Ua emi anei ka hiki o kou kino ke kaua aku i nā maʻi? (Immunocompromised) E kamaʻilio kākou e pili ana i kēia!

Loaʻa pinepine iā ʻoe ke anu akā ʻaʻole nalo i loko o kekahi mau lā? A i ʻole ke manaʻo nei ʻoe ua maʻalahi ka loaʻa ʻana o nā maʻi ma mua o nā poʻe ʻē aʻe? Malia paha ua emi iho ka hiki o kou kino ke hakakā i nā maʻi, ʻo ia hoʻi kou pale ʻana. Kāhea mākou i kēia ʻano `(Immunocompromised)`. Mai hopohopo, e kamaʻilio kākou e pili ana i kēia me nā kikoʻī.

I ka ʻōlelo maʻalahi, he aha kēia kūlana i kapa ʻia ʻo `(Immunocompromised)`?

E noʻonoʻo he pūʻali koa pale ko kākou i loko o ko kākou kino, e like me ka ʻāina. Mālama kēia pūʻali koa iā kākou i ke olakino ma ke kaua ʻana i nā huakini e hoʻoulu ai i nā maʻi mai waho. Kāhea mākou i kēia ʻo ka ʻōnaehana pale . No laila, ʻo ke "Immunocompromised" ʻo ia hoʻi, ʻaʻole hana pono kāu ʻōnaehana pale, ʻo ia hoʻi, ua nāwaliwali. A laila ʻaʻole hiki iā ia ke hakakā i nā maʻi e like me ka mea e pono ai.

Hiki paha iā ʻoe ke hānau ʻia me kēia maʻi. A i ʻole e hoʻonāwaliwali ʻia paha kou ʻōnaehana pale ma muli o kekahi mau maʻi, nā lāʻau lapaʻau, nā maʻi e like me ke kanesa, a i ʻole nā ​​pilikia olakino ʻē aʻe i kou ola. Hiki paha iā ʻoe ke lohe i kēia i kapa ʻia ʻo "Immunosuppression." ʻAʻole ia he mea i hānau ʻia me ʻoe, akā he lāʻau lapaʻau a maʻi paha ma hope e hoʻohaʻahaʻa i kou ʻōnaehana pale.

Pehea ʻoe e ʻike ai inā loaʻa iā ʻoe kēia maʻi?

ʻO nā hōʻailona nui o kēia, ʻo ia ka maʻi pinepine ʻana a me ka lōʻihi o ka manawa e hoʻōla ai i ka wā e maʻi ai ʻoe. Eia naʻe, ʻaʻole nā ​​​​kānaka a pau e maʻi pinepine ana he ʻōnaehana pale nāwaliwali ko lākou. He mea nui nō hoʻi ke ʻano o ka maʻi āu e loaʻa ai. No ka laʻana, he mea maʻamau i nā keiki liʻiliʻi ke loaʻa pinepine i ke anu.

Eia nō naʻe, inā loaʻa pinepine iā ʻoe nā maʻi bacteria, nā maʻi e like me ka pneumonia, a i ʻole nā ​​maʻi kikoʻī ʻē aʻe, he hōʻailona paha ia ʻaʻole hana pono kāu ʻōnaehana pale. I ke kūlana immunocompromised, hiki i nā mea e like me kēia ke hana:

• Maʻi ʻoe i nā huakini e pale mau ana i nā poʻe ʻē aʻe me ka ʻole o ka maʻi ʻana.
• ʻO kahi maʻi palupalu a hiki ke ho'ōla ʻia no ka hapa nui o nā kānaka hiki ke lilo i mea koʻikoʻi loa iā ʻoe.
• He lōʻihi ka manawa e ola ai mai ka maʻi mai.
• ʻOi aku ka nui o kou loaʻa ʻana i nā pilikia mai ka maʻi (e like me ka loaʻa ʻana o ka maʻi pneumonia ma hope o kahi maʻi hanu ma mua o nā poʻe ʻē aʻe).
• ʻO kekahi mau maʻi viral i hala mua, e like me ka maʻi Epstein-Barr a i ʻole ka maʻi varicella-zoster (ka maʻi e hoʻoulu ai i ka moa), hiki ke hoʻi hou mai.
• ʻOiai inā loaʻa iā ʻoe nā lāʻau pale, ʻaʻole paha kou kino e hana i nā antibodies.

