The Added Value of Traditional Native Hawaiian Healers in Primary Care

Background and Purpose:

Traditional native Hawaiian healing practices have seen a resurgence in the past few decades among kānaka ‘ōiwi or native Hawaiian people.  More recently, native healing practitioners have been incorporated into health centers serving medically underserved areas with large populations of kānaka ‘ōiwi. However, no studies to date have examined the impact of native healers and their profound knowledge at these health centers.  The purpose of this presentation is to examine the added value of native healers and healing practices, and provide an example of this work through the evaluation of classes in la’au lapa’au, a medical practice which specializes in using plant-based medicines.

Methods:

The study design is based on community-based participatory research principles and utilizes in-depth semi-structured interviews with the native healer, administrators, and providers at a federally-qualified health center serving a predominantly Native Hawaiian population. The evaluation of the la’au lapa’au classes are based on brief open-ended questionnaire regarding patient learning, satisfaction, and areas for improvement.  The data were analyzed through interpretive thematic analysis to develop codes that provide confirming or disconfirming evidence for the added value of the healer and the la’au lapa’au classes to the health center. 

Results:

The preliminary results demonstrate that there is strong added value of locating a traditional native healer at the clinic.  Factors that impacted these findings include strong administrative support for the integration of the healer into the regular care of the patient compared to an added, but separate service.  The healer’s background as a member of the community and credentials in traditional medical practices through mentors and educational lineage played a role in acceptance and trust in integrating traditional healing into patient care.  Provider knowledge of native healing and support for integration also played a significant role.  Finally, patients overwhelmingly found classes on la’au lapa’au very helpful, not only to their care, but also as a way of connecting to their native Hawaiian roots.

Conclusions and Implications:

The incorporation of traditional healing practices into primary care is an emerging field, but not unprecedented.  Eastern medicine, e.g., Chinese herbal medicine, acupuncture, mindfulness, tai chi, yoga, as well as western complementary practices, e.g., natural products, homeopathy, massage, are increasingly becoming a part of mainstream regimens in maintaining health.  This study extends this literature to include the wisdom of indigenous populations in promoting and improving health, particularly for kānaka ‘ōiwi. This study also provides a model for the integration of traditional healing practices into primary care that is not only acceptable to patients and providers, but also provides added value to western medical practices.  Social work, and particularly indigenous social work researchers and practitioners can play a significant role in promoting indigenous practices into health settings.  Implications for social work practice, policy and research will be discussed.