Waianae, USA - It was Tuesday and the high school volleyball player had a painful sprained finger, but she really wanted to play that Friday.
So she and her family sought out a practitioner of Native Hawaiian healing. The practitioner pounded leaves of a plant, mixed it with a pinch of Hawaiian salt, massaged the girl's arm, and placed the mixture on the injured finger.
"Her mother later told me the pain went away and the girl was able to play on Friday," said the healer, Alapai Kahuena.
A growing number of Hawaii residents are turning to traditional healing methods long practiced in these lush Pacific islands as an alternative or in addition to visiting a regular doctor.
Despite a shortage of Hawaiian healers, Native medicine is being combined with standard approaches in state-supported health care programs. The University of Hawaii also has a new department that recognizes and studies Hawaiian medicine.
With skyrocketing drug and health care costs, Native Hawaiian healing is part of a national trend in recent years toward non-conventional approaches to medical care.
A Harvard study released in January found that 35 percent of Americans have used some form of alternative healing. The National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, found that more Americans are using Yoga, meditation, herbs, special diets and other healing methods.
If the number who believe in the healing power of prayer is added, the study showed that close to two-thirds of Americans have sought something other than doctors and medicine to treat physical ills.
"People are not happy with Western medical treatment and are seeking alternatives," said Babette Galang, complementary health officer for Papa Ola Lokahi, a nonprofit group set up to improve the health and well-being of Native Hawaiians.
Traditional healing goes on in a variety of settings around the islands — in clinics and community health centers as well as private homes and public parks.
"We're not just talking about Hawaiians," said Galang. "The Chinese brought their medicines, and many Chinese herbal shops are found in Chinatown."
Kahuena frequently uses an herb called olena, a ginger family plant also known as turmeric, to treat several ailments. It is anti-bacterial and anti-inflammatory, she said. In the case of the volleyball player, she used leaves of ha`uoi, a plant also known as verbena.
Kahuena said she tries all herbs before prescribing them, and is using olena herself for treatment of diabetes and heart problems. She hopes eventually to be free of her Western medicines.
"People want a quick fix but that's not how it works," Galang said. "It's a whole way of looking at life, a whole way of living, taking care of yourself."
Another major part of traditional healing is the spiritual element.
"It's all very spiritual, like how American Indians speak of a higher power, such as Mother Earth," Galang said.
The state realized the need for a greater emphasis on Native healing in the 1980s after studies found that Hawaiians' health was lagging when compared to other groups. Papa Ola Lokahi was established to develop the infrastructure to address concerns of the studies.
A lingering concern is regulation. Traditional healers are exempt from state licensing, but their qualifications are reviewed by elder councils affiliated with the health care systems, and in turn reviewed by a Native Hawaiian health board, said Hardy Spoehr, executive director of Papa Ola Lokahi.
"Some say cultural practices are protected under the state constitution, but others say there needs to be some kind of oversight from the Hawaiian community," Spoehr said. Papa Ola Lokahi is organizing a conference early next year to deal with this issue.
The University of Hawaii's medical school recently created its Department of Native Hawaiian Health, which is committed to improving the health and wellness of Native Hawaiians while embracing traditional Hawaiian values and practices.
"We believe Western medicine can be complemented by traditional practices to maximize the health of our people," said Dr. Kalani Brady, a family practitioner and vice chairman of the department.
The medical school's new Kakaako campus has a la`au garden that includes plants used in traditional healing.