As a primary care physician working in Wahaiwa for the past four years, I am very concerned about the precarious state of the health safety net for Wahiawa, Waialua, Haleiwa, Mililani and Kunia. Imminently endangered are not only the critical preventative, emergency and inpatient services of Wahiawa General Hospital (WGH) — the only readily accessible hospital for a population of 110,000 people — but also the few remaining practices providing access to comprehensive care.

The demise of WGH would derail efforts to develop a federally qualified community health center for the area, sacrificing a critical opportunity to bring urgently needed federal dollars and a more stable health infrastructure to a community experiencing epidemic levels of diabetes, hypertension and cancer as well as extremely high rates of kidney failure. WGH is the only readily accessible medical facility providing screening for breast, lung, colorectal and urologic cancers, and the only area hospital that admits dialysis patients.

Recent revelations about WGH’s possible closure prompted over 7,000 signatures and an upwelling of community support for the hospital within days. Hundreds packed legislative hearings about the hospital’s need for funding, with many testifying to life-saving interventions that have affected them personally. The community is obviously passionate about its health care needs and loyal to its embattled hospital, including its wonderful on-site rehabilitation and long-term care facility. So what are the undermining forces?

The glacial progress toward establishing a community health center since Wahiawa received a medically underserved designation over five years ago has not helped to offset WGH’s financial woes, especially as the impending departure of the UH family practice residency program for Pali Momi portends a major void. Sadly, over 100 family practice residents have completed their hospital training at WGH but not one has stayed on to serve the community. WGH serves an 85 percent Medicare and Medicaid population and to its credit, is the only nonprofit hospital in the state.

Despite these factors, it would not be fair to absolve WGH’s leadership of any responsibility for the hospital’s current condition. A legal brief last year available online — No. CAAP-13-0000042 in the Intermediate Court of Appeals State of Hawaii — provides a comprehensive narrative of events involving the WGH board starting in the late 1990s.

With attorney Rodney Sato at the helm, and a gift of 250 acres at Koa Ridge to the hospital by Castle &Cooke as a catalyst, the board changed course and began devoting its energies to the concept of building a “replacement” hospital more than halfway down the H-2 freeway to Pearl City.

State Rep. Marcus Oshiro, a hospital board member at the time, became a champion for idea of a replacement hospital. Wahiawa General Hospital CEO Don Olden has also publicly advocated a move to Koa Ridge.

Oshiro and Olden did not act to introduce a bill or to update a grant-in-aid request for WGH last legislative session, although both surely were aware of the hospital’s urgent need for a subsidy more than a year ago.

As for that planned hospital at Koa Ridge, some believe it would never get the certificate of need it requires from the state to break ground as long as WGH is in operation.

Most of my patients don’t even know where Koa Ridge is. Most of them either don’t drive outside of Wahiawa, or rely on WGH because of the distances they must already travel from Waialua, Haleiwa and Sunset Beach. Vast numbers, including many vulnerable kupuna, would be immediately at risk should the hospital close.