This story was published in partnership with The Intercept.
In August 2023, a catastrophic series of wildfires swept across the island of Maui, claiming the lives of more than 100 people, reducing thousands of homes to ash, and causing billions of dollars in structural and economic damage. In the immediate aftermath, grassroots mobilization became a vital lifeline for a grieving and displaced population. Noelani Ahia, who is Kanaka Maoli and co-founder of the Maui Medic Healers Hui, helped organize nearly 600 volunteers in Lahaina, bringing together doctors, nurses, mental health therapists, and community advocates to deliver urgent care where official systems struggled to keep pace.
Three years later, however, the emergency has far from subsided. While the immediate flames were extinguished long ago, the housing and health crises on the island remain acute and deeply embedded in daily life. The Maui Medic Healers Hui continues to operate a free clinic to serve the community’s ongoing medical and emotional needs, but Ahia notes that the scale of the crisis demands vastly more resources. She wishes the organization could open ten more clinics just to scratch the surface of what local residents are experiencing. "The fire may be out, but the catastrophe is not over by any stretch of the imagination," she said, reflecting on the prolonged suffering of her community.
The devastation wrought by the fires extended far beyond the tragic loss of human life and the physical destruction of neighborhoods. Last year, public health research published by scientists with the University of Hawai‘i at Mānoa’s Maui Wildfire Exposure Study, known as MauiWES, revealed that more than 1 in 5 residents surveyed suffered from reduced lung function following the disaster.
Now, groundbreaking new research from the same comprehensive project has uncovered elevated levels of toxic metals in the bodies of island residents months after the fires occurred. Crucially, the study found that higher exposure to these toxic elements was directly associated with impaired lung function. These troubling findings offer further empirical evidence that the health consequences of modern catastrophic wildfires can persist long after the flames are extinguished, the smoke clears, and the immediate news cycle moves on.
Alika Maunakea, who is Kanaka Maoli and co-director of MauiWES, explained the shifting paradigm of environmental disaster research. "What we consider and sometimes look at as a one-time event isn’t really one-time anymore," Maunakea told Grist, highlighting how climate change and urban environments intersect to create enduring toxic legacies.
At this stage, researchers do not yet know the exact breakdown of the contamination sources—specifically, how much of the toxic metal exposure came directly from the burning disaster itself and how much was already present in the local environment due to historical land use. That distinction carries immense weight as wildfires increasingly sweep through densely populated towns like Lahaina and major metropolitan areas like Los Angeles. In these modern urban-wildland interfaces, the burning of homes, commercial buildings, automobiles, and modern infrastructure leaves behind a complex cocktail of synthetic and heavy metal contaminants that people are forced to live among, breathe, and encounter for months or even years afterward.
"We have traditionally thought about wildfire exposure primarily through the lens of smoke," Maunakea said in a press release detailing the study. "But when an entire community burns, we are dealing with a much more complicated exposure environment." Researchers are now tasked with untangling a complex web of variables: understanding what contaminants were already present in the soil and structures, what hazardous compounds the fast-moving fire may have vaporized or released into the air, and what substances ultimately entered the bodies of the residents who call the area home.
The comprehensive research project evaluated 1,400 adults across Maui between six and 18 months after the fires took place, analyzing 24 distinct metals through urine samples. The findings were stark. Participants showed significantly higher concentrations of several heavy metals when compared against a broad nationwide health survey conducted prior to the Maui fires.
Specifically, the study found that residents had roughly 2.2 times as much arsenic, 2.3 times as much barium, and 3.8 times as much manganese in their systems as the baseline comparison groups. Even more alarming was the detection of antimony—a chemical element frequently utilized in flame-retardant materials and manufacturing processes that has been previously linked by medical literature to severe lung irritation, persistent stomach pain, and a variety of other debilitating health symptoms. Antimony was found in residents at levels nearly 40 times higher than typical baseline expectations.
Because the researchers lack comparable biological and environmental data from the affected population prior to the disaster, they cannot yet definitively state what precise percentage of these elevated metal exposures resulted directly from the wildfire. However, Maunakea told Grist that answering that critical question is the primary objective for the next phase of the project, which has recently received a substantial $3.6 million grant from the National Institute of Environmental Health Sciences. That upcoming work will involve rigorous scientific investigation into whether, and to what degree, historical agricultural and industrial activity on the island contributed to the pre-existing soil and environmental contamination.
For community leaders and residents, these scientific inquiries cannot be separated from the historical context of the land itself. Noelani Ahia emphasized that current environmental health challenges are inextricably linked to larger historical forces. "It’s important to realize that these are all part of settler colonialism," Ahia said. "So what we’re looking at is confounding factors that are to the detriment of the health of our local people."
Decades of intensive plantation agriculture fundamentally altered natural water systems across the Hawaiian islands, introduced heavy loads of herbicides and chemical pesticides, and systematically displaced native plant species. That industrial history left an enduring legacy on the landscape that is still deeply felt today. When natural disasters such as fast-moving wildfires and severe storms strike, they do not occur in a vacuum; instead, they compound and amplify these ongoing, foundational environmental problems.
Katie Kamelamela, who is Kanaka Maoli and an assistant professor at Arizona State University based in Hawai‘i, noted that narrowing the scope of a disaster to just the hours the fire burned obscures the root causes of vulnerability. "If we begin the story when the fire starts, we miss the decisions that shaped the landscape and the community’s ability to respond," Kamelamela said. "Micro climate change acts on places already shaped by histories of land ownership, water diversion, development, and unequal access to resources."
Kamelamela stressed that true community recovery must look far beyond the physical rebuilding of structures. "I want recovery to be measured by whether people can remain in their communities, care for ‘āina, and pass on their knowledge and practices in place," she said, utilizing the Hawaiian word for land, which carries a profound cultural meaning far deeper and more relational than Western concepts of property or mere real estate. "Rebuilding should not recreate the same conditions that left people at risk. Caring for ‘āina and caring for people need to be funded and planned together."
The multitude of intersecting pressures—from housing shortages and economic displacement to the environmental harms driven by heavy tourism and historical plantation legacies—is precisely why Maunakea and his colleagues felt compelled to pursue this line of research. As global climate change continues to accelerate, these longstanding systemic issues facing Native Hawaiians threaten to compound future crises.
"We worry that disasters like this that we experience on Maui, as well as the floods and other storms that we’re experiencing now, is just going to continue widening the gaps in health disparities that already exist in those populations," Maunakea warned.
Looking ahead, the research team is committed to ensuring that their scientific project does not merely document health risks from a distance, but actively assists residents in navigating and responding to them. As part of the study’s protocol, participants receive their individual health results, have opportunities to discuss the findings directly, and are connected with qualified health professionals to address any emerging medical concerns.
"People now know that there’s these types of potential hazards, and what to do about them is a big concern," Maunakea said, acknowledging the anxiety felt across the island. "We still don’t have all the answers for sure, but we are taking the next steps to get a better picture and inform our community around it."