Ka Wai Ola - Office of Hawaiian Affairs, Volume 2, Number 9, 1 September 1985 — He Mau Ninau Ola [ARTICLE+ILLUSTRATION]

He Mau Ninau Ola

Some Healih Quesfions by Kekuni Blaisdell, M.D.

Q: E kauka, you make it seem too simple. To solve our health problems, all we Hawaiians need to do is be culturally happy and get the government to support us. But how does this improve our health statistics? A: Ekalamaiia'u(Iapoligize) for misleading you. Our Pilikia ola (health prob-

lems) are hihia (comp!ex), not ma alahi (simple). Our major pilikia vary from ma'i pu'uwai (heart disease), ma'i 'a'ai (cancer), hahau (stroke), and kokopi'i (high blood pressure), to ulia (accidents), mimiko (diabetes), ma'i pu'upa'a (kidney failure) and suicide. Other lahui (races) have similar pilikia ola, but we po'e Hawai'i (Hawaiians) have the highest overall rates for these ma'i. Causal factors also are hihia, multiple, interact and in some instances are not completely identified. In 1979, a group of Mainland experts estimated the relative roles of the four main causal and risk factors of illheakh in Amelika to be as follows: Causal factors Relative Role 1. Unwholesome lifestyle, e.g., high-fat, high- 50*\> sugar, and high-sodium foods; self-abuse with cigarette-smoking, aleohol and drugs; physical inactivity; and stress. 2. Environmental hazards, e.g., harmful 20"<> chemicals, accidents, insanitation, homelessness, family disruption, aborted schooling, unemployment, advertising propaganda, and enme. 3. Human biological factors, e.g., heredity; 20% obscure cellular and biochemica! mechanisms. 4. Inadequatehealthcare,e.g.,lackofhealth 10% professi'onals, hospitals, medications, immunization, and early detection. Whieh of these causal or risk factors apply especially to us modern po'e Hawai'i, and why are we so vulnerable when our kupuna (ancestors) of pre-haole Hawai'i were so robust? Na pane (answers) to these ninau are certainly hihia, not ma'alahi, and we weleome your no'ono'o (thinking). Hawaiian health historical and cultural task force of E Ola Mau, a parent

health needs study group, is now considering the following mau koho mua (hypotheses): — Since the fatal impact of the first foreigners in 1778 and the rapid depopulation of our po'e Hawai'i kahiko by introduced infections and customs, we have almost completely lost our native culture and language. Our elected, Constitutional government was overthrown by the landing of U.S. armed forces. Our lands have been, and continue to be, taken. We are no longer self-sufficient, living off the land and sea, but rather, pawns dependent on, and controlled by, multinationa! overseas business conglomerates. — The majority of us po'e Hawai'i have failed to adapt to the dominant haole competitive eeonomie, social, political and educational culture whieh promotes commercial exploitation, pollution and destruction of our fragile environment, showy consumption and waste and whieh continues to demean our indigenous culture and is insensitive to our people's needs. — Yet, too many of us po'e Hawai'i have eagerly embraced some harmful, haole lifestyle ways, such as faulty nutrition, puhi paka (cigarette-smoking) and inu loa (aleohol). This unwholesome health assessment is only one dimension of a conquered and despirited people who, in our own native land, are mere remnants of a onee proud and thriving oeeanie race. Tentative recommendations to ho'opono (correct) this plight include: 1. Input of po'e Hawai'i in all aspects of planning and implementtion. 2. Fostering of na mea pono Hawai'i values and practices beginning with our goals. These goals are defined in our traditional holistic terms of pursuit of meaningful lives through lokahi (unified, harmonious) interaction of ka'uhane (spirit), with ke kino (body), ka na'au (intellect), ka manawa (emotions), na 'ohana (family), ka lahui, na kupuna, na 'aumakua (family guardians), and ke ao (world, nature and environment), rather than merely improved health statistics. 3. Kako'o (support) of ke aupuni (government), schools, industry, labor and communications media in return and preservation of productive Hawaiian lands, self determination, self'sufficiency, healtheducation within na 'ohana, train ing of culturally-sensitive po'e Hawai'i healih professionals, and culture-awareness training of non-Hawaiians. Na mea piha pono (details) of these and other hihia proposals will be presented in future columns. Meanwhile, e ha'awi mai nei i mau ninau ola, ke 'olu'olu.