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Running on Empty IF outreach clinics on the North Shore were to close, says Claire Kumura, "I don't know where I would be. ... Not only me, but a whole bunch of people having a hard time."
Without more funding a
North Shore clinic could close
and leave many without careBy Helen Altonn
haltonn@starbulletin.comThe Haleiwa resident and other patients are facing that prospect in about two weeks if funds are not found to keep the Waikiki Health Center's Ho'ola Like (Healers Together) Outreach Project going.
"We are running out of resources for the program, and it would be tragic for the people out there if we had to close," said the Rev. Frank Chong, executive director of the health center.
The three mobile clinics provide medical care and medicine for up to 150 uninsured and underinsured patients a month. However, grants supporting the project from the Queen Emma Foundation and Office of Hawaiian Affairs have ended, Chong said.
OHA could not renew the health center's grant, among others, because the state attorney general said it did not go through the state Procurement Code's competitive bid process. Legislation is pending to address the concerns.
Meanwhile, about 30 to 40 grant applications are on hold, including the Waikiki Health Center's, said Nancy Holt, OHA grant specialist. "I feel so sorry for them. They have such a good program."
Kumura and her husband, Glenn, a part-time postal carrier for 17 years, are typical patients of the portable clinics. They have no medical insurance and are overwhelmed by medical problems, bills and medication needs.
They have been going to the Haleiwa clinic since Kahu Samuel Saffery provided space for it in July 1998 at the Queen Liliuokalani Protestant Church. The health team is there on Tuesdays, spending all day. Thursday mornings, it's at the Queen Liliuokalani Children's Center in Punaluu, and Friday mornings at the KEY Project in Kahaluu.
The clinics had 1,739 patient visits last year, of which about 60 percent were uninsured and 70 percent were of Hawaiian ancestry, said Mary Spadaro, health center director of development.
About 20 percent were children, not only getting treatment for illnesses, but school physicals and immunizations.
More than half of the adult patients have diabetes, hypertension or asthma-related chronic diseases, Spadaro said.
Chong said, "In all likelihood, they would not get help" if the clinics close because hospitals are too far, and many patients have no way to get to them. "What we say is, 'The North Shore is the ninth island.' You can get to Hilo in less time than it takes to get to Haleiwa."
Five nurse practitioners, two full-time outreach workers and about six nurse practitioner students from Hawaii Pacific University, the University of Hawaii and some mainland colleges see patients at the clinics.
They work as a team with Hawaiian healers Francine Dudoit and Bula Logan, combining Western and traditional medicine.
The program was selected two years ago by the U.S. Health Resources and Services Administration as a national model for "breaking down barriers to health care access."
Spadaro said the health center has made some grant proposals, but it needs funding until something materializes.
"It's terrible," said Dale Allison, HPU professor and nurse practitioner who coordinates the program. "What they've told us, if we can't come up with approximately $70,000 by March 15, they're going to close us."
Allison said many people who lost jobs, medical insurance and housing after Sept. 11 have been going to the clinics with depression and physical problems.
"But those are just Sept. 11 people. We have a lot of other people who have been living on the edge a long time."
Kumura, 40, disabled in an auto accident five years ago, suffers from diabetes, high cholesterol and arthritis in her spine and joints. She takes six different medications daily. She receives some Medicare assistance for her disability but no drug coverage.
Her husband also has diabetes and high blood pressure and was hospitalized a week with heart problems. Kumura said they are paying a $6,000 hospital bill to a collector, in addition to bills from three doctors and the emergency room.
"What's helping us a lot is the clinic," she said, adding that if it closes, "I just won't take the medicines because I can't afford to buy them."
MedQUEST will not help because her husband's income is "a little over the limit, but we're barely making it," she said. "We're living one day at a time."
Allison said her students really appreciate the training setting in the community and the chance to see integration of Western and Hawaiian medicine.
It works great, said outreach worker Dino Kealoha, because people in the area trust Hawaiian healers, and trust spreads from one side to the other. "It helps because Aunty Francine is a registered nurse and a traditional healer.
"Hawaiians are really proud people," Kealoha said. "They will not ask for a handout. They bring fruits for somebody else. They work it off or volunteer. They want to give back something."
She tries to get people on MedQUEST or Supplemental Social Security or whatever she can find to assist them.
"A lot of them could survive and be normal working people if they could get assistance. ... They want to be self-sufficient. It's hard when your health won't let you do what you want to do.
"This is a great program to help people with nowhere to go, but nobody will fund us, " Kealoha added. "If we close, where will these people go?"