Ka Wai Ola - Office of Hawaiian Affairs, Volume 25, Number 12, 1 Kekemapa 2008 — Hāna follows its own road in solving a DIALYSIS DILEMMA [ARTICLE+ILLUSTRATION]

Hāna follows its own road in solving a DIALYSIS DILEMMA

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To be screened for diabetes or for further infonnation on dialysis treatment, Native Hawaiians may contact one of the following Native Hawaiian Healthcare Systems: Ho'ola Lāhui Hawai'i (Kaua'i and Ni'ihau) 246-3511 www.hoolalahui.org Ke Ola Mamo (O'ahu) 845-3388 www.keolamamo ,org Na Pu'uwai (Moloka'i and Lāna'i) 560-3388 www.napuuwai.com Hui No Ke Ola Pono (Maui) 244-4647 www.huinomaui.org Hui Mālama Ola Nā 'Ōiwi (Hawai'i) 969-9220 www.huimala maolanaoiwi.org Papa Ola Lōkahi www.papaolalokahi.org

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I- e. ī, 1 " J_, - ■"•«■ i -Below: Hōna resident Unele Francis Blue Lono (background) wos receiving diūlysis in Woiluku, when he convinced a visiting Medicore official to toke the Hōno Highwoy — a move thot helped roise understonding of Hono's diolysis plight.

DIALYSIS

Cūntinuad fram paga IG is also a factor, since "People with lower ineome have a tendency to eat eheap fast food that's very high in fat." Lehua Cosma and others in the Hui touted the bad news in puhlie meeting after meeting anned with resolve to help their loved ones. "I told our story so many times at the Maui County Council that I got to the point where I no longer needed the pieee of paper with all the facts written down. I knew it all by heart," said Cosma, who credits East Maui County Councihnan Bill Medeiros for his support. Madge Schafer of the Governor's Advisory Council also heeame interested in helping the Hui Laulhna O Hāna. At last there eame a tipping point - not from a seat of polhieal power, but rather from the quiet voice of 67-year old Unele Francis "Blue" Lono, a Hāna fishennan and employee of the Nahonal Tropical Botanical Garden who catches the Maui Eeonomie Opportunity bus to Wailuku for dialysis treatment. "Go drive the Hāna Highway and see for yourself what it's like," he suggested to visiting Medicare official, who happened to be making a site visit to Wailuku. "(The official) took the ride on a terrible stonny day— and he got it. He sent out an e-mail the next day saying no one should have to endure what our dialysis patients go through," said Cosma. "The people of Hāna were steadfast in their grassroots effort. They helped federal officials to really experience their circumstances and govermnent then agreed to serve their special need," said Kini Birnie of the Native Hawaiian heahh organization Papa Ola Lokahi. In the last few months, Medicare and govermnent parties have moved concertedly with service provider Liberty Dialysis to implement an innovative plan first hatched by Madge Schafer of the Governor's office in discussions with the Hui Laulima O Hāna. Under this arrangement, patients will eome to the eommunal home, where they will have individualized dialysis machines and a private bedroom for the duration of their treatment; at the same time, professional caregivers and heahh educators will be on hand to assist when needed. As Cosma has always hoped, 'ohana wih be weleome to be part heahng process. "From the beginning, we envisioned a plaee of nurturance so that people in dialysis would never have to feel forgohen and alone," she said. A county-controlled-home in the Wakiu

area of Hāna has been selected as a loeation for the eommunal home. The roomy vintage structure — a familiar landmark to Hāna residents, poses some technical problems, though. An executive order stipulates use of the structure be lnnited to a physician's residence for the Hāna Community Heahh Center. Maui Mayor Channaine Tavares has sent a letter of request to the Board of Land and Natural Resources to lift the order and has also given notice to the home's current tenants to vacate the premises by the year's end. A spokesperson for the Mayor said she expects the site issues will be resolved by late January. The County is also providing $105,000 in funding to make needed infrastructure hnprovements to the home to ensure eomplianee with various regulations. Three patients, including Lehua Cosma's nioni, are ready to use the home as soon as it opens. Meanwhile, there is widespread agreement in the medical conimunity — whieh is seeing an explosion of diabetes cases statewide - that the Hāna residents have accomplished something important for all Hawai'i. Suzette Kaho 'ohanohano, a dialysis nurse for Hui No Ke Ola Pono, Maui's Native Hawaiian Health Care System, said Hāna's high profile advocacy has drawn attention to the silent dangers of a disease that often creeps up on people without producing any symptoms in the early stages. The laek of awareness of type 2 diabetes has particularly hurt Native Hawaiians in geographically isolated areas with less access to diabetes screenings. "They don't know they have the disease until it progresses to the point where dialysis is necessary to survive," said Kaho'ohanohano. "Hāna people have gotten diabetes into the headlines and sent the lifesaving message to know your numbers," said Kaho'ohanohano. Translation: get the simple blood sugar test, whieh will tell you if you are developing a diabetic condition (see insert). Guy Lay said that getting the eommunal home for dialysis in Hāna is just part of a bigger plan for Hawaiians to return to the healthy Hawaiian traditions of "working their own land and satisfying their sweet tooth by eating mangoes from the trees — not junk from a fast-food restaurant." He says he feels the entire Hāna coimnunity has been empowered by their success in keeping dialysis patients not only in their hearts but physically in their homes. "We were used to feeling we were off the radar. Now we know, reach out and make a difference." E3