The quarterly PIHOA E-Newsletter features news, upcoming events, and resources for the U.S. Affiliated Pacific Islands health community. 
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Volume 3, Issue 3
Quarter 3: August 2018
PIHOA News
A Message From the PIHOA Board President
My Dear Colleagues,

As health leaders of the USAPIs, we constantly wonder what we can do more for the people we serve.  We often have limited resources and not enough time to do it all.  But with our continued passion, we keep in mind that stories must be constantly told to those that can and should help.  The Pacific Island Health Officers Association (PIHOA) consist of leaders that have the passion and indeed have lots of stories to tell.  

With the support of the Secretariat, we have a stronger voice and we can bring joint efforts to get our health challenges addressed. I’m looking forward to the upcoming 64th PIHOA Executive Board Meeting in Honolulu and seeing my fellow leaders again.  Beginning with a retreat that will give us the opportunity to review our strategic plan and to seek further input in bringing our goals to fruition, the agenda is filled with resources and opportunities to hear of best practices that have worked and can work in our islands.  Most importantly, we will be amongst friends and individuals that care for the people in our remote islands.  It will definitely be worthwhile and we hope you’ve already made arrangements to attend.   

Safe travels to all of you and as we say in the CNMI, si Yu’us in fan’binendise gi kare’ran miyo!  See you all soon!

Respectfully,
CEO Esther Muna, CNMI CHCC & PIHOA Board President
Updated Results are in for the RMI TB and Leprosy Screening!
In March 2017, with the joint effort between the  RMI Ministry of Health and Human Services (RMI MOHHS) , the World Health Organization (WHO)  , Centers for Disease Control and Prevention (CDC) , and  PIHOA , a mass screening and treatment program for tuberculosis was conducted on the densely populated island of Ebeye in the Republic of the Marshall Islands.

This June 2018, the similar TB and Leprosy project has kicked off in Majuro, RMI. This is a much larger project than the screening in Ebeye as the population is larger and the project will include screening children, especially for leprosy.
Screening in Majuro for active TB, latent TB, Hansen's disease (leprosy) and diabetes began in June 2018, continuing every Monday through Saturday with more than 300 people being screened each day. Week ten out of 14 total is currently underway. As of August 7, 2018, public health nursing teams have tested and interviewed 15,984 people for tuberculosis and leprosy, representing 59% of the total population of 27,275 per the RMI 2011 Census.
Tuberculin skin test reading in Majuro, RMI
Newly trained Community Health Worker in Majuro prepares materials for sputum collection
Home-based TB skin testing and registration with the RMI Ministry of Health (RMI MOH) public health nurses and outreach workers was implemented from June 19, 2018 to improve service to the community and decrease waiting times at the screening centers. The RMI MOH is steadfast in their commitment to a successful campaign towards sustainable TB and Leprosy elimination in RMI. An impressive all-of-government approach remain in place and the campaign has befitted from several departments and agencies. Collaboration with non-governmental organizations continues to be critical towards the success of the campaign.

After the initial visits at home, 11,883 (74%) have come to the screening sites to complete all screening steps. More than one percent of the screened population has been diagnosed and begun treatment for Active TB. Next steps for this project includes the newly trained Community Health Outreach Workers (CHOWs) participating in weekly education sessions on topics such as safe monitoring of treatment and possible side effects for patients on medications for latent TB infection (sleeping TB). The RMI MOH would like to continue to encourage young children and infants to participate in the TB screening, especially if there has been a TB case in the household.
Majuro Community Health Outreach Workers Carefully sort LTBI medicine packs
To reduce waiting times, TB skin tests are placed at each residence
Dr. Rachel Dwillow (TB doctor from Canada) works with an interpreter to begin treatment for latent TB
Screening is expected to last until mid-September 2018. The TB treatment, follow-up care, and TB prevention activities will continue until November 2016. The Hansen's screening will be done on adults and children over two years old. Diabetes testing will also be done for adults undergoing workup for TB, adults who are TST(+), and adults referred for HD testing.