ʻAʻole paha ʻoe e ʻike i kekahi mau hōʻailona kikoʻī no ka mea ua palupalu kou pale ʻana i ke kino. Eia nō naʻe, inā he maʻi kou e hoʻoulu ai i kēia ʻano (e like me kekahi mau ʻano maʻi kanesa), hiki iā ʻoe ke ʻike i nā hōʻailona e like me:

• Manaʻo luhi loa (Fatigue)
• Nā hou o ka pō
• Nā kuni e hoʻi hou ana
• Ka pohō kaumaha i manaʻo ʻole ʻia
• Nā ʻōpū lymph pehu

Nā maʻi kūikawā e kū mai ana i nā poʻe me nā ʻōnaehana pale i nāwaliwali

Aia kekahi mau maʻi i hiki i ke kanaka olakino ke pale aku a lanakila maʻalahi. Akā inā loaʻa iā ʻoe kēlā mau maʻi, hiki i ke kauka ke manaʻo ua nāwaliwali kou ʻōnaehana pale. ʻO ia mau maʻi:

• ʻO ka niumonia Pneumocystis (PCP) kahi ʻano niumonia.
• ʻO ka maʻi cytomegalovirus (CMV) hōʻailona
• Nā maʻi fungal e laha ana mai nā māmā i nā ʻāpana ʻē aʻe o ke kino (e like me coccidioidomycosis, cryptococcosis, histoplasmosis)
• Nā maʻi bacteria pinepine
• Nā maʻi pinepine a lōʻihi paha e like me ka pneumonia, herpes simplex, campylobacter, a i ʻole cyclosporiasis.

He aha nā kumu o kēia emi ʻana o ka palekana?

I nā manawa he nui, ʻo nā kumu nui o ka nāwaliwali o ka ʻōnaehana pale maʻi kekahi mau maʻi, nā hopena ʻaoʻao o kekahi mau lāʻau lapaʻau, a me nā mea e like me ka hoʻoili ʻana o ke kino a i ʻole ke kumu cell. Hiki i kēia mau mea āpau ke hoʻonāwaliwali i kāu ʻōnaehana pale ma nā ʻano like ʻole.

Nā maʻi a me nā kūlana e hoʻonāwaliwali ai i ka ʻōnaehana pale

Hoʻopau kekahi mau maʻi i kā mākou mau hunaola pale kino a hoʻopilikia paha i ko lākou hiki ke hoʻoponopono pono iā lākou iho. ʻO ia mau maʻi:

• ʻO ka immunodeficiency mua: ʻO kēia kekahi ʻano e hoʻonāwaliwali ai i kāu ʻōnaehana pale, inā paha ua hānau ʻia ʻoe me ia a inā paha e nāwaliwali maoli kāu ʻōnaehana pale ma hope o ke ola.
• Maʻi HIV (human immunodeficiency virus): Hoʻouka pololei kēia i ka ʻōnaehana pale.
• Kanesa: ʻO nā kanesa e pili ana i ke koko, ʻoiai ka leukemia, lymphoma, a me ka myeloma maha, nā kanesa maʻamau e hoʻopilikia i ka ʻōnaehana pale. Eia nō naʻe, hiki i nā ʻano kanesa ʻē aʻe ke hoʻopilikia i ka ʻōnaehana pale.
• ʻO ka maʻi diabetes (Diabetes Mellitus)
• Nā maʻi Autoimmune: ʻO kēia ka manawa e hoʻouka ai ka ʻōnaehana pale i nā hunaola ponoʻī o ke kino.
• Maʻi ʻeha o ke kelepona ʻokiʻoki
• ʻO ka maʻi ʻaʻai
• ʻO ka maʻi hepatitis viral (ka mumū o ke akepaʻa)

Pēlā nō, ʻo ka poʻe nele i ka thymus (kahi e oʻo ai kā mākou mau pūnaewele T, kahi ʻano pūnaewele pale) a i ʻole ka spleen (kahi ʻōkana e loaʻa ana a kaohi i nā keʻokeʻo koko keʻokeʻo) he haʻahaʻa ko lākou palekana.

