[Congressional Record Volume 145, Number 158 (Wednesday, November 10, 1999)]
[Extensions of Remarks]
[Pages E2338-E2339]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          ``NOW AND TOMORROW''

                                 ______
                                 

                           HON. PATSY T. MINK

                               of hawaii

                    in the house of representatives

                       Tuesday, November 9, 1999

  Mrs. MINK of Hawaii. Mr. Speaker, I am inserting an article by Sally-
Jo Keala-o-Anuenue Bowman that tells the story of one recipient of a 
Native Hawaiian Health Scholarship, which is funded by Congress under 
the 1988 Native Hawaiian Heath Care Act. This article provides 
compelling testimony on the value of this important program.

                   [From Island Scene (Summer 1999)]

Now and Tomorrow: A Hawaiian Social Worker in Wai'anae Brings Together 
                          Her Work and Culture

                  (By Sally-Jo Keal-o-Anuenue Bowman)

       Wai'anae Valley. A breeze through the crimson bougainvillea 
     at Kahumana Residential Treatment Center offsets the noontime 
     sun.
       In the parking lot, even before Julie Ann Lehuanani 
     Oliveira opens her car door, Kenneth Panoke waves to her, and 
     his sun-browned Hawaiian face breaks into a puka-toothed 
     grin. Oliveira, 28, is young enough to be his daughter.
       But he meekly follows her into the main building, rubber 
     slippers slap-slapping the tile floor. He holds her hand 
     while she talks with the center's medical director. Later he 
     clears her lunch plate when she finishes an informal 
     conference.
       Social worker Oliveira is on her Wai'anae rounds. Panoke, 
     who has bipolar disorder, is glad to tag along. They're old 
     friends from 1993, when he was a State hospital patient and 
     she was a practicum student from the University of Hawai'i 
     School of Social Work. Panoke had been in and out of the 
     State hospital all his adult life.
       Neither Panoke nor Oliveira is from Wai'anae, but this 
     Leeward O'ahu community with its entrenched reputation for 
     the classic Hawaiian problems of poverty, drugs, crime, and 
     life-threatening diseases, offers Oliveira a chance to serve 
     her own people. To Panoke, Wai'anae is a place to heal.
       Oliveira's road to social work started on Maui, where she 
     grew up in a Hawaiian-Portuguese family. Because her mother, 
     Hazel Makahilahila Oliveira, was widowed at age 26, she 
     counseled her five daughters to excel in school so they could 
     be independent. Oliveira had known since she was 8 that she 
     would join a helping profession. She earned a bachelor's 
     degree in business administration before earning a master's 
     in social work from the University of Hawai'i to be able to 
     provide both direct and administrative services.
       Her father's uncle, Lawrence Oliveira, was like a 
     grandfather to Oliveira. When Uncle Lawrence was dying in 
     Hana in 1997, he told Oliveira to promise him she'd return 
     home and take care of her community, her people. ``We talk 
     about how Hana is so small that everyone knows each other, 
     and the people have a hard time talking about their troubles. 
     He told me that's where I could help.
       These views meshed with the idea behind the Native Hawaiian 
     Health Scholarship Program, which fully funded Oliveira's 
     master's degree.
       The goal of the scholarship program is to train Hawaiians 
     to treat Hawaiians. The hope is that scholarship grads will 
     return to work in their home communities.
       The health of Hawaiians as a people is not good. They have 
     the highest rates of diabetes and heart disease, and the 
     lowest life expectancy of any ethnic group in Hawai'i. One 
     contributing factor is that sometimes, because of cultural 
     differences, Hawaiians are reluctant to seek health care. 
     Hawaiian physicians and other health care workers help open 
     the door, especially when these professionals grew up in 
     those communities. That's why priority is given to applicants 
     from under-served areas with large Hawaiian populations, such 
     as Hana, Wai'anae, and Moloka'i.
       The scholarship program, federally funded through the 1988 
     Native Hawaiian Health Care Act, has awarded 82 full 
     scholarships since 1991. In exchange, recipients--doctors, 
     dentists, nurses, dental hygienists, social workers, public 
     health educators, clinical psychologists, nurse midwives--
     promise to work in a Hawaiian community one year for each 
     year of their professional training. Eight have stayed in 
     their jobs beyond the required time, some in their home 
     communities.
       Oliveira remained in Wai'anae when she finished her 
     obligation in 1977 at Hale Na'au Pono, the Wai'anae Coast 
     Community Mental Health Center.
       She began at the mental health center as a clinician in 
     1995, soon becoming head of the Adult Therapy Division. 
     There, she recruited four other scholarship recipients--a 
     move that boosted mental health service in Wai'anae and 
     bounded the new professionals in their mission to help fellow 
     Hawaiians.
       ``The most beneficial part of the scholarship is not the 
     financial assistance, but the networking with other students 
     and having encouraging mentors,'' Oliveira says. ``I

