Molokai may
get dialysis unit

Molokai residents currently
must move or commute to
another island for
kidney dialysis

By Helen Altonn
Star-Bulletin

Seven Molokai residents who had to move to Oahu for kidney dialysis may be able to return home this year.

St. Francis Medical Center's Renal Institute of the Pacific is working with Molokai's people to build a dialysis facility there.

"The target date still is being adjusted on when we're actually going to start construction," said Roberta Lovely, the institute's administrative director. "I'd like to shoot for summertime this year."

Judy Mikami, Molokai General Hospital's Kidney Health Program manager, said at least 250 residents have been identified by the Molokai Family Health Center with renal insufficiency and potential renal disease.

Describing the critical situation recently to legislators, she said eight patients needing treatment have been able to remain on Molokai through a home-based hemodialysis program.

Two others off-island are waiting for aides to be trained so they can be treated in their own homes, she said.

St. Francis provides the training and the machines. However, state funds for the aides will end July 1, Mikami said.

Without about $120,000 to continue the home dialysis program, or a facility on Molokai, patients will have to relocate or commute three times a week to another island for treatment, she said.

For those who have done that, Mikami said, "The stress of traveling and the physical, mental and financial impact (that it) caused resulted in a shorter life span, minimal or no quality of life and many other problems for them and their families."

Mele Look, manager of Queen Emma Community Health, points out that Hawaii has the highest rate of kidney failure in the nation at 9 per 10,000 population, and Molokai has the highest rate of all the islands at 19 per 10,000 population.

She said the home hemodialysis program, funded by the state Legislature and the Queen's Medical Center four years ago, has been cost-effective and innovative.

It has built on Molokai's community strengths, such as a tight family system and cooperation among agencies and neighbors, to provide prevention and treatment services, Look said.

Lovely said the dialysis facility also "is something that's coming from the community."

She said a site has been identified near Molokai General Hospital, which is part of the Queen's system.

St. Francis will design and build the facility and provide personnel, and is looking for additional funding for equipment and dialysis machines, she said.

A grant is being requested from the Legislature to help with the costs, estimated at more than $300,000 excluding rent, she said.

Six stations are planned that could serve 12 to 18 patients three days a week, Lovely said.

Patients still would have the option of home dialysis.

St. Francis also is working with Molokai General and community groups on education and prevention of diabetes and kidney problems, Lovely said.

Look said a diabetes care management effort was initiated since more than 75 percent of the island's dialysis and renal insufficient patients have diabetes.

"What is so exciting is this Molokai-style of doing it," she said.

Queen's and St. Francis are collaborating with patients and neighbors to form support groups and patients are educating each other, Look said.

"Instead of just recipients of care, they have become teachers of care... It has become a model that can be taken to other communities," she said.