Over the past several years — from the time I got pregnant to my mom’s cancer diagnosis — I’ve been a regular at hospitals. I got an IV once a week during the first, very difficult trimester of my pregnancy, and my mom saw doctors and rehab therapists sometimes multiple times a week for years.

I was on a first-name basis with most nurses, receptionists and parking attendants.

While hospitals and clinics strive to create a safe space for patients to get medical care, modern designs have focused mainly on functionality and often come off as sterile and cold —  and that can create anxiety and stress in patients and may negatively impact their healing (like leading to shorter hospital stays). My mom never liked being in a hospital setting, and I have definitely deferred visits to the ER because I hated sitting in uncomfortable chairs in too-cold rooms waiting for care.

But designs of health care centers today have dramatically changed. They are much more patient-centric, open, welcoming and inspired by nature.

That was the thought process behind the design and construction of Hale Ola Alua, a new facility for the Waimanalo Health Center that opened in 2019. The federally qualified health center — there are 14 across the state — is currently raising money to renovate and expand its older campus, keeping the needs of their predominantly Native Hawaiian patients in mind.

“Waimanalo Health Center was born from community advocacy efforts for health services in Waimanalo,” says CEO Dr. Mary Oneha. “We saw our first patient in 1992, and 30 years later, we remain committed to providing affordable, quality health care for the community. We continually strive to meet community needs, and as the demand for services grew, so did we.”

The 19,500-square-foot, two-story facility, designed by Ferraro Choi, is bright and spacious, incorporating wai — or water — into the design. There’s a wall in the lobby listing the names of donors in what looks like raindrops, with the adage, “Ola i ka wai a ke ʻōpua.” It translates to, “There is life in the water from the clouds.”

This is a huge expansion for WHC. The new building sits on the 1-acre site of the former employee parking lot. It allowed the center to open a pharmacy and expand its services. The exam rooms here are notably larger, too, to accommodate patients who visit with their families — common with the Koolaupoko community it serves. In the center’s older buildings, the rooms are between 57 and 100 square feet; here, some are as large as 120 square feet.

“It was important to us to honor the rural character of Waimanalo and infuse the colors of wai and the Koolau,” Oneha says. “The open waiting areas and spacious exam rooms respect the large ohana that walk through our doors. It ensures our mamas and their keiki have room to navigate strollers and families can take tutu to see their physician with ease. The garden elements and the natural light that permeate through the building pays tribute to our aina. It’s not just a building but a feeling of malama and aloha.”

One of the areas where WHC has seen the greatest need is in dental care. In 2020 it completed renovations to expand dental services and, two years later, doubled its residency program to four from two dental residents who are available to provide care to anyone, from keiki to kupuna. That’s in addition to the three full-time dentists who, with their staff, do everything from routine cleanings to root canals.

According to WHC, people, especially during the pandemic, neglected their dental health. It didn’t help that 10 years ago Med-QUEST cut its adult dental benefits. But these benefits were restored in January — though many members don’t realize it — and WHC, like other federally qualified health centers, offers a sliding scale of pay for services. Sometimes the care is free.

Earlier this month WHC received a $500,000 grant from the Hawaii Dental Service Foundation to fund its new Kaneohe clinic and renovate its existing offices in Waimanalo. And part of the plan is to make sure the new space is inviting and not intimidating. (It’s hard enough to get people to go to the dentist in the first place.)

But where WHC really shines is in the way it integrates modern health care with traditional Native Hawaiian practices — and how that has been incorporated into its physical space. (This is true at the Waianae Coast Comprehensive Health Center, too.)

Behind the green trailer buildings on its original campus is the hidden gem of WHC: the laau lapaau garden. Laau lapaau is the Native Hawaiian practice of using herbs and plants for healing, and WHC offers this as part of its Maiola Services, the center’s cultural health program that launched in 2015. Herbs and plants like noni, mamaki and kukui are grown in this garden, an oasis from exam rooms and medical equipment.

Here, patients and community members can take classes from one of seven of the center’s cultural practitioners to learn how to grow these plants and make their own salves and teas at home. The program, which is led by kumu Leinaʻala Bright, offers laau laapau and lomilomi massage services to patients, too.

“Serving a patient population that is over 52% Native Hawaiian, and being in the special place of Waimanalo, it is important that we provide culturally responsive care,” Oneha says. “Integrating Hawaiian healing practices of lomilomi and laau lapaau has been effective in engaging patients in their care and involving patients more in their health journey through the sharing, education and growing of laau for themselves and their family.”

The space really does matter. It’s not uncommon to see WHC staffers holding meetings or eating lunch in the garden, too, enjoying the Waimanalo breeze under the kukui trees.

The upgrade to this part of WHC will replace the aging portables and expand dental, vision and preventive health services — but it won’t disturb the garden. That will stay.

These are the reasons 98% of patients surveyed said they would recommend WHC to family and friends. Or why a portion of its patients drive to WHC from outside Koolaupoko. Or why the center is serving more people than ever — and that’s likely going to grow.

I wouldn’t have minded weekly IVs if I got to spend time in a garden, too.

Civil Beat’s community health coverage is supported by the Atherton Family Foundation, Swayne Family Fund of Hawaii Community Foundation, the Cooke Foundation and Papa Ola Lokahi.