Hawaiian ancestry. Queen Kapi'olani, the first pelekikena (president), was succeeded by her nephew Prince Kuhio upon her death in 1899. In 1917, 19 years after ho'ohui'āina (U.S. annexation of Hawai'i), paying and Hawaiian mākuahine (mothers) were first admitted, and the official translation of "Lāhui" in the name and motto of the Maternity Home, was changed to "human race." This was the beginning of de-Hawaiianization and non-Hawaiian control of the institution. At this time, kānaka maoli numbering about 40.000 were outnumbered by about 210,000 non-kānaka maoli in the territory. The fo!lowing year, a charter amendment shortened the facility's name to "Kapi'olani Maternity Home." Deleted were: "of the Ho'oūlu a Ho'ōla Society."

In 1922, with the death of Prince Kūhiō, his widow Princess Kahanu was chosen pelekikena. After becoming Mrs. Frank Woods the next year, she !ed the drive for a modern maternity hospital. To attract kauka (physicians), all of whom were haole, and who were delivering more kamaiki at the Queen's and Kauikeolani Cl.,dren's Hospitals, an arrangement was reach with the county for indigent mākuahine hāpai (pregnf women) to be admitted to the Maternity Home with their care subsidized by the government. A i other women were charged a $25 admission fee. By 1929, with an all-haole businessmen advisory board and another medical adviso' y board of allhaole kauka, saie of the Beretania Street land, a bank loan, and private donations, a new 50-bed building arose on Punahou and Br gham Streets. Featured firsts were modern deii -ery rooms, a separate nursery, an operating suite an X-ray unit and a laboratory. Clearly justified was the 1931 charter amendment with another name change, this time to "Kapi'olani Maternity and Gynecologieal Hospital." I kēia mahina a'e (next month). we will consider further de-Hawaiianization of the Kapi'olani Medieal Center and failure to meet the persistent mākuahine and kamaiki needs of nā kānaka maoli.