Voyaging canoes could help bring balance to health care

The resurgence in Polynesian voyaging throughout the Pacific was made possible by the rediscovery of the ancient skills of the navigator. This breakthrough has created another opening: the opportunity to revive the traditional role of the kauka (doctor) on board. Doing so will further preserve, protect and perpetuate Hawaiian culture. It also will support the health of the people of Hawaii. Bringing together the best of modern medicine and indigenous healing arts has the potential to help resolve health disparities and guide a more skillful allocation of resources resulting in improved outcomes.

A week from today, Hoku­leʻa and Hiki­ana­lia, her sister vessel, will depart Hawaii on a three-year worldwide voyage. I have been blessed with the sacred opportunity to serve as medical officer for both canoes as far as Tahiti during the first several weeks of the trip. The journey, Malama Honua (caring for the world) represents the first time a traditional-style Polynesian voyaging canoe will sail beyond the Pacific Ocean. It will also mark the beginning of a leadership transition to the next generation of Hawaiian way-finders.

Hokuleʻa’s first sail to Tahiti in 1976 was a watershed moment. She demonstrated that Hawaiians could still lash together a canoe strong enough to stand up to the many faces of the great ocean. It also proved that, under the tutelage of Papa Mau Piai­lug from Sata­wal, Hawaiians had rediscovered the art of celestial navigation and, guided by the ancestors, could find isolated islands as small as Rapa Nui (Easter Island) by observing the stars, prevailing winds, ocean currents and sea life along the way.

In contrast to the navigator who relies on the heavenly bodies instead of a GPS device, the canoe’s medical officer still draws primarily on modern science. The kauka on board works out of two coolers tightly packed with medicines and equipment prepared to treat the many ailments one might encounter upon the open ocean such as seasickness, dehydration, overexposure, infection and trauma. During nearly 40 years and over 140,000 miles, the crew has been in capable hands.

The worldwide voyage represents a fresh opportunity to expand this purely scientific perspective and rediscover the traditional role of the kauka on board — integrating both conventional health care and ancient healing practices. The Hawaiian tradition, for example, includes elements such as lauau lapaau (herbal medicine) and lomi­lomi (hands-on treatment).

Still, the position of kauka as hookele (way-finder) comprised far more than knowledge of plants and physical treatments. Unlike modern health care, where the human patient may be hardly noticed in comparison with the ruptured appendix, broken bone or cancer under treatment, indigenous medicine always considers relationships. Awareness of the ancestors, one’s ohana, food preparation and the changing seasons all contributes to health through balance. This is a common theme among native traditions throughout the world.

A successful transformation in the role of the navigator to that of hoo­kele models the potential to evolve the position of medical officer. The crews aboard these long voyages will benefit from care that draws from the best of both worlds to ensure not simply safety, but vibrant health.

The larger community that supports the worldwide voyage also may benefit immensely. Bruce Blankenfeld, captain and master navigator for Hiki­ana­lia’s first long leg to Tahiti, describes how a voyaging canoe brings a community together. It becomes a source of inspiration for new ideas and instills a sense of interconnectedness and personal responsibility.

American health care has been shown repeatedly to be outlandishly expensive for the outcomes it provides, and Hawaiians especially are party to profound disparities in areas such as diabetes, heart disease and obesity. This has to change.

Evolving the role of the medical officer on board is both natural and necessary but will take time and effort among many competing priorities. Sailing a traditional-style Polynesian voyaging canoe is by itself labor-intensive and arduous. Star navigation requires unwavering concentration and a relentless memory. Science experiments as well as new partnerships with organizations such as Google, National Geographic and Huffington Post add another set of responsibilities for the crew to document and share its experience while underway.

Yet, a transformation in how we as a society utilize our resources to support the health of our citizens is both essential and inevitable. Bringing together the best of modern medicine and traditional healing arts to achieve health through balance will be a cornerstone for the change afoot. This is the mission of Malama Honua.

Ira “Kawika” Zunin, M.D., M.P.H., M.B.A., is a practicing physician. He is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.