THE 2008 TINY MALAIKINI AWARD: Dealing with Dialysis

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Andrew Park Sr. keeps a chain saw in his 2004 Kia Sorento when driving his wife, Cecelia "Cece," from Hana to her dialysis treatments in Kahului three times a week. The drive on the road to Hana through the lush rain forest and along the scenic coastal cliffs and over its many "famous" bridges has been romanticized and promoted in songs, photos and tourist guides. But when traversing the winding, narrow road in the darkness of the early morning, in driving wind and rain, for a procedure necessary for sustaining life, the travel can be arduous, scary and dangerous.

"There were several times my father had to move rocks from the road . . . trees," said Lehua Cosma. "My father carries a chain saw.

"Nobody should be going like that, especially with this heavy rains," said Cosma. "You never know when landslides going fall on your car."

Mr. and Mrs. Park, both 69, leave home at about 2:30 a.m. Tuesdays, Thursdays and Saturdays. The drive one way is about 2 hours; the dialysis lasts for 3 hours. When the couple returns from Central Maui, usually between 4 and 5 p.m., Cosma makes it a point to go over to visit with them.

"She's tired. . . . I tell her go rest," Cosma said.

And while her mom has health issues, the family keeps an eye on dad, as well.

"It's my father we're worried about . . . the toll it's taking," she added.

The sometimes treacherous, always time-consuming trek and the pain and exhaustion of the patients and their families have motivated Cosma for the last four years to establish a Hana site, where residents can go for dialysis. Because of her work, details are falling into place: A site was identified, permits are being secured and donations are being solicited for kidney dialysis machines and staff.

For her work in bringing kidney dialysis to Hana and in serving as a custodian at Hana High & Elementary School, Cosma has been named this year's winner of the Tiny Malaikini Mea Kokua Award, presented annually to a Hana resident who selflessly works for the East Maui residents and community. Nominations come from the Hana community, with the final selection made by Malaikini's widow, Lynette, and her children.

Viewed Paniani "Tiny" Malaikini embraced the generous, caring ways of an older Hawaii. Born and raised in Hana, he was a popular bartender at Hotel Hana-Maui, an accomplished musician who volunteered his time and talents for many Hana gatherings, and a practitioner of hooponopono, the Hawaiian technique of problem-solving. He shared the Hawaiian culture with visitors and gave of himself for the improvement of the community and its residents.

Cosma received the honor - which included a cash award, a koa-framed certificate and her name being etched on a perpetual trophy - at the Hana Aloha Festivals celebration Oct. 17.

"For her continuing commitment to the students, parents and staff of Hana School, and for her persevering dedication to the procurement of dialysis treatment for the residents of Hana, the Hana community gratefully acknowledges Andrea Lehua Cosma as the 2008 recipient of the Tiny Malaikini Mea Kokua Award," the certificate reads.

The 2008 Malaikini award winner, who will turn 48 on Thursday, is Hana born and bred. She married Patrick Cosma Sr. 30 years ago this past Monday. The couple has four grown children, Patrick Jr., Felix, Ashley and Mandy Contreras, and four grandchildren.

Mrs. Cosma graduated from Hana School, getting a housekeeping job at the Hotel Hana-Maui while a sophomore in high school. Sixteen years ago, she jumped at the chance to return to her alma mater, taking a job as a school custodian.

"I'm glad I made that choice. It's such a rewarding job," Cosma said. "It's rewarding because the children appreciate what you do for them. Everyone calls you aunty. It's real ohana."

Cosma acknowledges that being a school custodian may not be seen as "much of a career" by some, but she says that at Hana School the custodial staff is much more than the cleanup/landscaping crew. They are respected school staff members who are available to counsel students with difficulties, drive the bus in school evacuations and lead in organizing school events such as the Christmas program.

The holiday program was on the verge of being eliminated several years ago, so the custodial staff decided to take it on. The celebration goes back years; Cosma was among the students who enjoyed the program.

