You're Not Alone This Time

When a storm hit Kaʻū, doctors whose own practices were struggling organized care within days. Local doctors, local aunties, and a county partnership. The people with the least to spare showed up.

HHTF Staff · 2026-09-23

The people with the least to spare are the ones who show up.

David Isei, MPH, MAOL, PMP · Executive Director, Hawaiʻi Healthcare Task Force

In August, a storm came through Kaʻū.

Within days, an independent physician from the island was organizing doctors to go down. Seven of them, and a medical student. They picked up chairs and tables at the Pāhala gym, not knowing whether they would be set up inside or outside, and headed for Nāʻālehu. The roads changed by the day. The official closure map, she said, was "not based in reality most of the day."

She ran it under her own clinic's insurance, in direct partnership with the county. There was talk of handing the whole thing to a large outside relief organization. She said no. Her reasons are the best short course in rural care I have heard this year.

"Encouraging and supporting a local response is really important. Almost all the doctors that we're gonna bring down have either worked in the community, or they're from the area."

And then, more simply: "We have aunties down there."

A physician on the same call put the other half of it into words. Instead of someone coming in, doing their thing, and leaving, she said, "trying to build it up from within makes so much sense." The doctors who see you in the gym can connect you to a primary care home afterward, because they are the primary care home.

Look at who was volunteering

Here is the part I want every healthcare worker in Hawaiʻi to sit with.

A radiologist on that call said it plainly.

"It's both tragic and enheartening that a bunch of folks whose practices are about to go out of business are all trying to work on this."

He was right on both counts. The people who drove to Kaʻū were not the best-resourced people in Hawaiʻi healthcare. Many of them are the ones worried about next month's payroll. They went anyway.

Then a physician on the call said something to one of them that I wrote down and taped where I can see it.

"You're not alone this time."

We should not get used to it

At the small hospital in Kaʻū, after the storm, the staff went days without running water. Staff members and a few of their own family members carried water in buckets so the building could keep working.

When we talked about it later, someone asked the honest question. This is Hawaiʻi. Isn't that just how it is?

My answer was no. "We should not get used to that. That's the whole fight."

Resilience is a gift. It is not a plan. The people who carry the buckets deserve a system that does not make them carry buckets.

It does not stop at the shoreline

The Big Island does not only take care of itself. Before the Task Force was even an organization, a handful of members met on an evening in December 2024 and agreed that Hawaiʻi Island's county medical society would help Maui physicians draft and move their prior authorization bill. The next summer, when a Maui lawmaker asked for a briefing, Big Island members went and found the researchers studying health after the Lahaina fire and brought them to the table.

Nobody asked whose island it was.

What losing looks like, and what we do

Last summer, the last doctor at one of Hilo's specialty clinics retired. There used to be four names on that door. He told a colleague it had become impossible to recruit anyone new to Hilo. The Task Force said goodbye to him on our member list, with thanks, the way you say goodbye to family.

That is how the island handles loss. Out loud, and together.

We have members who have already lost their clinics. They are still in the Task Force. They still come to the calls. They believe in the fight.

If you are carrying a practice alone on this island, hear this from all of us. You're not alone this time.

Truth in the data. Care in the community.

Sources and data modes. MEASURED means computed by us from record-level data. DIRECT means published by a named authority. FIELD-VERIFIED means reported by the people doing the work, corroboration pending. Kaʻū relief response, August 2026: accounts of the physicians who organized and staffed it, from a recorded working call, used with permission and without names. FIELD-VERIFIED.

Conditions at the Kaʻū hospital after the storm: account of a Task Force physician, September 2026. FIELD-VERIFIED; to be confirmed with the hospital before publication.

December 2024 action items and June 2025 legislative briefing: Task Force correspondence.