Healthcare Crisis on the Island of Molokaʻi

by OHA Trustee Keli‘i Akina, PhD,  Ka Wai Ola, August 1, 2023

Imagine an island with no doctors permanently living there, where patients must travel by air to access specialized medical care.

Such a place is not a figment of the imagination, but rather the stark reality faced by the people living on the island of Molokaʻi. With the highest concentration of Native Hawaiians per capita, Molokaʻi continues to grapple with an acute healthcare crisis. Compounding this dire situation, two of the island’s cherished physicians died last year resulting in a 50% reduction in available healthcare services. One of those doctors provided care to about 1,700 residents. Currently, only a handful of doctors make periodic visits to the island to provide medical care.

On July 11, 2023, the Office of Hawaiian Affairs (OHA) hosted a community meeting on the island of Molokaʻi. Before and after that meeting, I had the privilege of engaging with OHA beneficiaries. They candidly expressed their firsthand experiences dealing with the healthcare crisis affecting their island.

Trustee Akina (center) visits with Molokaʻi residents to talk story about health care. – Courtesy Photo

Ruth Tanielu said that “every two-three days, a couple of doctors fly in to work at Molokaʻi General Hospital and then they fly out as another group of doctors arrive.” Ruth also shared that a German doctor has been rendering medical assistance to help meet the healthcare demand. She lamented the fact that she must still “travel from Molokaʻi to Maui or Oʻahu to receive specialized medical care from a cardiologist because Molokaʻi does not have the necessary equipment.”

Adding to her ordeal, Ruth often finds herself missing critical appointments due to the unpredictable flight schedules of Mokulele, the sole airline serving Molokaʻi.

In emergency situations where surgical intervention is needed, patients are transported to Kaunakakai Regional Park on Molokaʻi, where they wait to be airlifted by helicopter to The Queen’s Medical Center on Oʻahu.

Debbie Benjamin, another Molokaʻi resident and OHA beneficiary, highlighted the presence of a “mental health crisis” on the island. She noted the absence of psychiatrists at Molokaʻi Community Health Center where only one psychologist is available.

Other beneficiaries echoed similar sentiments, revealing the lack of long-term care facilities for kūpuna. Consequently, many are compelled to leave Molokaʻi to access long-term care services on neighboring islands. These beneficiaries stressed the fundamental right of kūpuna to “die with dignity on their home island.”

Numerous Molokaʻi beneficiaries offered potential solutions to address the healthcare crisis.

Kupuna Judy Caparida, for instance, advocated for high school counselors to guide students toward careers in healthcare. Another possible solution involves offering increased financial incentives to physicians who choose to practice in rural areas. Similarly, medical education could be subsidized for future doctors and other healthcare professionals who commit themselves to work for a period of time in places with the greatest need. The State of Hawaiʻi could also play a crucial role by reducing regulatory obstacles and making it easier for private long-term care companies to establish facilities on the island.

Whatever the solutions may be, the bottom line is that time is running out for thousands of residents on Moloka’i, especially our kūpuna.

E hana kākou – let’s work together now to solve the medical crisis on Molokaʻi!