Nā lāʻau lapaʻau a me nā lāʻau lapaʻau e kāohi ana i ka pale ʻana

Hiki i kekahi mau lāʻau lapaʻau, e like me ka radiation therapy a me ka chemotherapy no ke kanesa, ke hoʻonāwaliwali i ka ʻōnaehana pale ma ke ʻano he hopena ʻaoʻao. Aia kekahi mau lāʻau lapaʻau ʻē aʻe e kāohi ana i ka ʻōnaehana pale ma ke ʻano he ʻāpana o kā lākou hana. No ka laʻana, ʻo ka hoʻoili ʻana o ka iwi iwi e hoʻopau pinepine i kāu ʻōnaehana pale holoʻokoʻa a hoʻololi iā ia me kahi mea ʻoi aku ka maikaʻi.

Hana nā lāʻau lapaʻau he nui no nā maʻi autoimmune ma ka hoʻonāwaliwali ʻana i ka ʻōnaehana pale, e pale ana iā ia mai ka hoʻouka ʻana i nā hunaola olakino. Kāhea mākou i kēia mau lāʻau immunosuppressive (nāna e hōʻemi i ka hana o ka ʻōnaehana pale) a i ʻole nā ​​lāʻau immunomodulatory (nāna e hoʻololi i ke ʻano o ka hana a ka ʻōnaehana pale).

ʻO kekahi mau lāʻau lapaʻau a me nā lāʻau lapaʻau e kāohi ana i ka palekana:

• ʻO ka iwi iwi a i ʻole ka hoʻoili ʻana o nā ʻōkana paʻa
• Kemoterapia
• Hoʻōla radiation
• Nā Corticosteroids (e.g. prednisone, prednisolone, dexamethasone)
• ʻAzathioprine (Imuran®)
• ʻO Cyclosporine (Gengraf®, Neoral®)
• ʻO ka Hydroxychloroquine (Plaquenil®)
• ʻO ka Leflunomide (Arava®)
• ʻO ka Methotrexate (Rheumatrex®, Trexall®)
• ʻO ka lāʻau lapaʻau Sulfasalazine (Azulfidine®)

He aha nā hopena ʻaoʻao e hiki mai ana o kēia?

Ke nāwaliwali kou ʻōnaehana pale kino, ʻoi aku kou pilikia o ka loaʻa ʻana o nā pilikia e hoʻoweliweli i ke ola mai nā maʻi. No ka mea ʻaʻole hiki i kou kino ke pale aku i ka maʻi, hiki i nā maʻi ke laha ma kou kino. Hiki i kēia ke alakaʻi i ka hōʻino ʻana o nā kino, sepsis (kahi ʻano e like me ka lāʻau make koko), a me ka septic shock (kahi emi nui o ke koko). Hiki i kēia mau mea a pau ke make. Inā pilikia nui ʻoe, e hele i ka lumi pilikia kokoke loa.

Pehea e ʻike ai ke kauka i kēia?

Hoʻoponopono nā kauka i ka maʻi pale ʻole a me nā maʻi e hoʻoulu ai ma ka nānā ʻana i kou koko a me nā ʻiʻo kino. Hoʻohana ʻia kekahi mau hoʻokolohua kikoʻī e hana i kēia:

• Helu koko piha (CBC)
• Ka hoʻāʻo ʻana i ka antibody
• ʻO ka cytometry kahe (helu ʻana i nā pūnaewele pale)
• Ka hoʻāʻo ʻana i ka genetic e nānā i nā loli genetic e hoʻopilikia ai i ka pale ʻana
• Ka nānā ʻana i ka mimi
• Ka hoʻāʻo ʻana i ka maʻi HIV
• ʻO ka biopsy o ke kiko lymph
• ʻO ka biopsy iwi
• Biopsy akepaʻa
• CT scan a i ʻole nā ​​​​hoʻokolohua radiological ʻē aʻe

Pehea ʻoe e mālama ai i kahi kanaka me ka ʻōnaehana pale haʻahaʻa?

