内容摘要：Mass General transplant nephrologist Dr. Leonardo Riella said Andrews was weak and struggling with diabetes, including a slow-healing diabetic foot ulcer that hindered walking. He’d have to get more fit to be a candidate.

Mass General transplant nephrologist Dr. Leonardo Riella said Andrews was weak and struggling with diabetes, including a slow-healing diabetic foot ulcer that hindered walking. He’d have to get more fit to be a candidate.

The structures are attuned to their natural environment and add to the state’s sense of place, Kiersten Faulkner, executive director of Historic Hawaii Foundation says. “In Hawaii, of course, that’s all rooted in Native Hawaiian culture, local building materials.”Builders often looked to the past for inspiration, she says. That includes using traditional features like pili grass thatching and rock walls made from local volcanic stone.

After Western contact, the architecture evolved to incorporate joinery, with techniques that came out of shipbuilding, Faulkner says, and skilled carpenters from Japan popularized pocket doors and single-wall construction. Missionaries brought whitewashing and fenced gardens; sugarcane and pineapple plantations popularized arts-and-crafts style bungalows, where workers lived.This image shows the kidney-shaped pool at the Liljestrand House in Honolulu, Hawaii, designed by architect Vladimir Ossipoff. (Kristina Linnea Garcia via AP)This image shows the kidney-shaped pool at the Liljestrand House in Honolulu, Hawaii, designed by architect Vladimir Ossipoff. (Kristina Linnea Garcia via AP)

“Hawaii starts to be this place where all of these traditions come together,” Faulkner says. “It really did form a unique style. Much of it is oriented to the trade winds and to take advantage of natural ventilation … to be light on the land, really.”Hawaii is hard on preservationists. Between heat, wood rot, fire risk and termites, the islands cultivate the idea of impermanence. But the greatest threat is

“Hawaii has exceptionally high land value and so there’s often pressure to redevelop — anything — to a more intense commercial use,” she says. “It takes a lot of commitment to say we’re going to keep something that’s important to us, even in the face of that kind of pressure.”

Remarkably little of Hawaii’s 20th-century architecture has been preserved, especially in urban areas, says William Chapman, dean of the school of architecture at the University of Hawaii at Manoa.drive past apple orchards and cornfields stretching to the desert horizon. Aguirre goes door to door with a cooler

. In one of Latin America’s biggest Mennonite communities, she knows many will decline to be vaccinated or even open their doors. But some will ask questions, and a handful might even agree to get shots on the spot.“We’re out here every single day,” said Aguirre, pausing to call out to an empty farm, checking for residents. “To gain trust of the Mennonites – because they’re reserved and closed-off people – you have to meet them where they’re at, show a friendly face.”

Aguirre’s work is part of an effort by health authorities across the country to contain, as cases climb not only here but