Original air date: Tues., May 3, 2011
Raising Public Awareness for Hawaiian Health
This week on Long Story Short, Leslie Wilcox talks with Claire Ku’uleilani Hughes, who has spent more than three decades raising public awareness of Hawaiian health needs. Dr. Hughes became the first Native Hawaiian registered dietitian in 1959 and became the chief of the nutrition branch for the State Department of Health. She was recently named one of 2011’s Living Treasures of Hawaii by the Honpa Hongwanji Mission of Hawaii in recognition of her groundbreaking work in drawing attention to the benefits of returning to a more traditional Hawaiian diet and for her advocacy for health programs on behalf of the Hawaiian community.
Claire Hughes Audio
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They don’t see the professional woman. They don’t know I have a doctorate. And so they treat you like they presume who you are. Discrimination is alive and well. And I can only tell you that there are many Hawaiians that have no means of being recognized. They’re just ordinary people. We will hear from people about their treatment when they go to get services somewhere.
She’s a strong woman. Push her and she’ll push back. Next on LONG STORY SHORT, a longtime champion for Native Hawaiian health care needs and advocate of the traditional Hawaiian diet…Dr. Claire Hughes.
Aloha mai kakou, I’m Leslie Wilcox. We’re about to talk with a Living Treasure, Dr. Claire Hughes, the State of Hawaii’s first registered dietician of Hawaiian ancestry, awarded the honor by the Honpa Hongwanji Mission of Hawaii, in 2011. But Dr. Hughes didn’t always feel valued. In fact, there were many times she felt dismissed. That’s one of the reasons for her lifelong pursuit of education, which included earning a Ph.D. Her tremendous dedication and strong will have helped her advance Native Hawaiian health care initiatives, including research showing the benefits of a traditional Native Hawaiian diet. Claire Hughes’s “small kid time” was spent on a sugar plantation. Growing up in the late 1930s, she was among the thousands living in various plantation camp communities that were generally segregated along ethnic lines. At Kekaha Sugar on Kauai, Claire and her parents and two siblings lived in Haole Camp, with its superior acccommodations.
We were the only Hawaiian family that lived in Haole Camp. And Haole Camp is where all the managerial staff are. So my father started out as the engineer on that company plantation, and then he moved to personnel director. So we lived in Haole Camp. And at the time, I wasn’t really aware that I should be on edge, because I was the only Hawaiian. And it wasn’t too obvious to us, ‘cause there were a couple other graduates from Punahou School, which is the school my father graduated from. And so we were quite at home. We had friends that lived maybe a block and a half away that were Hawaiian, so we were not alienated totally from people who were Hawaiian. And I really had no idea that Haole Camp was that special until I was way into adulthood, and met a young lady who lived on a plantation. And when I disclosed that I lived in Haole Camp, she was so impressed.
What made Haole Camp different from the other camps?
Okay. Well, we had homes that were ranch style, one level. They were on about an acre of property. The back yard went back forever. My mother had uh, a banana tree farm, and pets back there, ducks and all kinds of things. But down in Japanese Camp, the homes were much closer. And things were not as pretty. We had gardeners that helped us do the yard work and then Filipino Camp was just about like Japanese Camp. But there were definite camp demarcations, and you could tell by the look of the camps, that Japanese Camp had a lot of shoji door type things. And so Portuguese Camp was where there was a big outside oven. And it was right next to the school, and on certain days, all of the Portuguese ladies brought their bread out and cooked it in this big oven. And as a kid, I can remember thinking, Ooh, the smells were so good.
So Haole Camp had bigger yards, free gardeners, and—
Well, we had the latest of things. We had a washing machine, number one. And uh, everybody was outfitted with that. And then, we had a crank phone, party line. And so, there was just a box on the wall with a speaker that came out, and an earpiece you picked up. And when you wanted to call somebody, you picked up the receiver, and you cranked the phone. And our phone was one long, and two short. So you cranked one, two, three, if you wanted to call home. And then, if you wanted to call anybody else, my mother would say, Auntie Esther is three shorts and one long. So we go, one, two, three, and then crank one more time around.
When you say party line, who could listen in?
Anybody…everybody heard the ringing, and they know, Ooh, the Hughes are getting a phone call.
Even though you had these big lots, they could hear it?
Oh, yes. Oh, well, they pick up the receiver. And in those days, if you picked up on the ring, nobody knew, and you could listen to the whole thing if you wanted to. Children didn’t get to use the phone a lot. It was usually to deliver a message. There were many things we were not allowed to do, and we listened.
You did listen? Were your parents considered strict for the time?