ʻO ke ʻano o ka mālama ʻana no ka ʻōnaehana pale i nāwaliwali ma muli o ke kumu. Hiki i nā kauka ke mālama i kekahi mau kūlana kumu a kōkua i ka hoʻoikaika ʻana i kāu ʻōnaehana pale. ʻO ia mau lāʻau lapaʻau:

• Lapaʻau Antiretroviral: Hiki i kēia mau lāʻau ke hōʻemi nui i ka nui o ka HIV i loko o kou kino. Ke hōʻemi ʻia, ʻaʻole ia e hoʻopilikia i kāu ʻōnaehana pale.
• Ka lāʻau lapaʻau no ka maʻi kanesa:Hoʻōla ʻia nā maʻi ʻaʻai e hoʻopilikia ana i ka ʻōnaehana pale me ka chemotherapy, radiation therapy, a me ka immunotherapy.
• ʻO ka inikini Pegfilgrastim (Fulphila®, Neulasta®): Inā haʻahaʻa loa ka helu o kāu mau keʻena koko keʻokeʻo (neutropenia), kōkua kēia inikini i kou kino e hana i nā keʻena koko keʻokeʻo hou aʻe a hoʻoikaika i kāu ʻōnaehana pale.
• Ka hoʻoili ʻana o Granulocyte: He hoʻoili koko laha ʻole kēia no ka neutropenia koʻikoʻi.
• Hoʻoili pūnaewele kumu: Hiki ke hana i kahi hoʻoili pūnaewele kumu e ho'ōla a kāohi paha i kekahi mau maʻi e hoʻonāwaliwali ai i ka ʻōnaehana pale.

Aia kekahi mau lāʻau ʻē aʻe e hiki ke kōkua i ka pale ʻana a i ʻole ka hakakā ʻana i nā maʻi.

Ke mālama ʻana i nā maʻi i ka wā e haʻahaʻa ai ka palekana

Inā nāwaliwali kou ʻōnaehana pale maʻi, ʻaʻole paha ʻoe e hiki ke hoʻōla me nā lāʻau lapaʻau i kūʻai ʻia ma ke kūʻai aku ke maʻi ʻoe. Hoʻomaka pinepine kāu kauka i ka lāʻau antibiotic, antifungal, antiviral, a i ʻole antiparasitic i ka manawa koke, ma muli o ke ʻano o ka maʻi.

Hiki ke hoʻokomo ʻia ʻoe i ka haukapila e kōkua i ke kaua ʻana i ka maʻi. Ma laila, hiki ke hāʻawi ʻia iā ʻoe nā lāʻau lapaʻau e like me:

• Nā antibodies monoclonal
• Plasma hoʻōla
• Nā inikini gamma interferon
• ʻO ka globulin pale ʻōpū intravenous (IVIG)

He aha kāu e manaʻo ai i ka wā e noho ai me kēia maʻi?

ʻAʻole like nā kānaka a pau me ka ʻōnaehana pale kino nāwaliwali. No kekahi poʻe, he loli liʻiliʻi paha ia, akā no kekahi poʻe hiki ke hoʻololi i ko lākou nohona holoʻokoʻa.

Eia kekahi, ua emi wale ka pale ʻana o kekahi poʻe no ka manawa pōkole. Pono paha kekahi i nā lāʻau lapaʻau a i ʻole nā ​​maʻi e hoʻololi i ke ʻano o ka pale ʻana i ke ola holoʻokoʻa. E kamaʻilio me kāu hui mālama ola e pili ana i ka mea e manaʻo ai ma muli o kou kūlana.

