The Maui Wildfire Exposure Study has offered a healthcare lifeline to fire-impacted Maui residents. It also provided a model for tracking the long-term effects of the disaster.
“MauiWES has served more than 2,500 people since the program began. In total, the program has supported more than 4,000 appointments, including health screenings, follow-up visits, referrals, mental health assessments, physical health checks,” said Ruben Juarez, University of Hawai’i Economic Research Organization Professor of Health Economics.
Juarez has led the study, along with Alika Maunakea, professor in the Department of Anatomy, Biochemistry and Physiology at UH’s John A. Burns School of Medicine.
“For many participants, MauiWES has been one of the few consistent ways to receive mental and physical health checks after the fires,” Juarez told HPR. “People are coming to us because they need answers, they need support, and they need access to care.”
MauiWES was launched in January 2024, just months after the wildfire burned the town of Lahaina and parts of Kula.
Juarez calls it more of a community program than a study because providing care access is just as important as the research aspect.
“It gives results, connects people to care, identifies risk early, and it's helping decision makers understand where the needs are the greatest, and where they need to put their money, and unfortunately, for many participants, this is just not abstract research. It is one of the few places where they can get results,” said Juarez.
Now, the study lacks the funding to continue.
“There is nothing in sight, and as of now, so the study is closed, because we just don't have funding to operate, unfortunately,” explained Juarez. “We had our last participant this past Friday.”
A state bill that would have allocated $3 million to continue and expand the study failed unexpectedly at the end of the legislative session. Now, study leads are just hoping they can scrape together enough funding from other sources to keep it alive.
Dr. Chris Knightsbridge is a study co-author and practices clinical psychology in Lahaina.
“The community is amazing, which is why I get a bit passionate and a bit angry when I feel that our state is neglecting their needs, or they try to minimize the data that is collected, or try to say that things are okay, because they're not,” said Knightsbridge. “They're not okay.”
He said a lot of that stems from not getting answers.
“What I've noticed the most is that what's really, really hurting the people right now is the uncertainty,” he said.
Not knowing if they’ll have enough money to rebuild their home, find interim housing, be able to get a job, and put food on the table is taking a toll.
“When basic needs are not met, we can't even begin to process the actual traumas that they experience,” said Knightsbridge. “This is three years on [after the fire]. So, from a mental health perspective, they're not in a recovery stage yet, they're still in a crisis stage. I hear people tell me a lot that they don't feel like they're living, they just feel like they're surviving, and it's becoming exhausting for them.”
Half of the participants have symptoms of depression.
“Mental health is kind of a silent killer, people don't like to talk about it,” said Knightsbridge. “We got lots of kupuna just sheltered in place in their homes because they're too afraid to leave. This study really helped get them out.”
Knightsbridge said the statistics are concerning, especially for children.
“I've had patients who have been as young as six and have stated the words, ‘I want to kill myself, I don't want to live anymore,’ and per parents reports, they were never that way before the fire,” he said.
About half of the failed bill’s funding had been allocated to expand the exposure study to reach more keiki. Juarez said kids are a critical but understudied part of the post-disaster population.
“We have no information about what's happening for children, except for a small cohort of 200 individuals that we had,” Juarez explained.
Knightsbridge said the study had a vital mission: “Prevent an entire generation of children from suffering this kind of generational trauma. We're willing to put in the work, we just need the support.”
Additionally, Juarez said many health impacts of the fire may not manifest for 5 to 10 years, making long-term tracking critical.
“[The wildfire] is the largest and most damaging disaster in Hawaii's history,” he said. So it's not going to be a short-term thing, it's going to be a long-term impact that we need to continue investing into it, unfortunately, to be able to prevent some of the potential consequences of it.”
Past disasters have shown that the full health consequences often take time to appear.
“We know that more people died after 9-11 due to exposure to environmental contaminants than during the disaster itself, and these people who died, basically took them several years for them to develop secondary conditions, including all the way to cancer… so this is the type of things that we are trying to prevent right now from happening,” explained Juarez.
This week, he and Maunakea are in Washington D.C. advocating for financial backing.
“We are definitely actively seeking sustainable funding, so MauiWES can continue serving the community,” said Juarez. “We believe that this program is just too important to stop.”