Well, my mother was the strictest mother. And my father was kind of not so strict. And so, we knew we could work my dad for things, and that my mother was very difficult. I ran away from her one day. Because I didn’t want to do something, I ran away. I mean, physically ran. And I ran into the neighbor’s yard, and she called us. [CHUCKLE] All the kids over there were, Catch Claire. And they caught me, and I got a … whipping with a Panax hedge
With Panax hedge branch?
Yeah. We had to go pick it ourselves, and then bring it to her.
Did you try to find one that wouldn’t hurt?
Well, I always, lolo, thought the skinny ones were the better ones. So I’d try and get a small skinny one. Well, those were more pliable, and we were stung, yeah? When they hit you, go whack. So I learned very quickly, get the big brittle one, because it might break. [CHUCKLE]
And then she’ll stop?
How many whacks did you get?
Oh, it depended. That day, I think I got quite a few. Yeah, I did.
Dr. Claire Hughes’s family eventually moved to Oahu where she attended Kamehameha School. She says her career path involved a bit of serendipity. When her mother pressed about her career plan, she blurted out the first thing that came to mind, because she’d just read an article that mentioned it: dietitian. Once committed, she stuck to that off-the-top-of-her-head choice. Fighting homesickness and struggling though her courses at Oregon State University, she earned a Bachelor’s degree in Science. On her return to the islands she couldn’t find a job in the dietetics field and settled on work in school food services. In the late 1960s she found a foothold in State government which became a career of more than 30 years at the Department of Health. She started out a Clinical Dietician and Public Health Nutritionist. While working and raising two children, Claire Hughes studied for and received her Master’s of Science in Public Health Nutrition. She saw education as an equalizer in an imperfect world.
And then later, much later in my career, I was representing Hawaiians and Hawaii sometimes in national meetings. And especially in the Hawaiian things, I noticed, because you’re with other ethnic groups, yeah, that I was being looked down upon often. Because I was Miss Hughes to them. I was not Doctor, right?
One time, I got very angry at this one man who was about six-foot-ten, and—
And what did you do?
And ooh, I was so hot. And I thought, I’d like to just punch him. And I thought better of it, ‘cause he was so much bigger than I. And he’s one of the ones that said, Oh, I don’t know what to call you. I said, What do you mean? And he looked at my table tent, and I turned it around and it said Claire Hughes. So I said, Well, you can call me Claire, you can call me Hughes, or you can call me Hey You. I don’t care. So whoo, he was really angry. And he had all these bars on his shoulder. So I just said, Okay, Claire, don’t get smart. You’re playing a game in a arena with people who have skills that surpass yours. So don’t get smart. Go get a degree, so they have to treat you like you’re an equal. And besides that, you will better represent your people. So I bit the bullet, and I went back to school. It took me eight years, because I worked fulltime, and went to school.
In the late 1980s Dr. Claire Hughes collaborated with medical Doctors Emmett Aluli and Kekuni Blaisdell on what was to be groundbreaking work, establishing the value of returning to a traditional Hawaiian diet to restore and maintain health.
They had done in 1985 a cardiovascular study, cardiovascular disease study. And they looked for risk factors, and they found many. And they found many untreated, and previously undiagnosed problems. So, both doctors were trying to devise some kind of a approach to reducing those risk factors. And they were looking for a crosscutting issue. What can we take that would lower the risk for hypertension high cholesterol, overweight, and all of these things. Well, what’s a crosscutting issue? Eating. [CHUCKLE] So they decided, diet. Okay, diet. We studied a lot of Kawena Pukui’s work with the Handys. They were two professors. Kawena Pukui worked with them to identify all of the plants, and then to describe how they were used, and describe the diets usually for children and for pregnant women, and for adults. And so, when I worked with both doctors, we decided that, Okay, this is what the diet was gonna be, we’re gonna include all of these foods. And on that diet, no one was allowed to lose weight. Okay.
Why is that?
They wanted any blood change, blood fat and blood sugar, and all of those changes, they didn’t want it to come from the body losing weight and getting rid of those things.
They wanted to maintain the body weight, so any changes in the blood would show uh, what was being changed. Which we were, what we were changing was the food that was going in. So with the change in the food, would that be enough to lower blood um, cholesterol. That was the main emphasis. And so anyway, we ran this diet program. One week was adjusting, and then we went to a straight-on Hawaiian food only and traditional Hawaiian food. Didn’t look anything like a luau table looks like today.
No squid luau?
