Future of Health in Kohala 1

The Future of Health in Kohala : Challenges
A lively Health Roundtable convened at the Public Library on March 13th and brought forth many needs, challenges, and both planned and potential improvements in our local health care system. Pressing challenges identified as the greatest barriers to improving health care included: difficulty in attracting and retaining doctors, the absence of mid-level health care workers at the Registered Nurse, Nurse Practitioner and Physician’s Assistant levels, the high cost and lack of capital available to help doctors set up private practices, and the lack of patient access to / participation in primary and preventative health care.
Representatives from Kohala Hospital (Carmen Rice, MPH), Hamakua-Kohala Health (Milton Cortez), Dr. Ardolf and Associaties (Deborah Ardolf, ND) Hawaii Blue Zones (Sue De La Cruz), North Hawaii Hospice (Katherine Werner, MHA ) and the Same Canoe ‘Food is Good Medicine’ Project (Marcy Montgomery) were the speakers. The audience included representatives from Kokolulu Retreat, the Kohala Hospital Board and Auxiliary, the Hamakua-Kohala Clinic Board and staff, the Hawaii Public Health Institute, Hawaii Blue Zones, retired nurses, social workers and doctors, and members of the public.
Hosted by Stephen Shrader of One Island Sustainable Living, the six roundtable speakers were asked to address four questions and discuss their responses, while also receiving community input. This month’s article covers responses to question one:
What are current challenges to improving health care in North Kohala?
The reality of improving health care in Kohala requires our community to address a serious problem: North Kohala lacks an adequate number of local doctors, nurses, and health care providers.
In discussing this challenge, four specific factors were identified: the lack of available rental or affordable housing for purchase in Kohala, the low numbers of islanders pursuing nursing degrees, finding a match with health professionals who appreciate the nature of rural living, and Hawaii does not provide start-up capital or low cost loan options to help new practices get established. These barriers directly impact our community’s ability to attract and retain doctors, nurses, dentists, and medical staff.
While the Hamakua-Kohala Clinic has primary care doctors and dentists calling to inquire about filling open positions at the local clinic and for the dental bus, they note that without affordable housing, relocating to Kohala is not feasible for potential candidates. Likewise, the Kohala Hospital also faces serious housing challenges in attracting long term, as well as short term visiting practitioners, that are essential staff for both emergency and long term care services the Hospital provides. Adding to both the housing challenge issue, and the lack of available nurses, Dr. Ardolf noted from her first-hand experience in establishing a local private practice that she has as yet been unable to find a rental home and shares in the difficulty of finding available and qualified nurses to help grow her business.
Forthcoming articles will cover other challenges (access, transportation, cultural barriers, and education) and solutions that are in place and on the horizon, including developing a Wellness Campus that provides innovative housing options for professionals, patients and interns-in-training.

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