In 2022, East Hawaii Health Cancer Center (EHHCC) at Hilo Medical Center, embarked on a renovation project, including enhancing the building’s façade with artwork that would create a welcoming setting that reflected the clinic’s diverse patient population.

Recognizing the unique climate challenges posed by Hawaii’s environment, the project team needed an exterior design that was weather resilient—including for the artwork.

After seeing previous oil paintings by Kristie Fujiyama Kosmides across the island, EHHCC originally thought about displaying a painted mural on the newly renovated façade of the cancer center. However, considering Hilo’s tropical weather, the artist worked with the healthcare organization to propose another idea—a mosaic made of 1/2-inch vitreous glass tile that would be able to withstand the area’s humid and rainy conditions.

Artwork that represents its community

After deciding on a medium for the artwork, the project team next focused on what the mosaic would display. “EHHCC knew they wanted to represent the community in the mosaic mural but those were the only guidelines. I had the freedom to create something that was more than just a piece of art—but a beacon of hope for the center’s patients,” Kosmides says.

Completed in December 2023, Kosmides’s “Ka Lōkahi O Ke Aloha” (meaning “in love and togetherness there is unity”) features depictions of locals—some of whom have battled cancer themselves, as well as the loved ones who supported them. The 202-square-foot mosaic mural comprises more than 100,000 vitreous glass tiles in 31 different colors. To accurately render the forms of each person, Kosmides worked with a local photographer to capture their poses and figures for the artwork.

To accurately render the forms of each person, Kosmides worked with a local photographer to capture their poses and figures for the artwork. The artist then partnered with Artaic, a Boston-based mosaic design and fabrication company, to transform the original drawings into the finished art piece.

Kosmides says she placed each person in the mosaic mural to either be making direct eye contact or physically touching another person in the scene to convey a sense of connection and community in the artwork.

Additionally, for the mural background, she drew inspiration from native Hawaiian flora and fauna, the local Wailuku River, rainbows, and clothing by Sig Zane, a Hilo-based designer, to create a visual thread of connectivity.

“‘Ka mana’olana aloha o nā lima ko’o o ke ’ānuenue’,” the inspiration statement behind the mosaic mural, means ‘the supporting hands of the Rainbow bring hope, love, and healing for all who come to here.’ Our island’s Rainbow Falls waterfall is next door to the facility, so I hope the artwork is a greeting that tells all entering it that they are not alone in their journey,” Kosmides says.

Hospital spokesperson Elena Cabatu says the cancer center is honored to display the local artwork at its facility. “The quality of the artwork and the guarantee of it lasting in tile work ensures that our patients will be comforted for many years to come,” she says.

Tracey Walker is managing editor of Healthcare Design and can be reached at