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Ma ka hana mua ʻana o Glen Hayashida ma ka National Kidney Foundation ma ka makahiki 1995, he 1,000 mea maʻi hoʻomaʻemaʻe koko o Hawaiʻi a emi aku. 

Ma kēlā manawa, ua haʻi ʻia ʻo ia, ʻo ka helu o nā mea maʻi e kaukaʻi ana i nā mīkini e hoʻomaʻemaʻe koko me he hakuʻala lā, e māhuahua aʻe ana nō paha ua helu nei he pālua ma o ke aupuni i kēlā me kēia kekeke. Ma Hawaiʻi naʻe, he keu ka helu o ka māhuahua ʻana, he 4,000 mea maʻi hoʻomaʻemaʻe koko o ka mokuʻāina, wahi a Hayashida.

E nui aʻe ana nō ʻo U.S. Renal Care, ʻo ia kekahi o nā hui ʻohana ʻekolu e mālama ana i nā kikowaena hoʻomaʻemaʻe koko ma Hawaiʻi, a aia nō lākou ma ke alahele e hoʻomāhuahua pālua ʻia ai ka helu o nā kikowaena hoʻomaʻemaʻe koko a lākou e mālama aku ana ma ka makahiki 2023. 

I kēlā mahina aku nei, ua ʻāpono akula ka Hawaiʻi Department of Health i palapala pono no kahi kikowaena hou ma Kapaʻa, aia nō ia ma ka ʻaoʻao ʻākau o Līhuʻe ma Kauaʻi hikina. Ke nānā nei ke keʻena i kekahi palapala noi ʻē aʻe no kahi kikowaena hou ma Kahului ma Maui. A ma kēia kauwela, e wehe aʻe ana ʻo U.S. Renal Care i kikowaena hoʻomaʻemaʻe koko hou ma Kalihi ma Oʻahu. 

Hoʻohauʻoli nā kikowaena hou i nā lālā kaiāulu e ukiuki ana i ka nele i nā noho hoʻomaʻemaʻe koko ʻole. ʻO ka helu liʻiliʻi o nā wahi, he mea ia e pono ai nā mea maʻi e ala ma ke kulu aumoe a i ʻole hoʻi lohi i ka hale ma ke ahiahi no ka mālama ʻia ʻana. No kekahi, holo lākou ma ke kaʻa ʻōhua no hoʻokahi hola a ʻoi no ka hōʻea ʻana i laila a me ka hoʻi hale ʻana, a i ʻole, kaukaʻi lākou i nā lālā ʻohana e hoʻokū i kā lākou hana ponoʻī no ke kalaiwa ʻana aku a me ke kalaiwa ʻana mai iā lākou i ka hoʻomaʻemaʻe koko ʻia ʻana. 

Akā naʻe, i loko nō o ka hōʻoi ʻana i nā keʻena a pau i ka hiki ʻana o nā kānaka ke komo i ka hoʻomaʻemaʻe koko ʻia ʻana, he aka nō ka hoʻolaha aʻe ʻana i ka ʻoiaʻiʻo minamina no ka maʻi hakuʻala kuluma e pilikia ana, wahi a Hayashida, ʻo ia ka luna hoʻokō no ka National Kidney Foundation of Hawaiʻi. 

Hōʻike ka ʻikepili aupuni i ka nui o ka maʻi hakuʻala end-stage — ʻo ia ka mea e pono ai ka hoʻomaʻemaʻe koko a i ʻole ka hoʻoili hakuʻala — a ua māhuahua aʻe ua nui nei ma Hawaiʻi ma o kēlā kekeke aku nei i 5,700 mau mea maʻi a ʻoi ma ka makahiki 2019, ʻo ia ka helu kūikawā i hiki ke ʻike ʻia ma ka U.S. Renal Data System. He hoʻoluhi kino a he mea hoʻohopohopo ka hoʻomaʻemaʻe koko ʻia ʻana, a he mea nō ia e pipiʻi aʻe ana me ka hoʻonui ʻana aʻe i ke kumu kūʻai pekelala no Medicare. 

“Ua like nō ia me ka wehe ʻana i ke kī wai, ʻoi aku ka wikiwiki o ke kahe wai ʻana ma mua o ka hoʻomaloʻo wai ʻana,” wahi a Hayashida. “No laila, aia mākou ma kahi e pono ai ke kūkulu ʻana a me ke kūkulu hou ʻana.”

He Pono ʻOkoʻa

Ua hoʻopilikia ʻia nā Kānaka Maoli a me nā poʻe Pakipika e nā maʻi kuluma like ʻole ma Hawaiʻi. Hiki i ke kaiāulu ke make i ka mimikō me ka pahiki he pā 3.32 ke hoʻohālikelike ʻia me ko ke kamaʻāina ʻawelika ma Hawaiʻi. Loaʻa pū iā lākou ka helu nui loa no ka maʻi hakuʻala kuluma a hiki nō paha iā lākou ke loaʻa ka maʻi hakuʻala end-stage ma o ka mimikō ke hoʻohālikelike ʻia me nā kaiāulu ʻē aʻe. 

