Hawaii’s Trauma Center Crisis
Big Island residents face a critical gap in trauma care, relying on outdated facilities and a Level I Trauma Center over an hour away by helicopter on Oahu. Rhonda DePontes Freedman’s story highlights the human cost of this crisis. In trauma cases, the 'Golden Hour' - the first hour after injury - is crucial for survival, yet Big Island has no facility equipped to handle severe trauma locally.
While $18 million in upgrades went to Kona Community Hospital in 2023, none of it went toward establishing a Level I Trauma Center. In Hawaii, we have the resources to protect our community, but without local immediate care and the proper resources, the lives of our kamaʻāina, our kupuna, our keikis, and our ‘ohanas are at risk. Watch, share, and stand with us to advocate for trauma care that will serve more of Hawaii, not just one island.
Proposed Hospital Plans and Why That Is Not Enough
A new hospital facility is being developed in Kona through a partnership between The Queen’s Health Systems and Hawai‘i Health Systems Corporation. The project is described as an effort to expand health care access on Hawai‘i Island and modernize infrastructure.
While this investment is important, current plans do not clearly commit to building a fully designated Level I Trauma Center in Kona. Expanding facilities without expanding trauma designation leaves a critical gap. A modern building alone does not guarantee the continuous specialist coverage, surgical capabilities, research requirements, and comprehensive trauma resources required for the highest level of care.
With a new hospital already in motion, this is a pivotal opportunity to align infrastructure with the actual emergency needs of Hawai‘i Island. Without intentional planning for advanced trauma designation, the island may once again receive improvements that fall short of what residents and visitors require in critical moments.
You can read more about the project here:
THE CURRENT PLANS FOR A NEW HOSPITAL AREN'T ENOUGH
The Case for a Level I Trauma Center in Kona:
Prioritizing Lives, Ohanas, and Our Community
TIME IS OF THE ESSENCE: THE GOLDEN HOUR matters
Trauma victims’ chances of survival drop by 20-25% for every 30-minute delay in care. Without a Level I Trauma Center, emergency airlifts to Oahu—averaging $10,000 per trip—are the only option, taking 2-3 hours when factoring in flight time, logistics, and hospital readiness, costing more lives.
LIMITED TRAUMA CARE OPTIONS OUTSIDE OF OAHU
The only Level I and Level II trauma centers in Hawaii are on Oahu, overworked, and hundreds of miles away. The Level II trauma center only serves military-affiliated individuals, leaving the rest of us without access to this advanced trauma care.
THE ISLAND AND VISITOR Population ARE GROWING
Big Island’s population has grown by nearly 80%, and over 12 million visitors come annually. In 2021 alone, Kona Community Hospital handled over 22,000 emergency room visits, straining its outdated infrastructure and resources for both residents and tourists.
the existing infrastructure is outdated
Kona Community Hospital, built nearly 50 years ago, is no longer in the area with the highest population density, leaving many residents far from critical care. The hospital is also at risk of losing its Level III trauma designation due to aging infrastructure and lack of resources.
PLANS FOR A NEW HOSPITAL location IN KONA are already being made
With a new hospital already in the works for Kona, it’s the perfect time to ensure it includes a Level I Trauma Center to meet the needs of both residents and visitors.
family hardship: emotional AND financial
When loved ones are airlifted to Oahu, families face impossible choices: pay steep travel and accommodation costs or remain separated during critical moments, adding emotional and financial stress to an already tragic situation.
The Golden Hour
"There is a golden hour between life and death."
In trauma medicine, the first hour after a severe injury is often referred to as the Golden Hour. During this period, rapid surgical intervention and advanced care significantly improve survival rates. Studies show that trauma victims’ chances of survival decrease with each delay in receiving definitive treatment.
On Big Island, severely injured patients are frequently stabilized locally and then transported by air to O‘ahu for advanced trauma care. Even under optimal conditions, air transport can take several hours when factoring in dispatch time, flight duration, weather considerations, and hospital intake procedures. For residents in South Kona, Ka‘ū, or North Kohala, total transport time can exceed the window in which certain traumatic injuries are most survivable. When minutes determine outcomes, geography should not be the deciding factor.
