Kekona Smith spent nearly all of his first two weeks of life in the state’s largest homeless shelter — one of the luckier babies growing up homeless in Hawaii.
Kekona last week was at the Institute for Human Services family shelter in Iwilei with his 18-year-old mother, teenage uncles and aunties, and a grandmother who had her first of seven children as a teenager.
At IHS, Kekona and his family have access to on-site medical care and on-site social service case workers.
Just 2 miles down the road at the persistent Kakaako homeless encampment, an 8-month-old boy named Nasaiah Totoa is being raised, like Kekona, by homeless teenage parents.
Nasaiah doesn’t even have a floor to crawl on.
His 17-year-old mother tested positive in one pregnancy test, said Nasaiah’s father, Isiah Totoa, adding that she plans to take another test.
Totoa, 18, faces the prospect of becoming a father for the second time in less than two years as a homeless teenager himself.
“It teaches you a lot about life,” he said.
He said he earns money working as an “under-the-table landscaper.” But he has also earned some notoriety.
Totoa told the Honolulu Star-Advertiser last year that he was involved in the June 29 attack on state Rep. Tom Brower that drew attention to safety and health issues as the growing encampment became entrenched around the University of Hawaii Medical School and Hawaii Children’s Discovery Center.
Brower was attacked as he photographed the encampment. Totoa’s cousin — who was 14 at the time — was arrested.
The case was handled in Family Court and Brower has said that he does not know the outcome, but the boy’s family said he is back in the encampment.
A study released Thursday showed that more homeless people than ever — 14,954 — accessed homeless services such as shelters or social service outreach help in the 2015 fiscal year.
The only bright spot in the study by the Center on the Family at the University of Hawaii at Manoa and the Homeless Programs Office of the state Department of Human Services was the fact that 1.8 percent fewer homeless children accessed homeless services.
But the study still found that 3,494 children such as Kekona and Nasaiah were growing up homeless across the islands.
They not only face the challenge of being homeless, but have additional struggles being raised by homeless teenagers who are typically scared and unsure how to get help.
Pregnant teenagers in general tend to neglect proper prenatal care, a pattern that’s only exacerbated by poverty, said Dr. Nadine Tenn-Salle, chief of pediatrics at the Queen’s Medical Center.
“In Hawaii, about 14 percent of pregnant women do not get prenatal care,” Tenn-Salle said. “And for young girls 15 to 17, that number is even higher — at 26 percent. For girls younger than 15 it jumps to 51 percent. For a young teenager with an additional life stressor such as homelessness or poverty, it can be very complicated for women like that to have a healthy baby. To be honest, unless someone goes out there and helps this girl (in Kakaako), it’s most likely that the first time she will connect with the health care system is when she’s in delivery.”
Nasaiah’s mother was sleeping each time the Honolulu Star-Advertiser repeatedly visited her tent last week in the mornings and afternoons.
Neither Totoa, nor his mother and father (who all live in the encampment) were clear about what kind of prenatal or birth control advice Nasaiah’s mother was receiving or what kind of medical checkups the 8-month-old baby was getting.
In general, babies born to mothers who do not receive proper prenatal care are more likely to have low birth weight, respiratory problems, learning disabilities and other potential complications, Tenn-Salle said.
Their prenatal problems can be made worse if their mothers are children themselves.
“There is a psychological barrier because a young teen is not quite sure how they feel about pregnancy,” Tenn-Salle said. “They’re so frightened, often in denial that they are pregnant and trying to hide it. But that window of time early in the pregnancy is the most critical for the baby’s health. They have to process all this and all the while the baby is growing inside them.”
Expectant women do not typically begin to show until four or five months into their pregnancy, which is well outside the first trimester when proper prenatal care is critical.
To a teenage girl, Tenn-Salle said, her pregnancy is “all theoretical until you see your belly growing.”
Kekona was born two weeks premature at Kapiolani Medical Center for Women &Children and entered the world at 5 pounds and 15.9 inches.
His 18-year-old mother, Kalena Smith, also has a 2-year-old boy from a different father. The 2-year-old is under the legal guardianship of a relative because he was born while Smith was underage, said David Lunceford, IHS family programs manager.
Smith is the second-oldest of seven children — six of whom are living at IHS’ family shelter with their mother. Their father is in prison for domestic violence, Smith said.
They had been living in a two-bedroom apartment in Makiki but could not afford the apartment and moved into IHS three months ago.
“We didn’t have food in the house,” Smith said. “We never had money left for anything.”
Sarah Yuan, an associate specialist with the UH Center on the Family who helped prepare the study released Thursday, said it’s unusual for homeless, pregnant teenage girls in Hawaii to seek help on their own, which could lead to problems for their babies.
“They don’t know if they’re going to be reported because they’re underage,” Yuan said. “We almost never see any unaccompanied underage youth through the system. They always have an adult in the family.”
Hawaii’s Child Welfare Services has said repeatedly that being homeless is not a reason by itself to take a child from a homeless family.
But their teenage parents living in homeless encampments are more likely to engage in risky, illegal behavior such as drug use or prostitution that could place their children at risk of being taken away, Yuan said.
“Sometimes they abuse drugs or they are in an abusive situation or they do other things,” she said. “They are at risk to themselves and at-risk that the child will be taken away from them. … A lot of time they don’t see too far into the future because they’re on survival mode. They’re living day by day.”
Once homeless children get old enough to attend school, Yuan said, “this group of kids faces a huge disadvantage in terms of school achievement.”
They tend to lack focus and discipline and are less likely to follow classroom instructions.
“It’s very challenging to raise kids outdoors with less-structured days to prepare them for school,” Yuan said.
The state Department of Education is teaching 3,576 homeless students this school year — up from 3,526 the year before, according to DOE data.
The biggest number of homeless students — 754 — attend school in the Nanakuli-Waianae complex, an increase from 725 students in the preceding year.
Clyde Aikau, the younger brother of legendary North Shore lifeguard Eddie Aikau, said he sees the struggles of homeless schoolchildren through his job as a DOE homeless concerns liaison.
“It’s endless,” Aikau said. “It’s just a real difficult situation.”
The children are fed breakfast and lunch at school, which are typically the only meals they’ll get all day, Aikau said.
Aikau sympathizes with their homeless parents, who could be children themselves.
“When you’re talking about young parents, they really have no skills and are overwhelmed trying to take care of their young child,” Aikau said. “They can hardly find a job and take care of themselves.”
But while he understands the challenges that homeless teenage parents face, Aikau’s priorities are clear:
“Kids first and parents second,” he said.
Aikau tells homeless students to never give up and “just put one foot in front of you.”
But he does not leave them to figure it out themselves.
Instead, Aikau tells homeless children, “‘Here’s Uncle Clyde’s number. If you get in trouble and you don’t have somebody to talk to, call Uncle Clyde.’”
“They need to know that somebody cares,” Aikau said. “We’ll never give up on our children because we love them.”