 Welcome to Perspectives on Global Justice Think Tech Hawaii program. This is your host, Beatrice Cantelmo. The secret relationship between children, mothers and families is universal. No matter where on earth we find ourselves at, special attention is paid to them. Some places are doing better than others with regards to infant mortality rates, public health policy and legislative work, as well as direct services that empower and support families, children and mothers to thrive. All the places have ways to go. Take the birth of a child, for example, and paid family leave. Why is it so important that parents have a chance to spend time with their babies at home without having to worry about losing their job and coming benefits? Some countries offer 52 or more weeks of paid family leave when a child is born. Or there's between 26 and 51 weeks, and some countries even 14 weeks. How many months of paid family leave do we have allocated in the United States? Zero. That means no paid family leave is available for families. Quite shocking, isn't it? Today we have a very special guest with us, Lisa Kimura, Executive Director of Healthy Mothers and Healthy Babies Coalition of Hawaii. Let's find out about what type of services this marvelous coalition offered to our community and how they're working with other community partners to ensure that maternal, child and family health continue to be improved in the state of Hawaii. And of course, let's find out how public education, advocacy and public policy development, along with your support, are the perfect ingredients to make that happen. On that note, welcome to our program, Lisa. Thank you. Thanks for having me. Absolutely. What an honor. What a special topic to talk about it. It's the heart of our states and the world, the family and children. Before we start, I'd like to give our viewers a little help to understand a little bit about our guests. And so do you mind telling us where you come from and what your professional and educational background is? Sure, sure. So I've been with Healthy Mothers Healthy Babies for almost five years and in that capacity, working on legislative advocacy programs, services, and just basically helping to make sure all moms and babies are supported before, during and after pregnancy. Prior to this, I was with Aloha United Way and working on, again, social services, primarily a lot on early childhood development, but as well as improving the whole social safety net that we have. I have three children of my own, so having those children are really what profoundly changed my life and gave me the direction and the passion that I have for making sure that moms have babies that are welcomed and thriving and happy and have all the resources and support that they need. Was that part of becoming a mother, the help to make that leap professionally and say, I want to work to improve maternal child health instead of Hawaii? A hundred percent. Yeah, having had my first couple of children, you know, I was in the nonprofit sector and for a while I was in the private sector and it was such a surprise to me about sometimes what the lack of availability of services are and the lack of supports that are available for new moms and knowing that those resources don't exist or aren't available to all moms or the fact that moms can just kind of fall through the cracks in terms of even making sure that the quality of care that they have is sufficient, all of those things really impacted me and helped me refine my focus and once I kind of got set on that path it was just, I just consumed as much information as I possibly could to work towards improving things for all parents. That's wonderful, so it really comes from the heart and that passion to make it better from personal experiences as well. Definitely. So do you mind telling us a little bit about the vision and mission of Healthy Mothers and Healthy Baby Coalition about why and also when the coalition was formed? This year is actually our 25th anniversary, so it's exciting for us. We got started and we've kind of changed throughout the years. Actually the National HMHB was founded in 1981, so 36 years ago. And it was started because of the Surgeon General's warning on the need to reduce infant mortality in the United States. And then locally, such as our local coalition, we're founded to work on the problems and the issues that are unique to our state and our islands. And so our coalition is based in Honolulu, but we serve all women, all families throughout all islands. We have programs on all islands that are designed, you know, primarily we want to reduce infant and maternal mortality rates. But we also just want to make sure that all families are getting access to healthcare, that the amount of services are sufficient for what they need. And we want to make sure that all pregnancies are intended because about half of all pregnancies are not. Of course, there's a lot of negative outcomes that come from pregnancies that are not intended, such as, you know, again, mortality rates are higher, but also just worse outcomes. Preterm births, low birth weight babies, babies that aren't getting sufficient nutrition during pregnancy. So in order to impact that, we want to make sure moms are getting access to reproductive healthcare. And that includes contraception, making it as readily available as possible. And the health screening as well. So healthy mothers, healthy babies do help parents