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 4
Quarter 4: January 2019
A Message From the PIHOA Board President
First of all, on behalf of the Commonwealth Healthcare Corporations’ Board of Trustees, Corporate Officers, Management and Staff, I want to give you all, our colleagues and friends, our sincerest and most heartfelt appreciation for all your thoughts, prayers, and support of our response and recovery from the devastation caused by Super Typhoon Yutu on the islands of Tinian and Saipan. Super Typhoon Yutu reminded our islands once again the importance of having a strong health care system, especially when responding to public health events and impacts resulting from disasters caused by climate and extreme weather events. 

We all play a critical role in ensuring Public Health, Surveillance, Food Safety, Mental health, and of course, Hospital services are available and ready. In many instances, our team’s response drives the resiliency of our community. So as we approach the Holiday Season, I join my fellow Board members in thanking each and every one of you who work and consult in the health care system in American Samoa, the Federated States of Micronesia, Guam, the Northern Mariana Islands, Palau, and the Republic of the Marshall Islands. We are grateful for all your contributions and your selflessness in ensuring the health of our community is optimized and often with limited resources. May you all have a joyous and healthy Holiday Season! Have a happy, healthy and resilient 2019!

CEO Esther Muna, CNMI CHCC & PIHOA Board President
PIHOA Pacific Islands Public Health Training Center (PIPHTC) Conducts Depression Screening During Worlds Diabetes Day
Over 150 individuals were screened for depression during the World Diabetes Day event held at the College of Micronesia-FSM (COM-FSM) on November 16, 2018 in Pohnpei, FSM. The event was a joint effort between the PIHOA Pacific Islands Public Health Training Centre (PIPHTC) and the Doctors and Dentists for Tomorrow (DDFT) program’s MEDDENT Society. Those screened were primarily students from COM-FSM , but also included faculty and staff.

DDFT students worked with Dr. Brian P. Mangum, Coordinator of the PIHOA PIPHTC to provide screening using a rapid screening tool commonly used in primary care to identify persons with, or at risk for, depression. The screening was part of the DDFT programs efforts to prepare regional students for entry into medical and dental school through a rigorous course of study that includes learning applied skills, such as depression screening, as well as rotations at the Pohnpei State Hospital from day one of the program. 
The PIPHTC also developed various educational displays and programs detailing the treatment available for depression in Pohnpei. There were also displays and educational material on the linkage between diabetes and depression, with diabetics being three times as likely to experience depression than those without diabetes.  

Those who were identified as having mild-moderate depression were provided brief interventions at the time of screening, and then referred to community-based resources, such as counsellors, primary care physicians, and the student health and counseling centers. Those at risk for depression, but with only mild mood disturbances, were provided lifestyle counselling advice related to diet, exercise, and stress management skills, particularly relate to the tension of being students as final exams approach.
PIHOA PIPHTC is currently working with the COM-FSM Division of Health Sciences, the Guam/Micronesia AHEC , and the Pohnpei Department of Health Services, to develop mental health and substance abuse counsellor training and certification programs. The PIHOA PIPHTC is part of the larger Western Regional Public Health Training Center based at the University of Arizona’s Zuckerman College of Public Health .  This HRSA -funded program works to upskill the public health workforce of the USAPI, as well as provide additional support services across the region.  
65th PIHOA Executive Board Meeting
March 25-29, 2019
Koror, Palau

Kosrae Kicks Off Their Hybrid Survey
Kosrae began collecting data for their Hybrid Survey in October 2018. This is the beginning of FSM's initiative to implement the Hybrid survey in all four states between 2018 and 2019 in order to have the first-ever FSM National non-communicable disease and risk factor prevalence estimates. A one-week training workshop with all surveyors was conducted from October 1-5, 2018 in preparation for data collection. The trainers for this workshop included Molly Murphy and Maybeline Ipil from the Marshall Islands Epidemiology & Prevention Initiatives (MIEPU), and PIHOA's Dr. Haley Cash. The survey supervisors were DDM graduates, Cecilia Sigrah and Robina Waguk.
Pacific Island Vector Management Council Fully Operational
At the September 2018 PIHOA meeting in Honolulu, the Board approved a region-wide vector management plan proposed by Regional Entomologist, Dr. Grayson Brown. The heart of that plan was a working group composed of vector management supervisors throughout the region called the Pacific Island Vector Management Council (PIVMC).  

