LIFE Summer Research Grant Reflections: An Approach to Reconciling Western Medicine with Native Hawaiian Healing

This is the final blog post in a series written by the 2024 recipients of the Duke University Libraries Summer Research Fellowship for LIFE Students. You can also read the first post, second post, and third post. Korey Cadiz is a senior majoring in Biology and Evolutionary Anthropology.

Between 75 and 85 million years ago, the Hawaiian Islands began to form. Volcanic activity from a stationary “hotspot” in the ocean floor created these islands as the Pacific Tectonic Plate drifted northwest. The first people to discover Hawai’i were likely Polynesians, as they arrived between 300 and 700 A.D. from the Marquesas, the nearest high islands to the south. Polynesia is roughly defined by a triangle connecting Hawai’i, Aotearoa (New Zealand), and Rapa Nui (Easter Island). By the time Polynesians reached Hawai’i, they had mastered their skills in sea voyaging and navigation through a deep understanding of astronomy, weather patterns, and ocean birds. They also carried with them the plants and animals necessary to colonize new islands. As a result, Polynesian culture flourished in Hawai’i.

The first Western contact with Hawai’i occurred in 1778 when Captain James Cook landed while searching for the Northwest Passage between the Pacific and Atlantic Oceans. His arrival initiated an influx of foreigners that brought various diseases, thereby devastating the Hawaiian people and resulting in an estimated 90% population decrease within 100 years. Over time, additional Western influence began to threaten the existence of Hawaiian culture, such as the language, conventions, and ways of life. This included traditional medicinal techniques and healing rituals, which suffered near erasure and continue to be dismissed as primitive from the Western beliefs that “West is best.” Consequently, many Native Hawaiians during the past few centuries have found themselves struggling to reconcile Western ideologies with Hawaiian customs.

Throughout my life, my community has instilled in me the belief that it is important to know our history and understand the ways of our ancestors so that we may appreciate and return to the traditions that once characterized our people and culture as one of the most innovative, healthy, and productive societies in the world. Descended from the original people of Hawai’i and raised on the islands they cultivated, I was taught to embrace my genealogy, learn what remains of its legacies, and incorporate that ancestral knowledge into my life. As a contemporary Hawaiian pursuing a career in Western medicine, my goal for this summer’s research was to bridge the historical practices of my home with the modern techniques I hope to study.

I began my research by compiling locally sourced and endorsed literature written over the past three centuries by Hawaiian scholars and allies. The publications covered a range of topics, from language (grammar, vocabulary, and semantics) to history (cultural and colonial), advocacy, restoration, healing, botany, philosophy, and more. Ancient Hawaiians thrived because they lived holistically, viewing all aspects of nature as interconnected and cyclical. In order to study the significance and effectiveness of their practices, such as medicine and healing, it is necessary to explore multiple aspects of their culture and beliefs.

For instance, traditional Hawaiians did not distinguish between “medicine” and “healing” as Westerners do. The West defines medicine as “a substance or preparation used in treating disease” and healing as “to make free from injury or disease; to make sound or whole” (Merriam-Webster). In Hawaiian, the most relevant term is lā’au lapa’au, meaning vegetation (lā’au) used to heal, treat, or cure (lapa’au). While these rituals might be categorized by Westerners as herbal or primitive medicine, ancient Hawaiians rarely believed that healing was exclusively superficial. Illness, injury, and pain were frequently regarded as signs of an imbalance in lifestyle or a lack of harmony.

One example of this is kapu kai, a ceremonial bath in the kai (sea) or other saltwater. It is used to purify oneself after encountering physical or spiritual defilement and to remove the resulting kapu (taboo). Kapu kai is performed in numerous situations, such as after contact with a dead body or as a treatment for illnesses and trauma. This ritual embodies the Hawaiian belief that ailments can arise from various forces and must be corrected or cleansed to achieve full restoration and wholeness. Therefore, the treatment goes beyond consuming herbal remedies, as multiple actions are often required to resolve the underlying issue and prevent its recurrence.

Similarly, pī kai involves sprinkling seawater or other salted water to purify a person, item, or place from spiritual contamination and remove harmful influences or taboos. Pī kai is most commonly conducted at the opening of a new building or home and accompanied by pule (prayer) but can also be completed informally to find solace and spend time alone. A prevalent modern example of this is swimming in the ocean to organize thoughts, relax muscles, and emerge with a clear plan of action. The flexibility of pī kai—in terms of where it can be performed, who can execute it, and what can be purified—allowed it to be an accessible practice for ancient Hawaiians and now contemporary ones.

Another essential Hawaiian healing ritual is ho’oponopono, which translates to “make things right.” It is used to restore and maintain harmonious relationships within a family and with supernatural powers. During ho’oponopono, conflicts are “set right” through prayer, discussion, confession, repentance, restitution, and forgiveness. Rather than focusing on a particular ailment, traditional Hawaiians believed that restoring lōkahi (unity and balance) among akua (God) and nā ‘aumākua (deified ancestors), ‘āina, moana, and lani (nature and environment), and kānaka (humankind) would address the internal or external forces affecting a person. For example, an injury or illness might be seen as a punishment from nā ‘aumākua (deified ancestors) for family transgressions, in which case ho’oponopono would aim to resolve familial conflicts and improve health.

Learning and engaging in rituals like kapu kai, pī kai, and ho’oponopono is significant because of their remedial capabilities. Western medicine in Hawai’i, which is a byproduct of colonization, normally treats physical symptoms without addressing their psychological, social, and environmental root causes, thus contributing to the near loss of these restorative Hawaiian techniques. By contrast, ancient Hawaiian healing focuses on the person and their lifestyle as a whole and emphasizes foundational principles in patient care. The reintroduction of such Hawaiian practices has the potential to serve as a model for recovery within the existing population of Hawai’i, offering both improved functional wellness and a pathway for cultural reconciliation.

My upbringing has taught me that a person’s identity, comprised of their history, conventions, and beliefs, is central to their lifestyle, health, and well-being. As I continue to pursue a career in Western medicine, I intend to learn and share the knowledge, customs, and values of my ancestors while promoting the importance of holistic awareness. Ultimately, I hope to someday witness the revival of traditional Hawaiian healing practices in my community and contribute to the cultural integration of modern healthcare.