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 1, Issue 3
Quarter 3: October 2016
60th PIHOA Executive Board Meeting Summary
The 60th PIHOA Executive Board Meeting was held in Honolulu, Hawaii from August 30 - September 1, 2016.  The meeting brought together key national stakeholders, Pacific development partners, and US federal agency leadership to discuss health issues of regional significance.  Key topics that were discussed by the PIHOA Board and Associate Members included, coordinating and planning multiple local, regional and global commitments to health, an update on the USAPI NCD response, intersections between climate change mitigation and public health and disaster preparedness, PACOM engagement in the USAPIs, updates from the USAPI laboratories, health information and data-driven policies and interventions, hospital administration issues, telehealth and telemedicine services, and an update on human resources for health and workforce development programs in the USAPIs.  

A very interesting and long topic of discussion focused on the U.S. Department of Health and Human Services representatives and setting priorities for their engagement and support to the USAPIs in the next five years.  A few stakeholders and partners who presented at the meeting include, CDC leadership from the Office of State, Tribal, Local, and Territorial Support (CDC OSTLTS), senior leadership of the Association of State and Territorial Health Officials (ASTHO), Secretariat of the Pacific Community (SPC), U.S. Department of Health and Human Services Region IX (HHS Region IX), and the World Health Organization (WHO).  At the end of the meeting, the PIHOA Board and Associate Members reflected on the presentations and topics that were discussed during the meeting and set goals on key priorities through official communiques, resolutions and recommendations.  If you weren't able to attend the 60th PIHOA Executive Board Meeting in Honolulu, visit the PIHOA meeting website here for meeting documents and presentations.

A message from the PIHOA Board President

Dear PIHOA Board Members and Affiliates. Buens yan Hafa Adai from Guam! 

I recently attended the WHO Regional Committee Meeting held in Manila.  Secretary Magdalena Walter from the Federated States of Micronesia and Minister Kalani Kaneko from the Republic of the Marshall Islands attended.  Other business prevented Palau's attendance, as well as American Samoa and the Commonwealth of the Northern Mariana Islands.  As usual, there were agenda items that were and are important to all of us. 

What I found very impressive was an early meeting on the Sunday before the formal meeting. This meeting was held strictly with the Pacific Island Countries and Territories.  For the first time since I have been attending these kinds of meetings, we spoke about how much influence the small Pacific Island Countries have, since there are many that vote on the WHO agenda items.

It was a fortuitous meeting since just before the start of the formal meeting, a high level forum on Environment and Climate change was held.  Many of the Pacific Island Countries attended, Guam also sent a representative.

In my outgoing Chairman's speech, I mentioned the major threat that climate change poses to the Pacific Region and that if we do nothing about the causes of climate change, humans as a whole could face disastrous consequences.  The Pacific Island Countries and Territories that are the most vulnerable have not contributed to the damages caused by developed countries.  The fact that Kiribati will soon be lost to rising sea levels is a sad and sobering reality.

We, at PIHOA must continue to voice our concerns about climate change and perhaps become more active in making development partners aware of our plight.

-Director James Gillan, Guam DPHSS

Thank you to everyone who helped celebrate PIHOA's 30th Year Anniversary!

PIHOA is Hiring
Visit the PIHOA website Careers Page for updated job vacancies!
Sub-regional Microbiology Enhancement & Skill-up Training for the USAPI Laboratories
Through the use of the ASTHO funds, three sub-regional microbiology enhancement and skill-up training for the USAPI laboratories were implemented and completed in Pohnpei, FSM (June 13th – July 1st 2016); Majuro, RMI (June 20th – July 8th 2016) and Palau (July 12th – August 25th 2016). 

The three training sites hosted the following microbiology technicians for the training:

1. Pohnpei State Hospital Laboratory – Pohnpei, Chuuk and Kosrae Hospital Labs (6 participants)
2. Majuro Hospital Laboratory – Ebeye Medical Health Center Lab (3 participants)
3. Belau National Hospital Laboratory – Palau and Yap Hospital Labs (3 participants)

*CHC Laboratory, Saipan, CNMI was unable to send a participant to this training.

Dr. Johnny Hedson Acting Director/Chief of Staff Pohnpei State Hospital during Microbiology Training in Pohnpei
Microbiology Training in Majuro, RMI
Palau participants  ready to sub-culture blood cultures
The objectives of the 3-weeks training were to improve the laboratory preparedness and response of the USAPI labs to infectious disease outbreaks through the:

1. Provision of training to skill-up and enhance the diagnostic microbiology testing capacity in the USAPI labs.

2. Improvement of the USAPI lab testing capability to detect and report the 5 outbreak-prone infections including typhoid, cholera, shigellosis, gonorrhea and meningococcal meningitis.

