The quarterly PIHOA E-Newsletter features news, upcoming events, and resources for the U.S. Affiliated Pacific Islands health community.
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Pacific Island Health Officers' Association
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A Message From the PIHOA Board President
Greetings, my colleagues and friends,
The first quarter of 2018 is just about to end and it's hard to believe that the Easter celebration is almost upon us.
Our sincerest appreciation to American Samoa Department of Health Director Motusa Tuileama Nua & staff, PIHOA Executive Director Emi Chutaro & staff, and everyone else involved in the preparations for this meeting. We are expecting a packed agenda of presentations, but most importantly, we are looking forward to your participation in discussions on issues that affect your specific region.
-CEO Esther Muna, CNMI CHCC & PIHOA Board President
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Doctors and Dentists for Tomorrow Tutors Attend Regional Medical Schools, Vow to Return to Micronesia
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While the Doctors and Dentists for Tomorrow (DDFT) program will not graduate its first class until May 2018, the program is already proving successful in securing the future health security of the region. Already, three former DDFT tutors have been admitted to medical school, with all three crediting their experience with DDFT as a key factor in their admission.
Working alongside DDFT faculty allowed the former tutors to learn basic science concepts using problem-based learning clinical (PBL) applications. This set them apart from other regional candidates and was part of the reason they were accepted to medical school.
Most regional medical schools use the PBL model, which is why the DDFT program focuses on this approach in teaching courses such as human anatomy, medical microbiology, medical psychology, human nutrition, and more.
Two of the former DDFT tutors are now entering their second year of medical school at the
University of Fiji
. Both have plans to become general surgeons and return to practice in the
Federated States of Micronesia
. While there is a shortage of all types of physicians in Micronesia and across the Pacific, surgery is an area of particular need. The third former tutor is beginning her first year of medical school at
Fiji National University
this month, with plans to become an internist and preventative cardiologist before returning to Micronesia to practice. Given the high incidence of heart disease in the region, the addition of a cardiologist in the future will be most beneficial.
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63rd PIHOA Executive Board Meeting,
March 27-29, 2018
Pago Pago, American Samoa
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For the updated meeting agenda and additional meeting details, click
HERE!
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12 Candidates Graduate from the RMI Nurse Practitioner Training Program in March 2018
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NPTP students and other nursing and doctor colleagues pose for a photo with their certificates of participation after completing a two-day workshop on the World Health Organizations' (WHO)
First Embrace, Early Essential New Born Care,
conducted by WHO personnel!
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Through a Memorandum of Understanding (MOU) with
FNU
, the 18-month program has been delivered in Majuro at the
MOHHS
. The year and a half academic curriculum began on September 19, 2016, and is scheduled for completion on March 18, 2018. The program has been taught by
FNU
faculty, led by head instructor, Kavekini Neidiri. Of the 20 original candidates, 12 have passed all of the courses so far and graduated this past week. Candidates were experienced nurses working for the
RMI MOHHS.
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Most of the NPTP courses to date have been classroom‐based, though full-time clinical rotations have begun in late November 2017. In Fiji, NPTP graduation is followed by a 12‐month NP clinical internship run by the
Fiji MOH
, after which NPs are eligible for full licensure and practice within the
Fiji MOH
.
RMI MOHHS
Minister Kalani Kaneko and Secretary Julia Alfred have requested consultation by the
PIHOA
Secretariat to assist with the planning for the NP internship in the RMI.
NPTP graduates will now undertake a 12-month internship program which will prepare them to be fully licensed nurse practitioners in the RMI, effectively tripling the number of indigenous medical providers delivering care in the RMI. They will especially be instrumental in improving preventative services delivery in public health clinics and outlying health centers.
PIHOA's
Human Resources for Health Coordinator, Dr. Gregory Dever said the last nurse practitioners to be trained in the region were trained on Guam in the 1980s. Dr. Dever said "There is a shortage of local primary care practitioners," and emphasized that "local" is important in ensuring quality care of patients because there are no language barriers for nurse practitioners. Click
HERE
for a summary from the
Marshall Islands Journal
.
Congratulations NPTP Graduates!
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Guam Conducts Its First-Ever Walkability Assessment
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Data for Decision Making Graduation Ceremony in the RMI!