[[Page E2339]]

     know that many of the opportunities I have are a direct 
     result of the scholarship program.''
       Hardy Spoehr, executive director of Papa Ola Lokahi, the 
     administrative branch of the Native Hawaiian Health Care 
     systems, says: ``All the scholarship students come out of 
     their special Hawaiian seminars with a sense of Hawaiian 
     culture that others may not have. They become aware of 
     culturally appropriate ways, such as how to approach kupuna 
     [elders]. By 2002--when Federal funds are up for 
     reauthorization--we'll have at least a hundred Hawaiian 
     health professionals in the field.''
       In 1985, ``You could count on two hands the number of 
     Hawaiian physicians in Hawai'i,'' Spoehr says. ``If these 
     scholarships can continue for a total of 20 years, we'll 
     build a pipeline of health services for 50 years--and make 
     major changes in Hawaiians' health status.''
       The idea of how powerful a rich presence of Hawaiians in 
     health care could be first came to Oliveira while she worked 
     with Hale Na'au Pono, then bloomed big on a trip she arranged 
     in 1997 for some of her women mental health clients. They 
     spent three days on Kaho'olawe, the limited-access island 
     that is still in transition from being a military practice 
     bombing target to a re-sanctified cultural resource for 
     Hawaiians. Oliveira saw metaphors for both her clients and 
     herself.
       ``I talked to them about how the breakdowns in their lives 
     were like Kaho'olawe's destruction,'' she says. ``Their 
     recovery will take their families' help. Nobody can do it 
     alone. Kaho'olawe represents that. You can't be by yourself--
     it's contradictory to the Hawaiian perspective.''
       Oliveira is convinced that such cultural experiences are 
     essential to the recovery of Hawaiian health. She also knows 
     the major obstacle: funding.
       Her new mission is to develop ways of documenting cultural 
     approaches to solving mental health problems, to help ensure 
     such programs will not forever be relegated to ``fighting for 
     funding scraps.''
       In 1997, to start a doctoral program in social welfare at 
     the University of Hawai'i, she shifted her role at Hale Na'au 
     Pono from directing day-to-day operations to consulting. She 
     also began consulting at Wai'anae's Hui Hana Pono Clubhouse 
     program and facilitating a women's group in the community for 
     the Ho'omau Ke Ola drug and alcohol treatment center.
       She is currently a consultant for the Native Hawaiian 
     Health Care Systems (one office of which is on the Wai'anae 
     Coast), and for the Kahumana Residential Treatment Center. 
     She is also conducting research with the UH Department of 
     Psychology to look at the impact of managed care on the 
     severely mentally ill.
       Farrington Highway is a fact of life, as Oliveira commutes 
     from her Waikele home to Wai'anae.
       There's much to be done. This is confirmed by Annie 
     Siufanua, clinic intake coordinator at the mental health 
     center. ``On the Wai'anae Coast, we don't have anger 
     management training, or programs for sex abuse or domestic 
     violence,'' says Siufanua. ``One psychiatrist comes three 
     days a week. Sometimes you can't get an ambulance--there are 
     only two for 65,000 people. The entire health care outlook is 
     getting worse.''
       That doesn't deter Oliveira. ``Our mission is to improve 
     the health status of native Hawaiians. It's worth it if you 
     can make a difference in even one person's life.'' She says, 
     pausing. ``But you pray at night that in 10 years the 
     daughter of your client won't be in the clinic for the same 
     thing.''
       By the time Oliveira finishes a Wai'anae day, the sandy 
     beaches border the highway gleam gold in the sinking sun. 
     Already in her short career, she has served Wai'anae well. 
     The community has also served her. It's here she developed 
     her idea that ``there's not enough for us Hawaiians at the 
     policy level. That's why we have a hard time getting the 
     funding we need.''
       Driving home, she keeps one eye on the road, the other 
     scanning the mountains and the sea in this community where 
     she has learned so much. ``I couldn't have asked God to put 
     me in a better place to prepare me to go home to work in 
     Hana,'' she says.
       And that preparation is already paying off. Julie Oliveira 
     has recently begun providing individual and family therapy in 
     Hana two weekends a month.

     

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