No squid. [CHUCKLE] Well, maybe squid luau, but, no cake—
And no lots of sugar—
—put into the—
Yeah. Yeah; nothing like that. So it was just plain Hawaiian food. And there was not enough food on that island. So quite often, I’d get a call early in the morning. Okay, Claire, we need so much taro, we need so much poi, can you get it for us? So I’d have to call around downtown and find out what poi factory would be able to give me these items, and then I would run it on my lunch hour, I’d run it down to the airport, and they’d throw it on the plane toMolokai. So the diet ran four weeks, I believe it was. And then, the same people went on the the new regime, which was to go back to what they were eating originally. So all the high saturated fat, all the salt, all the awful things that we had told them were awful. And their blood picture changed. And it frightened them. And so, I would never be part of that again, uh, test on a human test, where you take away things and show people how healthy they’re getting, and then you put back the harmful things and let them see how sick they are. So anyway, what we did find out, that just changing to poi and taro, and sweet potato, and banana, and all the greens, Emmet Aluli allowed absolutely no Western food. So with all of that, we found that their blood sugar dropped, their cholesterol dropped significantly. There were fewer allergies. I mean, there were just a whole array of improvements that the people felt.
Now, what is the magic of poi? Why is that such a great food?
Well, for Hawaiians, of course, it is representing the god Kane, the taro plant. And he is the most primal force that we have in our belief system. That has a spiritual essence that surpasses any other food. We found out with the University studies that were done in the 40s, they found out that it is one of the easiest foods for babies to digest. There are B vitamins in it. There’s a little bit of calcium in it, more than potatoes have. And because Hawaiians ate such a large amount of poi, it actually amounted to something. The calcium amounted to something. If you ate the leaves of the taro, the luau, you’d have plenty calcium. Plenty iron. There’s a little bit of iron in the,taro corm as well. So it’s chock full of all kinds of minerals, as the—calcium and iron being two.
And then, of course, it’s starchy, so you have a good source of calories for the day.
When you’ve talked about doing things on behalf of native Hawaiians to study diet, you’ve talked about rushing to do it during your lunch hour, or after hours. Is there a reason for that?
Yeah. There was no support for my doing it on company time.
And you worked for the State Health Department.
Yeah. Yeah, yeah.
So you represented all people in the State.
Why wasn’t there support?
Well, it was the particular decision of my boss. So I had to do this when the calls came in from Molokai, they had to be very short. No talking and getting into long, drawn out conversations. That was frowned upon. And then, I would have to make the arrangements very surreptitiously. Is that the word? And make the call to the poi company. And I had one poi company who thought, surely, I was Chinese, and so he’d allow me to have poi. He was Chinese, old Chinese man. And I’d go and ask him if had … You got taro? No. No. And he’d look at me, and I’d have this forlorn—forlorn look on my face, and he’d say, Wait. [CHUCKLE] And then he’d go behind, and he’d get what I wanted and bring it to me. Here. [CHUCKLE] So I just let him think I was Chinese. My mother taught me that long ago. People think you’re something, just say yes. And act nice. [CHUCKLE] And so, I would have to do all of that work on my own time. So lunch, I often had no lunch.
And yet, this is what you’re known for.
On the Molokai diet study we called it Hooke ai. Dr. Aluli called Dr. Jack Lewin called—
Department of Health Director.
Yes. And he said to Jack Lewin, We need Claire. And so, Jack Lewin came down and told his boss, Claire is needed. So they had to find money to send me over there, to be part of this. ‘Cause that was what the Department was supposed to be doing, supporting doctors in the community. So that’s how I got to do that.
So you got to be legit on your—
—native Hawaiian diet.
Yeah, and that, Jack Lewin was not too long ago. So that’s in the—
Took a while for this …
—way of thinking—
—to come back.
Yeah. To this, to give support. Yeah.
What do you think people should know, but don’t know, about a native Hawaiian diet?
Our calculations were seventy-five to seventy-eight percent plant food. So if you picture a clock, from the twelve all the way around to ten, on your plate would be full of sweet potato, taro, poi, all the greens in the world, limu, yams, whatever. And we had a few fruit, not many. And many were forbidden to women, like bananas, we couldn’t eat, women couldn’t eat. So, three quarters of your plate would be full of vegetables and plant food. The twelve percent would be for protein. And with Hawaiian diet, it’s fish. And everybody says, Well, there’s pork. Well, pork was a really ritualistic food. I mean, it was saved for the big celebration, it was a ritual food. It was not really eaten every day.
And then the last little bit would be fat. Because the fat was not added. You didn’t put gravy, you didn’t put butter, you didn’t put oil, ‘cause there was no such thing.
So where did the fat come from?
From the food itself. From inside the fish, inside the chicken. There was also chicken, and they ate birds too, and that’s why Hawaiians were not fat.
The first Europeans described them as tall, lean, muscular, very agile, and very athletic. Yeah. We were taller than Captain Cook, who was about five-foot-two, or three.
He was a squirt.
They were very impressed with the stature of Hawaiians.
Outside of her full-time job with the Department of Health, Dr. Claire Hughes helped secure federal funding for culturally-based health and nutrition programs. Her drive and dedication led to a comprehensive report on Hawaiian health care concerns. Dr. Hughes was selected to be a part of a panel called upon to testify before the U.S. Senate. The end-result was the Native Hawaiian Health Care Act of 1988.
