HAWAIIAN PHYSICIANS EMERGING

I have read with interest the many letters attacking and supporting Kamehameha Schools. Perhaps I might add an interesting medical education dimension.

From the time of contact with Captain Cook in 1778 until 1892, no Native Hawaiians were sent abroad to receive a medical education, none whatsoever, until Dr. Matthew Makalua (sent to England by King Kalakaua in 1882) received his degree from King's College, London, in 1892. Twenty-two years later, Kaumu Hanchett (Kamehameha, 1908) received his M.D. from Harvard Medical College. Although there were a few other Native Hawaiians in the subsequent decades who received medical degrees, the next physician from Kamehameha was George Mills, M.D. (KHS '40), then Kekuni Blaisdell (KHS '42).

For the past 30 years, I have researched Hawaiians who studied medicine. With affirmative action programs beginning in the 1970s, the numbers began to accelerate. Today, we have such individuals as: Roberta Apau Ikemoto, M.D., radiology (KHS '60); Gary Gutcher, M.D., neonatology (KHS '62); Chiyome Fukino, M.D., state Department of Health director (KHS '68); Kuhio Asam, M.D., psychiatry (KHS '70); Clayton Chong, M.D., oncology (KHS '72); Angela Pratt, M.D., obstetrics and gynecology (KHS '80); Donna Kalauokalani, M.D., anesthesiology (KHS '82); Winnie Mesiona Lee, M.D., pediatrics (KHS '87).

These are specialists, but even in the day-to-day delivery of primary care, Kamehameha is well represented: Bernard Chun (KHS '62); William Ahuna, M.D. (KHS '64); Noe Apau, M.D. (KHS '70); Gerard Akaka, M.D. (KHS '72); Martina Kamaka, M.D. (KHS '78); Kelli Ann Voloch, M.D. (KHS '85); Ming Tim Sing, M.D. (KHS '83); William Thomas, M.D. (KHS '77). The current medical director of the health clinic (Hale Ola) at Kamehameha is Phillip Reyes, M.D. (KHS '74).

Contrary to the accusations of so many letter writers, most of these Kamehameha physicians did not come from privileged backgrounds. They came from working-class families who were not able to afford the other private school tuitions but who still struggled to provide them with a good education at Kamehameha.

Attorney Eric Grant, in a moment of triumphant oratorical grandiloquence, quoted Martin Luther King's comments about "content of character" but somehow failed to mention whether King would have condemned the HBCU (otherwise known as Historically Black Colleges and Universities), whose preferential admission policies still help to correct inequities, disparities and underrepresentations of African-Americans within the medical profession.

In the mid-1970s, there were only 10 Hawaiians licensed to practice medicine in the state of Hawai'i. Today, there are more than 200, and most of these physicians are graduates of Kamehameha. Yet this number represents only 3 percent of all licensed physicians in Hawai'i.

I am a Hawaiian physician but not a graduate of Kamehameha Schools. Yet it is with no small amount of pride that whenever I glance toward Kapalama Heights, I see the faces of Kamehameha's graduates who are now making an indelible mark in improving the lot of an indigenous people who, sadly, still top the list of morbidity and mortality tables.

I was glad to see the article on bottomfish recovery in the waters of the Kaho'olawe Island Reserve. The article mentioned the use of kapu as a tool to manage the ocean resources surrounding Kanaloa, the ancient name for Kaho'olawe many Hawaiians still prefer.

I was also pleased to see the feedback letter by Albert A. Nakaji on Aug. 10. He describes several types of kapu, none of which were area-specific. He could have mentioned that kapu can also apply to restricted areas. An ali'i, for example, would often kapu a fish pond, a section of reef or an offshore ko'a, to the exclusion of others. These areas could often be quite large. Because kapu assured a sustainable resource, the entire community and the resources themselves benefited from judicious use of this tool.

Albert is correct in pointing out that it was never applied to an entire island system. However, our kupuna never had to deal with: (1) unexploded ordnance and the safety issues it creates; (2) commercial fishing, utilizing methods that exploit fishery resources on a massive scale, usually outside of the ahupua'a; (3) large fishing fleets; (4) refrigeration, which allows for taking more than one needs; and (5) electronic fishing technology, like three-dimensional sonar that allows fishermen to "see" under and into caves at depths greater than 600 feet deep.

Under these circumstances, it is my opinion that our kupuna would have certainly considered implementing the type of traditional kapu that the Kaho'olawe Island Reserve Commission has implemented, not only in the reserve, but also in other waters. The commission has chosen the most prudent path available to effectively carry out its ocean management responsibilities. Other governmental agencies should consider using all the tools available to them, especially traditional methods such as the various kapu whose effectiveness was proven by the original resource managers of these Islands.

Our kupuna never managed in terms of years, they always managed in terms of generations. More state agencies and members of the public should make use of this wisdom and incorporate it in their planning and stewardship decisions. Using kapu and other traditional methods with a history of success is more important and relevant today than ever, especially since tomorrow's resources have never been at greater risk.

Correction: Dr. Gary Gutcher's name was misspelled in a previous version of one of these letters. In the same letter, it should have said that, from 1778 until 1892, no Native Hawaiians were sent abroad to receive a medical education.