Ka Wai Ola - Office of Hawaiian Affairs, Volume 40, Number 8, 1 August 2023 — Healthcare Crisis on the Island of Moloka'i [ARTICLE+ILLUSTRATION]

Healthcare Crisis on the Island of Moloka'i

V LEO 'ELELE V ^ TRUSTEE MESSAGES *

Imagine an island with no doctors permanently living there, where patients must travel by air to access specialized medical care. Such a plaee is not a figment of the imagination, but rather the stark reality faced by the people living on the island of Moloka'i. With the highest concentration of Native Hawaiians per capita, Moloka'i eontinues to grapple with an acute

healthcare crisis. Compounding this dire situation, two of the island's cherished physicians died last year resulting in a 50% reduction in available healthcare services. One of those doctors provided care to about 1,700 residents. Currently, only a handful of doctors make periodic visits to the island to provide medical care.

On July 11, 2023, the Office of Hawaiian Affairs (OHA) hosted a community meeting on the island of Moloka'i. Before and after that meeting, I had the privilege of engaging with OHA beneficiaries. They candidly expressed their firsthand experiences dealing with the healthcare crisis affecting their island. Ruth Tanielu said that "every twothree days, a eouple of doctors fly in to work at Moloka'i General Hospital and then they fly out as another group of doctors arrive." Ruth also shared that a German doctor has been rendering medieal assistance to help meet the healthcare demand. She lamented the fact that she must still "travel from Moloka'i to Maui

or O'ahu to receive specialized medical care ffom a cardiologist because Moloka'i does not have the necessary equipment." Adding to her ordeal, Ruth often finds herself missing critieal appointments due to the unpredictable flight schedules of Mokulele, the sole airline serving Moloka'i. In emergency situations where surgical intervention is needed, patients are transported to Kaunakakai Regional Park

on Moloka'i, where they wait to be airlifted by helicopter to The Queen's Medical Center on O'ahu. Debbie Benjamin, another Moloka'i resident and OHA beneficiary, highlighted the presence of a "mental health crisis" on the island. She noted the absence of psychiatrists at Moloka'i Community Heahh Center where only one psychologist is available. Other beneficiaries echoed similar sentiments, revealing the laek of long-term care facilities for kūpuna. Consequently, many are compelled to leave Moloka'i to access long-term care services on neighboring islands. These beneficiaries stressed the fundamental right of kūpuna to "die with dignity on their home island." Numerous Moloka'i beneficiaries offered potential solutions to address the healthcare crisis. Kupuna Judy Caparida, for instance, advocated for high school counselors to guide students toward careers in heahhcare. Another possible solution involves offering increased financial incentives to physicians who choose to practice in rural areas. Similarly, medical education could be subsidized for future doctors and other healthcare professionals who eommiī themselves to work for a period of time in places with the greatest need. The State of Hawai'i could also play a crucial role by reducing regulatory obstacles and making it easier for private long-term care companies to establish facilities on the island. Whatever the solutions may be, the bottom line is that time is running out for thousands of residents on Moloka'i, especially our kūpuna. E hana kākou - let's work together now to solve the medical crisis on Moloka'i! ■

Keli'i Akina, Ph.D. Trustee, At-large

Trustee Akina (center) visits wilh Moloka'i residents to talk story about health care. - Courtesy Photo