Maui was already facing a shortage of women’s healthcare providers before the 2023 wildfires devastated the island. In the aftermath, that crisis has only deepened. The fires, which killed more than 100 people and destroyed thousands of homes and buildings, further strained access to medical care, wiping out at least three medical practices—two of which provided maternal health services.
In response, the University of Hawai’i Maui College Health Center has expanded its services beyond its 3,000-student population, offering free care to the broader community. However, longstanding challenges remain. The island’s inflated cost of living, compounded by a severe housing shortage, continues to make recruiting and retaining medical professionals increasingly difficult, threatening efforts to rebuild its healthcare infrastructure.
To help address this urgent need, Direct Relief has awarded the UHMC Health Center a $100,000 grant to hire a registered nurse focused on women’s and maternal health. By bolstering staffing, the center aims to ensure more residents—both students and the wider community—receive essential care during the recovery.
Hannah Litt, an advanced practice registered nurse and the health center’s medical director, said the goal is to hire a graduate from the nursing program who is also from the area and can build culturally relevant connections with their patients who experienced the fire.
Litt, an instructor within the college’s nursing program and a certified nurse midwife, said adding a registered nurse will help fill gaps in care on days when she is teaching.
The health center plays a critical role in the community, where many women are underinsured or uninsured and lack access to consistent family planning services, prenatal care, and maternal health support.
“Access to contraception is probably the greatest, persistent need that is not being met in the community,” said Litt. “And I mean this is a pre-existing problem on the island anyway.”
According to the college, nearly half of Lahaina residents have difficulty booking medical appointments, and around 70 percent have reported delays in receiving care since the fires. The health center has been working to meet needs but needs more staff, and recruiting and retaining health professionals has proved difficult. The high cost of living in Hawai’i makes it challenging to endure long-term. Insurance reimbursements are lower than on the mainland, there are fewer housing options since the fires, and medical professionals can earn more elsewhere.
“People move here with the idea that living here will be something like being on vacation, at least on the weekends,” said Litt. “Then they move here and they’re extremely disillusioned.”
However, Litt said she plans to stay and hopes they can find someone who is as committed to Lahaina as she and Leslie Wilson, a medical assistant who also works at the health center.
“I’m lucky to have her,” she said. “She’s incredibly helpful in many ways.”
The health center has also explored partnerships with larger healthcare organizations to bring obstetricians to the area. Health center staff emphasize that patients need prenatal care throughout the first trimester to assess for high-risk pregnancies, access necessary medications, and receive ultrasounds.
While the health center continues to look for ways to support the community, Litt said what has been most important to patients is being seen and feeling heard during the recovery process.
Most residents have only recently received temporary housing, and the people of Lahaina remain ‘intensely impacted.”
“There’s (a lot of) attention initially, but a year and a half later there’s (just) less focus on it,” Litt said. “People don’t want to be forgotten.”
In response to the 2023 Maui wildfires, Direct Relief has shipped $2.8 million in medical support and distributed $3 million in financial assistance to organizations responding to the fires.
