Going clean — in a taro patch

By Vicki Viotti
Advertiser Staff Writer

Jay Lee, program director for Ho'omau Ke Ola in Wai'anae, helps clients Stephen Kila Jr., back left, and Peter Akuna Jr. clear weeds from a taro patch. The program teaches Hawaiian culture to recovering drug abusers. Bruce Asato • The Honolulu Advertiser

In a cultural sense, it's a world away.

"The first time I started was in a bathroom and I saw some guys using," he said. "They easily coaxed me into it."

Kila had long since lost touch with his own Hawaiian cultural values, or even with members of his family. Both parents had died by the time he was 14, he said.

"There was no one there to tell me that I can or I can't do this," he said.

Now Kila, 35, is one of 14 clients enrolled in the 75-day residential program of Ho'omau Ke Ola, a nonprofit, federally financed substance abuse program in Wai'anae that interweaves Western treatment strategies with instruction in Hawaiian culture. It's an approach, program leaders say, that attempts to reconnect abusers with the indigenous values, re-establishing a sense of belonging for people who often feel estranged in the clinical setting.

Those of Native Hawaiian ancestry, along with O'ahu's homeless, are the primary target group at Ho'omau because of a large incidence of substance abuse in this population, said director James Siebert.

Among the statistics that bear this out: Hawaiians and part-Hawaiians represent the largest ethnic group among admissions to Hawai'i substance abuse treatment programs — almost 41 percent of the total.

Using a cultural approach in addressing this problem is not unique to Ho'omau Ke Ola. Elaine Wilson, chief of the Health Department's alcohol and drug abuse division, cited another program, Drug Addiction Services of Hawai'i, which does something similar on an outpatient basis in Puna, a Big Island district with a large Hawaiian population.

"They use kupuna, who talk a lot to the clients about Hawaiian ways, and about how abusing substances is not part of the Hawaiian culture," Wilson said. "Weaving cultural values into a program is really important ... you need to reach people where they are at."

Cultural practices employed by Ho'omau Ke Ola include everything from learning chants to weekly canoe training sessions at nearby Poka'i Bay. And every Wednesday, the residents deck themselves out in their grubbiest attire and head for Ka'ala Farms to work in the kalo lo'i, the wet terraced fields where the taro is nudged to maturity only through hours of backbreaking labor.

Uncomfortable, yes — but comfortable, too. Waikelekele Cockett and other women were tending to a patch of wauke, which Ka'ala Farms also cultivates for the production of kapa for crafters and others who use the traditional barkcloth.

"It's like coming home," said Cockett, 26, tugging at a muddy gardener's glove. "You just feel right."

Ho'omau Ke Ola clients Stephen Kila Jr. and Peter Akuna Jr. help out at the Ka'ala Cultural Learning Center one day a week. Instruction in Hawaiian traditions, including taro farming, chants and canoe training to help program participants connect with the culture. Bruce Asato • The Honolulu Advertiser

"For this population, another type of approach would be more effective in reaching them," he said. "They have been disenfranchised."

The success rate here, defined as the proportion of clients who stay drug-free long term and are able to live a productive life, seems to indicate it's working, he said. Lee cited a national abuse treatment success rate of 1-in-15; at Ho'omau Ke Ola, the number is more like 1-in-8, he said.

Working in the fields is part of the "aloha 'aina" — love of the land — aspect of treatment, said Momi Cruz-Losano. As cultural coordinator, Cruz-Losano serves as a kind of kumu, teaching about this and other key Hawaiian techniques and concepts.

A partial list:

• Ho'oponopono, the collective means of resolving conflict, becomes a tool for managing the discord that is both a cause and a result of their substance abuse. Many of the clients have damaged their family ties, she said, so the process usually begins with only the counselor before there's enough healing to bring relatives back into the circle.

• Pono, a sense of balance, enables them to see that their bodies, minds and spirits need to align and that the abuse disrupts this equilibrium.

• Kuleana refers to their job, their responsibility. No task or chore can be justly shirked.

• Laulima refers to accomplishment through cooperation and unity.

• Ha'aha'a is the Hawaiian idea of humility. The individual must put the needs of the group before his or her own.

For the clients who are not Hawaiian — about one-fourth of the 132 residential and outpatient clients served last year were not — the program can be adapted to address other cultural needs, Siebert said.

"And we do believe these values are transcultural," he said. "What we would try to do is ask where are these values in another culture and try to tailor the program for them."

By teaching cultural practices to clients, Ho'omau Ke Ola has managed a treatment success rate of about 1-in-8 people as opposed to the national rate of about 1-in-15, program manager Jay Lee said. Bruce Asato • The Honolulu Advertiser

Peter Akuna Jr., 30, was a military dependent who chafed with being uprooted so frequently. When the family moved back to Maui, he quickly fell into a drug use habit.

"I turned rebellious," he said with a smile.

Akuna and Kila were lucky in that neither had been arrested for anything worse than a traffic violation, although both know it was only a matter of time.

"Drugs take us away from reality," Kila said. "I don't know when addiction starts, but getting your next hit, your next high, becomes the most important thing. And most resort to crime."

Western and Hawaiian sensibilities intertwine in this treatment strategy, and neither can be abandoned, Siebert said. For example, the conventional approach to a client who is coping with emotional pain is to address his or her low self-esteem, he said.

"The question is: How do you build that back up?" he said. "But from a cultural perspective, it's building their sense of identity, who they are as a Hawaiian."

This is Kila's second rehabilitation program. At the first, he attended only the group therapy offered on site; Ho'omau Ke Ola insists that its clients become connected with external Alcoholics Anonymous or Narcotics Anonymous groups while still in treatment.

Beyond that transitional assist, Akuna said, there's something even more essential at work here.

"For me," he said, "it's the spiritual part of the program. It's very in tune with your spiritual side."

Reach Vicki Viotti at vviotti@honoluluadvertiser.com or 525-8053.