This group has now been organized and just completed its third monthly Zoom video conference meeting.  At these meetings, the group describes vector status, issues, solutions for individual islands, discusses updates provided by PIHOA entomologists, and reports from the regional vector management laboratory on Guam. Attendance is normally 10 to 15 people and includes representatives from majority of the USAPIs.

They also hear from visitors from outside the region. In the last meeting, the headline visitor was Dr. Chris Barker, co-director of the CDC -funded Center of Excellence for Vector-Borne Diseases at the University of California, Davis . Dr. Barker described the various ways in which his Center could directly assist vector managers in the Pacific islands and the procedures for obtaining that assistance.

After the holidays, the group will begin one of its principal tasks by discussing surveillance and management protocols across the region. This will be of significant help to any island that adopts any standards that may be recommended by the group. Vector management is improving rapidly throughout the USAPIs and the PIVMC is tangible evidence of that improvement.
Update on Lymphatic Filiriasis Mass Drug Administration in American Samoa
On Monday, September 24, 2018, the American Samoa Department of Health (AS DOH) , with the support of Governor Lolo Matalasi Moliga, cabinet members, legislature, government and non-government agencies, faith-based denominations and communities at large launched the lymphatic filariasis (LF) Mass Drug Administration (MDA) for American Samoa in Utulei.

AS DOH has been planning this MDA for the past year with the support from the World Health Organization (WHO) , Centers for Disease Control (CDC) and PIHOA

Lymphatic filariasis (LF) or mūmū tutupa in Samoan, is a parasitic disease caused by worms that are spread between people by mosquitoes. Infection can cause swelling of the arms, legs and other body parts. People can become infected with the worms for a long time before they start to see the effects of the disease.
Mass drug administration (MDA) is the process of giving medication to all eligible persons in the community to stop lymphatic filariasis. Participating in the MDA will ensure you and your family are protected from its effects. Taking the medication will also treat other conditions such as intestinal worms and scabies.

Between September and November 2018, two phases of the MDA process were carried out. The first phase targeted large gathering areas such as American Samoa Government workplaces, businesses, schools, churches, village guest houses, bingo halls, shopping centers and markets. The second phase focused on house to house visits to all those who could not make it to phase one sites. 
One of the LF MDA’s successes include being able to locate the LF patients and now focusing on how American Samoa can work with them and provide them with what they need.

What also made this project a success is the cooperation and involvement of the local media such as newspapers, radio and TV.

A Public Service Announcement and article of a local woman with LF resulted in the increase of individuals coming in to participate in the MDA. Read the article HERE .
Stayed tuned to the next PIHOA E-Newsletter for full results from the American Samoa LF MDA project. American Samoa is planning to continue its LF MDA efforts this year as well.
PIHOA Regional Lab Coordinator Attends Annual PITCA Meeting in Saipan
PIHOA's Regional Laboratory Coordinator, Ms. Vasiti Uluiviti attends the Annual Pacific Islands TB Controllers Association (PITCA) Meeting from September 10-13, 2018 in Saipan, CNMI. Ms. Uluiviti presented in the planetary session on External Quality Assessment for TB lab diagnosis and facilitated the TB lab break-out session. Pictured on the left is PIHOA Board President and CNMI CHCC CEO Esther Muna and Ms. Uluiviti.
Palau Completes its Second and Third DDM Modules
In August and October 2018, the second and third modules of Data for Decision Making (DDM) were completed in Palau. The DDM program is a Fiji National University (FNU) accredited certificate program that aims to train epidemiology technicians. The DDM program consists of five modules delivered in-country to a cohort of health workers who have data-related roles throughout the health department. In order to receive their certificates, DDM students must pass all modules and complete a final project. DDM in Palau was facilitated by Tmong Udui from the Palau Ministry of Health , Dr. Thane Hancock from CDC / PIHOA , and Dr. Haley Cash from PIHOA .  
PIHOA Staff Attends 2018 PIPCA Meeting
PIHOA Executive Director, Emi Chutaro, Human Resources for Health Coordinator, Dr. Greg Dever, and Health Information Systems Coordinator, Dr. Mark Durand represent PIHOA at the 2018 Pacific Islands Primary Care Association (PIPCA) Meeting in early September 2018 in Honolulu! Former PIHOA ED, Michael Epp also attended the meeting.
PIHOA Regional Entomologist, Dr. Grayson Brown Honored by the Entomological Society of America as an Honorary Member!
As a follow-up from PIHOA's last E-Newsletter, Dr. Grayson Brown, PIHOA Regional Entomologist, was honored by the Entomological Society of America at a joint meeting of several large entomological societies in Vancouver, Canada, in November 2018. The award is an Honorary Membership and is given in recognition of his scientific achievements, society involvement, and advancement of the discipline. 

