Dr. Kapono Chong-Hanssen views wellness from the perspective of both a doctor trained in Western medicine and a Native Hawaiian who is closely tied to culture and traditions.
He is the medical director of Hoʻōla Lāhui Hawaiʻi/Kauaʻi Community Health Center, a federally qualified health center serving Kauaʻi and Niʻihau whose mission is “to enhance the health and wellness of our community with an emphasis on culturally appropriate services for Native Hawaiians.” Those services include ancient healing practices such as lomilomi, hoʻoponopono, and lāʻau lapaʻau.
A family medicine physician, Chong-Hanssen is treating patients with cancer, diabetes, heart disease, and other life-threatening diseases, but this is the first time in his 12-year career that he is facing a nemesis as formidable as COVID-19. To date, it has taken the lives of more than 3.8 million people around the globe, and thousands more are at risk of debilitating, long-term complications from it.
On one hand, Chong-Hanssen recognizes vaccines are the most effective tools to end the pandemic; protect our ʻohana and communities; and once again enjoy travel and large gatherings with food, dance, music, and intimate greetings such as honi.
“Our best strategy to safely return to life as we knew it is to vaccinate as widely as possible,” he said. “That way, the few who may not want to be vaccinated or are not able to be vaccinated because of contraindications or medical issues will be protected by the immunity of the majority of people in their social circle.”
That said, he understands how history has fueled skepticism among some Kānaka Maoli, beginning with the arrival of foreigners in the late 1700s and the subsequent decimation of the Native Hawaiian population from measles, smallpox, and other infectious diseases from which they had no immunity. Just as devastating were Western business interests who disempowered Hawaiians and used them for financial and political gain, which ultimately led to the overthrow of the monarchy in 1893.
Chong-Hanssen believes this troubling pattern continues to this day, with tourism now acting as a neocolonial driving force.
“Hawaiʻi’s public-health and health-care systems have often felt more imposed on our lāhui rather than developed by us,” he said. “There’s the feeling that government leaders prioritize the wealth generated by tourism, whose primary beneficiaries are foreign investors, over the health of our people and our ʻāina.”
Negative impacts of tourism on Native Hawaiians range from the reinterment of sacred iwi to accommodate resort development and renovations, to the exploitation of precious land and marine resources, which some Kānaka Maoli need for subsistence. A long break from the stress of more than 10 million visitors per year allowed bays, reefs and rivers to make a dramatic recovery.
Some of Chong-Hanssen’s patients remain reluctant to be vaccinated because they think it will pave the way for the return of high-volume tourism. They don’t have confidence in government and public-health authorities and can’t depend on them to look out for their wellbeing. The vaccines are one more reason to be wary.
“Strengthening our lāhui by vaccinating as widely as possible puts us in the best place to protect our people and our home in the future,” Chong-Hanssen said. “But now that we’ve seen how a tourism-dependent economy can be detrimental, a renewed focus on economic diversification and sustainability, including production of more of our food, is warranted. Tourism can happen sustainably too; for example, controlling access to popular areas by requiring advance reservations, which is already being done at Hāʻena State Park on Kauaʻi. Under the leadership of John De Fries, the first Native Hawaiian to lead the Hawaiian Tourism Authority, there is new hope the industry will move toward sustainability in a more meaningful way.”
According to Chong-Hanssen, managing a pandemic, vaccination program and tourism boils down to kūkākūkā. In his opinion, the entire breadth of travel regulations should be considered along with global data, not just information from states in the continental U.S. whose geography and culture are far different from Hawaiʻi’s. New Zealand, Australia, Taiwan and Singapore – all island countries that actively promote tourism – made the safety of their residents a top priority and, interestingly, they experienced relatively little social and economic disruption.
Concerning vaccinations, Chong-Hanssen notes many Hawaiians’ sense of wellbeing is influenced more by their relationship with nature, their family, and Ke Akua than by doctors and public health officials. He and other Native Hawaiian physicians would like to bridge that gap.
“Many of my patients who initially did not want to be vaccinated agreed to it after we discussed it,” he said. “It’s a scary, upsetting time. They just needed their questions to be answered in simple terms by someone who understands the science – and who they know really cares about them.”
For help scheduling COVID-19 vaccinations visit hawaiicovid19.com/vaccine/.