Ma Hawaiʻi nei, ʻo nā kaiāulu me nā helu nui no ka mimikō, nui nā kānaka e pono ai ka hoʻomaʻemaʻe koko ʻia ʻana, wahi a nā kahu mālama olakino. ʻO ka pilikia no ka ʻimi ʻana i nā hakahaka liʻiliʻi, he mea ia e pilikia ai nā ʻohana e koho paʻakikī. 

Wahi a ke kamaʻāina no Līhuʻe ʻo Marie Mendaro, ua hoʻonoho ʻia kona makuakāne ma Oʻahu no ka hoʻomaʻemaʻe koko ʻia no nā mahina he ʻeono ma o kona kali ʻana i ka wehe ʻana o kahi hakahaka ma Kauaʻi, a ʻelua wale nō kikowaena hoʻomaʻemaʻe o laila. A no nā mea maʻi i pani i ka hakahaka, hiki i ke kaheaholo ma ke alanui ʻololī pālua ke hoʻolohi i ke kalaiwa ʻana o nā mea maʻi no Kauaʻi ʻĀkau he hoʻokahi hola a ʻoi no ka hōʻea ʻana i ke kikowaena kokoke ma Līhuʻe. 

ʻO ka pono lako he $7 miliona i hoʻolālā ʻia ma Kapaʻa, e loaʻa ana nā noho he ʻeiwa wale nō, akā e kōkua ana kēlā i nā mea maʻi e like me ko Mendaro makuakāne, pēlā kāna i kākau ai ma kāna ʻōlelo hōʻike lehulehu ma ka lā 29 o Malaki no ka paipai ʻana i ka pono lako. 

“No mākou ʻo koʻu makuahine a me koʻu kaikunāne, ua paʻakikī loa ka mālama ʻana iā ia ma kona noho ʻana ma kahi mokupuni ʻē aʻe a me ka ʻimi ʻana i kahi hale a me kahi kahu nona i loko nō o ko mākou noho ʻana ma Kauaʻi me ka hana a me ka hele kula ʻana,” wahi a Mendaro. 

Manaʻo ʻo Liberta Albao no Kapaʻa, he nūhou maikaʻi loa ke keʻena hoʻomaʻemaʻe koko hou no ke kaiāulu ma ke kapakai ʻākau a me ke kapakai hikina o Kauaʻi, ʻoiai, e kokoke ana ua keʻena nei i ka ʻāina hoʻokūʻonoʻono Hawaiʻi ma Anahola. 

I mau makahiki aku nei, hoʻomanaʻo ʻo ia i ke kalaiwa ʻana o kona mau hoa hānau mai Hanalei i Līhuʻe i ʻekolu mau manawa i kēlā me kēia pule no ka hoʻomaʻemaʻe koko ʻia ʻana, i loko nō o ka mamao a me ke kaheaholo. 

ʻO ka pono no ka mālama olakino no nā mea maʻi mimikō, ʻaʻole nō ia ma Kauaʻi wale nō. ʻO Rick Hayashi, he kauka hakuʻala ʻo ia e hana ana ma Oʻahu a lele ʻo ia i Hilo i kēlā me kēia mahina e hui pū ai i nā mea maʻi ma laila. Ua hoʻomaka ʻo ia me nā kauka ʻē aʻe no Hawaiʻi Kidney Specialists i ke kipa ʻana i laila i kēlā me kēia mahina o kēia makahiki, no ka mea, ʻaʻole lawa ka nui o nā kauka hakuʻala ma o ka paeʻāina. 

E loaʻa koke ana kahi kikowaena hoʻomaʻemaʻe koko iā Hilo, wahi a Pliny Arenas, ʻo ia ka mea e nānā iā Hawaiʻi no U.S. Renal Care. Ua hoʻomaka ʻo Arenas ma ka mokuʻāina ma ka makahiki 2013, a ʻo kona nānā akula nō ia i ka wehe ʻana i nā keʻena hoʻomaʻemaʻe koko hou ma Waipahū, Beretania, Oʻahu Komohana, Honouliuli, Waipiʻo a me Waiʻanae. 

Ma Kēkēmapa, 37 mau kikowaena hoʻomaʻemaʻe koko o Hawaiʻi. Ma waho aʻe o Kapaʻa, Kalihi a me Kahului, he hoʻolālā kā U.S. Renal Care no ka wehe ʻana aku i nā keʻena hou ma Kīhei, Kona, a me Hilo ma ka makahiki 2023. 

ʻO Hawaiʻi kekahi o nā mokuʻāina he 35 e koi ʻia ai nā hui ʻoihana e loaʻa nā palapala mokuʻāina iā lākou e hōʻoia leʻa ʻia ai ka pono no ka pono lako ma mua o ke kūkulu ʻana i ka ʻōnaepuni mālama olakino nui. He mau mahina ke kaʻina hana no ka hōʻoia ʻana i ka pono no kahi kikowaena hoʻomaʻemaʻe koko. Ma luna aʻe o ka ʻāpono ʻia e ka mokuʻāina, koi ke kūkulu keʻena hou ʻana i nā palapala ʻae no ke kūkulu kamaʻāina ʻana a me ka palapala pekelala. Ke hoʻohui ʻia nā mea a pau, he ʻelua makahiki nō paha ke kaʻina hana. 