This particular award is not easy to obtain. Nominees are first screened by a panel of past society presidents who recommend a semi-finalist slate to a governing board. The board then selects a few candidates from that slate and offers the finalists to the world-wide membership. In the ensuing general election, votes are cast from over 130 countries around the world. 

It is the only award in entomology that requires support from rank and file entomologists world wide, that is what makes the award unique. "To be recognized by ones peers throughout the world makes this award truly special to me," says Dr. Brown. "It's very humbling and I am deeply appreciative," he said.

In addition to the plaque, Dr. Brown receives lifetime membership in several societies, lifetime gratis registration for their meetings, lifetime gratis subscription to their journals, and he is ensconced in the Entomology Hall of Fame.
USAPIs Represented at the WHO Health Emergency Risk Management Training in Nadi, Fiji
USAPIs represented at the  World Health Organization Regional Office for the Western Pacific  Meeting on Health Emergency Risk Management - Preventing, Preparing for and Responding to Health Emergencies in the Pacific from September 18-21, 2018 in Nadi, Fiji.

The training covered presentations, discussions, outbreak sessions and stimulations focused on health emergency prevention, preparation and response.

Pictured from left to right is Guam Representative, Jonathan Lujan, FSM Representative, Arthy Nena, PIHOA's , Emi Chutaro, and Palau Representative, Komtil Ngirmang.

During the training, FSM Representative, Arthy Nena did a presentation on FSM's Joint External Evaluation (JEE) as FSM has become the first Pacific island country to complete a JEE.
DDM Graduate from Pohnpei, Delpihn Abraham Published in the Hawai’i Journal of Medicine and Public Health
One of our Data for Decisions Making (DDM) program graduates, Delpihn Abraham, published her first-ever manuscript in the Hawai’i Journal of Medicine and Public Health in November 2018.  

Her manuscript, entitled: “High prevalence of non-communicable disease risk factors among adolescents in Pohnpei, Micronesia” presents data from the Pohnpei Rapid Youth Survey conducted in 2015, and highlights the high non-communicable disease risk factor burden among high school students in Pohnpei.  

Finalization of the USAPI Regional STI, HIV, VH, TB Strategic Framework for Action Meeting Held in Guam in December 2018
In follow-up to the first Regional STI/HIV/VH/TB Strategic Framework for Action planning workshop held in Guam in December 2017, the CDC NCCHSTP PCSI Kick-Off Meeting held in Guam in February 2018, and the second Regional STI/HIV/VH/TB Strategic Framework for Action planning meeting in Honolulu, Hawaii in July 2018, and on request from the CDC NCHHSTP’s TB Prevention and Control Branch, the PIHOA Secretariat held the final planning meeting to complete the development of the USAPI Regional Strategic Framework for Action 2018-22 in Guam from December 5-7, 2018.

This meeting addressed critical capacity and system gaps in the prevention and control of HIV, other STIs, Viral Hepatitis and TB, with specific emphasis on finalizing the TB components of the plan. Stay tuned for PIHOA's next E-Newsletter for more information on the progress of this Strategic Framework.
Mr. Robert Greathouse, MPH
Regional Public Health Advisor, 
USAPI NCD & PHEP Programs,
Hagatna, Guam

Mr. Robert Greathouse joined PIHOA in September 2018 as an independent contractor, serving in the role of Regional Public Health Advisor, supporting both noncommunicable disease and public health emergency preparedness programs across all six USAPI jurisdictions. He is based at PIHOA’s Guam Office located in Hagatna. Mr. Greathouse comes to PIHOA with a Bachelor of Arts in Sociology from Texas Southern University (TSU), and his Master’s Degree in Public Health (with an emphasis on Community Health and Development) from Emory University’s Rollins School of Public Health .