This screening has roughly 90+ volunteers assisting with this project, eight groups of 10 to 15 people over the duration of three weeks per group, from June to September 2018. These volunteers are TB doctors, nurses and epidemiologists from the USAPI region, the U.S. Public health officials and site staff who continue to improve and streamline the screening process.
PIHOA Board President and Secretariat Staff Visit the Health Resources and Services Administration!
From July 23-27, 2018 the PIHOA Board President and CNMI CHCC CEO Esther Muna along with PIHO A Secretariat Staff, Ms. Emi Chutaro, Executive Director, Dr. Angela Techur-Pedro, Pacific Basin Primary Care Office Coordinator, Ms. Elisa Dunlap, Finance Officer, Mr. Sean Perez, Accountant and Ms. Andrea Whitt, Program Support Officer made a site visit to the Health Resources and Services Administration (HRSA).  

The purpose of this annual site visit is for PIHOA Board Members and Secretariat Staff to meet with HRSA officials and review related grants, budgets, and programs related to the U.S. Affiliated Pacific Islands (USAPIs). This site visit also gives PIHOA an opportunity to advocate for the health needs of the USAPI community and generate further discussions and solutions to improve these health issues in the islands. Pictured above from left to right is Dr. Techur-Pedro, Ms. Chutaro, HRSA's RADR Kerry Nesseler, HRSA's Deputy Director Austin Demby and CEO Muna.
PIHOA Doctors and Dentists for Tomorrow Program Resumes at COM-FSM, Graduates Apply to Regional Medical and Dental Schools and Future Cohorts Planned!
The second class of twelve Doctors and Dentists for Tomorrow (DDFT) programme at the College of Micronesia-FSM (COM-FSM) have begun their second, and final year of training, as they prepare to compete for entry into regional medical and dental schools.  

Students are undertaking their second semester of human anatomy and physiology, their first semester of human nutrition and medical psychology, as well as advanced reading, writing, and speaking courses.  In their final semester, which will be taught next spring, students will take the second half of medical psychology, medical microbiology, medical epidemiology, and a final reading and writing course as they prepare to graduate with their associates degrees, and apply for medical or dental school in early 2020.  
DDFT is taught using the problem-based learning (PBL) model, whereby students learn the basic sciences through applied patient-based problems, as opposed to lectures.  According to Dr. Greg Dever, PIHOA Regional Human Resources for Health Coordinator, and one of the developers of the DDFT programme, “Teaching using the PBL method is critical, as this is the main method of instruction at regional medical and dental schools.  We want DDFT graduates to be ready to hit the ground running when they arrive in Fiji or New Guinea."

In addition to PBL instruction, students also rotate through the hospital, clinics, and public health department in Pohnpei.  “From the first semester on, students are in the clinics and on the wards seeing their PBL lessons applied in real life,” says Dr. Paul Dacanay, DDFT Professor of Medical Sciences, noting that the connection between theory and practice is an important part of the DDFT curriculum.
The first cohort of twelve DDFT students, which graduated with their associate’s degrees from COM-FSM in May 2018, are in the process of applying to the MBBS medical programmes at the University of Fiji , Fiji National University , and the University of Papua New Guinea , and the BDS dental programmes at Fiji National University and the University of Papua New Guinea for January 2019.  

During the summer break, DDFT graduates and students worked on various health-related projects, including a public health grant with the Public Health Training Programme at the COM-FSM , where they gained valuable field experience conducting surveys on obesity and lifestyle choices as part of a larger regional grant looking for genetic markers for obesity among Pacific Islanders.  As medical and dental schools in Fiji and Papua New Guinea do not begin until January 2019, many graduates have also returned to COM-FSM to take additional courses in epidemiology and public health; skills they will need when they become the future healthcare leaders of the region. 
A unique aspect of the DDFT programme is its focus on both learning the basic sciences, as well as preventative skills, that will allow them to address the regional non-communicable (NCD) crisis as both the future providers and leaders of healthcare in the region.  “We want them to be ready to go to medical or dental school, to become excellent clinicians,” says Dr. Brian P. Mangum, DDFT Professor of Medical Science, “but we also want them to be ready to think about the bigger picture, how to address the regional NCD crisis from a preventative as well as policy-based level.  They must be leaders as well as providers!”

