Hawai‘i in Public Health

Abstract

Historical trauma occurs across generations and is evidenced by indigenous disparities. Efforts made to address this issue commonly utilize European ethnocentric methods. Rather, a community-based approach should be used to empower indigenous communities. God's Country Waimanalo (GCW) is a grassroots organization developed by Native Hawaiians for Native Hawaiians. Its wa‘a (canoe) project, Ho‘omana‘o Mau (everlasting memories; abbreviated Ho‘o) is meant to perpetuate pre-colonial Hawaiian practices by educating Native Hawaiian communities and its partners through hands on experience. Since 2012, GCW has opened its wa‘a curricula to educators, counselors, and students from the University of Hawai‘i at Manoa, Queen Lili‘uokalani Children's Center, Alu Like, Hina Mauka, and the Youth Correctional Facility and contributed to Waimanalo based events such as funeral ash scattering and the papio fishing tournament. As metaphor, Ho‘o is viewed as the catalyst to engage the next generation of Hawaiians to remember where they descend from, the lineage of chiefs and royalty, while establishing a solid foundation of independence and enhancing their ability to become self-sustaining. As a method, Ho‘o is viewed as a classroom, a hands-on learning environment, and an ocean vessel, assembled according to traditional Hawaiian knowledge. Through this knowledge and practice, both indigenous and non-indigenous communities can work together in empowering Native Hawaiians to overcome historical trauma and reduce health disparities.

Background

As time progresses, many of ancient Hawai‘i's cultural practices have all but disappeared. The influx of modern technology and the encroachment of foreign ideology, politics, and religion have greatly altered the homeostasis of a once thriving and self-sustaining Hawaiian community. The severity of these transformations from old world order to modern day life has caused the once thriving Hawaiian nation to become minorities in their own land.¹ Previous research has shown that the trauma of western colonization has not only severed the connections to sources of sustenance but has also caused displacement of Hawaiian families and communities.²

Prior to colonization, Native Hawaiians thrived in an existing culture, government, language, and religion. However, new worldviews dissolved the indigenous systems as foreigners judged the native ways of life based on western standards. In 2008, the United Nations recognized that the indigenous people have “suffered from historic injustices as a result of colonization.”³ Historical trauma can be defined as psychosocial trauma experienced by indigenous groups as a result of colonization, war, genocide, or cultural, social, and political subjugation.^4,5 The literature suggests that historical trauma occurs across generations, beyond those who experience the traumatic events first hand.^4–6 Evidence can be seen in the health disparities that Native Hawaiians face compared to other ethnicities in Hawai‘i. As a whole, Native Hawaiians experience high rates of acute diseases, depression, self-destructive behaviors, hostility, and chronic bereavement.⁷ Although previous efforts have been made to amend the outcomes of this disparity, the western-centric methods utilized continue to compare indigenous communities to European standards.⁸ Decolonizing methodologies such as community-based participatory research (CBPR) are recommended because they apply perspectives that challenge the European ethnocentric paradigms and empower indigenous people to improve their lives using their own approaches and aims.^9–11 Further, Native Hawaiian health programs should be developed, implemented, and researched by Native Hawaiians.

Waimanalo is a town that lies along the windward coastline beside the Ko‘olau mountains. Prior to colonization, Waimanalo's ahupua‘a (traditional land division) extended from present day Olomana to present day Hawai‘i Kai. During the 1960s, Henry J. Kaiser dredged part of the original Waimanalo and converted it to a series of luxury condominiums and homes now known as Hawaii Kai (“Kai” for Kaiser). Nearly one third of the Waimanalo residents are Native Hawaiians and the average family income is 31% less than that of the state.¹² Many efforts in Waimanalo have been made to improve the circumstances of its indigenous residents. God's Country Waimanalo (GCW) is a grassroots organization located in Waimanalo, O‘ahu, Hawai‘i. Their mission is to propagate and perpetuate the Hawaiian culture by incorporating the following values: (1) Kuleana - privilege, responsibility, (2) Malama - to care for, protect, and maintain, (3)‘Ike Pono - to know, see, feel, and understand, and 4) Ha‘aha‘a - humility and humbleness.

One of the projects implemented by GCW is the wa‘a (canoe) project, Ho‘omana‘o Mau (Ho‘o), which means “everlasting memories.” Ho‘o is a fifty-two foot long single-hull voyaging canoe moored off shore at Pa Honu, Waimanalo. It is used to build and strengthen the community through hands-on experiences guided by Native Hawaiians. Ho‘o facilitates the emphasis of Hawaiian culture preservation and Hawaiian people empowerment as a metaphor and method.

As metaphor, Ho‘o is viewed as the catalyst to engage the next generation of Hawaiians to remember where they descend from, the lineage of chiefs and royalty, while establishing a solid foundation of independence and enhancing their ability to become self-sustaining. As a method, Ho‘o is viewed as a classroom, a hands-on learning environment and an ocean vessel, assembled according to traditional Hawaiian knowledge. According to Pukui,¹³ ma ka hana ka ‘ike, translates as “in doing one learns.” Discovering cultural identity through cultural healing will allow Native Hawaiians to mitigate their own trauma, reduce internal discord, and heal wounds thus improving their social, mental, and physical health.¹⁴

Community Engagement

In January 2012, Mike Muller donated the wa‘a, or canoe, Ho‘omana‘o Mau to GCW to serve the Waimanalo community and its partners. Since then, with the help of Ho‘o's kahu (caretaker), Bob Lastimosa, GCW has been developing integrative curricula that involve cultural competency lessons for outsiders and cultural healing through practice for Native Hawaiians. The purpose of Ho‘omana'o Mau is two-fold: (1) to perpetuate Hawaiian culture and knowledge through educators and counselors by facilitating their understanding and utilization of this knowledge to improve and support the advancement of Native Hawaiians in today's society, (2) to assist Native Hawaiians in regaining their cultural identity that was lost through historical trauma by bringing back canoe culture and reinstating Hawaiian cultural practices such as navigation, fishing, and the idea of ahupua‘a through hands on learning.