Ma luna aʻe o nā ālaina maʻamau, he mau miliona ka hoʻokumu ʻana i nā kikowaena hoʻomaʻemaʻe koko. Koi nā keʻena i hoʻokahi kauka hakuʻala a ʻoi, a wahi a Arenas, he paʻakikī nō kēlā no nā wahi kuaʻāina ma muli o ka nele ʻana i nā limahana olakino ʻole. 

“ʻAʻole nō ia he kaʻina hana maʻalahi,” wahi a Arenas. 

ʻO Nā Alahele ʻĒ Aʻe

ʻŌlelo akula ʻo Hayashi, ʻo ka pono hoʻomaʻemaʻe koko ma nā mokupuni ʻē aʻe, he aka nō ia no ka paʻakikī ma o ka moana nui, e like me kāna i ʻike ai ma kona hana ʻana no ka Department of Veteran Affairs a me kona huakaʻi ʻana i Sāmoa ʻAmelika — ʻaʻole lawa ka hana hoʻomaʻemaʻe koko e kō ai ka pono. Akā, nona iho, ʻaʻole ka haʻina ke kūkulu ʻana i nā keʻena hou. E paipai ana ʻo ia i nā mea maʻi e aʻo i ka hoʻomaʻemaʻe koko ʻia ʻana ma ka hale. 

ʻAʻole hiki i nā kānaka a pau ke hana pēlā, e laʻa nā mea hoʻomaʻi kuewa a me nā kānaka i hoʻopilikia kino ʻia i hiki ʻole ke hana i ka mikini a loaʻa ʻole nā kahu olakino iā lākou. Akā, he pane nō ia i hiki ke hōʻalo i ke kalaiwa loa ʻana a me nā pilikia i pili i kēlā ʻano huakaʻi ʻana. Hiki i ka huakaʻi ʻana ke hoʻopilikia i ka hana ʻana, e hoʻomehameha i ke kanaka, a e hoʻonui i ke kaumaha a me ka hāʻawi pio ʻana o nā mea maʻi, wahi a Hayashi. 

“Inā hiki iā kākou ke hōʻalo i ka lilo ʻana o nā kānaka i ka hoʻomaʻemaʻe koko ʻia ʻana, ʻoi aku ke koʻikoʻi o kēlā ma mua o nā mea ʻē aʻe a pau,” wahi āna. 

ʻO ka ʻike ʻana i ka hoʻomaʻemaʻe koko ʻana me he koho hope loa lā no nā mea maʻi me nā hakuʻala i holo ʻole, ʻo ia kahi kumu no ka paipai ʻana o ka National Kidney Foundation a me U.S. Renal Care i nā polokalamu hōʻalo mimikō a me ka hoʻomaʻemaʻe koko ʻana ma ka hale. Kālele nā kahu olakino, ʻo ka ʻai pono a me ka hoʻoikaika kino, ʻo ia nā lāʻau e lapaʻau ʻia ai ka mimikō. 

ʻO Sean Chun, he Kanaka Maoli e lāʻau lapaʻau ana ma Kauaʻi, ʻōlelo akula ʻo ia, he hohonu loa ka pilikia. Mālama ʻo ia i nā hui kaiāulu e kōkua aku ana i nā kānaka ʻōiwi e like me ia ma ka hōʻoi ʻana i ka hauʻoli a me ka haʻaheo. 

ʻIke ʻo ia i ka helu nui loa no ka mimikō ma kona kaiālulu me he pilikia hanauna lā i ili ʻia ma o ke kāʻili ʻāina a me ka hoʻokele waiwai e hoʻoneʻe i nā kānaka mai ka ʻāina mai i nā ʻoihana e paʻakikī ai ka nohona olakino maikaʻi ma muli o nā loaʻa kālā ʻuʻuku loa, ka huakaʻi hana loa, a me ka nohona noho paʻa ʻana. 

Manaʻo ʻo Chun, e aho e hoʻololi ʻia ka ʻōnaehana olakino holoʻokoʻa, a e aho e hōʻoi i ka holo kaʻa ʻana no nā kūpuna. Makemake ʻo ia i ka hoʻonui a me ka hōʻoi ʻana i ka hoʻonaʻauao ʻana, a me ka hōʻoi ʻana i ka hiki ʻana ke kūʻai mai i ka ʻai pono. 

Aka, ma kona lohe ʻana i ke kūkulu kikowaena hoʻomaʻemaʻe koko ma Kapaʻa, ʻōlelo akula ʻo ia, he kōkua nui nō ia. 

“Maikaʻi nā mea a pau e hoʻomaʻalahi ʻia ai ke ola,” wahi āna. 

Ua hoʻopuka ʻia kēia moʻolelo ma o ke kākoʻo ʻia ʻana e ka USC Annenberg Center for Health Journalism’s 2022 Impact Fund no ke kūkala nūhou ʻana i ke Kaulike Olakino a me nā ʻŌnaehana Olakino, a me kahi kākoʻo Civil Beat ʻo Dr. Mary Therese Perez Hattori.