DDFT was also successful in capturing a grant from the U.S. Health Resources Services Administration (HRSA) that will allow them to plan future cohorts, with an increased emphasis on providing oral health training at the dental assistant level to graduates and local candidates, bringing visiting dental teams to the Federated States of Micronesia from E-Da University, and more basic science training in oral pathology to encourage students to consider careers as dentists.  “With this new grant, we can continue to train Micronesians to become the doctors and dentists,” says Mr. Robert W. Spegal, DDFT Programme Manager, “who will one day return to care for their own people!”

DDFT is a joint programme of the PIHOA , the John A. Burns School of Medicine AHEC at the University of Hawai`i, COM-FSM , and HRSA designed to produce leaders and healthcare providers for Micronesia.

64th PIHOA Executive Board Meeting
September 3-6, 2018
Honolulu, HI
Mosquito Suppression in Preparation for the 2018 Micronesian Games in Yap, FSM!
The 9th Micronesia Games were held in Yap, FSM from July 15-27, 2018. PIHOA Regional Entomologist, Dr. Grayson Brown joined a team of individuals in Yap to suppress mosquitos on island the first week of July before athletes, fans and visitors traveled to Yap.

Pictured to the right is Dr. Brown during the first night of mosquito trapping under the Sports Complex Grandstand in Yap where the opening ceremonies of the Micro Games were to take place. Note that Dr. Brown is wearing short pants and a short sleeve shirt for doing landing counts. Dr. Brown had just measured nearly 30 landings a minute at this site (and had the facial expression that goes with that). Also note the field-expedient CO2 generator (brown sugar, water, and yeast) and the trap is powered by D-cell batteries. This is the only practical way these traps can be used on the island.
Dr. Brown uses a small USB microscope for mosquito identification when he's on the road. Here he's working in his hotel room shortly after retrieving his traps in the morning.
The team tryng to get an old backpack ULV sprayer running. These things are only marginally useful if they are working perfectly.
Dr. Brown offering a few tips to Yap's Mr. Jeremy Defag on how to use the sprayer. At this point it is charged with water only and is ready to be calibrated.
With the main sprayer having been misplaced in shipment and the ancient backpack ULV unit having issues, the team went to Plan C. This was an improvised hose-powered unit made from a plastic hose-end sprayer with a reinforced nozzle and a whole lot of hose.
Above is a before and after photo of the mosquito spraying with the improvised sprayer under the baseball field grandstands in Yap. Results are from one night of trapping with a CDC miniature light trap with yeast-sugar CO2 generator.
The chart above shows the success of the mosquito count before and after treatment in Yap. One week after the treatment, control was still effective and Yap had enough product to apply additional treatments if needed. Quoted during the Micro Games, Laurence Yug stated, "Things looked good. Mosquito problem is under control at the athletes villages and the sport complex where we've sprayed, including the baseball field and track grandstand."
The IATA Shipping of Dangerous Goods Re-certification Training of Trainers (TOT), Regional Biosafety Training and
Laboratory Preparedness and Response Workshop was Conducted in early August 2018 in Guam!
The International Air Transport Association (IATA) shipping of dangerous goods re-certification training of trainers was conducted in Guam from August 6-7, 2018. Participants from all of the U.S. Affiliated Pacific Islands (USAPIs) labs were represented at this training, including staff from the Guam Public Health Environmental Health Lab . Training was on the IATA 59th edition dangerous goods regulations with an emphasis on the shipping of infectious substances and related to hazmat and an overview on principles of training adult learners. Training involved theory PowerPoint presentations, interactive group work and presentations and a final examination with an 80% requirement to pass and be a certified trainer and/or shipper.
As of August 7, 2018, 15 trainers of shippers and eight shippers of dangerous goods were re-certified and certified. Day one of the training was facilitated by Ms. Maria Marfel, the Yap State lab supervisor and day two was facilitated by Mr. Allen Capelle, the Ebeye Medical Health Center lab supervisor and Association of USAPI Lab Managers (AUL) President. The training was also co-facilitated by PIHOA Regional Lab Coordinator, Ms. Vasiti Uluiviti and Hawaii State Labs , Mr. Mark Nagata.
On August 8, 2018 participants continued their training focusing on enhancing biosafety practices in the USAPI Labs with emphasis on risk assessment. Each USAPI Lab provided an update of biosafety activities that have been in their respective labs since the last training in May 2017. T he training scenario focused on conducting risk assessments and application of risk assessment findings on the testing of specimens suspected to contain Neisseria meningitidis, the causative agent of meningococcal meningitis. Ms. Mere Cama from the Belau National Hospital lab biosafety officer was the facilitator, along with Ms. Rebecca Sciulli who was the main facilitator on risk assessments.