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The program consisted of five courses and multiple practical projects. These included mapping of “hot spots” for leprosy and tuberculosis, mapping service coverage for early childhood vaccine coverage, vitamin A and helminth mass treatment for children, protection measures for cervical cancer (including screening and vaccination of girls), institution of tracking system for cancer patients, productivity monitoring for medical staff, development of annual key performance indicators reporting system for the health sector, and development of a system for monthly monitoring of health programs performance and financial status. This program was delivered as a partnership between
PIHOA
and the
Centers for Disease Control and Prevention (CDC)
with assistance in the performance monitoring projects from the
Association of State and Territorial Health Officials (ASTHO).
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PIHOAs Dr. Mark Durand, RMI Minister of Health and Human Services, Mr. Kalani Kaneko, and RMI Secretary of Health and Human Services, Mrs. Julia Alfred pose with DDM Graduate.
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PIHOA Executive Director, Ms. Emi Chutaro
joined by Zoom to give congratulatory
remarks to the RMI DDM Graduates!
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Ms. Rica Dela Cruz Explored Disparities in Adverse Perinatal Outcomes Among Pacific Islanders in the CNMI
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Ms. Rica Dela Cruz had her first manuscript published this month in
Preventing Chronic Disease
. Her manuscript is entitled: “Disparities in Adverse Perinatal Outcomes Among Pacific Islanders in the Commonwealth of the Northern Mariana Islands”. In this publication, Ms. Dela Cruz found that Pacific Islander mothers living in the CNMI were more likely than non-Pacific Islander women to have pre-term babies and babies with macrosomia, and therefore highlighting an important ethnic disparity. Ms. Dela Cruz's article can be found
HERE
.
Ms. Dela Cruz was born and raised in the CNMI and completed her MPH at
UCLA
last year. Next year she will begin a PhD program in Public Health at the
University of Hawai’i.
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Tuberculosis Lab Training Was Conducted in Kosrae, FSM
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A Tuberculosis (TB) laboratory training was held in Kosrae from February 12 to March 7, 2018. The purpose of the training was to s
trengthen the Kosrae TB Program by providing training for three Kosrae Hospital laboratory staff on TB specimen processing including quality sputum collection, Ziehl Neelsen staining method for acid-fast bacilli; AFB smear microscopy, reading, interpretation and reporting; Genexpert testing of TB specimens, result interpretation and reporting; and TB lab data management.
The training provided continuous education (CE) sessions to the Kosrae Hospital Staff on the importance of ensuring the collection of quality sputum specimens for effective TB lab diagnosis in Kosrae. The training was also an opportunity to review and update the Kosrae TB Standard Operation and Procedure (SOP) Manual.
The training was a combination of lectures and practical sessions with the major emphasis on AFB microscopy through blind slide reviews of AFB-stained slides, result interpretation and reporting. The elements of assessment for the TB lab training included: weekly quizzes; final theory and practical examinations. All three lab staff trained were new to handling and testing TB specimens.
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Demonstration of TB specimen preparation for Genexpert TB testing by Lilkiak Alik
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The trainees from left to right, Likiak Alik, Pamela Velasco , Rebinson Renton, and Vasiti Uluiviti (trainer)
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Pamela Velasco performing AFB microscopy
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A trainee performing ZN staining of a sputum smear
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All trainees successfully completed the training, passing both the theoretical and practical components of the training assessment. The newly assigned TB lab technician for the Kosrae Hospital Lab is Mr. Rebinson Renton, with two back-up/support technicians, Pamela Velasco and Likiak Alik. The reviewed and updated Kosrae TB lab SOP manual is now available at the Kosrae State Hospital Lab effective for use as of March 9, 2018. There was a good turn-out during CE sessions by the Kosrae Hospital staff on February 28, 2018 with about 30 attendees. Issues and challenges relating to the prevention of quality sputum collection for TB lab diagnosis across the USAPI were emphasized.
Due to the low incidence of TB in Kosrae, the newly trained lab technicians’ competency in AFB smear microscopy may decline over time. To address this challenge, two recommendations have been proposed to the Kosrae TB Program and the Kosrae Hospital management. The first recommendation is to allow training/work attachment at the
Guam Public Health Lab
, Chuuk Hospital Lab, FSM, or Majuro Hospital Lab, RMI, for the newly assigned TB lab technicians at the Kosrae Hospital lab for a period of two-four weeks. The second recommendation is to have the
PIHOA
Regional Lab Coordinator, Ms. Uluiviti arrange collection of both AFB negative and positive smears and send them to the Kosrae Lab for blind slide review by the recently trained lab technicians.
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ZN stain preparation by Rebinson Renton and Likiak Alik
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Lecture session in the lab
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High-Level Palau Delegation Makes First Visit to the Republic of Cuba in February 2018
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A delegation from the
Republic of Palau
made their first, official high-level visit to the
Republic of Cuba
in late February 2018.