when they are pregnant. How does the screening process and linking a mother with the services happen? So sometimes it's as simple as just making sure that all of the dots are connected between Department of Health, Department of Human Services, birthing hospitals, other nonprofits, and making sure that, you know, especially high-risk low-income moms, if they're finding that they're not getting the services that they need, that we're connecting them. And then when we find that those times, things that we can impact, such as screening women for substance abuse during pregnancy, it's a very simple but very critical element that can take place. And we've worked collaboratively with a lot of partners to help make sure that doctors have screening tools that are appropriate and that they're asking questions in the right way so moms don't feel threatened or victimized or worried or, you know, have the tendency to not want to be honest about what's really going on because there's help available, but we just have to make it available to them in the right way. So that being a very simple way that we've approached the issues, it also goes so far as we're working on a statewide strategic breastfeeding plan right now and we're working collaboratively between a lot of partners on all islands to make sure we get education to providers so that they know how to give good advice to moms that are struggling resources because they just don't have them and so on and so forth. So let's talk about one of the universal gifts of motherhood and breastfeeding. So I know that that's one program that is big for our state and that you promote. So what are the benefits of breastfeeding a child of us providing formula? You know, when a mom is not able to breastfeed for some reason, you know, formula is absolutely a life-saving substitute. However, when moms do have the ability to breastfeed, it is by far and away the most important thing they can do for the lifelong health of their child as well as their own health. So moms get benefits too, reduce risk of ovarian cancer, breast cancer and other things. For babies, though, it is the building block for their immune system. So everything from reduced risk of respiratory infection in colds, allergies, asthma, diabetes, even childhood leukemia rates are reduced by breastfeeding. SIDS, sudden infant death syndrome is another one that children that are exclusively breastfed have about a 50% reduced risk of dying from SIDS. So the impact is huge. It's broad. And then that's not even talking about all the other little things like bonding with your baby and having a really special relationship with each other that's just, you know, that certainly babies can be healthy and thrive even without a breastfeeding relationship, but it's just an amazing gift that you can give. Yeah, absolutely. So you do have a program that supports that with mothers, young mothers, first-time mothers or... We do. So we work with a teen population because that tends to be statistically one of the populations that's least likely to breastfeed. We also know there's other, some ethnic groups and education levels and such play a big part into why moms choose to breastfeed. You know, sometimes it's an education level, just not knowing how to get started or knowing how to get help. Sometimes it's family support and, you know, having parents or grandparents that didn't grow up or didn't raise their children breastfeeding and so it seems foreign and seems unfamiliar to them. Yeah, look at that. We just got a picture with the breast milk has more of a... good things for babies in need. So look at all of these amazing gifts. Yes, and all of these things are completely irreplaceable and absolutely unable to be reproduced in a lab. So of course you can give babies the building blocks to grow, but it's a sterile substance. It's not a living substance like breast milk is. You know, when you're sick your body produces antibodies that pass through the milk so it protects the child from what illness you have. It gives them immune protection that you just can't get from, you know, from formula and again it is important that babies have access to that if mom is not able to but it is an absolutely unique substance just between mom and baby and it continues to change from the time baby is brand new newborn to the time you lean which a lot of people ask when is a good time. The World Health Organization recommends up to age two or longer preferred. So there's no expiration date, there's no cut off. It's really simply what's best for mom and baby. Right. And I think also in our country there's such a stigma attached to breastfeeding but it's changing to more workplaces making it available that a woman can express the milk or breastfeeding public. It doesn't have such a, you know, controversial ramifications and not being arrested. Right. Well, you know, it's in our culture we've sexualized breast so much that it's very difficult for people to sometimes separate that especially if they're new mom for the first time and it seems like a crazy thing than they've done before. But, you know, 49 out of 50 states including ours protect a woman's right to breastfeed anytime, anywhere. And particularly in our state you do not need to be covered up. A lot of moms ask that question. It is not in decent exposure and moms don't need to be worried about that. Any public place that you're allowed to be, you're also allowed to feed