As of 1996, Mr. Henry Akina has served as the General and Artistic Director of the Hawaii Opera Theatre, (HOT), where he has founded the Mae Z. Orvis Opera Studio as well as directed. In addition to his administrative duties, he has directed productions of Madama Butterfly, Tosca, La Bohème, Les Contes d'Hoffmann, Salome, and the Hawaii premieres of Wagner's Tristan und Isolde, Elektra, Macbeth and Il Trittico. He was also a fellow of the Center for Art and Media Technology in Karlsruhe, Germany, where he was responsible for the development of interdisciplinary music and theater projects.

"The 2009 Savonlinna Festival has got off to a fine start with a new production of Madama Butterfly. The Asian-American production team of Henry Akina (director), Dean Shibuya (set designer) and Anne Namba (costumes) have synthesized various ideas ranging from well-observed socio-cultural detail to touches of Japanese theatrical fantasy and come up with an intriguing whole... For the lengthy introduction to the third act Henry Akina has created a brilliantly effective scene: Cio-Cio-San's dream. Goro appears, once again offering the hand of Prince Yamadori while the Bonze glowers from the opposite side of the stage. A smiling Pinkerton suddenly appears, hugs his little son and the reunited family poses for a photograph. The sweet dream suddenly melts away, rendering the ensuing final act even more poignant."