You’re a petite woman, but you strike me as somebody who—
—I wouldn’t want go—
Don’t get me angry. All my friends know, when I am angry, I am a formidable opponent.
What gets you angry?
Oh, I think most of the time, it is discrimination. Yeah. I don’t like that.
Well, I will fight for others. But I don’t like it when it happens to me, either. And in my old age, I will let people know that I am not at all pleased. If somebody gives me an attitude that—
—I know is trying—is dismissive because of who I am, what they think who I am, I’ll let ‘em have it right between the eyeballs.
Well, I went into a doctor’s office one day, and apparently, I didn’t have an appointment. But I had to stop in downstairs and it was a new situation, and I got my chart, which was an irritant for me. And then I went into the doctor’s office, and this very officious woman came up and she says, You have an appointment with the doctor? Who gave you that appointment? And I said, I don’t know. So she turned to one girl, she said, Did you give her this appointment? And the girl said, No. And then she went to the other. Did you give her this appointment? She said, No. And so, I could see that the girls were kind of frightened of her. So she goes, Who gave you this appointment? I said, I don’t know. It was on the phone. Some officious woman gave me an appointment. And she goes [GASPS]. [CHUCKLE] So she knew I was quite angry. And then she didn’t want to give me my chart back. So I said, Give me my chart, please. And she said, No, this is my chart. I said, Excuse me, who handed you that chart? And she said, You did. I said, Then hand it back to me, I want it now. She gave it back to me. And I walked out, and I took my chart back home, and I threw it away. Never went back there.
Wow. Why would people be dismissive of you?
Well, I don’t know. I can only presume. Okay? ‘Cause my appearance is a dead giveaway. Okay, who I am. And that’s what they see of me, and they treat me like that.
You’re saying you’re native Hawaiian?
Even in this day and age?
And you’re a professional woman.
They don’t see the professional woman. They don’t know I have a doctorate. And so they treat you like they presume who you are. Now, I’m known, so when I go into certain circles, they’re a little bit nicer. Some of them are very much nicer to me.
—people are …
Discrimination is alive and well. And I can only tell you that there are many Hawaiians that have no means of being recognized. They’re just ordinary people, which I was apparently to this woman, and they don’t like it, and we hear that often. We will hear from people about their treatment when they go to get services somewhere. And it always is the same, that I felt.
Where does it come from?
I don’t know, people do that because they want to feel more powerful, I guess. I have no clue.
I have no clue. I think they’re annoyed maybe, by certain things Hawaiians want to do, or are doing. I followed Kekuni Blaisdell once, talking to some professionals about the Hawaiian diet. And he said, Well, Hawaiians believe that their foods represent the gods, the four primary gods. And so he said, When we eat our foods—he’s so cute. When we eat our foods, we become godlike, and—
I can see him—
Isn’t he cute? And so, I saw the look on everybody’s faces, you know, in the front row. There was like—there were—revulsion on some cases. So I—I loved it, because it was my turn next.
And I said, You know, um … I don’t know what you were thinking, but by faith, I’m an Episcopalian. And I said, When I go to the communion rail, I’m offered a wafer. And it is called the … and I had to respond, the body of Christ. And I said, Then the minister says, Take and eat it. Ooh, eat it? And I said, And then a chalice of wine is passed, and they tell me this is the blood of Christ. Blood of Christ? Take and I made them say, drink it. I said, [GASP] How heathen. I said, This is the same thing, exactly. And I think it’s a wonderful thing that people picture the foods that they’re eating as strength-giving representations of the gods. I think it’s a beautiful thing. And how wonderful that you can take this in three times a day. Take in this strength, to make you more godlike. And I think it’s a wonderful thing. Puts you very close to your gods.
Dr. Claire Hughes is a Living Treasure honoree—she’s polished, with a bit of an edge. She has fought for respect as a Hawaiian and as a professional in her field. She credits her colleagues and teachers with providing support and direction in her career. In retirement, Dr. Hughes continues to advocate for healthful lifestyles in her column for the OHA publication, Ka Wai Ola. Mahalo piha, Dr. Claire Hughes, for sharing your “Long Story Short,” and thank YOU for watching and supporting PBS Hawaii. I’m Leslie Wilcox. A hui hou kakou.
And quite often, when they ask me for my CV, I’ll send it to people, and they go right down the list of what degrees I have. You can just see the kids get just so bored, like, Okay … I said, What does that mean? So I said, It means that you could learn your entire life long. You don’t have to stop. You can keep on going, and keep on going, as long as you want to. You can always learn. So I thought, Oh, good one. The ancestors sent me that one I think.