your baby. So we can't ask a mom to leave, you can't ask her to cover up, you can't ask her to go to her car, all of those things. And moms it's important to know when they go back to work that's one of the huge stumbling blocks for why they might stop breastfeeding. Using a pump might be inconvenient, they might be worried about getting break time but all employers are required to give moms a time to pump as well as a place that's private, shielded from the view of their coworkers and is not a bathroom. And it doesn't need to be an expensive bill bow, all it needs to be it could be as simple as having a curtain that protects them from view of others and certainly an electric outlet as well for them but it's simpler than people think it might be. Exactly, well that's wonderful to hear that something so simple can yield such a big impact and result for both mother and babies. So that's one critical service that you provide through Healthy Mothers and Healthy Babies. So there's another one, it's a big one with CID. So we can talk a little bit about that and then kind of jump in and wrap it up with that topic at a flower break. So what would you like to tell us about the problem that you've been solving statewide? Right, so one of the most common cause of accidental infant death is sleep-related deaths and that could be suffocation, it could be SIDS which is a very unexplained sort of mysterious disease where babies die for no apparent reason while they're sleeping and it could be asphyxiation, it could be a variety of things it could be rolling over on them in bed where all of these factors combined, it is the most common cause of accidental death and all those deaths are, 90% of them occur within the first six months of life and they're largely preventable. So our program is based on a national program called CRIBS for Kids and what we do is we work with partners on multiple sites on all islands to get referrals They have to meet an income threshold as well as be defined as high risk due to prenatal factors such as substance use or history of domestic violence or other things that make them more likely to be susceptible to mortality. We take them to a one-hour class where they learn all of the protective factors and they're surprising things. Again breastfeeding is a surprising protective factor because it doesn't seem to correlate to sleep but it has a huge direct correlation and things also like smoking in the household babies that are exposed to tobacco smoke in utero and as you know out in the environment have a also hugely more increased risk of death and so teaching parents these things that they can do to protect their child making sure that they have their own secure place to sleep whether they're not going to rub up against a pillow or smother against a bumper pads or have somebody who's heavily under the influence or sleeping very heavily well on top of them people don't want to think these things happen but they do happen they happen every single week and throughout our state and so teaching people these things and at the end of the class we give them a free pack and play crib so they can take it home and that way they have a safe space they can move it right next to their bed so they don't have to be away from their child it's recommended they be sleep in the same room as parents for the first year of life and so that gives them the option to do it safely. That's wonderful. Quick break and I'll be right back. Thank you. Welcome to Sister Power. I'm your host Sharon Thomas Yarbrough where we motivate, educate, empower and inspire all women. We are live here every other Thursday at 4 p.m. and we welcome you to join us here at Sister Power. Aloha and thank you. This guy looks familiar. He's a self-the-ultra fan but that doesn't explain all this. Why? Why? He planned this party, planned the snacks, even planned to coordinate colored shirts but he didn't plan to have a good time. Now you wouldn't do this in your own house so don't do it in your team's house. Know your limits and plan ahead so that everyone can have a good time. Welcome back to Perspectives on Global Justice. Think Takawai program. This is Beatrice Kintama. We're back with Lisa Kimura. We're talking about two very important services that seem so simple and yet that impacts the life of children and mothers in such big ways. To give our viewers a perspective in terms of mortality rate or health issues related to low infant weights and also death and also related to seeds. Where are we at with our state and how are we at compared to all the states and where should we be? You know nationwide we as an industrialized country are I think 24th out of the world in terms of infant mortality. So you would think that we'd be higher. We do spend the most per capita on healthcare so we have a lot of room to grow. A lot of that has to do with access to healthcare and making sure that moms are getting prenatal services as early as the first week of pregnancy and making sure that there are doctors that are taking Medicaid patients and making sure that we have our Medicaid program still intact. Those are critically important and with things the way they are it's very, very important that we protect the services that we have because when moms and babies are born babies are born healthy and moms are healthy that's the absolute cornerstone of a healthy society and we have to do what we can to protect that. Absolutely. So I know that