Unreliable Flights Causing Medical Access ‘Crisis’

Molokai residents are continuing to struggle with unreliable flights on the island’s only air carrier, and many say they have missed critical medical appointments off island because of delays. Several options are being explored to address the issues, but will they solve the problem?
“It’s sad, because if we get delayed or canceled, we just not going to make our appointment,” said resident Andrea Dudoit, who is battling breast cancer. “And that’s putting lives at risk. It’s just not fair. I don’t think it’s right.”
Dudoit said she has missed two chemotherapy treatments on Oahu because of delays or cancellations on Mokulele Airlines, the sole airline currently serving Molokai.
“I think at this point, a lot of people just expect delays and cancellations, because that’s just the new norm, unfortunately,” she said.
But when she had to be hospitalized for a week after a bad reaction to her treatment, the “norm” wasn’t going to work for her. She went to the airport on Oahu, hoping for a quick return home so she could rest.
“I was checking in, and then I got a text that my flight was over five hours delayed,” she said. “But I was in no shape to hang out at the airport for that amount of time, because I was still recovering from being at the hospital. There’s no way I could have done that. So I called a family member, very last minute, and I stayed the night.”
Dr. Randi Taniguchi-Fu, a primary care doctor and medical director of Molokai General Hospital and Outpatient Clinic, calls Mokulele’s record of unreliability “horrible.”
“When you’re relying on the airlines to get people to see these critical specialists, that’s a lot of times life and death,” said Taniguchi-Fu. “And with such an unreliable airline, it puts a lot of strain and pressure — of course, the patient is affected the most, because they can’t get adequate care — but as a provider, it’s difficult to practice here.”
A majority of Taniguchi-Fu’s patients have told her they’ve dealt with canceled, rescheduled or delayed flights to medical appointments.
“They’ve been burned so many times that they know they have to fly the day before, which is ridiculous,” she said. Many of her patients can’t afford the extra financial burden of paying for a hotel just to ensure they make it to their medical care, she added.
For Dudoit, she’s grateful she has family she can stay with, because she now always travels in advance.
“For me, I fly down the day before,” she said. “I don’t take chances anymore when it comes to my cancer care.”
Specialists trying to come to Molokai to provide care as an alternative to patients flying out, are also affected by the airline’s unreliability. Taniguchi-Fu said specialists take a day off from their own practices on Oahu to serve Molokai. But when flight delays take up most of the day, they have to cancel their Molokai clinic, too.
“Not only is it not profitable for them, it’s extremely frustrating,” said Taniguchi-Fu. “And in fact, a lot of people said, ‘You know what, we can’t physically come there anymore. The flights are so unreliable that we can’t afford to lose out on that clinic day.’ So there’s pulmonologists that used to come here that no longer come here because of the flight issues.”
More Planes Coming
Mokulele Chief of Staff Keith Sisson said reliability has improved, especially recently.
“In the past few months, we have run a much-improved operation for the people of Molokai,” Sisson said. “In the last two months, we are looking at a 96 percent completion rate.”
He said delays at the beginning of this year were due to weather.
“Unfortunately, a lot of times when we do have weather involved — and there was just terrible weather in the first couple of months of the year, people may remember back in January, when the Kona lows came through, we were socked in, we weren’t able to get flights in and out of Molokai and Lanai for a couple of days,” Sisson said.
Residents expressed understanding for weather-delayed delays, and said the instances they referred to were unrelated to weather conditions.
Sisson also said new planes coming soon will also bring service improvements.
“We’ll have three additional aircraft coming in the next two weeks,” he said. “So that’s pretty exciting for us. And when we have those instances where we have those kind of long delays that drag out over a couple of days due to weather, we’ll have the extra aircraft now to really accommodate those passengers.”
Those three planes are more of the company’s nine-seat Cessna Grand Caravans, while three more aircraft — nine-seat Tecnam Travelers — are being relocated from Guam to Honolulu. The airline originally stated the Tecnams were expected to join the Hawaii fleet last spring.
“We expect to get those into operation pretty soon with some FAA checks coming up in the middle of March to get those aircraft back and flying for the first time in the State of Hawaii,” said Sisson last week. “So a lot of good news happening here and the spring is shaping up to be really good for reliability and also for availability having some extra flights.”
Meanwhile, Molokai residents remain skeptical of Mokulele’s promises.
“At this point, a lot of people just don’t trust their word,” said Dudoit.
Legislative Action
State Representative Mahina Poepoe of Molokai said she’s recognized the problem of unreliability for years, motivating her to propose a bill this legislative session to address the issue of medical transportation.
House Bill 2455 would establish a two-year pilot program through the Department of Health for chartered flights for non-emergency medical patients on Molokai and Lanai.
“Ever since getting elected and even before, we knew that we were facing what I feel like can only be described as a crisis in reliable air transportation, to and from Oahu or Maui for all of our residents on Molokai and Lanai,” Poepoe explained.
She said the bill isn’t intended to be a “long term solution for general air transportation reliability” but she hopes it will help address the medical care crisis.
“It would work similar to the way medical appointments off Island currently works where insurance providers or medical providers, make the appointment and work with the patient to make a reservation,” Poepoe explained. “It’s just that the service would be provided through the Department of Health who would then contract an air carrier to provide a chartered flight.”
If the bill passes, the DOH would need to determine what company would provide the charter flights. The bill has passed in the House and crossed over to the Senate for further consideration.
Poepoe said insurance providers have also voiced support for the bill and the stability it would bring to patients.
Follow the bill or submit testimony by visiting capitol.hawaii.gov and typing “HB2544” into the search bar.
With the additional aircraft coming, Sisson thinks the charter flight bill won’t be necessary.
“We think that we have the solutions in place so that a program like this would not be needed in the future,” Sisson said. “And perhaps this is trying to solve a problem that has historically happened that may not be happening right now present day.”

Other Options
‘Ohana by Hawaiian discontinued Molokai service in 2021. With an upcoming merger between Alaska Airlines and Hawaiian, some residents hoped Alaska would bring in some competition. But Alaska Airlines executives say there are currently no plans to purchase smaller aircraft needed to maneuver Molokai and Lanai’s shorter runways.
But another flight option is available to Hawaii residents struggling to get to medical appointments. Hawaii Wing Leader and volunteer Ace Ellinwood says Angel Flight West is a nonprofit providing flights for medical needs as part of a national network.
“The pilots pay for everything as volunteers, and then the flights are free for the patients,” he explained.
Last year, seven Hawaii pilots flew 189 missions, according to Ellinwood. Of those flights, nearly 100 were for Molokai patients. Currently, the demand for flights is greater than pilots can accommodate, he said.
“The majority of what we do is fly patients to medical appointments,” Ellinwood explained. “We also can do other things like flying blood supplies, or flying doctors or nurses to places where they’re need to go.”
The nonprofit has also assisted people needing to relocate due to domestic violence, or flights for veterans, he said.
Patients or medical providers can request a flight by calling Angel Flight West’s California office or visiting their website, angelflightwest.org. If a reservation can’t be accommodated, the nonprofit works with local airlines to donate flights, a program Mokulele has participated in.