APHN ProgramCulture Of Health

Hui Mālama Ola Nā ʻŌiwi. Hui means a body of people. Malama means to care for people. Ola Nā ʻŌiwi ʻŌiwi.is in reference to the bones which is in reference to the people. So Hui Mālama is this body takes care of its people. And the idea is to make health, the people to be healthy. And so when we started essentially we just did transportation because that was the biggest need at that time.

And so when we started looking at the programs, the people started coming in, and we started asking questions. One of the things I identified which is a very cultural kind of component particularly with the Hawaiian people but it’s true with all the cultures. People don’t want to talk about their health problems. So they come in asking for help and they say oh I don’t have transportation to the doctor. What they don’t really tell you is I really have to see a doctor. They give you transportation as an idea.

The other part that added to that was we noticed that they were not really, they were afraid to ask for help. And so when you design our programs what we looked at, we started with educational programs. We started out with diabetes, then we included hypertension, then we added a cancer support group,

And for our first diabetes class we registered 15 people and only four people showed up for my class. And that was the way it was when we first started. People would say yes they want to come but they would be embarrassed to come. And at that one class, this lady, I was explaining to them that there’s no such thing as a stupid question. There’s no dumb question. If you have a question about something that’s bothering you don’t be ashamed to ask. So this one lady in the class she raised her hand very slowly and she said can I ask a dumb question. And I said there is no dumb question. And when she asked her question, my husband was sitting across the room, he said they was like the lightbulbs went on in everybody’s eyes in that room. They all turned to her like oh my gosh. Like you could tell, I thought I was the only one going through that.

And so when I gave that explanation, I answered her question for her. It was like the whole class just changed their attitude. And so we started developing classes because we realized that people were embarrassed to ask about their diabetes about their blood pressure, about any kind of health problem they had. And they didn’t want to be called dumb, or stupid.

I had this one lady, the doctor called me and he asked if I would, if there was anything I could possibly do to help this lady because she refused to take her insulin. Her numbers were really high, but she was so scared.

So she came to the office, and we tried to make our area very very user friendly, so we always had spaces where if they didn’t want to be seen by anybody we could be with them alone. If it didn’t matter to them, we could sit in the living room, you know. But we had it set up so that there were places where we could be at where they would be comfortable. So I had her come into my office. And I started out, by which is the way I did things, was I would take the registration for her, but instead of saying okay question number one, what’s your name? Question number two, what’s your address? Question number three, what’s your social security? I would just kind of talk with her to tell me about her family life, her history, where she grew up. And as she told me those things I would write it down on my registration form. And then I finally got to the place where she was really comfortable, really relaxed.

She was telling me all about her family. And then I said oh so, your doctor is kind of worried about you. Yeah cause I don’t wan take the insulin, I scared. I said, you know what? I’m gonna show you a trick I learned in school. My associate next door to me, she had an orange. I said, okay, I said. I ran out, and I said, can I borrow your orange? She brought her orange to me. So I said, I gonna show you something. I said, this is how I learned to do insulin when I started to be a nurse.

Two weeks later, I’m in the supermarket and I hear this scream. Aunty!

She said, you should see my numbers!

And then her doctor called me. What did you do? I said nothing really. Just helped her to understand how important it was for her to do it. He said, I can’t believe it. She’s actually doing her insulin twice a day as I instructed her. And her numbers have gotten so good. She didn’t think that was ever a possibility.

for somebody like that who’s got all these fears and is not doing what’s healthy for them, we sometimes have to kinda make it things look, you know, kind of more like fun than serious yeah? And it worked for her

So with a lot of the classes or educational things that I did. I primarily did things like that. I tried to make it user-friendly. I tried to give them an environment that was comfortable and then I tried to make it simple so that you know, I wasn’t using really high-tech wording or you know anything that was real medical-sounding. I tried to simplify for it them so they would feel comfortable with it.

And anytime they had a question they could call me. And they could talk to me any place or anywhere they would be comfortable. So if they didn’t want to do it at home because they didn’t want their family to know they were asking questions about this then I would meet them wherever they wanted to meet. It didn’t matter to me where it was. Just some place where they would be comfortable. Just the environment itself alone I think sometimes really made a difference on how more alert they were and how more willing they were to listen and understand.

With the Hawaiian culture anything that has to do with your body is very private. This is not something you discuss with anybody. So for our Hawaiian people to come out and ask for care for their health was a very very difficult area because they did not want to talk about that. So we had to explain to them and we had to take them into an environment where we were not saying well what’s the matter with you? How come you not doing this? And why you not doing? You didn’t lecture them, yeah? You sat them down and explain why it was important for them to do certain things.

Anytime the Hawaiians needed help they must look stupid. And they would say no, they not helping you because you stupid. They helping you because they’re there to help you. And it’s their job to help you.

I think we really made a difference on our island with our agency was when, they used to tell me that you know, I feel like when I walk through your front door I feel so welcome. I feel like I’m part of your family. I feel like I belong, yeah? And they would be fearful about coming in. Because Oh I’m gonna look stupid, because I’m going to Hui Malama for health, education. So, I must be stupid. But they said that when they would walk through the door that idea would just kind of disappear.