![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-sign-scaled.jpeg\")
For 16 years, Hale P\u014dmaika\u2018i has allowed H\u0101na patients to receive treatment close to home. HJI \/ COLLEEN UECHI photo<\/p>\n\nFor 16 years, Hale P\u014dmaika\u2018i has allowed H\u0101na patients to receive treatment close to home. HJI \/ COLLEEN UECHI photo<\/p>\n
H\u0100NA \u2014 When Cece Park first started dialysis in 2005, she and her husband Andrew would get up in the middle of the night, pack a chainsaw in their truck for fallen trees, and make the winding two-hour drive from H\u0101na to Wailuku on a roadway known for landslides and rainstorms in order to make her 4 a.m. appointment.\u00a0<\/p>\n
She chose a slot at the crack of dawn so she could finish her session of three and a half hours and make the long drive back as early as possible, a routine the Parks repeated three times a week for several years.<\/p>\n
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Dialysis patients living in the remote East Maui community had few other options at the time. Missing the critical treatments<\/a>, which clean out waste from the blood when a patient\u2019s kidneys are failing, is dangerous and could lead to heart problems and death, according to the National Kidney Foundation.<\/p>\n But Lehua Cosma, the Parks\u2019 daughter, was just as concerned about her parents and other patients making the thrice-weekly journey. <\/p>\n \u201cThe long trips to the other side really took a toll on their health and their well-being,\u201d she said. \u201cSome gave up treatment.\u201d<\/p>\n Sixteen years ago, Cosma\u2019s pleas to government officials helped turn a former county physician\u2019s home on the outskirts of H\u0101na town into the first communal home dialysis center in the country<\/a>. Hale P\u014dmaika\u2018i has allowed patients like her mom to receive treatment much closer to home.\u00a0<\/p>\n But now the aging, four-bedroom, 1,500-square-foot home is in need of fumigation and repairs, with termites eating into the wood and the front bedroom sagging. Treatments can no longer take place in the front bedroom, and the three patients \u2014 two women and one man ranging in age from their late 50s to their 70s \u2014 have been using the other three rooms.<\/p>\n Maui County, which owns the home and leases it to the nonprofit Hui Laulima O H\u0101na led by Cosma, plans to provide funding to help with the repairs.\u00a0<\/p>\n Cosma and Madge Schaefer, the dialysis home\u2019s former project manager, say they\u2019re trying to do everything they can to keep the patients from having to drive to Central Maui again for treatment.<\/p>\n \u201cThe house has been a lifesaver for those H\u0101na residents and we just need to do it quick,\u201d Schaefer said.<\/p>\n ONLY A MATTER OF TIME<\/strong><\/p>\n When dialysis home staff first noticed the cracks in the front bedroom about a month ago, Cosma called Rick Rutiz. The retired founder of Ma Ka Hana Ka \u2018Ike<\/a>, a youth vocational training program, had brought a crew to build a handicap-accessible ramp and spruce up the interior when it first opened in April 2009.\u00a0\u00a0<\/p>\n Rutiz crawled underneath the home and poked at the wood. The house had been built upon uneven rocks instead of more modern pier blocks and was starting to sink into the stones. But \u201cthat\u2019s not what\u2019s making it tilt,\u201d he said. \u201cIt\u2019s more the termite damage and the dry rot.\u201d<\/p>\n In the front bedroom, growing cracks are visible in the top and bottom corners of the room. The window frame is crooked in places. The slant in the floorboards is palpable.<\/p>\n The house doesn\u2019t need to be torn down, but the front bedroom needs to be fixed, and the home needs to be fumigated, Rutiz said. A nearby gunpowder tree \u2014 named for the gunshot-like sound its branches make when it falls \u2014 also needs to be removed because the roots are poking through the pavement fronting the house and it\u2019s causing mildew on a shaded section of the home.\u00a0<\/p>\n Rutiz emphasized the house needs to stay intact for the sake of the community, saying: \u201cIt\u2019s still safe, and it serves a very important purpose.\u201d<\/p>\n The property also includes a two-bedroom cottage for additional patients. \u00a0<\/p>\n Hui Laulima O H\u0101na met with Maui County Mayor Richard Bissen, Director of Human Concerns Lori Tsuhako and other county officials near the end of October to discuss the situation.\u00a0<\/p>\n The lease makes it clear that the nonprofit is responsible for the upkeep and maintenance of their property, which is \u201ca standard sort of language in our leases,\u201d Tsuhako said.