Mr. Greathouse brings to his current position five years supporting grants and project management functions for CDC -funded global health projects, as both a Project Officer and Senior Project Officer. Mr. Greathouse has supported CDC -funded projects in both Sub-Saharan Africa and Southeast Asia, spanning a wide array of program areas, including HIV, TB, malaria prevention, infection prevention and control, strategic information, and organizational systems strengthening programming. Before joining PIHOA , Mr. Greathouse worked for three years at the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) as a Country Program Officer in Washington, D.C. Subsequently, he served for two years as a Senior Project Officer at ICAP at Columbia University in New York City. In both roles, Mr. Greathouse provided technical assistance to a portfolio of country programs across the three phases of the grants life cycle, including the pre-award, award, and post-award phase. Mr. Greathouse has accrued expertise in proposal management, project startup including work plan and budget development, financial and programmatic reporting, the preparation and submission of prior approvals, and project closeout processes. 

Mr. Greathouse conveys that his goals and objectives as the PIHOA Regional Public Health Advisor are to improve the processes deployed by USAPI jurisdictional NCD and PHEP programs in the award and post-award phases of the grants cycle, particularly with respect to budget and financial report preparation. In the long term, he also hopes to work in tandem with colleagues in each jurisdiction to reduce unobligated balances for each respective program, and strengthen the capacity of these colleagues to support grants management functions across the grants lifecycle and form a cadre of “Grants Management Champions” for federal grants management in each jurisdiction. Welcome to the Pacific Mr. Greathouse!
PIHOA Secretariat Staff Attends 2018 ASTHO Meeting
PIHOA's Health Information Systems Coordinator, Dr. Mark Durand and Communications Officer, Billie Hiraishi attend the 2018 Association of State and Territorial Health Officials (ASTHO) Meeting from September 26-28, 2018. Esther Muna, PIHOA's Board President and CNMI CHCC Chief Executive Officer also attend the meeting.

Dr. Durand did a presentation at the ASTHO meeting sharing the collective efforts being done in the USAPIs through policy to improve NCD's.

Read more about Dr. Durand's presentation HERE .
Palau Recognized at the 69th WHO Regional Office for the Western Pacific Regional Committee Meeting
The 69th session of the World Health Organization Regional Committee for the Western Pacific was held in Manila, Philippines from October 8-12, 2018. The Republic of Palau was officially recognized and awarded for their successful elimination of Lymphatic Filariasis.

Accepting the award was Dr. Emais Roberts, Palau Minister of Health and PIHOA Vice President. Palau joins other Pacific nations of the Cook Islands, Marshall Islands, Niue, Vanuatu, and Tonga in successful elimination of Lymphatic Filariasis since 2016! Congratulations Palau!
DDM Training Continues in Ebeye, RMI
The Data for Decision Making (DDM) Course 805, Computers for Public Health Practice was completed in Ebeye from November 12-19, 2018. The DDM project in Ebeye is centered around building the QI program for the Community Health Center and Hospital. Following formal delivery of the course, an extra week was spent on-site working one-on-one with participant projects.

The course was facilitated by PIHOA's Health Information Systems Coordinator, Dr. Mark Durand and PIHOA Contractor, Ms. Jill McCready.
Successful TB Training Held in Weno, Chuuk
A regional training for USAPI healthcare professionals who are involved with tuberculosis contact investigation and sputum collection was held in Weno, Chuuk from November 27-30, 2018.

The training consisted of lectures, discussions and case presentations. Topics covered included TB transmission and diagnosis, treatment of TB infection, TB contact investigation, confidentiality and sputum collection. Training was also provided by PIHOA's Regional Laboratory Coordinator, Vasiti Uluiviti.
Other Pacific Island Health News
At the last two PIHOA Executive Board Meetings, Princeton University’s Master of Public Affairs Fellow, Ms. Alexandra Wheatly did presentations on her graduate research regarding the Compact of Free Association (COFA) ending in 2023, specific to health.

Her research title is, “Health system strengthening in FSM-RMI: engagement challenges and strategic perspectives for the 2023 transition.”

Local & National Events

January 27, 2019
2019 Cervical Cancer Conference
Location: Guam

February 4-8, 2019
ASTDD & PBDA Meeting
Location: Honolulu, HI

March 25-29, 2019
65th PIHOA Executive Board Meeting
Location: Koror, Palau

April 22-25, 2019
Cancer Council of the Pacific Islands (CCPI) Meeting
Location: Honolulu, Hawaii

June 18-20, 2019
Location: Sydney, Australia

September 23-25, 2019
Location: Bethesda, MD

February 2020 (tentative)
Location: TBD
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.