Native Hawaiian medicine: Hawai'i's original orthopedic care

Ka mauli o ka 'aina a he mauli kanaka — "the life of the land is the life of the people." That statement is the ethos of Native Hawaiian medicine. From their love of the land and of family, Native Hawaiians built a progressive and impressive network of healing and healthcare — one that cared for the community's physical and spiritual well-being at the same time.

Colonization diminished this once-strong tradition, but it did not erase it. Many Native Hawaiians preserve and practice these healing arts today, and their history holds real lessons for modern medicine — orthopedics included.

Kahuna were healers who often served as teachers and priests within their families and communities. Their preparation rivaled a modern medical education: beginning at a young age, a kahuna studied for 15 to 20 years — anatomy, herbs, conservative treatments, simple surgical procedures, and prayer. They trained in special temples called heiau, and certain places on the islands were believed to hold particular healing power.

Kahuna were traditionally very secretive about their treatments — the word kahuna itself means "keeper of the secret." Huna (knowledge) was considered sacred and passed only from one kahuna to another, which makes studying Native Hawaiian medicine challenging today. Fortunately, letters from the 1700s and 1800s describe the practice, and they reveal something familiar: like modern Western physicians, kahuna specialized.

Two of these specialties — the kahuna ha'iha'i iwi and the kahuna lomilomi — together covered much of what we now call orthopedic medicine.

Kahuna ha'iha'i iwi: the bone setters

Native Hawaiians traditionally believed the bones were the primary physical embodiment of a person. After death, bones were sacred — they carried the person's mana, or spiritual essence. The kahuna ha'iha'i iwi was entrusted with healing these sacred structures: setting broken bones and guiding them as they mended. Like today's orthopedic surgeons, they studied anatomy, surgical procedures, and splinting — though because their knowledge was kept secret, relatively little is known about exactly how they set bones.

Kahuna lomilomi: healing through touch

Ho'olomilomi is the practice of massage, and the kahuna lomilomi used it in both physical and spiritual rituals. Lomilomi treated a remarkable range of conditions — childbirth, joint pain, even lung ailments. A kahuna lomilomi was a spiritual leader, physical therapist, respiratory therapist, and physician in one: their touch was believed to relax and detoxify the body, increase circulation, and relieve pain, all while channeling mana, the life force.

While many Native Hawaiians work hard to preserve their culture, colonization — including the warfare and diseases brought by European settlers — drastically reduced both their numbers and their ability to practice. In the 19th century, Christian missionaries outlawed the passing of huna, cutting the thread by which this knowledge had survived for generations.

Much of what we now know about kahuna was written by colonizers and non-Natives, which makes the truth difficult to ascertain. Those accounts are often laced with misunderstanding — labeling kahuna as "sorcerers" and "shamans" and losing the nuance of their true place in Hawaiian society as physicians, teachers, and community leaders.

Later arrivals reshaped the tradition further. Immigrants from China and Japan added their own influences, blending acupuncture and shiatsu with Native Hawaiian values to create a hybrid form of alternative medicine. Tourism changed things too: visitors today often think of lomilomi as simply a style of spa massage rather than a specialty of Native Hawaiian medicine. Traditional practitioners still exist — but their numbers have certainly decreased.

Ancient Hawaiians viewed the body, mind, and spirit as one, and their healing practices addressed all three at once. Before colonization, huna kept families and communities healthy — physically and spiritually. Since then, the Westernization of diet and lifestyle has contributed to serious health problems in the Native Hawaiian community, and honoring these traditions may be part of restoring that health.

Traditional Hawaiian medicine also has a great deal to offer Western medicine itself: a reminder that technical skill matters most when it is paired with attention to a patient's emotional and spiritual well-being. That whole-person philosophy shapes how Dr. Morton practices — modern robotic hip and knee surgery, delivered with unhurried consultations and care close to home at clinics in Honolulu, West O'ahu (Kunia), Hilo, and Kona.