The last day of the training on August 9, 2018, training focused on the development of a draft laboratory preparedness and response plans, a first ever type of topic to be emphasized at this type of training. The first presenter of the day was Mr. Peter Judicpa, the Centers for Disease Control and Prevention's (CDC) Immunization Project Advisor based at the PIHOA Guam Office. Mr. Judicpa delivered a very captivating presentation on the expectations of public health lab capabilities in the management of vaccine-preventable diseases that reassured laboratorians of the importance of the roles they play in disease outbreaks and its effective management.
The training continued with the following thought-provoking scenario that was geared towards working in groups to develop draft lab preparedness and response plans and group presentation of their plans. "It’s early Saturday morning. You, the lab manager, have been contacted by the Director of your healthcare facility that there is a suspected outbreak of meningococcal meningitis on your island.  Two patients have died the night before and there is a high influx of patients at the Emergency Room with the same symptoms, with four patients being admitted the same morning. At the same time, an announcement over the radio the same morning that heavy rains and a possible cyclone is expected to hit your island nation in the next 48 - 72 hours. How prepared is your lab?" The best group plan was judged by Ms. Rebecca Sciulli and was awarded $160 cash, with compliments from the facilitator of the day, Ms. Uluiviti. The Federated States of Micronesia group was the winner of the best plan.
The Republic of the Marshall Islands (RMI) Uses Their Recently Collected Hybrid Data to Prioritize NCD Action!
On June 18 and June 20, Hybrid Survey dissemination workshops were conducted in Majuro and Ebeye.  During these workshops, results from the 2018 Republic of the Marshall Islands (RMI) Hybrid Survey were presented, and teams of community members from various agencies used these data to prioritize health indicators and identify appropriate public health strategies.  Results from these workshops will be used for RMI’s Non-Communicable Disease (NCD) Strategic Planning, set to be conducted later this year.
PIHOA Executive Director, Ms. Emi Chutaro advocates for the USAPIs at the  Aspen Global Change Institute  Workshop held in Honolulu in May 2018!

The workshop was entitled “Integrating Climate Change Adaption and Disaster Risk Management to Protect Health and Build Resilience in Pacific Islands." The Aspen Global Change Institute is a non-profit organization dedicated to advancing the understanding of earth system science and global environmental change through interdisciplinary workshops, research and consulting, and education and outreach.
Meet PIHOA’s Summer 2018 Intern
University of California Los Angeles (UCLA) Masters of Public Health (MPH) student, Ms. Sarah Ritz spent her summer learning about public health in the U.S. Affiliated Pacific Islands (USAPI) and assisted Dr. Haley Cash with multiple projects. Ms. Ritz spent most of her summer in the PIHOA Honolulu office where she developed the Republic of the Marshall Islands (RMI) Hybrid Survey final report and programmed electronic data collection forms for the upcoming Hybrid Surveys in Kosrae and Yap. 
She also spent two weeks in Majuro and Ebeye to assist with RMI’s Hybrid Survey dissemination workshops, and the delivery of the second module of Data for Decision Making (DDM) in Ebeye. Ms. Ritz has worked hard all summer, and we wish her the best of luck in her future endeavors!  
PIHOA Regional Entomologist, Dr. Grayson Brown Honored by the Entomological Society of America as an Honorary Member!
Dr. Grayson Brown, PIHOA Regional Entomologist, was recently honored by the Entomological Society of America as an Honorary Member.  This award recognizes the recipient not only for his/her scientific achievements but also for their efforts to advance the field of entomology, in Dr. Brown’s case by increasing collaboration, coordination, and cooperation among professional entomological societies world-wide.  To win the award, nominees are first screened by a panel of past presidents of the Society.  The panel’s recommendations then go to the Society’s Governing Board which further reduces the candidates to a small number.  The remaining candidates are then voted on by the general world-wide membership from more than 130 countries.