with that in mind I mean I think advocacy and the work with legislature not only at state level but at federal level to ensure that these services not only are maintained intact but also encouraged to be improved. It's very crucial. So what could you tell our viewers that would help them become more active players in this process right now with the healthcare reform that we are about to go under and also with Planned Parenthood which a lot of people don't realize it's really the only place that women and men may access for reproductive care and help and also many ways in which a mother may find out that she's pregnant and decide that okay I need further services for prenatal care that may be very well under jeopardy Absolutely. Planned Parenthood is a huge hand in hand partner with us because a lot of our mission is aligned. We all care about making sure that all the whole family has access especially for screenings and for contraception access going in for even just regular well woman visits all of those things are services that they provide that people don't tend to think about and they're one of the things really critical partners that we often refer to because they have a sliding fee scale so for those that don't have insurance there's still an option for them that can take care of them. People need to be vocal about protecting them and they need to be vocal about protecting the insurance and the Affordable Care Act and the services that we currently have available within our state and within the country. There are huge disparities between the infant mortality rates for example the state of Texas has the highest rate of maternal mortality in the industrialized world so it is more dangerous for a woman to be born there because of a lot of factors more dangerous for a woman to give birth there and it's just not fair for one thing but it's not right and we have incredible advocates working in that state but we need to be vocal even in our state and not to get complacent about the incredible amount of access and the incredible amount of progressive thoughts that we have here we have to hang on to that and we have to talk about why it's important. Right, so on that note I know that this year Family Pay Leave Act laws were introduced in our state legislature and what happened? Yeah, so we've had Paid Family Leave has been introduced for several years and we always kind of move the needle forward the issue sometimes is we as a state we don't have paid sick leave options for families either so people who are working sometimes low wage jobs or other service industry oriented jobs they don't even have access to paid sick leave so that's huge minimum wage is an issue too because we need families to be financially self sustainable when they're not everybody suffers and those issues again don't necessarily seem related but they absolutely are and Paid Family Leave is an issue that's important to us because when not only when a mom gives birth but also if you have a spouse that gets ill a parent that's ill your own self and you need someone to take care of you if you're taking time out of the workforce to be able to care for a family member or care for a brand new baby and you have to choose between your family obligations and your job that's not a choice anybody should have to make and so by giving people the ability to care give which is a critical necessity and also not making them financially unsustainable during that time it's a way to bridge and make sure again we have a healthy society and we have a continuum of care for all people so this year with the Paid Family Leave efforts we've had we are one of the founding members of the Hawaii Paid Family Leave Coalition and our organization has been working on doing focus groups with small and large businesses unions, parents and other caregivers to ask them what a model Paid Family Leave insurance program would look like how many weeks we should take off what percentage of our wages should be replaced who should pay for it, how much it should cost and we've been doing some financial actuarial studies also to look at what our existing insurance structures look like and what our existing FMLA and Hawaii Paid Family Leave or I'm sorry Hawaii Family Leave laws look like and so we can marry it all together and have a program that's financially tenable financially sustainable and serves 100% of Hawaii employees that's wonderful so with that and the pipeline right now so what is the plan for the fall and what is your hope for 2018 legislative session what are you hoping you know as far as Paid Family Leave if we could accomplish it in 2018 that would actually be our gold standard and with the very temporary preliminary numbers that we have it's about $2 per paycheck that it would cost if we had 100% of employees paying into a system like this and it would work the same way that a lot of insurance programs do you pay in and when you need it you collect and that would give people right now if you work for a company that's covered by FMLA you get 12 weeks of unpaid leave entitled to you you would still get those same 12 weeks but rather than having no income during that time you would have some sort of wage replacement so wait a minute I heard the magic number $2 per paycheck yes could actually fund Paid Family Leave for the entire 12 weeks yes and that would be for the entire state of Hawaii right at a percentage of your wages $2 so we're talking $8 