<\/p>\n But, \u201cthe challenge is that this is a very, very small organization\u201d with limited funding and a staff of four. Maui County pays the hui a grant of about $130,000 to operate the dialysis home, but that\u2019s \u201cnot a lot of money that can be set aside to put into repair and maintenance,\u201d Tsuhako said.\u00a0Those funds go toward costs like the two technicians\u2019 salaries, utilities and insurance, Cosma said.<\/p>\n Tsuhako said the department has $100,000 in funding that could help pay for fumigation and repairs, but the county has to wait and see how much the repairs will cost. An estimate is expected next week.<\/p>\n Claire Kamalu Carroll, a H\u0101na resident and office manager for the Maui County Business Resource Center, has been calling up contractors to get quotes and said one company offered to do the termite tenting at $5,000. They\u2019re waiting on an estimate from the contractor who plans to fix the bedroom.\u00a0<\/p>\n Carroll said she is recusing herself from looking into tree removal companies because her son operates one in H\u0101na. Schaefer said they got an initial quote of about $12,000 to remove the tree.\u00a0<\/p>\n While the work is ongoing, \u201cwe collectively as the county will do everything we can to try and reduce the burden on the patients and their families,\u201d Tsuhako said.\u00a0<\/p>\n However, the solution is not as simple as moving the machines into patients\u2019 homes. The plumbing and electrical system in the dialysis home had to be upgraded to handle the requirements of the machines, and each machine has its own drain, Schaefer said. Most homes are not equipped for the full setup of hoses, wires and the volume of water that needs to be filled and drained. <\/p>\n \u201cWe\u2019re hoping that whatever they do, they can do it in phases so that the patients could continue to receive treatments at the house safely,\u201d Schaefer said.<\/p>\n The goal is to get the repairs done by the end of the year, and Schaefer said they hope to block off the dilapidated front bedroom so contractors can work on it while patients continue treatment in the back rooms. They also plan to schedule fumigation on a day when the patients aren\u2019t coming in. <\/p>\n However, if the patients do have to leave the house, Cosma said the plan is to have them get treatment at Fresenius Medical Care, which offers dialysis services in Maui Lani and Kahana and supplies the H\u0101na home with machines.<\/p>\n TAXING TREATMENT<\/strong><\/p>\n No one wants to add a longer commute for patients already undergoing exhausting dialysis treatment. <\/p>\n \u201cIt is taxing on your body because if you think about it, your kidney works 24 hours a day, so when you\u2019re having dialysis only three days a week, that constitutes \u2026 maybe 15% of what a kidney function would do,\u201d explained Joy Carvalho, charge nurse with Fresenius Medical Care.<\/p>\n The dialysis machines used in the H\u0101na home are gentler on the body than the ones in the clinic because they\u2019re removing fluids more slowly over a longer period of time \u2014 four days as compared to three.<\/p>\n In Hawai\u2018i, the number of people living with kidney failure has increased 61% since 2011, according to the American Kidney Fund. In 2024, a total of 6,048 people were living with kidney failure, with 5,063 on dialysis.<\/p>\n Nationwide, about 815,000 Americans are living with kidney failure, and nearly 555,000 are on dialysis, the American Kidney Fund reported<\/a>.\u00a0<\/p>\n The number of patients at the H\u0101na dialysis home may be few, but the service is vital in a town with one main clinic \u2014 H\u0101na Health, a private nonprofit \u2014 and a two-hour commute to the island\u2019s only acute-care hospital, Maui Memorial Medical Center. <\/p>\n When Cosma first started thinking about how she could make it easier for her mom to get dialysis, she talked with Dr. Steven Moser, a local nephrologist who saw patients in H\u0101na twice a month. But when he unexpectedly died in his sleep<\/a> in March 2005, Cosma \u201cfelt so lost, because he was spearheading this.\u201d<\/p>\n \u201cI didn\u2019t know what else to turn to,\u201d Cosma said.<\/p>\n That\u2019s when she heard about an advisory committee appointed by then-Gov. Linda Lingle to hear concerns on different islands. Schaefer was the chair, and when they held a meeting on Maui, Cosma shared the story of her parents\u2019 grueling journey. The committee said they would look into it.\u00a0<\/p>\n \u201cI knew exactly what she was talking about,\u201d said Schaefer, whose father had been on dialysis after contracting sepsis.<\/p>\n They set their sights on an old plantation home in H\u0101na that a 1927 executive order by Hawai\u2018i\u2019s territorial governor had set aside for a Maui County physician. That was no longer the case; the doctor there worked for H\u0101na Health. But getting permission to convert the home was a complicated task \u2014 the state owned the land, the county owned the home, and the federal government needed to approve a home dialysis facility.