The award includes lifetime gratis membership in the Society and its affiliates, lifetime gratis registration at all meetings, lifetime gratis subscription to its many journals and publications, and the awardee is ensconced on the Society’s “Wall of Fame.”  An award ceremony in Dr. Brown’s honor will be held at a joint meeting of the Entomological Society of America and Entomological Society of Canada in November 2018, Vancouver, British Columbia.  Nearly 5,000 entomologists from around the world are expected to attend this meeting.

While Dr. Brown is honored and grateful to the Society for this recognition, he is most humbled by having been elected to this award by his colleagues and peers throughout the world. Congratulations to PIHOA’s Dr. Brown!
Save the Date!

2018 ASTHO Annual Meeting
September 26-27, 2018
Alexandria, Virginia
PIHOA's very own, Dr. Mark Durand will be a featured key note speaker at the upcoming  ASTHO Annual Meeting! This event is the largest gathering of state and territorial health leadership and provides a unique opportunity to strategize with governmental public health experts on fresh perspectives and ideas related to numerous aspects of community resiliency.
PIHOA Secretariat Staff Visit CDC Headquarters in August 2018!
From July 30-August 3, 2018 the PIHOA Secretariat Staff, Ms. Emi Chutaro, Executive Director, Ms. Elisa Dunlap, Finance Officer and Mr. Sean Perez, Accountant made a site visit to the Centers for Disease Control and Prevention (CDC) Headquarters in Atlanta!

The purpose of this site visit is for the PIHOA Secretariat Staff to meet with CDC officials and review CDC funded grants, budgets, and programs in the U.S. Affiliated Pacific Islands (USAPIs). With PIHOA's Fiscal Team on board, meetings with CDC officials included many grant, budget, and program specific discussions.

Ms. Chutaro also participated in the CDC State, Tribal, Local and Territorial (STLT) Subcommittee meeting to discuss public health surveillance and social determinants of health (SDOH) practice in STLT public health.
RMI Nurse Practitioner Training Program Graduates Featured in the Fiji National University Newsletter!
The Nurse Practitioner Training Program (NPTP) is a joint project of the RMI Ministry of Health and Human Services (MOHHS) , Fiji National University School of Medicine, Nursing & Health Sciences (FNU) and the Pacific Islands Health Officers' Association (PIHOA). Candidates are prepared for primary care practice and upon successful completion are awarded a post‐graduate diploma as nurse practitioners.

This past June 2018 the NPTP had 12 graduates that received their post-graduate diplomas as primary care nurse practitioners in Majuro, RMI.
A Message from the PIHOA Executive Director, Emi Chutaro
Dear Pacific Colleagues,

Just wanted to share with you a proud first for the RMI MOH graduating their first-ever cohort of Nurse Practitioners! Jerammon (congratulations and good luck), again, to the RMI MOH and the Nurse Practitioner grads! A first for both RMI and FNU . This has been a significant multi-year effort!

I want to acknowledge the absolute dedication of Dr. Greg Dever and Dr. Mark Durand, who persevered with the FNU and RMI MOH to make this a reality – Dr. Dever for the vision inspired by a request for assistance from RMI MOH way back in late 2013, pushing through with FNU despite multiple obstacles, and getting all the partners together to get the program up and rolling in November 2015; and, Dr. Durand for his unflagging remote and on-site clinical guidance, troubleshooting, and ensuring the program stayed on track and produced quality graduates.

Thank you so very much to the U.S. Department of Interior (DOI) who awarded PIHOA funds through their Technical Assistance Program back in May 2015 to support the planning and delivery of this program from start to finish, and initial six of 12 months of advanced clinical internship training going on as we speak.  RMI has contributed its own Compact funds to supplement program delivery and the last six months of advanced clinical internship training.

