The Yap AHEC: an update 2002-2006.

The Yap Area Health Education Center (AHEC) is one of three U.S. Health Resources and Services Administration-funded AHEC programs in the U.S.-Affiliated Pacific Island jurisdictions (together with those in Palau and the Commonwealth of the Northern Mariana Islands). The Pacific Island AHECs are administered through the University of Hawai'i, John A. Burns School of Medicine and were founded in response to recommendations for development of the local health workforce by the U.S. Institute of Medicine in its 1998 report, "Pacific Partnerships for Health". The goal of the Yap AHEC is to build human capacity in the health workforce, and thereby strengthen the health service and improve health status for the people of Yap State. An ancillary goal is to pilot test new approaches to health workforce development, which might be shared with others in the region. These goals have been pursued by building partnerships with colleges in the region, with the new Wa'ab Community Health Center project in Yap and the Yap State Department of Health Services to bring formal college programs for students and health service staff to Yap State. To date, formal relationships have been established with five colleges; Palau Community College (PCC), the College of Micronesia-Federated States of Micronesia (FSM), Fiji School of Medicine (Department of Public Health & Primary Care), University of Hawai'i, Hilo, and the University of Alaska, Anchorage. A total of 143 students have been enrolled in 48 courses in several health worker disciplines, including clinical nurses, health assistant/dispensary managers, community health outreach workers, public health program staff pharmacy technicians and x-ray technicians. In addition to facilitating the delivery of courses in Yap, a new 6-course certificate program has been developed for community outreach workers in collaboration with the College of Micronesia, FSM and the Wa'ab Community Health Center (Wa'ab CHC) in order to support the CHC's innovative health service delivery model. The Yap AHEC has also assisted the College of Micronesia-FSM in the World Health Organization sponsored development of a proposal for the establishment of a nursing program, which is based on the decentralized, on-site (DC-OS) nursing training model that has been pilot tested in partnership with PCC at Yap State Hospital.

An outbreak of dengue fever in Yap State.

Between May and December 2004,Yap State experienced an outbreak of Dengue Fever, type 1 with a final total of 658 recorded clinically compatible cases, including 42 hospitalisations and 12 cases of dengue haemorrhagic fever/shock syndrome. There were no fatalities. Lessons learned from this outbreak include: the importance maintaining a high index of suspicion and on-site diagnostic capability for dengue fever, the importance of prompt in-service training for health care workers, the danger posed to neighbors by local lapses in outbreak prone disease surveillance and the utility of the Pacific Public Health Surveillance Network in responding to such diseases, the importance of active disease surveillance in outer island populations, and the importance of instituting preventive measures against the nosocomial spread of dengue fever.

Cancer in Yap State, Federated States of Micronesia.

Little is known about the impact of cancer and the extent of cancer-related services in Yap. The purpose of this study, funded by the National Cancer Institute, was to document the state of cancer awareness and services in Yap and to prioritize cancer-care needs. Findings suggest that cancer is the leading cause of death in Yap, yet cancer-related awareness, prevention, detection, and treatment services are limited. A number of needs were identified, and an action plan was developed based on five priority areas: 1) establishing a cancer registry; 2) increasing awareness of cancer risk, prevention, and detection; 3) expanding cancer screening and detection programs; 4) expanding cancer-related training opportunities for clinical staff; and 5) purchasing cancer-related equipment & supplies.

In-country and community-based postgraduate family practice training for Micronesian physicians--the Palau AHEC: a collaborative effort.

The U.S. Institute of Medicine in its 1998 review of the health care systems among the U.S.-Associated Pacific Islands (USAPI) identified promotion of primary health care (PHC) and training of the regional health workforce including postgraduate training for physicians as priorities. With the support of the health leadership of the USAPI and the Republic of Palau, the John A. Burns School of Medicine (JABSOM) of the University of Hawaii captured U.S. federal Area Health Education Center (AHEC) funds to implement a postgraduate program to train Family Practitioners - physician specialists in primary care for the region. The Palau AHEC has evolved into ajoint activity of JABSOM, the University of Auckland Faculty of Medicine and Health Sciences (UAFMHS), the School of Public Health & Primary Care--Fiji School of Medicine, and Palau Community College to provide Diploma-level training in Family Practice and Community Health for Micronesian physicians.