\u00a0<\/p>\n The local governments were supportive. In January 2009, the state Board of Land and Natural Resources backed the use of the .85-acre property for \u201chealth and safety programs,\u201d the Honolulu Advertiser reported at the time<\/a>. In February 2009, Lingle cancelled the 1927 executive order, and that same month, the Maui County Council voted to lease the property to the hui<\/a> for 20 years at a rate of $1 a year.\u00a0<\/p>\n Medicare officials were the only ones on the fence. Schaefer, Cosma and the dialysis patients kept bugging them.\u00a0<\/p>\n \u201cYou folks think easy what we gotta go through,\u201d Cosma recalled Lono saying. \u201cYou go drive that road. You come back. You tell me.\u201d<\/p>\n Finally, while at a conference in Honolulu, a Medicare official decided to fly to Maui, rent a car and drive to H\u0101na on his own. Both Cosma and Schaefer recall the ill-fated drive, which reportedly ended near Kailua, in the pouring rain, with the official throwing up.\u00a0<\/p>\n \u201cHe turns around and goes back and calls me and says, \u2018OK.\u2019 That\u2019s how we got the approval,\u201d Schaefer said.\u00a0<\/p>\n Once they got the home, preparing it for patients was \u201ca real community effort,\u201d said Schaefer, who became the project manager. <\/p>\n Rutiz would call with a wish list of supplies, and a volunteer with a pickup truck would load them up at Home Depot and bring them to H\u0101na. Someone tracked down a brand-new, unused generator that they bought for a discounted price. Cosma still remembers how Schaefer and her husband came all the way from K\u012bhei to help put up wallpaper and install the fans.\u00a0<\/p>\n When the home opened in April 2009, Cece Park and Francis \u201cUncle Blue\u201d Lono were the first patients.\u00a0<\/p>\n \u201cShe was so happy,\u201d Cosma said of her mother. \u201cShe said, \u2018I never thought (my) dream would come true.\u2019\u201d<\/p>\n Cosma told her mom to pick a room. She chose the front bedroom, because she could see all the cars passing by. While she was getting the life-saving treatment, Cosma\u2019s dad stayed busy cleaning the yard or cooking up the fish he\u2019d caught for the patients\u2019 lunch. The smell of frying fish would waft through the home as the hungry patients emerged from their treatments.\u00a0<\/p>\n Cosma spent many hours in the front bedroom while her mom went through dialysis. Her mom was in so much pain, but she tried not to show it in front of the staff.\u00a0<\/p>\n \u201cShe just played tough,\u201d Cosma said. \u201cShe always was smiling.\u201d\u00a0<\/p>\n Her mom died in December 2009, after a fall in the bathtub flared up an old tailbone injury from her days of horseback-riding and she contracted sepsis in the hospital. Afterwards, Cosma would go into the front bedroom where she used to get dialysis and hang out there, because it still smelled like her.<\/p>\n \u201cIt took about a month before I really got over it,\u201d she said. \u201cBut it made me stronger and wiser, to never give up and fight for what we need.\u201d<\/p>\n Cosma said Uncle Blue, the other patient, was \u201ca living testament of how long you can live with dialysis.\u201d<\/p>\n His younger sister Alice Kai said her brother was happy to stay in H\u0101na and not have to take the bus to Central Maui three times a week.<\/p>\n Doctors told Lono he\u2019d only had about seven more years to live. He outlasted that by eight years, dying in 2015.\u00a0<\/p>\n \u201cOnly he knows, only God,\u201d Kai said. \u201cAnd I guess my brother was strong.\u201d<\/p>\n Schaefer remembers the morning Cosma called her and said, \u201cI want to tell you about Uncle Blue.\u201d Schaefer braced for bad news but got the opposite. His wife had woken up and found he wasn\u2019t in bed, so she went to the kitchen and found he\u2019d made coffee, something he hadn\u2019t been well enough to do in years.<\/p>\n \u201cIt all comes down to how you care for people,\u201d Cosma said. \u201cIt was home, near his family, and he looked forward to treatment because the girls that take care of him would make him laugh.\u201d<\/p>\n Cosma and the hui have done what they can to make the home as comfortable an experience as possible. There\u2019s a hospital recliner in each of the four bedrooms, and they\u2019re all equipped with TVs to keep the patients entertained during sessions.\u00a0<\/p>\n Sometimes Cosma brings them musubi or manapua, \u201cjust the small treats. Oh, you see their face light up.\u201d Some patients live off the grid with no electricity or freezers, and they have k\u016bpuna meals delivered to the dialysis home. The staff will heat up the food in the microwave before they go home and keep the extras in the freezer for them.