Thank you so very much to Dr. Paula Vivili, SPC PHD Director, who stuck in there with us and got the FNU/NP program on the wider Pacific regional agenda to support our requests to FNU that give us that much-needed, extra regional boost with FNU .  Thank you so much to Dr. Aina Garstang at RMI MOH who, despite so much on her plate, was dedicated to seeing this program through as the RMI MOH lead for this program. And, thank you so much to the College of the Marshall Islands, who stepped in to provide the core academic prep for the NP trainee candidates at the very beginning before the NP program took off to ensure the highest possible success rate.

It took a family to make this happen, and we have great hopes of the graduates providing much needed clinical support to the RMI.

Kommol tata nan aolep (thank you to all of you) for your continued support,

Emi Chutaro, PIHOA Executive Director
Click HERE to read the full Fiji National University June 2018 Newsletter, featuring the RMI NPTP Graduates!
PIHOA Pacific Islands Public Health Training Centre Receives Grant Funding Through 2022!
PIHOA is pleased to announce that the Pacific Islands Public Health Training Centre (PIPHTC) has been refunded through 2022. The PIPHTC is a local performance site of the larger Western Regional Public Health Training Centre (WRPHTC) , which is housed at the University of Arizona’s Zuckerman College of Public Health , and has additional local performance sites in Arizona, California, Nevada, and Hawai`i.  This is the second such grant award for the PIHOA PIPHTC , which serves the continuing professional development needs of public health, medical, nursing, and allied health practitioners in the Pacific region and beyond.  
There are currently ten Public Health Training Centres located across the United States.  Public Health Training Centres must be located in an accredited school of public health, and are funded by the U.S. Health Resources Services Administration(HRSA) .  Each training centre, and the associated local performance sites, have a specific training mandate, with the WRPHTC / PIPHTC focusing on obesity and nutritional disorders.  This focus is highly applicable to the Pacific region, given that in 2010, PIHOA , which represents the regional Directors and Secretaries of Health, declared a non-communicable disease (NCD) emergency.  

To assist in addressing this crisis, the PIPHTC , which is housed at the College of Micronesia-FSM’s Public Health Training Program in Pohnpei, FSM, provides a range of entirely free, online, and distance-based learning opportunities in basic and advanced public health topics.  Recent programmes have included a ten course Certificate of Professional Practice in the Epidemiology and Control of Non-Communicable Disease, an ongoing twelve course Certificate of Professional Practice in Community Health and Development, and over twenty stand-alone one hour continuing professional development courses in topics such as type two diabetes, nutrition, environmental health, infectious diseases, and more.  

The PIPHTC also engages in other programmes, such as assisting in the admission of Pacific students to undergraduate and post-graduate public health programmes at regional partner universities, such as Fiji National University ; medical school at both Fiji National University and the University of Fiji ; upskilling local faculty in research and teaching skills; and more.
 
Since it was originally funded in 2015, the WRPHTC has trained over 97,000 individuals, representing 20% of all training's in the Public Health Training Centre programme; with the PIPHTC having trained just over 5,000 individuals, or 5% of all training's in the WRPHTC .  While the PIPHTC is primarily focused on the Pacific, there are regular participants from the United States, Southeast Asia, Australia and New Zealand, the Caribbean, Africa, and even Europe who take the online courses for both professional development, as well as licensing requirements for nurses, physicians, and others.
The PIPHTC is under the direction of Ms. Emi Chutaro, PIHOA Executive Director, Dr. Greg Dever, PIHOA Regional Human Resources for Health Coordinator, and Dr. Brian P. Mangum, PIPHTC Coordinator.  
Final USAPI Regional STI, HIV, HBV, TB Planning Meeting Held in Honolulu in July 2018
The final U.S. Affiliated Pacific Islands (USAPI) Regional STIs, HIV, HBV, and TB Strategic Framework for Action Planning Meeting was successfully conducted in Honolulu from July 10-12, 2018. In follow-up to the first regional planning workshop held in Guam in December 2017, this was the final planning meeting to complete the development of the draft USAPI Regional Strategic Framework for Action 2018-22 to address critical capacity and systems gaps in the prevention and control of HIV, other STIs, Viral Hepatitis and TB.