The custodial crew collects donations, makes goodie bags for students and community members, displays festive decorations, runs a wreath contest, "kinda overseeing everything," said Cosma.

"We feel it's a tradition that we like to continue . . . to pass down to generations," she said.

The custodial staffers are leaders and role models, said Cosma. Some refer to them as "Na Kia'i O Ke Kula O Hana," or the guardians of the school.

"There are times with kids who are troubled, we take that extra time to talk to them and calm them down . . . (tell them) they will be all right," she explained. "We're pretty neutral. We just make ourselves available to anyone who needs help. As leaders of the school we have to take that role."

The work of the custodial staff - which is led by her husband and includes her son, Patrick Jr. - was recognized by the Hawaii Department of Education in 2006 as state "Team of the Year." A Maui County Council proclamation cited the staff for organizing the Christmas program, raising funds for custodial supplies, landscaping projects and keeping the school clean.

Lehua Cosma has assumed other leadership roles - serving as co-chairwoman of the Hana School Community Council and having sat on the Hana advisory committees to the mayor and the Maui Planning Commission.

The Hana woman has learned about community organizing through the years, and she put that knowledge and experience to work as founding chairwoman of the nonprofit Hui Laulima O Hana, which seeks to bring kidney dialysis to Hana. She spearheaded creation of the organization about the time her mother began needing kidney dialysis.

"By experiencing the burden my parents were going through and seeing so many people dying who were on dialysis . . . I said, 'Somebody gotta do something.' Some people in Hana said 'we tried' . . . but I personally felt they didn't try hard enough," she said.

With the help of nurses and others in Hana, she called a community meeting. An estimated 60 to 80 people attended, including the late Dr. Steven Moser, whom Cosma credits with playing a big role in the organization of Hui Laulima O Hana.

"From that meeting . . . we just took off from there," she said.

Cosma began attending hearings and public meetings to plead the case for Hana dialysis. She learned from her daughter how to send e-mail. Hui Laulima O Hana has a Web site, www.dialysisforhana.com.

All of this lobbying and testifying did not come easily to Cosma.

"I was never a talker, spokesperson," she said. "I was always shy (but) I made this my passion, and I overcame that shyness. . . . It made me overcome those things."

The effort is paying dividends. Last month, the Centers for Medicare & Medicaid Services gave its approval to the communal home-dialysis project. A county-managed home used by the Hana Health Clinic doctor has been designated as the site; permits are being secured and necessary improvements are being identified. Some county funding has been appropriated for renovations.

Liberty Dialysis is raising funds for six dialysis machines at $20,000 each and will train staff to run them. Hui Laulima O Hana is fundraising to pay for the staff, upkeep and improvements of the facility, Cosma said.

Trying to convince people the dialysis program is needed for a handful of patients sometimes wasn't easy. There are three area residents who receive dialysis treatment.

"These are not numbers, these are lives," she told those skeptics.

"I got so attached to all them (the dialysis patients)," she said. "It wasn't fighting for dialysis. . . . (It was) going into their homes, giving financial support or emotional support. It's the bond."

The recent deaths of two patients reinforced how important her work is. One woman couldn't handle the drive anymore; so she left Hana for Hale Makua, where she died.

"Her heart was in Hana," Cosma said.

The other woman, a retired colleague of Cosma, had told her family, "Nuff, tired, no more," Cosma recalled.

"We all said prayers around her bedside. The next day she passed away . . . but that's what she wanted, to be at home. That's where her family was."

The current dialysis patients as well as those who have died inspire her to continue the effort.

"Every day, I see my mom and dad and the tiredness in her eyes. I say I cannot give up because my mom would give up. . . . By watching and seeing what is going on, it gives them hope. . . . There's people talking about them now, not like they are all alone."

Donations may be made to Hui Laulima O Hana at P.O. Box 405, Hana 96713.

* Lee Imada can be reached at leeimada@mauinews.com.