3. Provision of technical assistance to strengthen lab-based surveillance of outbreak-prone diseases.
Trainers for the training included:

i.   Pohnpei training – Mr. Autiko Tela, Senior Medical Laboratory Technologist, Ministry of Health, Fiji;
ii.   Majuro training – Ms. Seini Biukoto, Technical Supervisor-Microbiology, LBJ Tropical Medical Center, American Samoa; and
iii.   Palau training – Ms. Vasiti Uluiviti, Regional Laboratory Coordinator, PIHOA:

The training focused mainly on the improvement bench and practical skills in diagnostic microbiology including the emphasis on quality assurance in microbiology. Assessment tools for the training included weekly quizzes, final theory and practical examination.

The outcomes of the training included:

i.   A total of 12 USAPI lab technicians were successfully trained.
ii.   A proposed USAPI regional test algorithm for the isolation, detection, identification and confirmation of typhoid, cholera, shigellosis, gonococcus and meningococcus that will be shared with the Association of the USAPI Laboratories (AUL) for their endorsement and implementation was established.
Thank you trainers and participants for improving our USAPI labs! 

PIHOA Spotlight: Zika Surge Response Team

The Regional team of PIHOA Consultants have been placed to focus on the Zika Surge Response in American Samoa, the Republic of the Marshall Islands and Kosrae, FSM.  The Zika Project Manager, Alison Amoroso, joins PIHOA with over 30 years experience in Public Health.  Recently, she has held posts as Project Officer at Atlanta’s CDC office as well as on the ground in Africa for the Ebola Response team.   Her role is to engage with the Zika regional consultants, jurisdiction’s key Health leadership and field assignee's to develop a plan, for effective Zika surge response activities.  Because she is passionate to see the USAPIs engaged in a well prepared and response program, her value add is welcome.

Jada Walton, is the Project Assistant for the Zika Surge Response team, and has recently became a PHEP graduate of the Chicago CDC team.  To assist the Zika Surge Response Project Manager in the planning, coordination and execution of CDC-approved Zika project activities.  This will include administrative support for the recruitment and placement of Zika regional and field assignee technical staff, including assistance with location/office set-up, procurement of office supplies and equipment that support assignee contracts and operations.  She will also assist with the compilation and analysis of project data, outputs and impacts in preparation for submission of project reports to the CDC.

Kinsey McFadden joins PIHOA from the Army, MedComm Division.  He has recently worked on Health Information Technology Systems, providing assistance to nations in Africa affected by Ebola.  He will be responsible for the coordination with the regional team for development of plan of action and technical assistance provision to strengthen administrative preparedness and response capabilities, while aligning systems and capacities as appropriate to each jurisdiction. 

Within the last month, the Zika Surge Response Team, along with PIHOA Executive Director, Emi Chutaro and Guam Office and Program Support Officer, Andrea Whitt have visited American Samoa, Kosrae, FSM and Majuro, RMI to assess the needs in regards to Zika.  Stay tuned for updates from the Zika Surge Response Team on future PIHOA E-Newsletters.

Zika Surge Response Team Site Visit to American Samoa
RMI MOH-FNU-PIHOA Nurse Practitioner Training Program Opening Ceremony

In collaboration with the Republic of the Marshall Islands Ministry of Health, Fiji National University, and PIHOA, the opening ceremony for the Nurse Practitioner Training Program was held on October 3, 2016 in Majuro, RMI.  This 18 month postgraduate diploma in Nursing Practice as a Nurse Practitioner educational programme is designed for nurses registered both as nurses and midwives. 

The goal of the Postgraduate Diploma in Nursing Practice Programme is to prepare experienced professional nurses for the full range of advanced community primary health care.  The programme consists of sequential phases, including Advanced Health Assessment (Phase I), Advanced Clinical Decision-Making in Primary Health Care (Phase II), and a four to five month Clinical Practicum (Phase III).