This final meeting brought together Program Collaboration and Services Integration (PCSI) focal points and surveillance leads from the USAPIs. The current plan focuses on laboratory testing and procurement, regional and national/state surveillance systems, improving reach to vulnerable populations, including LGBT, rural populations, and pregnant women, workforce development assessment and planning and regional coordination and strategic engagement networking, information sharing and resource mobilization. Stay tuned for the next PIHOA E-Newsletter for an update on the framework.
Guam Takes Steps Towards Better Health by Conducting a Walkability Institute!
On June 5-6, 2018, Guam hosted the region’s first-ever Walkability Institute.  Over these two days, representatives from various agencies on Guam came together to hear about Guam’s recent Walkability Assessment and develop multi-sectoral strategies to make Guam more pedestrian and cyclist friendly in order to promote physical activity. 
The Walkability Institute was led by the Guam Department of Public Health and Social Services (Guam DPHSS) , supported by the Centers for Disease Control and Prevention’s Department of Nutrition Physical Activity and Obesity (CDC DNPAO) , and facilitated by walkability experts Mr. Mark Fenton and Ms. Kelly Morphy. 

This project will involve ongoing follow-up to monitor progress of identified projects on Guam.   
Northern Pacific Environmental Health Association (NPEHA) Completes Strategic Planning Meeting in Guam!
The Norther Pacific Environmental Health Association (NPEHA), a PIHOA Affiliate Member successfully completed their strategic planning and regional meeting from July 17-20, 2018 in Guam. The purpose of the meeting was to have members re-establish a regional dialogue to finalize and endorse the organizational strategic plan and participate in a capacity building training.