\u00a0<\/p>\n There\u2019s a thrift store on site, affectionately called the \u201cHana Macy\u2019s,\u201d where people can give monetary donations in exchange for clothes, glassware, books and old Hawaiian music cassette tapes.\u00a0Cosma said they tap into donations to cover shortfalls when needed. <\/p>\n The dialysis home\u2019s mission is personal for the close-knit community. Before it opened, Carroll remembers her dad, former Maui County Council Member Bob Carroll, driving Lono into town for treatments. The most recent dialysis patient to pass away was a cousin of hers.<\/p>\n \u201cThese are friends and family,\u201d she said. \u201c\u2026 We cannot lose our dialysis center. I mean, I\u2019ll try any means to always keep it up and running.\u201d<\/p>\n Schaefer pointed out that folks on dialysis can still live full lives. After their treatment, \u201cthey go back to their regular jobs and their regular functioning. It\u2019s not a handicap.\u201d <\/p>\n Keeping the dialysis home going was Cece Park\u2019s last wish. In December 2009, on the night before she died, she called her daughter one last time from Maui Memorial.<\/p>\n \u201cPlease, promise me something,\u201d she told Cosma. \u201cAlways make sure the dialysis is here. Don\u2019t give up. There\u2019s many more going to need it.\u201d<\/p>\n When Cosma was born, her mom had to go to Wailuku to give birth because of complications during her pregnancy. That\u2019s why you turned out so hard-headed, she told Cosma, the oldest of her seven children. But that stubborn streak came in handy when Cosma lobbied for the dialysis home, and she\u2019ll need it again to tackle the latest obstacles.\u00a0<\/p>\n \u201cI just feel like I have to carry on her legacy,\u201d Cosma said. \u201cI made a promise.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"For 16 years, Hale P\u014dmaika\u2018i has allowed H\u0101na patients to receive treatment close to home. HJI \/ COLLEEN…\n","protected":false},"author":3,"featured_media":384734,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[183777,171813,183778,183779,183780,183781,210,1141,1142,298,63103,36821,89001,125439,52503,67,132,68],"class_list":{"0":"post-384733","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-dialysis","9":"tag-east-maui","10":"tag-hale-pomaikai","11":"tag-hana","12":"tag-hana-dialysis","13":"tag-hana-dialysis-home","14":"tag-health","15":"tag-health-care","16":"tag-healthcare","17":"tag-kidney-disease","18":"tag-kidney-failure","19":"tag-maui","20":"tag-maui-county","21":"tag-npcrosspost","22":"tag-rural-health-care","23":"tag-united-states","24":"tag-unitedstates","25":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115563875278416929","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/384733","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=384733"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/384733\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/384734"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=384733"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=384733"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=384733"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-lehua-cosma-2-scaled.jpeg\")
Lehua Cosma stands in one of the rooms of the dialysis home on Nov. 13, 2025. HJI \/ COLLEEN UECHI photo<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-cracked-ceiling-scaled.jpeg\")
A crack is seen in the ceiling of a sagging bedroom in the H\u0101na dialysis home on Nov. 13, 2025. HJI \/ COLLEEN UECHI photo<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-window-scaled.jpeg\")
A crooked windowframe shows evidence of the home\u2019s front bedroom starting to sag on Thursday, Nov. 13, 2025. HJI \/ COLLEEN UECHI photo<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-machine-scaled.jpeg\")
A dialysis machine is seen at the Hana dialysis house on Thursday, Nov. 13, 2025. HJI \/ COLLEEN UECHI photo<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-front-bedroom-scaled.jpeg\")
The front bedroom of the Hana dialysis home is in need of repair. HJI \/ COLLEEN UECHI photo<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-alice-kai-2-scaled.jpeg\")
Alice Kai, younger sister of the late Francis \u201cUncle Blue\u201d Lono, poses with a photo of her brother (top photo, at left) on Nov. 13, 2025 in front of the home where he once received dialysis treatments. HJI \/ COLLEEN UECHI photo<\/p>\n![\"\"](\"https:\/\/www.europesays.com\/us\/wp-content\/uploads\/2025\/11\/cu-hana-dialysis-leah-scaled.jpeg\")
The thrift store on site, known as the \u201cHana Macy\u2019s,\u201d helps generate donations for the nonprofit that runs the dialysis home. HJI \/ COLLEEN UECHI photo<\/p>\n