Thursday, November 15, 2001

From left, psychology trainees Kamana'opono Crabbe,
Jill Oliveira-Berry and Lisa Kaneshiro worked with
supervisor John Myhre Tuesday at the Waianae
Coast Comprehensive Center.

for care

Native Hawaiian students and
communities benefit from a health
care scholarship program

By Helen Altonn

Young Hawaiian health professionals are helping patients as "curbside counsels" at the Waianae Coast Comprehensive Health Center.

Dr. Gerard Akaka, the center's medical director, said that is how he is using students training as psychologists under the unique Native Hawaiian Health Professions Scholarship Program.

Launched in 1991, the federally funded program has awarded 111 scholarships to date in 13 health professions, from doctors and dentists to nutritionists and even a nurse midwife. Costs per student may total more than $50,000.

After completing their studies, recipients must give one year of service for every scholarship year. Priority work sites are federally designated community health centers in native Hawaiian health care systems.

Tripler Army Medical Center has joined the program to train scholars in its psychology department funded by the Department of Defense.

At the Waianae health center, Akaka said if patients are in good health but experiencing depression, anxiety or other minor problems, he turns them over to the psychologists to spend more time with them for a better diagnosis.

He sees the program "as a relatively efficient way to get mental health-type care for a lot of our patients who are off the radar screen, with mild to moderate problems. ... This new kind of model takes care of a lot of patients who would be waiting six weeks or maybe not even be identified as having a problem."

John Myhre, waiting for his license as a clinical psychologist after completing the scholarship program, supervises Tripler's scholars at the Waianae center: Jill Oliveira-Berry, Lisa Kaneshiro and Kamana'opono Crabbe.

They cannot say enough about the program's benefits or about Tripler. Its role cannot be overstated, Myhre said, noting few accredited internships and fellowships are available in Hawaii.

Without Tripler's participation, psychology scholars probably would go to the mainland for residency and remain there to practice, Kaneshiro said.

The four scholars spend a day or two a week at Waianae, and Myhre and Oliveira-Berry also go one day a week to the Hana Community Health Center on Maui.

Kim Ku'ulei Birnie of the Hawaii Primary Care Association, placement director for the scholarship program, noted that while about 20 percent of the state's population is Hawaiian, only 5.5 percent of all physicians are Hawaiians.

Because of high chronic disease and death rates among Hawaiians documented in a 1985 study, she said, "the situation was determined to be dire, and Sen. (Daniel) Inouye pushed through the Native Hawaiian Health Care Act."

The act created Papa Ola Lokahi, a nonprofit group concerned with improving health of native Hawaiians, five Hawaiian health care systems and the Hawaiian Health Scholarship Program.

Birnie said it is believed Hawaiian patients would more likely seek preventative care and treatment at earlier stages if Hawaiian health professionals were working in their communities.

Kamehameha Schools manages the scholarship program with Papa Ola Lokahi and the Primary Care Association. Papa Ola Lokahi is expected to take the lead in January with Kamehameha Schools pulling out.

Hardy Spoehr, executive director of Papa Ola Lokahi, said the program "will dramatically affect the health and well-being of native Hawaiians in the next generation."

He said Hawaiian health professionals "are not only trying to make the Hawaiian community healthier, but the whole community. They're seeing people of all ethnic backgrounds and social and economic standing, so their impact is far beyond just the Hawaiian community."

Spoehr said the organizations are excited about Tripler's involvement. "Until Tripler stepped forward, in terms of clinical psychologists here, they basically had to go to the mainland to complete their education."

Oliveira-Berry said the scholarship program "helps to focus students on school and staying in your home to give back to the community."

Fewer than 1 percent of Hawaii's psychologists are Hawaiians, Crabbe pointed out, stressing the need to develop health expertise and knowledge with a culturally sensitive approach to serve Hawaiian people.

Birnie, who matches students to community needs for service, said: "When they are pau, they can return to the University of Hawaii and go into research or teaching, or into private practice. They can move out of Hawaii or join the military.

"Our hope is they will continue to serve particularly underserved Hawaiian communities."

Scholarship facts

The Native Hawaiian Health Professions Scholarship Program at a glance:

>> Students must be native Hawaiians studying a primary health-care profession.

>> Priority is given to applicants from areas of greatest need, such as Molokai, Lanai or Hana, Maui, or to those going into priority professions, such as nutrition, nursing or social work.

>> Professions represented include doctors, dentists, nurses, dental hygienists, social workers, public health educators, clinical psychologists, family and substance abuse counselors, nutritionists and a nurse midwife.

>> Of 111 scholarships awarded since 1991, 67 recipients have been placed in Hawaiian or underserved areas to fulfill their obligation of one year's service for each scholarship year; 41 have completed service.

Source: Hawaii Primary Care Association

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