Discussion topics throughout the conference included the re-establishment of a regional dialogue setting aimed at assisting each of the jurisdictions and insular areas to effectively communicate, food standards for the Northern Pacific countries, food laboratory constraints in the Northern Pacific, regional mosquito surveillance and prevention control framework, and environmental health in the Western Pacific.
Other Pacific Island Health News
The Guam Mosquito Laboratory in Dededo received a $107K grant from the U.S. Department of Interior to improve vector management and control on Guam. The purpose of the Mosquito Lab is to conduct surveillance of mosquitoes to protect Guam and regional pacific neighbors from mosquito borne diseases, such as Dengue Fever, Zika Virus and Malaria. This will not only help Guam but it will improve its ability to serve as a regional lab for the U.S. Affiliated Pacific Islands (USAPIs). For updates follow the Guam Mosquito Lab on their Facebook Page HERE .
From June 18-22, 2018 the American Pacific Nursing Leaders Council (APNLC) , a PIHOA Affiliate Member held its annual conference in Guam. The conference was particularly special this year as APNLC celebrated their 40th year anniversary with the theme of, "40 years of Innovative Nursing, Promoting Health Across the Pacific." Congratulations to APNLC on your 40th Year Anniversary! Read more about this conference HERE .
New Zealand Prime Minister Jacinda Adern plans to create a special refugee via for Pacific Island residents who are forced to migrate because of rising sea levels. With ocean levels rising due to climate change, one of the most direct effects has been on the residents of low-lying Pacific Nations such as the Republic of the Marshall Islands and the Solomon Islands where coasts have been subsiding and some islands have disappeared. As some Pacific counties prepare to relocate entire communities, New Zealand's newly-elected Labor-led coalition government has become the first country in the world to introduce a climate refugee scheme. Read more HERE .
From June 10-13, 2018 the Pacific Chronic Disease Council (PCDC) , a PIHOA Affiliate Member held its annual conference in Saipan, CNMI. Representatives of member nations of the PCDC talk about the challenges they face in dealing with non-communicable diseases in their respective communities. A trending topic discussed throughout the conference was brought up by PCDC Chairman, Mr. Patrick Luces on diabetes cases in the Western Pacific Region representing 37% of the total worldwide cases. Read more about this conference HERE .
In early June 2018, the Republic of the Marshall Islands President, the Honorable Dr. Hilda Heine met with Canada Prime Minister, Justin Trudeau at the G7 Summit in Canada. President Heine reminded the summit that countries like the RMI did not cause climate change and that they need the help of wealthy nations with financing climate change adaptation for sinking Pacific Island countries. Click HERE to learn more
PIHOA would like to congratulate Ms. Annette Aguon, the Immunization Program Manager for the Guam Department of Public Health and Social Services (Guam DPHSS) who was recently awarded the Natalie J. Smith Award from the Association of Immunization Managers at the AIM Leadership in Action Conference held in June 2018. Prior to that, at the National Immunization Conference held in May in Atlanta, GA, the Guam Immunization Program was publicly recognized by the Centers for Disease Control and Prevention (CDC) and received three immunization coverage awards!
An outbreak of polio has been confirmed in Papua New Guinea, 18 years after the country was declared free of the disease. Pacific Colleagues, please ensure appropriate actions accordingly. Click HERE for more information. 
From July 30-August 1, 2018, the Republic of the Marshall Islands public prosecutors and other law enforcement officers participated in a two day training aimed at strengthening their role in the implementation of the country's 2011 Domestic Violence Prevention and Protection Act.
The Federated States of Micronesia becomes the first Pacific Island country to complete the World Health Organization's (WHO) Joint External Evaluation (JEE), an Internal Health Regulations (IHR) evaluation process. Click HERE for more information.
Longtime PIHOA advocate, Dr. Neal Palafox selected as B.H. and Alice C. Beam Endowed Professorship. Dr. Palafox will use Beams Professorship funds to assess the need for and ability to access cancer screening by Hawai‘i Island rural and isolated Compact of Free Association (COFA) nations peoples.
The 2nd National Environment Symposium was held on August 28, 2018 in Palau at the Ngarachamayong Cultural Center with more than 200 participants from government agencies, education, health, and private/public organizations.  This year’s theme was “inter-relationships between environment and human health.”  The one-day event covered five themes; 1) community actions for health and well-being, 2) reducing waste to ensure protection of health and environment, 3) healthy ecosystems for healthy communities, 4) people and nature in balance, and 5) fish for health.  Representing PIHOA at the conference was Dr. Greg Dever, PIHOA Human Resources for Health Coordinator and PIHOA Board Vice President and Palau Minister of Health, Minister Emais Roberts.
While crowds cheered on teams of athletes at the 9th Micronesia Games in Yap last month, another team made up of individuals from across the Pacific were quietly working to ensure that the health of both participants and the public was protected. From July 15-29, 2018 multidisciplinary health teams composed of doctors, nurses, public health surveillance officers, environmental health workers, laboratory specialists, epidemiologists, communication officers and volunteers, worked hand in hand to serve the 1,328 people who visited health clinics in Yap during the games, sparing no effort to monitor the athletes and public’s health and prevent disease transmission. 
Local & National Events

September 3-6, 2018
Location: Honolulu, Hawaii

September 10-12, 2018
Pacific Island Primary Care Association (PIPCA) Meeting
Location: Honolulu, HI

September 10-13, 2018
Pacific Islands TB Controllers Association (PITCA) Meeting
Location: Saipan, CNMI

September 24, 2018
Location: New York, NY

September 25-27, 2018
Location: Alexandria, Virginia

October 8-12, 2018
21st Pacific Basin Medical Association (PBMA) Conference
Location: Koror, Palau

October 8-12, 2018
Location: Manila, Philippines

October 30-November 4, 2018
Location: Nadi, Fiji

November 10-14, 2018
Location: San Diego, California

November 29-30, 2018
Location: Dunedin, New Zealand

December 10-14, 2018 (tentative)
Cancer Council of the Pacific Islands (CCPI) Meeting
Location: Honolulu, Hawaii

March 2019 (TBD)
65th PIHOA Executive Board Meeting
Location: Koror, Palau
ABOUT PIHOA
OTHER NEWS/ RESOURCES
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If your agency or organization would like to contribute to the Quarterly PIHOA  newsletter, please  contact us . Content should be of interest to public health professionals in the U.S.-Affiliated Pacific Islands, and should concern the public health and healthcare system field and related activities.