Establishing a National Emergency Medical Team (EMT) in the Federated States of Micronesia (FSM)

Background/Introduction:The Federated States of Micronesia (FSM) is a Pacific Island nation of just over 100,000 people, with 607 islands spread over an ocean territory of over 2.5 million square kilometers. The nation is regularly struck by disasters and outbreaks - most recently Typhoons Wutip and Maysak, which affected populations on hundreds of islands. To strengthen rapid response to future emergencies, the FSM Government, with support from WHO, Japan, and USAID, is now developing a national Emergency Medical Team.1Objectives:To describe the development of FSM’s national EMT.Method/Description:FSM’s EMT development began with a workshop facilitated by WHO in November 2019, with participants from the National Department of Health & Social Affairs (DHSA) and representatives from all four of FSM’s State Health Departments. A national EMT focal point was jointly hired by WHO and FSM’s DHSA, a Technical Working Group was established, and SOPs developed. WHO initiated procurement of a tailored Pacific EMT cache for FSM’s EMT, along with other Pacific EMTs. FSM’s EMT development has been slowed by COVID-19, but there are plans to train team members from the country’s four States to be ready for self-sufficient national deployments by early 2023.Results/Outcomes:With support from partners, FSM is developing a self-sufficient national EMT capable of rapid response across hundreds of islands spread over a vast ocean territory.Conclusion:FSM is strengthening readiness for future emergencies by developing a national EMT capable of rapid response to the most remote and austere post-disaster conditions, including throughout its remote outer islands.

The China Alternative. Changing Regional Order in the Pacific Islands

The presence of China poses a challenge to the dominance of Western powers and their allies, who have set the agenda in the Pacific since the end of the Second World War. [...]today, the region has been characterised by (post-)colonial power structures. In her opening remarks, Dame Meg Taylor clearly states that the Pacific Island states regard the presence of China in the region as a positive development because it gives PIF countries access to markets, technology, financing and infrastructure. The Boe Declaration of the PIF meeting in 2018, which states that "climate change remains the single greatest threat to the livelihoods, security and wellbeing of the peoples of the Pacific" (ix) - is the principal element of efforts by Pacific Island state leaders to implement the "Blue Pacific" concept and stands in stark contrast to the environmental and security policy of PIF member country Australia as well as that of the previous Trump administration. In Australia alone, economic damage caused each year by Beijing's punitive actions in response to bans on Huawei equipment (Australia excludes the Chinese company from the country's 5G roll-out) and COVID-19 demands (Canberra's call for an independent investigation into the origins of the virus) runs into the billions annually.

Highly Skilled Migrant Workers as a Vulnerability of Small Island Developing States During the COVID-19 Pandemic: Cases of Three Countries in Micronesia

Several small island developing states (SIDS) in the Pacific managed to avoid the COVID-19 pandemic by implementing measures to ensure national isolation. Primarily due to being ordered to leave by their respective organizations, e.g., overseas development administration (ODA) in the developed world, many highly skilled migrant workers left these countries. This sudden exodus of highly skilled foreigners created a number of problems in these countries;for example, schools suffered from teacher staffing shortages and hospitals had reduced capacity to offer medical services due to the paucity of nurses and doctors. This study aims to examine the situations in the Federated State of Micronesia (FSM), Palau, and the Republic of the Marshall Islands (RMI), where many foreign workers have left their duty stations to return home under COVID-19, to elicit lessons learned and possible ways and means to alleviate the observed problems. To this end, literature surveys and interviews were conducted with informants. Results indicated that developing and maintaining a remote work environment is a promising method to fill the gaps caused by the sudden absence of foreign workers in management posts, even under non-emergency situation. This is because in the case that highly skilled migrant workers are forced to vacate their duty stations suddenly, immediately hiring replacements is often not possible. Promoting distance education also proved effective for COVID-19-free nations such as the FSM, Palau, and the RMI, not only during emergencies, but also during normal times. Similarly, the daily use of telemedicine is likely to be effective in coping with emergencies, as shown in the case of FSM’s Pohnpei State Hospital. We found both distance education and telemedicine to be effective measures to address the sudden departure of highly skilled migrant workers in the fields of education and medical services. Moreover, other forms of remote work should prove useful in other sectors such as industry and administration. These systems should be progressively developed during non-emergency times and integrated into the daily operations of relevant sectors. © Fuji Technology Press Ltd. Creative Commons CC BY-ND: This is an Open Access article distributed under the terms of the Creative Commons Attribution-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nd/4.0/).

COVID-19 containment ship model: a case study for Pacific Island response. (Special Issue: The impact of COVID-19 on the health and social welfare of the people of Hawai'i.)

The Republic of the Marshall Islands, American Samoa, the Federated States of Micronesia, and the Republic of Palau have been without any COVID-19 community transmission since the beginning of the global pandemic. The Commonwealth of the Northern Mariana Islands has experienced modest community transmission, and Guam has had significant COVID-19 community transmission and morbidity. Although several of these United States Affiliated Pacific Island jurisdictions made difficult strategic choices to prevent the spread of COVID-19 which have been largely successful, the built environment and the population density in the urban areas of the Pacific remain inherently conducive to rapid COVID-19 transmission. Rapid transmission could result in devastating health and economic consequences in the absence of continued vigilance and long-term strategic measures. The unique COVID-19 vulnerability of islands in the Pacific can be modeled through examination of recent outbreaks onboard several United States Naval ships and other marine vessels. The environmental characteristics that pose challenges to infection control on an isolated naval ship are analogous to the environmental characteristics of these Pacific island communities. Considering a collection of case studies of COVID-19 transmission on ships and applying to Pacific Island environments, provides a heuristic, easily accessible epidemiologic framework to identify methods for interventions that are practical and reliable towards COVID-19 containment, prevention, and control. Using accessible evidence based public health policies, infection risk can be decreased with the objective of maintaining in-country health and social stability. These case studies have also been examined for their relevance to current discussions of health care infrastructure and policy in the Pacific Islands, especially that of vaccination and repatriation of citizens marooned in other countries. The need for aggressive preparation on the parts of territories and nations not yet heavily exposed to the virus is critical to avoid a rapid "burn-through" of disease across the islands, which would likely result in catastrophic consequences.