PIHOA
Board Vice President and Palau Minister of Health, Minister Emais Roberts lead the group and met with high-level officials in Cuba as well as the Palauan students currently completing their medical studies in Cuba. Minister Roberts said, "This trip has opened my eyes. I have learned new things: culture and innovation with small resources. The strengthening of our partnership bilaterally and the success of it will benefit the people."
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Mr. Arurang will be completing his medical studies this June 2018. There is a total of 10 Palauan medical students in Cuba (pictured in both photos below); Jason Arurang, Terebkul Ngiraingas, Demei Yobech, Jade Adelbai, Remeldil Bells, Jun Rafael, Lara Reklai, Mya Siang, Ngesmus Hosei, and Irikl Master.
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In addition, the Palau Delegation visited three renowned medical and educational facilities in Cuba;
ELAM
, the Medical Clinic University of Havana, and Hermano's Medical Institution. They also made a visit to the pharmaceutical industry and one of Cuba's 498 polyclinic centers. A polyclinic center is a community clinic that provides initial medical assessments, primary healthcare, and general treatment. Polyclinic centers are the backbone of Cuba's healthcare system. The site visits allowed the group to learn about Cuba's healthcare system as well as witness the country's medical care firsthand.
Cuba is recognized for its success in primary healthcare initiatives and universal health care through the improvement of pharmaceutical (medicines and vaccines) innovations. Cuba is the only
Small Island Developing State (SIDS)
with free health care services and free education for primary and graduate learning.
Like many island nations, Cuba is facing issues caused by climate change and globalization such as health threats related to environmental factors, food and resource depletion, and urban growth. Cuba's late President Fidel Castro believed that investment in the areas of health and education was vital in addressing these issues. Fifty percent of Cuba's national budget supports health and education, with 28 percent of it invested in public health and social assistance.
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Diplomatic relations between the Republic of Palau and the Republic of Cuba was established in 2015. This recent visit by Palau's delegation was an opportunity to foster and strengthen the South-South Cooperation between Small Island Developing States across oceans, from the Pacific Ocean to the Caribbean Sea.
The Palau Delegation included Palau Minister of Health, the Honorable Dr. Emais Roberts, Palau Ambassador to the United Nations, Her Excellency Ngedikes Olai Uludong, Palau Minister of Education, the Honorable Sinton Soalablai, Palau Chief Justice, the Honorable Arthur Ngiraklsong, and Tenth Olbiil Era Kelulau Senator, the Honorable Aric Nakamura. Also part of the group representing the
Palau Ministry of Health
were Dr. Selaima (Lala) Lalabalavu and
PIHOA's
Human Resources for Health Coordinator, Dr. Gregory Dever.
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CDC and PIHOA Planning Meeting Held in Honolulu to Discuss the American Samoa Lymphatic Filariasis Elimination Project
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The
Centers for Disease Control and Prevention's
Ms.
Kimberly Won, Health Scientist, Ms. Tara Brant, Epidemiologist and Mr. Bill Gallo.
CDC OSTLTS
Associate Director for Insular Areas
met at the
PIHOA
Honolulu Office in February 2018 with
PIHOA's
Executive Director, Ms. Emi Chutaro and
PIHOA
consultants, Dr. Tamara Buhagiar, Medical Entomologist and Lymphatic Filariasis (LF) Program Management Specialist, and Mr. Robert (Uti) Gebauer, the LF Community Liaison and Outreach Coordinator.
Other meeting participants who joined in via conference call include Ms. Vasiti Uluiviti,
PIHOA's
Regional Lab Strengthening Coordinator, Dr. Thane Hancock, Regional Career Epidemiology Filed Officer for
CDC OPHPR
, Dr. Mark Durand,
PIHOA's
Regional HIMS and PM Coordinator, Ms. Andrea Whitt,
PIHOA's
Guam Office and Program Support Officer, Mr. Aifili Tufa,
AS DOH's
State Epidemiologist and LF focal point, Dr. Saipale Fuimaono,
AS DOH
and Tafuna CHC Medical Director, Ms. Margaret Sesepasara,
AS DOH
Director of Nursing, Mr. Ben Sili,
AS DOH
PHEP Coordinator, Dr. Aya Yajima,
WHO WPRO's
Technical Officer, and Ms. Lepaitai Hansell,
WHO
Apia's National Professional Officer.
