Maui residents say their ongoing illnesses are connected to the devastating 2023 wildfires

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• Geoff Bennett:

  It has been almost a year since the nation's deadliest wildfires devastated the island community of Maui.

  While much of the debris has been removed, many residents are still dealing with worrisome health issues that experts say are connected to the fires.

  William Brangham has this report. It's part of our series Race Matters.

• Nancy Garrett, Fire Survivor:

  All that area, it was a nightmare.

• William Brangham:

  While some greenery is returning to the valley behind Nancy Garrett's home in Kula, Maui she will never forget when this was all ablaze.

• Nancy Garrett:

  It burned right up here to my hedge. It was a wall of fire, I'm telling you what.

• William Brangham:

  The fires in this rural inland area started the same day as those that consumed the town of Lahaina 25 miles to the west; 101 people died there, and over 2,000 homes and other buildings were lost.

  While most of Lahaina's inferno was contained within days, the rough terrain here in Kula made it harder for firefighters and residents to control it.

• Nancy Garrett:

  And all day long, that's all I did. I'd see flare-up, flare-up. It was constantly.

• William Brangham:

  You were fighting the fire on your own property yourself?

• Nancy Garrett:

  Oh, yes. Oh, God yes, I did that for weeks right outside my back door here.

• William Brangham:

  Garrett moved here 48 years ago and now worries she can't afford to fix the fire damage on her roof and fence. She also believes the smoke she breathed in last year and remaining ash are harming her health.

• Nancy Garrett:

  I cough every day. And I'm not a cougher. And it depends on what kind of day it is. If it's windy and dry, I don't even want to be out here, but I am breathing it in.

• William Brangham:

  Garrett is not alone. Thousands of people on Maui now live in or near areas that were burned. In a recent study of residents impacted by the fires, almost half reported declines in their health.

  Almost 40 percent of those examined had compromised lung function, and people who'd been directly exposed to smoke, ash or debris reported worse symptoms.

  Alika Maunakea, University of Hawaii: People are still struggling with respiratory conditions post-wildfires, and then those who are more vulnerable already to respiratory health conditions, such as those with asthma, tend to have exacerbated symptoms and need the care.

• William Brangham:

  The University of Hawaii's Alika Maunakea is an epigeneticist, someone who studies how our behavior and environment affects our genes.

  He co-authored the study. He says the fires not only made people sick, but they have very little access to care. Before the fires, Maui had the worst shortage of primary care providers in the state and a 40 percent doctor shortage overall.

• Lorraine Young, Fire Victim:

  There was no clinic on island on this side. Like, we lost the clinic that I had and the clinic my mom had.

• William Brangham:

  The Lahaina fire burned Lorraine Young's family home. Today, this barren lot is all that's left, but it also damaged and destroyed medical clinics.

  We first met Young's family last September. They were crowded in a temporary hotel provided by the Red Cross. Her 83-year-old mother, Victoria, was still processing the loss.

• Victoria Jacinto, Fire Victim:

  I close my eyes and I'm there cooking, cleaning, but no more.

• William Brangham:

  They have now found more permanent housing, but Lorraine and her siblings have to drive across Maui for their mother's medical appointments.

• Alika Maunakea:

  Limited access to care, of course, was a huge issue, coupled with housing and unemployment and food insecurity that just compounded these conditions that we're starting to see from our health screenings.

• William Brangham:

  On top of that, Maunakea says many survivors, like Alex and Sandra Olivas (ph), are contending with both physical and mental health challenges.

• Alex Olivas, Fire Victim (through interpreter):

  I think that now we're more impacted than before, because we can see the repercussions of what happened. I wasn't sick, but now I'm feeling a little sick, actually a lot more sick.

• William Brangham:

  The Olivas and their four children are among the nearly 2,000 Maui residents still living in temporary accommodations covered by FEMA.

  Since the fires, Alex and Sandra have had trouble breathing and must now use inhalers. Alex was diagnosed with diabetes last month and is also now battling high blood pressure.

• Alex Olivas (through interpreter):

  I had a lot, a lot of anxiety. I couldn't sleep for months.

• Sandra Olivas, Fire Victim (through interpreter):

  I also get depressed sometimes, but I have to be strong for my kids.

• William Brangham:

  You do believe absolutely that this is because of the fire?

• Sandra Olivas (through interpreter):

  Yes, because, before the fires I had my home. We had our life, and now we don't.

• William Brangham:

  According to the study, over half the survivors show signs of depression compared to just a third before the tragedy. Rates of anxiety and other mental health issues also spiked and have remained high.

  While the Olivas can get by speaking English, they say it's near impossible to receive care in their native Spanish.

• Alex Olivas (through interpreter):

  We have struggled a lot with that, with the language. And when we go to the doctor, there's actually no one to translate.

• William Brangham:

  Maui's Latino community faces other unique challenges.

• Alika Maunakea:

  About 38 percent of Hispanic respondents reported they had no insurance coverage, and that's six times higher than the state average.

• William Brangham:

  When Maui's tourism cratered after the fires, many of their jobs disappeared, taking their incomes and their health insurance.

• Alika Maunakea:

  We already knew that populations that experience health disparities would be more vulnerable to these disasters, and the trauma that follows just further widens inequities.

• William Brangham:

  One factor Maunakea's study says can make a difference in how people rebound, social connections. Maui residents who reported high levels of social support had better mental health.

  When we were first here, we saw local Hawaiians banding together to provide food, clothes and other supplies.

• Woman:

  Have a good day.

• William Brangham:

  Local schools have also stepped up to provide that same support.

• Tonata Lolesio, Principal, Sacred Hearts School:

  We have been able to provide services for the children to help them have some sense of normalcy in their situation.

• William Brangham:

  Tonata Lolesio is the principal of Sacred Hearts School. It's a 162-year-old Catholic pre-K-12 school in Lahaina that burned.

  More than half its students and faculty were displaced by the fires, but the school continued with makeshift classrooms at a nearby church.

• Tonata Lolesio:

  This last day of this school year was just — was very special. We hugged. We cried. It felt as though we made it.

• William Brangham:

  But she's relieved they have found a new temporary campus with four walls and air conditioning for the upcoming year.

• Tonata Lolesio:

  We still have a long way to go, but having this new school was really a ray of hope for us, because we're moving forward together as a school ohana.

• William Brangham:

  A show of resilience and a slow return to normalcy for a community that is still scarred by fire.

  For the PBS "NewsHour," I'm William Brangham.