Bringing Dialysis Home to Kaʻū

Mālama Kaʻū Foundation is a 501(c)(3) Native Hawaiian Organization. Our giveback is not charity and it is not a handout — it is investment in outcomes our community can measure.

Establishing dialysis capability at Kaʻū Hospital in Pāhala is one of three ranked giveback priorities approved by our Board of Directors. It is the one this organization was founded on.

There is no dialysis chair in Kaʻū. A kūpuna (elder) who needs treatment drives to Hilo or Kona — a three-hour round trip — and does it again, week after week, in order to stay alive.

Many of our kūpuna can’t afford a vehicle. Many who do can no longer safely make that drive themselves, at either end of a treatment that leaves them exhausted.

Kaʻū is the largest district in the State of Hawaiʻi by area — the entire island of Oʻahu fits inside its borders — and it is connected to the rest of Hawaiʻi Island by a single two-lane highway. When that highway floods or closed due to Hawaii’s only active volcano Kilauea, the drive is not merely long. It is impossible.

By the numbers

• 0 — dialysis stations in Kaʻū today
• 3 — Our NHO will fund and establish three (3) dialysis stations at Kaʻū Hospital, Pāhala.

Progress to date

• Complete — Board of Directors approved dialysis as a ranked NHO giveback priority
• Complete — Site identified: Kaʻū Hospital, Pāhala
• In progress — Certificate of Need application in preparation for submission to the State of Hawaiʻi
• Next — Certificate of Need approval
• Next — Clinical staffing: dialysis technicians and registered nurses
• Next — Equipment: three dialysis machines and station build-out

We will report against these milestones publicly as they move.

Our largest obstacle is not medical, and it is not the money. It is a permission slip.

Before a new dialysis facility can be built in Hawaiʻi, the State must issue a Certificate of Need — a determination that the facility is warranted at all. Additionally, the existing dialysis provider (a foreign-owned multi-billion dollar corporation) is entitled to formally protest and oppose a new applicant. And according to the State of Hawaii, that’s not a conflict of interest…

For a rural district with no dialysis chair and a three-hour drive to the nearest one, that process is the difference between life and death. We are preparing our application, and we are prepared for it to be contested by the foreign-owned dialysis monopoly.

This work began with a promise our Chairman made to his father at his bedside before he died on 12/8/2023 — that dialysis care would come to Kaʻū.

The clinic is being pursued in his memory. 

It is the reason this foundation exists, and we are not going to give it up.

Give. Mālama Kaʻū Foundation is a 501(c)(3). Donations are tax-deductible, and we publish our Form 990 every year so the community can see exactly where the money goes. Make a donation.

Give in kind. If you can contribute any of the following, we want to hear from you:

• Dialysis technicians — certified, or willing to be trained
• Registered nurses with dialysis experience
• Dialysis machines, treatment chairs, and water treatment equipment
• Nephrology and clinical advisory support
• Construction, engineering, and facility trades

Contact us and put “Dialysis” in your message. We will answer.