Ka Wai Ola - Office of Hawaiian Affairs, Volume 8, Number 11, 1 November 1991 — Operations start at Hui No Ke Ola Pono administrative office on Maui [ARTICLE+ILLUSTRATION]

Operations start at Hui No Ke Ola Pono administrative office on Maui

Hawaiian Health Horizon§

by Keoki Sousa, Executive Director

Hui No Ke Ola Pono has started operations at 2307 Main Street, Wailuku to provide outreach, case management and administrative services, and at 4293-A Hana Highway in Hana to provide outreach and case management services. As of Oct. 1, two employees had been hired to initiate outreach and case management activities. As executive director, I am responsible for administering the grant and for managing overall operations. Terry Lee Poaipuni, the Hana Community Coordinator, is responsible for coordinatinq outreach and case management services in the area from Ke'anae to Kaupo. Other staff members are also being recruited and hired to fill the positions of case manager, office manager, community coordinator for central Maui, and community health workers for both sites.

Hui No Ke Ola Pono, whieh means "An Association to Strengthen and Perpetuate Life," is a Native Hawaiian organization created in response to Public Law 100-579, The Native Hawaiian Health Care Act of 1988, to serve Native Hawaiians on the island of Maui. The overall strategy of Hui No Ke Ola Pono is to acknowledge and celebrate the wisdom of our ancestors' teachings, and to rediscover and renew our knowledge of the old ways that worked then and whieh may work in today's society.

The Hui will strive to integrate the teachings of the past with the technology of the present, and to develop a health care system that meets the needs of the Native Hawaiian community on Maui. Outreach/case management teams at eaeh site consist of community coordinators, community health workers, and resource people from participating organizations, including public health nurses, public and private providers, and volunteers.

Our first-year goals are to enroll 10 percent (approximately 2,000) of the Native Hawaiian population on Maui and complete individual health needs assessments and follow-up on all enrollees. Also, recruit, hire and train staff, especially community health workers; plan and implement health promotion programs to be presented to families, public and private schools and other community groups; and cooperate with service providers in delivering health screening, immunizations, and other age-sex specific examinations (such as mammography); and develop referral mechanisms with participating primary care service providers. Additionally, we will initiate organizational planning activities to qualify Hui No Ke Ola Pono as a federally qualified health center (FQHC) to become eligible as a vendor under the Medicaid and Medicare systems.

A unique and historically significant provision of the act is that health care services may be provided by traditional Native Hawaiian healers. Accordingly, the Hui has developed a closely supportive relationship with the Kahuna La'au Lapa'au O Maui, the organization founded by Unele Harry Mitchell and Kahu Kawika Ka'alakea in 1986 to provide access to traditional practitioners on Maui. Finally, the Hui will implement the Maui Native Hawaiian Diet with groups of volunteers from Hana and central Maui who will commit themselves to staying on the diet for a year. Nearly 24 percent, or 18,837, of Maui's total populahon of 80,380 are Native Hawaiian, of whieh most are in the younger age groups (47 percent under 18 years of age, and 30 percent between the ages 18 and 34). From community meetings held this past spring, the following health care issues ranked

highest: laek of money to pay for services, laek of health insurance coverage, laek of quality health care services, the laek of knowledge of available services, distrust of doctors and "foreign" institutions, intimidating medical staff, forms, procedures and buildings, and long driving distances to heatth care.

From meetings with providers, the following issues were identified among their Native Hawaiian clients. From public healthnursing: drug abuse among youth and aleohol abuse among adults; illiteracy; a sense of helplessness; family system breakdown; laek of adequate role models; low self-esteem; and the loss of cultural values and identity. From mental health providers: family system dysfunction, including family violence, ineffective parenting skills; low self-esteem; laek of adequate role models; and poverty.

From a consortium of health care agencies: laek of preventive care; substance abuse; poverty; laek of nutrition education; poor eomplianee with medical orders; laek of parenting skills; teen pregnancy; diabetes; laek of prenatal care; heart disease. From elderly Native Hawaiians participating in a luneh program: diabetes; high blood pressure and heart disease; cancer, gout, asthma, and arthritis; high cost of medications; and laek of

transportation. Kauka Kekuni Blaisdell tells us that in the traditional Hawaiian view of man, all living things share the same original parents, sky father (Wakea) and earth mother (Papa), and are connected by a "life force" (mana).

Because everything in the universe was living and interconnected, it was important to the Native Hawaiian (kanaka maoli) to be in harmony or balance with everything else. Good health (olakino maika'i) was a matter of maintaining the proper balance or harmony (pono) between mind, body and spirit; and the traditional model of good health depended on the stability and effectiveness of the family ('ohana), whieh included the extended family and others regarded with affection.

When the 'ohana had achieved pono, other factors of a system in balance and harmony included healthy nutrition practices, maintaininga positive outlook on iife, engaging in low-risk lifestyle behaviors, maintaining physical fitness and engaging in regular spiritual practices. In the absence of pono, Hawaiians of old suffered physical and mental aiiments, most of whieh were attributed to a breakdown in harmony and halanee between members of the 'ohana. For further information, eall Keoki Sousa at 2444647, or Terry Lee Poaipuni at 248-7502.

(Ieft to right) Gen linuma, public health educator with the state Department of Health, Leilani Hays, vice president of Hui No Ke Ola Pono, Keoki Sousa. executive director of the

hui, and Avery Chumbley, president of the Maui County Fair Association. The hui booth tied for second plaee for decoration and theme of the fair.

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