There are 16 Nurse Practitioner Programme candidates enrolled in the program, and two instructors on island, Professor Kavekini Neidiri (who will be here throughout the full 18 months of the program) and
Dr. Paulini Qica, who will teach Maternal Health courses between now and Christmas.  Stay tuned for more news on the Nurse Practitioner Program (see next E-Newsletter). 
47th National Immunization Conference (NIC) - "It Takes a Community"
  47th National Immunization Conference (NIC)—It Takes a Community:  CDC NCIRD hosted the 47th NIC on September 13–15, 2016, at the Hilton Hotel in Atlanta, Georgia.  The NIC brought together a wide variety of local, state, federal, and private-sector immunization partners to explore science, policy, education, and planning issues related to immunization and vaccine-preventable diseases.  The successful conference had 1,511 attendees, including several international participants, as well as 199 speakers, 73 individual sessions, 42 exhibitors, and 68 poster presentations.

All six USAPIs were represented at the NIC by their respective National/Territorial immunization programs.  In addition to the official conference agenda, USAPI representatives also participated in a pre-conference awardee meeting with the CDC NCIRD/ISD Program Operations Branch leadership regarding updates to the current Immunization Cooperative Agreement and plans for the new 5-year project period scheduled to start in 2018. 

USAPI representatives were also able to capitalize on meetings with CDC Atlanta-based subject matter experts to gain technical assistance for their programs in areas ranging from vaccine spend plans, HPV evaluation projects, and immunization registry development, along with the opportunities for one-on-one consultations with their CDC Immunization Project Officer and USAPI regional public health advisors.
PIHOA Pacific CHOR Project’s MCH Workforce Capacity Building Site Visit - Anthropometric Measurement Standardization in Kosrae, FSM

PIHOA’s Pacific Basin Primary Care Office (PCO) Coordinator, Dr. Angela Techur-Pedro and PIHOA Consultant and Professor of Nutrition at the University of Hawaii at Manoa, Dr. Rachel Novotny conducted the second PIHOA Pacific CHOR project’s Maternal and Child Health (MCH) Workforce Capacity Building site visit from September 30-October 7, 2016.

The PIHOA Pacific CHOR project’s main purpose is to build and strengthen capacity of maternal and child health workforce in research across the USAPI’s.  This project is funded by the Centers of Disease Control and Prevention (CDC) through the National Association of Chronic Disease Directors.  Due to limited funds, select target sites, Kosrae State, FSM and Palau, were chosen for the initial phase of the PIHOA Pacific CHOR project.

During the second MCH workforce capacity building training in Kosrae, FSM, participants conducted anthropometric measurement standardization using regional standards across three different age groups and across different anthropometric measurements.  Results showed that all 10 participants were standardized in the height measure for children age 2-5 years old as well as all 10 participants passing the standardization in the weight, height and head circumference measures for children ages 0-2 years old.  Results for the adult weight and height standardization training concluded that all 10 participants were standardized in adult weight measure and 7 out of 10 were standardized in the height measure.

A side from the successful training results, Dr. Techur-Pedro and Dr. Novotny were able to meet with Kosrae State DHS Director, Dr. Livinson Taulung to discuss ways to develop and strengthen a regionalized institutional review standards of practice for protecting human subjects and intellectual property in research across the Pacific Basin USAPI region.  Action items that developed from this discussion are for Director Taulung to review IRB applications, the Kosrae DHS supporting PIHOA as a regional IRB alternative if necessary, and a PIHOA Pacific CHOR project IRB consultant drafting a regionalized institutional review standards of practice for a research manual for review and adoption by the Kosrae State DHS.

Dr. Techur-Pedro and Dr. Novotny will be traveling to Palau in late November/early December 2016 to conduct the MCH standardization training for Palau (see next E-Newsletter).

PIHOA's Dr. Durand's One-Year Consultancy in the RMI Comes to an end, Kommol Tata RMI MOH!

Sending a big Kommol Tata and mahalo to the RMI Ministry of Health for hosting PIHOA's Regional PM/QA/QI and Health Information Management Systems Coordinator Dr. Mark Durand during his one year consultancy in Majuro, RMI.
Local & National Events

November 8-10, 2016
Human Resource Management 2.0
Location: Honolulu, HI

November 18, 2016

November 19, 2016
Location: Honolulu, HI

November 28-December 2, 2016
FSM NCD Summit
Location: Pohnpei, FSM

December 3-4, 2016
Location: San Francisco, CA

December 5-6, 2016
Location: Chicago, IL

December 10-15, 2016

January 10-11, 2017
Epidemiology & Prevention of Vaccine-Preventable Diseases
Location: Honolulu, HI

February 6-7, 2017
Pacific Islands Infectious Disease Conference
Location: Tumon, Guam

March 27-31, 2017 (tentative)
61st PIHOA Executive Board Meeting
Location: Saipan, CNMI

April 25-28, 2017
Location: Atlanta, GA
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