Lives on the Line:
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Big Island residents face a critical gap in trauma care, relying on outdated facilities and a Level I Trauma Center over an hour away by helicopter on Oahu.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 last year, 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.
Plans for a New Hospital in Kona
Queen’s Health Systems has announced plans to build a modern 80-bed hospital in Kailua-Kona, aiming to deliver inpatient and emergency care, along with specialty services. The facility will include a state-of-the-art emergency department, ambulatory care center, and a helipad for quicker patient transfers to Oahu. Adjacent to the hospital, Queen’s also plans to build affordable housing for healthcare workers in hopes of attracting and retaining staff, and eventually establishing a stable, connected medical community.
Over the next seven years, Queen’s intends to expand services in Kona, including:
Outpatient care, Cancer treatment, Skilled nursing, Post-acute care, and Rehabilitation.
While this plan may improve access to certain types of care, it does not include a Level I Trauma Center—a critical need for Hawaiʻi Island residents. Without the ability to provide immediate trauma care on-island, patients will still face dangerous delays and costly airlifts. This plan is a start—but it’s not enough.
Here are some recent articles that go into more details about what this new hospital will entails:
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 the early 1980s, R. Adam Cowley, a U.S. military surgeon popularized the term "golden hour," words often used in trauma and emergency medicine settings. The term's origins lie in photography and reference the first hour of light after the sun rises and the last hour of light before sunset. That concept of a critical window of perfect sunlight was co-opted by emergency medical providers to refer to the crucial period of time immediately after an injury when appropriate life-saving medical or surgical intervention can offer the highest chance of survival for a traumatically injured patient.
