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Date of Report:
03/2010
Source:
Pacific AETC
Our country's affiliation with numerous island nations located within 2.5 million square miles of the Pacific Ocean-a geographic area comparable in size to the continental US-may surprise some. American Samoa, the Commonwealth of the Northern Mariana Islands (CNMI), the Federated States of Micronesia (FSM), Guam, the Republic of the Marshall Islands (RMI), and the Republic of Palau are all linked to the US through agreements that confer significant responsibilities on our country for the welfare of these unique societies. Although beautiful environs and vibrant cultures typify the region, the pernicious effects of globalization, the bitter legacy of colonialism, the eroding effects of Western cultural hegemony, and the corresponding erosion of stabilizing cultural touchstones have led to a precipitous decline in health. The approximately 500,000 inhabitants enduring these challenges are cared for by dedicated medical professionals with very limited means akin to better known resource challenged nations.
With the support of Minority AIDS Initiative, the Hawai'i AETC (HAETC) began work in June 2000 by conducting a thorough assessment of the region's HIV treatment and prevention capacity. The findings of profound and endemic health disparities meant that enduring outcomes would be achieved only through collaborative efforts focusing on tailored solutions for each area's unique needs.
HAETC technical assistance and clinical capacity building efforts in the region have led to successful HIV risk reduction counseling programs, the adoption of HIV treatment protocols, and a strengthening of public health systems. Through fruitful collaboration with the Secretariat of the Pacific Community, previously unavailable anti-retroviral medications are now used throughout the region whereas before, only palliative care awaited those who tested positive for HIV.
By patiently building consensus, establishing collaborations within nine distinct societies, cultivating clinical leaders, and respecting once unfamiliar social mores, the HAETC's most proud achievement has been its trained-trainers: people who can sustain clinical capacity, implement public health best practices, and forge a public health leadership cadre for the future. For example, Dr. Yoster Yichiro of Chuuk, FSM regularly attended HAETC training sessions and became a vital proponent of progressive public health policy in his community. When foes challenged his hospital's nascent confidentiality policy, Dr. Yichiro repeatedly presented compelling arguments to maintain the recently adopted guidelines and staunch the demand for the names of those infected with HIV. In small societies where communal needs traditionally trump privacy and individuality, Dr. Yichiro's courageous stands represented a significant turning point in the development of confidentiality measures that resonated throughout FSM.
HAETC trained-trainers have also become vital resources within the region. Dr. James Hofschneider of CNMI, Ms. Eleanor Sos, RN of Chuuk, Dr. Zachraias Zachraias of RMI, Dr. James Edilyong of Yap, and Dr. Selaima Lalabalavu of Palau exemplify the growing number of resources available to mentor, educate, and support their peers and communities. Our trained-trainers are now providing region wide trainings thereby marking the successful transfer of capacity from the LPS to the field.
With Minority AIDS Initiative support, HAETC has successfully planted the seeds of sustainable HIV prevention and care in the culturally diverse Pacific Island Nations.
-Kevin Patrick, Program Manager, Hawai'i AETC
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