The Hawaiian Culture and Healthcare

Hawaii is a state comprised of many islands that were formed thousands of years ago from under-sea volcanos. These islands soon after becoming home to many different racial groups. The first of these to populate the Hawaiian Islands were the Polynesians at around 400-500 AD. Following the Polynesians was a British explorer by the name of James Cook in 1788 (Linnekin, 1983). Soon after Cook’s arrival, many European, American, Asian, and Philippine travelers came to visit and migrate to the islands. The Hawaiian Islands have since become a very racially diverse population, with no single majority.

Although their racial population is diverse, there is one thing that most all Hawaiian Islanders share, and this is their common Culture. The reason that I chose to talk about the Hawaiian culture is because with every interaction that I have had with the Hawaiian people, whether in person or otherwise, they have come across as very passionate toward their culture and heritage. The Hawaiian culture “runs deep in their blood” and shapes many of their life choices.

As foreigners we sometime stereotype the Hawaiian culture as primarily “just pineapples, coconuts, tourists, grass hula skirts and leis’ (Young, 2004), when in reality they culture consist of much more. Hawaiians are a very traditional people. Many of their cultural practices are passed down and continued generation after generation. Some of these practices include dances and chants that tell a story of their ancestors, hand made canoes and clothing, agricultural medicines and foods, ancient temples, rituals, nature, and family!

The Modern native Hawaiians are a people known for their foods and fast and have become a more obese people than of those in times of old.

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However, this was not always the way. The ancient Hawaiians were believed to have had one of the greatest diets in the world. Some of the traditional foods that you would find amongst them, and as part of their culture are laulau (pork and taro leaves), pork, fruits, rice, chicken rice, poke (raw fish), “fish, pounded taro root, dried bananas, sweet potatoes, and breadfruit” (Linnekin, 1983). Hawaiians believed strongly in a healthy diet and in a healthy lifestyle. In Hawaiian the “word for health is ola. It also means life. Thus, the word health and life was one and the same” (Center on Disability Studies, 2009) for them.

With today’s native Hawaiian diet, modern western food choices have replaced those of culturally traditional ones. Where their traditional diet consisted primarily of fish, shellfish, fruit and pork with only one form of starch (taro), their modern diet has been replaced with foods high in sugar, carbohydrates, processed foods, rice and breads. As a result of this this there has been a decrease in health with a rise in obesity, diabetes, heart disease and high blood pressure. Culturally traditional healthcare practices were performed in ancient time, and in some modern practices, by Hawaiian healers known as kahunas. Some of the traditional remedy’s that these kahunas use include the Hula dance as a mind-body exercise to promote cardiometabolic and mental health, lower blood pressure, and reduce body pain; the kava root in a pounded or chewed form as a calming and consciousness-expanding tincture; and poi, a lactic-acid producing bacteria used as a dietary probiotic (JP, 2016).

Kahunas would use these herbal remedial in conjunction with other practices such as heat or hydrotherapy, bone setting, massage, prayer, and chants. In today’s modern healthcare setting, it is important to know if these traditional practices are being implemented in conjunction with modern medicine so as to not cause severe adverse reactions when treating with drug therapy. Also, as a nurse we should know if the patients would like to have a kahuna present and involved in their care plan and understanding how to safely incorporate him/her. In Hawaii, family is highly cherished and incorporates more than just blood relatives. The Hawaiians view communities as family as well and refer to those close to them as “Ohana”, meaning “family”. The Hawaiian family is very traditional in the sense that the mother tends to the home and garden, the father works to provide food, hunt, and build, and the children assist and learn from their parents based on the prospective gender. Hawaiian families have the expectation of every member to responsibly use his or her talents to the benefit of the entire family. In the healthcare setting it is important to understand that although all visiting parties for the patient might not be blood related, they are still viewed as family and should be treated with the same respect.

Much blood and non-blood related individuals will show up to provide support. Love, and concern and should be accommodated appropriately per the patient’s requests. Hawaiians also view their elderly with great respect and strongly heed to their council. Understanding this will help understand the background to the patients’ healthcare decisions and why they choose the treatment that they do. Hawaii is a place rich in cultural traditions and very family and community centered.

Although western modernization has heavily influenced a lot of Hawaiian practice, it is important to understand that many ancient cultural traditions are still practiced and still cherished. As a healthcare professional, it is important that we understand and respect that these cultural practices play a vital role in their health and recovery of our patients and that we need to ensure that we foster an environment and relationship that allows them to comfortably implement them as they wish.