a month depending on your pay pay by weekly come on people it's doable literally every other country in the world is already doing it and so there's really no reason why we shouldn't and it's not just about women it's not just about moms and babies it's about everybody and taking care of everyone in the family because everyone will need something at some point in their life it's about being allowed to be a human being and to have equity and health because I imagine it costs more to a society if you're looking from just a pragmatic number perspective to have somebody leaving the workforce to be able to take care of themselves or their children versus having that support they'll probably come back sooner prevention also is a big thing because if you're starting to realize that you're sick and you take care of yourself right away most likely you're going to get healthier sooner too as opposed to getting it so chronic that it might take you twice as long right the same as anything when you put off because you go when it's an absolute emergency rather than taking care of yourself the whole way it becomes a more expensive problem a more complicated problem but the state of California has had paid family leave for over a decade now and they have done done the studies on the impact the thing that they find is workers are more likely to return to work so we have lower turnover retention is higher, loyalty is higher people come back rested, relaxed and ready to work rather than we have about one quarter of moms returning to work within two weeks of giving birth to me that's absolutely unacceptable I mean mentally physically and the mom herself it's just not right but to leave a very vulnerable infant you know in the care of somebody else at an extremely vulnerable time that's not the kind of society we should be plus it's not good for the baby it's not good for our communities it doesn't make any sense physically, morally, ethically and it doesn't go hand in hand with the state of aloha spirit is all about that's not ohana so how can our viewers really tag along with healthy mothers, healthy babies in this upcoming year or years to support the effort of finally breaking ground so that we can be a state that can have paid family leave absolutely I would say the first thing is they're very active in recruiting people to share their stories share their own testimonial about what they went through and if they had paid leave how it helped them and if they didn't how it would have helped them all of the stories really add up I mean we hear things like a mom who had a preterm delivery her baby was in the NICU for over a month and by the time her baby was released from the hospital she had to go back to work and she has a very medically fragile infant who needs to be taking care of around the clock who's going to do that and for a single parent that is not a choice you should have to make so these kinds of stories that just tug at your heart and make you realize this is a human issue those are stories we want to hear from people and we want people to get up and talk about it and share with us so I would say first of all just visiting our website and following us on social media we're always posting things about ways that people can get involved and they can find out what the activities are that we're doing when to share up when to share their voice talk to others about it and things like our focus groups and stuff we just want to hear from people about what we can do to build the best possible program and we have a lot of other existing structures to work from so we're not starting from scratch but we want to make sure it works for the people of Hawaii that's absolutely so crucial and I'm so grateful that we have healthy mothers and healthy babies in the religion of Hawaii and so many other partners they're working together to make sure that that happens and that we have opportunities where people can be involved as well because it really is an interdependent and interconnected process it can't happen just with the organizations it has to have the support of the businesses it has to have the support of our legislators representatives just like you and I to make that happen I can't believe how quickly our program came to an end I hope that this is the faster of many businesses that you make to us and that we check in and see how we're doing and also I would like to extend an invitation to you and to all the community partners to also being able to look at what's happening with child maternal health in Hawaii but in other nations too because I think we can learn a lot and we can also get a lot of encouragement of how far we've come it's not only about the things they're not working it's also looking at how far we've gotten and looking at other models that we want to mirror ourselves absolutely it's about seeing what works and how to replicate that on that note this concludes our respectable global justice program today and just remember the way we measure the success of a society is by the way we treat our children our families, our elderly our disabled our people in general so basic needs need to be covered and the sanctity of us as people as humans also is something that we need to pay close attention to and the state of Hawaii is a perfect state to emulate that not only right here at home but to help all the states to look at what we're doing right and tag along as well so until next Friday we hope