Ma keʻano laulā, ʻo ka nānā ʻana no kekahi me ka ʻōnaehana pale nawaliwali e pili ana i ke kumu kumu. Hiki ke kāohi ʻia nā maʻi he nui e hoʻonāwaliwali i ka ʻōnaehana pale. Eia nō naʻe, he mea pono pinepine ke makaʻala loa i ke ola holoʻokoʻa e pale aku i nā maʻi a i ʻole e ʻimi i ka lāʻau lapaʻau ke loaʻa mai.

Hiki ke pale ʻia kēia?

ʻAʻole hiki ke pale ʻia ka hapa nui o nā maʻi immunosuppressive. Eia nō naʻe, ʻo ka pale ʻana i nā maʻi mai nā poʻe ʻē aʻe ke ala maikaʻi loa e pale aku ai i nā pilikia koʻikoʻi. Hiki iā ia ke kōkua i ka pale ʻana i kekahi mau maʻi immunosuppressive.

Hiki iā ʻoe ke hana i kēia mau mea e hōʻemi ai i ka pilikia o ka maʻi:

• Nā ala palekana: E holoi pinepine i kou mau lima, e hoʻomaʻamaʻa i ka moekolohe palekana, a e hahai i nā hana palekana meaʻai.
• Nā Pale ʻAna: E kiʻi i nā pale āpau i ʻōlelo ʻia nou. Hiki i kekahi mau pale ke hoʻomaʻi i ka poʻe me nā ʻōnaehana pale nāwaliwali. No laila e nīnau i kāu kauka e pili ana i nā pale kūpono iā ʻoe.
• Ka pale ʻana ma mua a ma hope o ka hōʻike ʻana: Inā ʻoe i ka pilikia nui o ka hōʻike ʻana i ka maʻi HIV, hiki iā ʻoe ke lawe i ka Preexposure prophylaxis (PrEP). Inā ua hōʻike ʻia ʻoe i ka maʻi HIV, hiki iā ʻoe ke lawe i ka Post-exposure prophylaxis (PEP). Aia kekahi mau koho prophylaxis ma hope o ka hōʻike ʻana no ka Hepatitis B.
• E kaupalena i ka pilikia: E pale i ka poʻe maʻi a i ʻole i pili i kahi mea maʻi. E hele i ka hale kūʻai a kūʻai i nā meaʻai i ka wā e emi ana ka poʻe. He mea nui loa kēia i ka wā anu a me ka maʻi palū a i ka wā e kiʻekiʻe ai nā maʻi COVID-19.
• E hoʻomaka i ka lāʻau lapaʻau i ka wā mua: Hiki i kāu kauka ke kuhikuhi i nā antibiotics a i ʻole antifungals e pale aku i ka maʻi.
• Ke hoʻāʻo nei no nā maʻi: Ma mua o ka hoʻomaka ʻana i ka lāʻau immunosuppressive, hiki i kāu kauka ke hoʻāʻo iā ʻoe no nā mea e like me ka maʻi HIV, hepatitis, tuberculosis, nā maʻi fungal, a me nā maʻi parasitic.

Pehea ʻoe e mālama ai iā ʻoe iho?

Inā nāwaliwali kou ʻōnaehana pale, pono ʻoe e makaʻala loa i kou olakino. Hiki i ke anu maʻamau ke hoʻomaʻi nui iā ʻoe. Ma waho aʻe o ka lawe ʻana i nā hana palekana kūikawā e pale aku iā ʻoe iho mai ka maʻi, aia kekahi mau ala ʻē aʻe e hiki ai iā ʻoe ke mālama iā ʻoe iho:

• E nānā i kou olakino: E nīnau i kāu kauka i nā hōʻailona o ka maʻi āu e makaʻala ai a me ka mea e hana ai inā loaʻa iā ʻoe. Eia kekahi laʻana, he kuni ma luna o kekahi mahana, nā hōʻailona e hoʻomau nei, a pēlā aku.
• E hoʻolālā mua: E mālama i kahi pale maka a me ka mea hoʻomaʻemaʻe lima. I ka wā e hele ai, e ʻike i kahi e loaʻa ai ke kōkua lapaʻau ma nā wahi āpau āu e hele ai. Lawe kekahi poʻe i kahi kāleka e hōʻike ana he haʻahaʻa ko lākou ʻōnaehana pale.
• E hoʻomaopopo i kāu poʻe aloha: E kamaʻilio me kou ʻohana a me kou mau hoaaloha e pili ana i ka lawe ʻana i nā hana palekana. Pono lākou e hoʻomaopopo e hiki iā lākou ke kōkua i ka mālama ʻana iā ʻoe i ke olakino. Inā maʻi lākou, pono lākou e haʻi iā ʻoe ma mua o ko lākou ʻike ʻana iā ʻoe.
• E hana i kahi hoʻolālā me kāu kula/wahi hana: E kamaʻilio me ka ʻoihana kumuwaiwai kanaka o kāu ʻoihana a i ʻole ke kula (inā ke kula o kāu keiki) e pili ana i nā hoʻololi āu e pono ai e hana e noho olakino a palekana. Pono paha ʻoe e hana pū me kāu kauka e hana i kahi hoʻolālā e hōʻike ana i nā hoʻoponopono ʻē aʻe no ka wā hiki ʻole iā ʻoe a i ʻole kāu keiki ke hele i ka hana/kula.
• E kamaʻilio ākea me kāu kauka: Hōʻalo kekahi poʻe i nā hālāwai lapaʻau no ka makaʻu i ka noho ʻana a puni nā poʻe ʻē aʻe. E kamaʻilio me kāu kauka e pili ana i ke ala maikaʻi loa e loaʻa ai ka mālama olakino me ka ʻole o ka pilikia. E ʻike inā hiki iā ʻoe ke hoʻonohonoho i nā kipa virtual (e like me nā kelepona wikiō) a i ʻole nā ​​​​hālāwai i nā hola ʻaʻole kiʻekiʻe.
• E ʻike inā hiki i nā loli o ke ʻano o ka nohona ke kōkua: E nīnau i kāu kauka inā hiki i ka hoʻoikaika kino a i ʻole ka ʻai ke hoʻololi i kou olakino pale.
• E hoʻoikaika i ke olakino noʻonoʻo: ʻO ka mālama mau ʻana i kou olakino kino hiki ke hoʻopilikia i kou olakino noʻonoʻo.ʻO ke kamaʻilio ʻana me ke kākāʻōlelo olakino noʻonoʻo, ka hele wāwae ʻana i kēlā me kēia lā, a me nā ʻano mālama ponoʻī ʻē aʻe e hiki ke kōkua i ka hōʻemi ʻana i kou pae kaumaha. Kōkua pū kēlā i kāu ʻōnaehana pale.

I ka manawa hea e pono ai iaʻu e ʻike i ke kauka/hele i ka haukapila?

E kamaʻilio me kāu kauka e pili ana i ka wā e pono ai ʻoe e ʻike hou iā lākou inā he nāwaliwali kou ʻōnaehana pale, a me ka mea e hana ai inā manaʻo ʻoe he maʻi kou. Hiki iā lākou ke haʻi iā ʻoe e hele pololei i ka lumi pilikia inā loaʻa iā ʻoe kekahi mau hōʻailona. Nui ka hilinaʻi i kou kūlana kikoʻī, akā ʻoi aku ka maikaʻi o ka nānā ʻana inā ʻoe e hopohopo nei i kekahi mea.

Āhea ʻoe e hele ai i ka Emergency Treatment Unit (ETU) ?

E nīnau i kāu kauka i nā hōʻailona e makaʻala ai a me ka wā e hele ai i ka lumi pilikia. E hele mau i ka ER inā loaʻa iā ʻoe nā hōʻailona o kahi maʻi koʻikoʻi:

• Kuni (ʻo kēlā me kēia mahana ma luna o 100.4 Fahrenheit/38 Celsius)
• Ka huikau a i ʻole ka ʻike i hoʻololi ʻia
• ʻEha poʻo nui
• ʻOʻoleʻa o ka ʻāʻī
• Ka luaʻi pinepine ʻana a i ʻole ka maʻi pākī
• Inā ʻulaʻula ka ʻeha, pehu, ʻeha, kahe ka pus, a mahana paha ke pā

He aha nā nīnau āu e nīnau ai i ke kauka?

