So much of the neighborhood activity at Papakolea Hawaiian Homestead takes place at its community center.

Children play basketball and participate in after-school literacy programs. Hula halau gather to dance. Kupuna attend computer literacy classes. It’s also a headquarters for local students of nursing and social work, who receive credit toward their degrees by caring for the elderly in the community.

COVID-19 has robbed the community of regular in-person programming offered by the nonprofit Kula No Nā Po‘e Hawai‘i.

But the work the nonprofit has conducted for years before COVID-19 — working with residents to define the needs of its own community on their terms — gave them tools to respond swiftly during this emergency.

Kula No Nā Po‘e Hawai‘i already held the responses from a home health survey that outlined health and economic struggles. Its relationships, along with its database of health needs, have proven vital during the crisis, said Adrienne Dillard, Kula No Nā Po‘e executive director.

“We knew based on our health data that our kupuna would be very vulnerable to catching COVID-19,” she said.

A Head Start On Health

When COVID-19 hit, suddenly acute needs for food and supplies took priority, especially among kupuna.

“We switched gears,” said Mahealani Austin, community liaison for the Papakōlea Kūpuna Community Care Network. The community center transformed into a call center of sorts to stay connected with the 300 kupuna and caregivers in their network.

Resources and attention were shifted to make sure everyone had the supplies and food they needed to stay at home for an extended period. Donations of items like diapers, wipes, bed pads, Ensure and toilet paper were redirected to those who needed them most.

Thanks to the community survey conducted years previously, program leaders knew what medical challenges existed: things like high blood pressure, diabetes, arthritis, asthma and dementia. They also knew from an environmental scan that many kupuna had accessibility troubles in their own homes.

Questions from elders poured in about managing health remotely, and whether or not it was safe to visit the doctor. Others asked for medical advice and how to apply for rental assistance or access food. One kupuna asked for more information about how to address high blood pressure. Another called in need of a wheelchair.

“It was having to explain things to kupuna, like, ‘Aunty, you can get your medication by mail,’ or help them with technology,” Austin recalled. “Some of them are on fixed income so they were not sure about what was going to happen and needed help accessing medical needs.”

A Clearer Picture

When COVID-19 prompted a statewide stay at home order, the Papakolea after-school programs went online. The Hula for Hypertension program went virtual. Home health visits by local nursing students were suspended.

“We can’t think of this as going back to how it was,” said Puni Kekauoha, the associate director of Kula No Nā Po‘e.

But in some ways, the pandemic has crystallized an understanding of the community’s needs.

Papakolea, along with its sister Hawaiian homestead communities of Kewalo and Kalawahine, is located in the heart of Honolulu, one of the priciest cities in the nation.

About 17% of households live below the federal poverty level, and nearly a third of the 2,077 residents are over the age of 55.

But program leaders know first hand how federal poverty measures can often miss the nuance of real life.  An Aloha United Way analysis of households by ethnicity and income found that 57% of Hawaiian households did not have a survival budget.

As they responded to COVID-19, there were a series of confirmations of such nuance: kupuna were eligible for state programs or federal assistance but hadn’t enrolled; others were barred from help because of artificially inflated household incomes due to multi-generational living. Those types of issues have become more clear, Kekauoha said.

“They get crossed out at the get go because of their income and the family who lives with them,” she said.

Across the state, an already fragile safety net has been laid bare by the pandemic. A record number of Hawaii residents have lost their jobs during the pandemic, and applications for health insurance have soared.

The 2018 report by Aloha United Way illustrated the financial fragility of Hawaii families before COVID-19: almost 40% of households earned more than the Federal Poverty Level, but less than the basic cost of living. Another 11% lived below the poverty level. Just one crisis such as a job loss or unexpected health emergency is enough to place people at higher risk for chronic health issues or housing loss.

The sudden need for meal assistance was a clear signal how COVID-19 has hurt households. Never before had Kula participated in meal assistance programs, but now it’s become a mainstay, thanks to new private sector and nonprofit donors.

About 250 households — more than half of the community — have signed up to receive boxes of produce, bread, milk and eggs on a weekly basis.

“What we’ve heard is that a feeling of dignity is maintained if you don’t have to sit in line for five hours to wait for food,” said Dillard.

Eligible elders also receive lunches delivered to their doors three times a week thanks to a partnership with Lunalilo Homes, Aina Momona and the Office of Hawaiian Affairs. The meal delivery visits are a huge mood boost for kupuna, the nonprofit’s leaders say, especially for those who suffer from memory loss or live alone.

The meal deliveries have also helped kupuna eat healthier, said Austin. Ingredients like kalo and ulu, or breadfruit, are making a welcome comeback.

“You’d be surprised at how many of them love their canned goods, but because now they’re getting hot meals, their overall health is improving,” she said. “It’s been really interesting hearing from all the different kupuna, like ‘What? Your Portuguese bean soup has kalo in it?’”

“They’re ingredients that they’re familiar with, but they might be being used in creative new ways that they haven’t seen before,” said Amanda Corby Noguchi, co-owner of Pili Group, who runs the Chef Hui network with her husband, chef Mark Noguchi.

New Connections

As they assessed the community’s greatest needs, Kula’s leaders also saw connections. The coronavirus has jumpstarted new partnerships, such as the one with Chef Hui, which has channeled food insecurity into a support system that keeps local restaurants and farmers in business.

Now, Chef Hui is looking for ways to preserve its new relationship with Papakolea.

“We’ve already started talking about what it would look like to fund cooking classes in Papakolea,” she said. “Are people interested in learning to break down whole fish? The exciting part is what can they teach us and what do their kupuna make? Feeding people has allowed us to have those kinds of conversations.”

Dillard and Kekauoha are looking at other ways to address food insecurity. Maybe families would be more open to an aquaponics project, Dillard said. There’s also ongoing discussion about how to help students who didn’t take well to distance learning, or what phone apps to adopt to streamline communication with families and kupuna.

“What this has done to us is teach us to be resilient,” said Kekauoha.