Aloha mai kākou,
Health is a major concern for us all, and is a key strategic priority of the Office of Hawaiian Affairs. In the Western model, the focus is on the individual. But in the indigenous perspective, we look at the collective – the people, the lāhui, the environment and the elements. We know from our traditions that our kūpuna addressed health through what we’d now call a “preventative” system: by creating a holistic system of resource management, a key outcome of which was a vibrant, healthy population. We need a similar mind-shift today.
The late Dr. Kekuni Blaisdell often spoke about how the ahupua‘a model, in addition to being a complex method for managing water, land and political resources, is also a public health system. By effectively managing fresh water, agriculture can be successful; the aquifer is recharged; fishponds are stocked and plentiful; and humans benefit from a healthy diet and rich culture of collective labor. The ahupua‘a leads to a healthy community, by design.
We know what happens when we are disconnected from this traditional design. In 1985 the E Ola Mau report described the truth that we see in much of our native community: that Native Hawaiians were highest in terms of chronic disease, substance abuse, behavior, health, over-incarceration, poor academic achievements. The data indicates that Hawaiians are at the tertiary level of care. Primary care is when you go to a doctor; secondary is when you have to see a specialist. Tertiary care is more acute, more invasive, and is often the most expensive level of health care intervention. This all ties back to the separation of kānaka from ‘āina, to the erosion of communities and economies which promoted health.
Many organizations and leaders in our community are working hard to restore a full measure of Hawaiian health, from mauka to makai, by connecting us back to our culture, to our ‘āina, to our families, to each other.
One successful model is what Earl Kawa‘a is doing with his “Board and Stone” project. He connects people to poi, to pa‘i‘ai, to Hāloa, to the land. His requirement is that participation should happen as an ‘ōhana, not as an individual woman, man, or child. So in the course of learning how make a papa ku‘i ‘ai or pohaku ku‘i ‘ai, we also learn an older set of cultural pathways, including how to take more responsibility as a parent, how to mālama your keiki, and how to regain a broader sense of family health.
We can rebuild these systems by reclaiming our political governance, our lands, and our waters, and building healthier communities and stronger ‘ohana. These are the vital steps to achieving a more healthy lāhui, and it’s a task that we’re working on everyday at OHA. Aia ke ola ma ka hale.
‘O au iho nō me ke aloha a me ka ‘oia‘i‘o,
Kamana‘opono M. Crabbe, Ph.D.
Ka Pouhana/Chief Executive Officer