He mea kōkua paha ka nīnau ʻana i kāu kauka i nā nīnau e like me kēia:

• Pehea ka lōʻihi o koʻu "immunocompromised"? He manawa pōkole a mau loa paha kēia?
• He aha nā hana e hiki iaʻu ke hana e pale aku iaʻu iho mai nā maʻi?
• He aha nā hōʻailona o ka maʻi e pono iaʻu e makaʻala?
• Āhea wau e hele ai i ka lumi pilikia?
• Āhea wau e ʻike hou ai iā ʻoe?

Hiki i nā kānaka ke lilo i "immunocompromised" no nā kumu like ʻole. ʻOkoʻa paha kou ʻike mai ko kekahi. Malia paha ke heluhelu nei ʻoe i kēia ma mua o ka hoʻomaka ʻana i ka lāʻau immunosuppressive, me ka manaʻolana ʻaʻole ia e kāohi iā ʻoe mai ka hana ʻana i nā mea āu e aloha ai. Malia paha aia ʻoe i loko o ka haukapila, me kahi maʻi ʻē aʻe, e noʻonoʻo ana i ka mea e hiki mai ana. A i ʻole paha ua "immunocompromised" kāu keiki, a ke hoʻāʻo nei ʻoe e hōʻoiaʻiʻo i ka honua ʻaʻole loaʻa i kou ʻohana ke anu.

ʻO kahi mea like i loaʻa i nā mea a pau me ka ʻōnaehana pale nāwaliwali, ʻo ia ka pono e hana i nā hoʻololi a lawe i nā hana palekana i makemake ʻole ʻia e kekahi poʻe. Hiki ke paʻakikī ke wehewehe i kāu hoʻokele olakino i nā poʻe ʻē aʻe. E hilinaʻi i kāu hui lapaʻau. Loaʻa paha iā lākou nā manaʻo no nā hui kākoʻo a me nā ala ʻē aʻe e mālama ai iā ʻoe i ka palekana a me ke olakino.

Inā he maʻi pale kino kekahi āu i ʻike ai, e hoʻolohe i kā lākou mau pono. E hana i nā mea a lākou e noi mai ai iā ʻoe e hana e kōkua i ka pale ʻana i ko lākou olakino noʻonoʻo a me ke kino.

Nā mea e pono ai ʻoe e ʻike (Leka Lawe-Home)

ʻAʻole ia he mea e makaʻu ai ka loaʻa ʻana o kahi ʻōnaehana pale haʻahaʻa, akā he mea nui loa ia e makaʻala i ia mea a hana i nā hana e pono ai.

• Inā maʻi pinepine ʻoe a inā lōʻihi ka manawa e ho'ōla ai i kou maʻi, e ʻimi i ke kōkua lapaʻau.
• Aia nā kumu like ʻole e hiki ai ke emi iho ka palekana; e hoʻomaopopo i kēlā.
• E hahai pono i ka lāʻau a me nā kuhikuhi a ke kauka.
• E hana i nā mea āpau e hiki ai iā ʻoe ke pale iā ʻoe iho mai nā maʻi. E hoʻomaʻamaʻa i ka holoi ʻana i kou mau lima a pale i nā wahi i piha ai ka poʻe.
• He mea nui loa nō hoʻi kou olakino noʻonoʻo. Mai kānalua e kiʻi i ke kōkua inā pono ʻoe.
• ʻAʻole ʻoe hoʻokahi. Aia nā kauka, ka ʻohana, a me nā hoaaloha e kōkua iā ʻoe.

E hoʻomanaʻo, no ka ʻike wale nō kēia ʻike. Inā he mau hopohopo olakino kou, e ʻoluʻolu e nīnau i ke kauka.

ʻO ka pale ʻana i ka maʻi, ka pale ʻana i ka maʻi, ka maʻi pinepine, ka ʻōnaehana pale, nā maʻi, ka lāʻau lapaʻau