This project will include work to support
AS DOH’s
NTD Program and to assist with the roll-out of mass drug administration (MDA) for population-wide elimination of LF as per the
WHO’s
Global Strategy for the Elimination of LF.
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Guam Kicks Off Their “Behavioral Risk Factor Surveillance Systems-Plus” Pilot Program
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It’s an exciting time for Guam’s NCD surveillance system! Guam has been collecting adult surveillance data using the phone-based
Centers for Disease Control and Prevention
Behavioral Risk Factor Surveillance System (BRFSS) since 2001.
In 2018, for the first time ever, Guam is piloting the “BRFSS-plus” in which Guam residents who complete a phone-based survey will also provide physical and biochemical measurements such as height, weight, blood pressure, fasting blood glucose, and total cholesterol. This will help the
Guam Department of Public Health and Social Services (DPHSS)
get a more accurate picture of their NCD burden to better strategize their public health efforts. Data collection will take place throughout 2018 and is being coordinated by Ms. Kimberly Dolores, a recent
University of Guam
graduate and current
PIHOA
contracted BRFSS-Plus Project Coordinator (pictured above, far right). Learn more about the BRFSS-plus pilot program
HERE!
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2018 IATA Shipping Re-Certification Training of Shippers and Trainer of Shippers in Kosrae in March 2018
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The purpose of the training was to strengthen and maintain the capability of the Kosrae State Hospital Lab to ship clinical specimens from off-island reference laboratory confirmatory testing of infectious diseases. The training also re-certified shippers and trainer of shippers by providing training on the 2018 59th edition of the
IATA
dangerous goods regulations with emphasis on Class/Division 6.2 infectious substances, category A and B.
All four Kosrae State Hospital Lab staff successfully completed the training. There are currently four certified shippers available for the Kosrae State Hospital Lab. The next re-certification training will be in March 2020.
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Currently certified shippers/trainer at the Kosrae Hospital Lab, FSM include, from left to right, Vasiti Uluiviti (trainer), William Nena (shipper & trainer), Rebinson Renton (shipper), Jacob Nena Jr. (shipper), and Pamela Velasco (shipper)
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Poster presentations during the IATA training in Kosrae, FSM
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PREL, a PIHOA Affiliate Member Kicks-Off the Pacific Partnerships in Education Web Series
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The first web series (above) includes an interview with
PREL
President and Chief Executive Officer, Mr. Paul Hadik sharing PREls mission and current projects in the region.
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The second web series (above) features an interview with Dr. Jojo Peter on the challenges for Micronesian families in the Hawaii education system and the opportunities for students and teachers alike.
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In collaboration with the
CDC
and
PIHOA
, over 40 participants from the U.S. Affiliated Pacific Islands were able to attend a five-day meeting from February 5 to 9, 2018 in Guam to discuss strategies and goals to address the prevention and control of HIV, STDs and viral hepatitis in the region!
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In January 2018,
Palau Ministry of Health's
Ms. Cheryl Rengiil, Mr. Osiro Lorin, Ms. Sylvia Tmodrang, and Mr. Gaafar Uherbelau attend TechCamp New Zealand: Transforming Health Communications in the Pacific Region. The three day conference introduced participants to new and innovative channels of communications being used, specifically related to vector control. Click
HERE
for more information.
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Local & National Events
March 17, 2018
Location:
Honolulu, Hawaii
March 27-29, 2018
Location:
Pago Pago, American Samoa
April 10-12, 2018
WHO International Health Regulations (IHR) Meeting
Location:
Nadi, FIji
April 13-14, 2018
Pacific Public Health Surveillance Network Meeting (PPHSN)
Location:
Denarau, Fiji
April 17-19, 2018
Location:
Lake Buena Vista, Florida
April 17-20, 2018
Location:
Atlanta, Georgia
April 18-19, 2018
Location:
Denarau, Fiji
April 18-May 11, 2018
PIHOA TB Lab Training
Location:
Koror, Palau
April 25-27, 2018
23rd Micronesian Islands Forum (MIF)/ Micronesian Chief Executives' Summit (MCES)
Location:
Saipan, CNMI
May 4-June 4, 2018
TB Mass Screening
Location:
Majuro, RMI
May 7-10, 2018
Location:
Honolulu, Hawaii
May 22-24, 2018
Location:
New Orleans,
Louisiana
June 2-5, 2018
Location:
Pasadena, California
June 10-14, 2018
Location:
West Palm Beach, Florida
September 25-27, 2018
Location:
Alexandria, Virginia
November 10-14, 2018
Location:
San Diego, California
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Have something to share?
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.
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