Ka Wai Ola - Office of Hawaiian Affairs, Volume 7, Number 10, 1 October 1990 — He Mau Nīinau Ola [ARTICLE+ILLUSTRATION]

He Mau Nīinau Ola

by Kekuni Blaisdell, M.D.

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

Ninau: Since, as you point out Hawaiians have the most teenage pregnancies, eomplications of pregnancy and infant mortality, wasn't Kapi'olani Maternity Hospital founded to save the Hawaiian race? Pane: Mamua (pre-

viously), we provided the evidence that we kanaka maoli (indigenous Hawaiians) in our own kulaiwi nei (homeland), continue to have 'oi aku ka 'ino (the worst or near-worst) statistics for hāpairelated pilikia, such as makuahine (maternal) hāpai complications, kamaiki (infant) mortality and hānau (birth) defects rates. Akā (however), available evidence indicātes that we kānaka maoli were a hardy, burgeoning po'e (people) of perhaps 1 million before the arrival of the first haole (foreigners) 212 years ago. The striking contrast between our ikaika nā iwi (robust) kiīpuna (ancestors) and our grim health status i kēia wā (today) is attributable to rapid emi i ka lāhui (depopulation) mahope o (following) the "fatal impact" of 1778, foreign expioitation, eultural conflict and despair, too eager adoption of harmful foreign ways, and failure of the dominant Western, non-Hawaiian, and sometimes antiHawaiian, health care system to meet our dire health needs. All of these major "social factors" ho'omau (eontinue) i kēia wā. They also account for other deplorable "social indices" for our fellow kānaka maoli, 'o ia ho'i, homelessness, painful school-drop-out figures, low family-income and high jail rates. While some would rightly point out that the total number of our kānaka maoli is ho'onui 'ana (increasing), piha Hawai'i (pure Hawaiians) have emi 'ia (declined) to less than 8,000 and other kānaka maoli are increasingly outnumbered by non-kānaka maoli. Kalākaua's motto, "Ho'oūlu a Ho'ōla i ka Lāhui," when he became king in 1874, also became the name of a non-profit, private, wahine kānaka maoli charity founded in 1880, and headed by his wahine Queen Kapi'olani. After 10 years of fund-raising efforts, Ho'oūlu a Ho'ōla Lāhui 'Ahahui (Society) established the Kapi'olani Maternity Home in 1890 "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 Maternity Home". (italics mine.) I kēlā wā (at that time), the twilight years of the kingdom, only 40,000 kānaka maoli remained, and they were outnumbered by 50,000 non-kānaka maoli. Kānaka maoli death rates exceeded their birth rates and writers, as previously, continued to predict the extinction of our po'e. Encouraged by the King, wāhine kānaka maoli assumed the responsibility and leadership for reversing this trend by establishing the Kapi'olani Maternity Home. To ensure this native responsibility, the initial charter specified that the majority of board lālā (members) and officers of the 'ahahui be kānaka maoli. Further, as clear evidence that th° institution was specifically to meet the needs of indigenous mākuahine and kamaiki, only Hawaiian wāhine hāpai were admitted and their care was manuahi (free). In 1899, ua hala o Ka Mōlwahine Kapi'olani no ka stroke (the Queen died of stroke). She wassucceeded as president of the 'ahahui by Princess Kahanu (Fig. 1), ka wahine (wife) o Pnnee Kūhiō, nephew of the late Queen. In 1917, with Hawai'i asanillegallyannexed U.S. territory, paying and non-kānaka maoli makuahine were first admitted, and the official translation of "lāhui" in the name and motto of the Maternity Home was changed to "human race." The following year, the name "(Jo'oūlu a Ho'ōla Society" was officially dropped. De-Hawaiianization progressed in 1925 when unable-to-pay mākuahine hāpai, regardless of race, were admitted with their care subsidized by the county government. Some considered this "Hawaiianization," with kānaka maoli sharing their facility with others in need. All other patients were charged $25 for admission. No laila, the institution was no longer exclusively for hāpai Hawaiian women, nor was it only the responsibility of and by a core of fund-raising wāhine kānaka maoli. Rising costs for more sophisticated care pressed for broader and more sophisticated finaneial resources and management. By 1931, with an all-haole businessmenadvisory board, an all-haole kauka (physicians) advisory board, a bank loan and territory-wide fund eampaign, a new 50-bed unit was built whieh acquired a new official name: Kapi'olani Maternity and Gynecological Hospital.

During World War II in 1945, expanded babydelivery demands called for another new building with a U.S. government grant of $318,000and new wording in the annual tax exemption statement: the haukapila (hospital) was for the care of "Hawaiian and other women ..." Yet, two notable wāhine Hawai'i reactivated the departed King and Queen's "Ho'oūlu a Ho'ōla Lāhui." Mary Robinson Foster in 1934 provided kālā (funds) for "five ward beds" to be maintained for needy wāhine Hawai'i. And in 1961, Lani Booth willed $600,000 to the Kapi'olani building fund. In 1946, the first male, haole banker Theodore Cooke, became a trustee; and in 1950, the first male, kānaka maoli businessman James Clarke, was elected pelekikena (president). There followed othe prominent kānaka maoli in that office, 'o ia ho'i, Sam P. King, Kenneth Brown, William Kea and Clorinda Lucas. In 1972, however, the official dominance of kānaka maoli in policy decisions ended when thenpelekikena Elia Long and kākau 'ōlelo (secretary) Winona Love signed the charter amendment removing the founding requirement that a majority of trustees and officers be kānaka maoli. Two reasons were given: eligibility for U.S. federal funds required no racial restrictions, and merger of Kapi'olani Hospital with Kauikeolani Children's Hospital whieh had no special commitment to kānaka maoli. The foregoing provides background for the July 31, 1990 response of Kapi'olani Medical Center's president Richard Davi to my inquiry about the

Lenter s health programs tor kanaka maoli and the Center's role in the Native Hawaiian Health Care Act of 1988, whieh we will consider i kēia mahina a'e (next month).

Princess Kahanu