In the traditional Hawaiian worldview all things have life, all things have value, and all things are related in a complex genealogy of the world. The Hawaiian fundamental belief in pono - of the balance needed for things to be right - is based on the proper relationships between the cosmology, the gods, the environment, and all living beings. The traditional Hawaiian concept of wellness incorporated pono so that in order for a person to have proper wellness all aspects - the physical, the environmental, the spiritual, the emotional, the social, the interpersonal - had to be properly attended and in balance.

The traditional Hawaiian subsistence way of life was a physically active lifestyle with a simple nutritious diet that maintained a robust and healthy population. In addition, the extreme isolation of Hawaii (the most isolated archipelago in the world) meant that Hawaii was free of most diseases and scourges that affected other parts of the world.
Unfortunately this isolation also meant that Hawaiians did not have the antibodies to fight diseases when they came in contact with them.

In addition, because of this holistic approach to wellness, when balance was disrupted through the collapse of the Hawaiian way of life, Hawaiians were vulnerable to all sorts of illnesses: physical, mental, emotional, spiritual.
     Through the history of Hawaiian health we are able to trace the history of the assault on Hawaiians and the Hawaiian way of life which began with the arrival of Captain Cook in 1778 and the introduction of gonorrhea and syphilis, and continued with the arrival of Protestant missionaries in 1820 at which time the Hawaiian population had declined by about 100,000 in less than a generation.

Continuing with the land division known as the mahele in 1848 which destroyed traditional Hawaiian land tenure and made the majority of Hawaiians landless. At this time also the first case of leprosy was noted, a disease that had an overwhelming impact on Hawaiian families. Continuing with the overthrow of Queen Liliuokalani in 1893 at which time the Hawaiian population had dwindled to 40,000 while the foreign population was 50,000.
     At this point in history, in 2002, Hawaiians have some of the worst health statistics in Hawaii for morbid obesity, substance abuse, depression and other mental illnesses, diabetes, respiratory illnesses, heart disease, cancer mortality. Hawaiians are also over represented in jails and prisons.
     However, Hawaiians have attempted all along to try and counteract the forces that were creating the structures, beliefs and behaviors that were destroying them. One form of resistance has been to try and find ways to maintain the health of the Hawaiian community against all odds. Kamehameha IV and Queen Emma established Queen's hospital in 1859 with free service to indigent Hawaiians. In 1874 Father Damien arrived in Kalaupapa to try and improve the condition of the leprosy patients that were forced to live and die there.
     In the latter half of the 20th century, institutional efforts have been made to improve the social situation of Native Hawaiians with such organizations as Alu Like founded in 1976, the E Ola Mau studies completed in 1985, the Native Hawaiian Health Care Improvement Act which established Papa Ola Lokahi in 1988 with the reauthorization in 1992 which established the Native Hawaiian Health Care Systems and the Native Hawaiian Health Scholarship Program.
     The push for Native Hawaiian determination and the attempts by Hawaiians to perpetuate their culture and revive their language and values includes the need for Hawaiians to improve their wellness by returning to what Hawaiians once knew and lived - wellness requires attention to all aspects of life and the return to pono. This Native Hawaiian Health site is part of an ongoing effort to empower Hawaiians by creating healthy individuals, families, and communities.

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Content written by Esther Figueroa, Ph.D., Juniroa Productions, Inc.

Update on Kanaka Maoli (indigenous Hawaiian) Health
by Kekuni Blaisdell, M.D.