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The Honolulu Advertiser
Posted on: Tuesday, April 22, 2008

Diabetes program in national spotlight

By Suzanne Roig
Advertiser Staff Writer

Hawaii news photo - The Honolulu Advertiser
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KALIHI — A unique way of fighting diabetes here has earned the attention of federal officials in Washington, D.C., and could serve as a model for communities around the country.

Two years ago, Kokua Kalihi Valley, whose clients are 95 percent Asian or Pacific Islander, realized that the Micronesian women they were counseling for diabetes weren't getting the message, said Dr. David Derauf, Kokua Kalihi Valley Comprehensive Family Services executive director.

It didn't help that the word for exercise didn't exist in their Chuukese language, Derauf said.

That forced him and his colleagues to think outside the box. The result was a program in which diabetics plant and harvest their own garden to manage their disease with fresh-grown free food and exercise.

Yesterday, officials from the federal Centers for Disease Control and Prevention and the National Institutes of Health trampled among the kalo leaves and sweet potato vines at the garden portion of the 100 acres leased by the health center.

"It's so good for other communities to learn from this," said Joanne Gallivan, an NIH registered dietitian. "What's happening here can be adapted to other communities around the country."

Using machetes, the women helped the center remove invasive species and bamboo plants and replant with rows of vegetables and herbs. The 30 women in the program grow 20 fruits and vegetables, including Okinawan sweet potato, tapioca root, pineapple and taro.

Johsi Wang, the Kokua Kalihi Valley coordinator in charge of the program, uses the vegetables to teach the women about food preparation and nutrition. Gardening got a much better response than chair aerobics, Wang said.

"We decide as a group what to plant," Wang said. "They get ready access to more fruits and vegetables at no cost and get physical activity without realizing it."

The program's successes were brought to the attention of national health officials by Mele Look, director of community engagement at the University of Hawai'i John A. Burns School of Medicine, who saw the program's broad applications. The school provides grants to the Kalihi Valley program.

"This program we consider as one of the leading-edge examples of what we should be doing with diabetes education," Look said. "If we can help this group, we can help others."

Diabetes is the seventh-leading cause of death in Hawai'i and hits Native Hawaiians and Pacific Islanders at twice the rate of Caucasians.

Complications from diabetes include heart disease, kidney or nerve disease, blindness, amputation and difficulties with pregnancy. Many problems can be avoided or reduced with medication, diet and early detection.

In Hawai'i, about 110,000 people have diabetes, according to 2003 data.

"Diabetes is on the increase in the United States," said Dr. Jane Kelly, CDC program director. "Often people feel frightened and out of control and we see hope with a project like this."

The hope comes from the simple act of farming, the physical activity and the chance to teach about nutrition, Derauf said.

"This was a way to reconnect them to their new home in Hawai'i," Derauf said. "Most of the patients at the health center have a connection to farming."

Reach Suzanne Roig at sroig@honoluluadvertiser.com.