So far a series of ocean perspective events known as Holo Kai (Ocean Voyage) has been offered to educators, counselors, and students from the University of Hawai‘i at Manoa, Queen Lili‘uokalani Children's Center, Alu Like, Hina Mauka, and the Youth Correctional Facility. In addition, Ho‘o has supported events and activities that help the community re-learn voyaging and navigation practices from thousands of years ago. Ho‘o welcomed her kupuna (elder) wa‘a, Hokule‘a, (navigational star), to our shores on October 19, 2013, during her around the islands tour. On two occasions Ho‘o and crew have supported scattering of ashes in waters off Waimanalo. Family members have shared aloha for the opportunity with heartfelt love and joy during a somber season of their lives. The annual papio fishing tournament in Waimanalo was established around the existence of Ho‘o. Families come together to share food and knowledge through this cultural event.

Pilot Evaluation

In February 2014, educators, counselors, and their families from the University of Hawai‘i at Manoa (UHM) were invited to participate in an integrative cultural competency training. A pilot evaluation was conducted by the students of School of Social Work and Office of Public Health Studies. The purpose of this pilot evaluation was to gather preliminary data that could guide the development of an effective curriculum that utilizes the wa‘a to perpetuate Native Hawaiian knowledge, culture, and traditions to educators and counselors.

Participants were asked to complete a non-identifiable pre and post training paper survey that asks for demographics (age, zip code, and ethnicity), training expectations, reasons for attending the training, and their opinion on whether and how learning traditional Hawaiian practices is valuable in the area of social work. All survey questions besides demographics allowed for free-text responses. Survey results were evaluated using univariate analysis. Qualitative analysis methods were used to identify common themes in the free response sections.

A total of 29 participants attended the training. Since most were affiliated with UHM, 55% of the participants were from central O‘ahu and the average age was 39 years old. Approximately half of the participants reported only one ethnicity whereas the others reported two or more. The majority of participants were of Asian or Pacific Islander descent.

The wa‘a experience met, if not exceeded, the expectations of the participants. Participants were expecting to learn and experience Hawaiian cultural concepts. The knowledge they retained after the experience revolved around the meaning and importance of place, community, and individuals. Participants were asked if and how learning traditional Hawaiian practices is valuable in the area of social work, before and after the training. Substantial differences in survey responses were evident when comparing themes generated from the pre- and post-training surveys. In the pre-training survey, many simply stated that traditional Hawaiian practices were important, but did not have any specific insight into how they might be valuable in social work. However, in the post-training survey, participants were able to provide specific reasons for why this activity was important. Participants also enjoyed the wa‘a ride and the interaction with the people who were present. Most participants did not suggest improvements to the wa‘a experience. A few recommended that the shipmen share their experiences, make the wa‘a ride longer, and make the experience more interactive. This event was successful in familiarizing educators and counselors with Native Hawaiian culture, regardless of ethnicity.

Future Directions

GCW plans to recruit and train the next generation of Waimanalo community members through the new curriculum, Malama Ho‘omana‘o Mau (taking care of or working for Ho‘omana‘o Mau). Although still in its planning phases, this curriculum aims to train the next generation of crewmembers by transferring wa‘a knowledge through hands-on learning opportunities with the veteran crew. Learning by doing is a Hawaiian mindset that is encouraged and infused at GCW in all activity areas and will be the cornerstone of the Malama Ho‘omana‘o Mau curriculum. The idea here is to take individuals who have minimum knowledge of traditional voyaging and teach them all facets of operating Ho‘o, including sail and engine operation, rigging, anchorage, first aid, and rescue swimmer techniques. Furthermore, collaboration with researchers is needed to identify a non-invasive and effective evaluation approach for this new curriculum.

Conclusion

Practitioner Kalani Ka'aihue once said that “every ahupua‘a needs a voyaging canoe.”¹⁵ Ho‘omana‘o Mau is poised to bring function and form to canoe culture in the Waimanalo community and beyond with the development of curricula that brings method and metaphor to life in a meaningful way, steeped in the Hawaiian cultural value of ma ka hana ka ‘ike for generations. With the resurgence of Hawaiian cultural practices looked upon in a positive light, more and more people want to engage and experience canoe culture, as well as other activities. Certainly, Ho‘o provides a foundation for young and old to see, feel and experience canoe culture from a practitioner's perspective. Through the wa‘a curricula, the Native Hawaiian community and its partners become knowledgeable and well acquainted with pre-colonial Hawaiian practices. This knowledge and practice in turn enable both indigenous and non-indigenous communities to work together in empowering Native Hawaiians to overcome historical trauma and reduce health disparities.

Conflict of Interest

None of the authors identify a conflict of interest.