Dr. (Col.) Joseph Dai, a pediatrician based out of Tripler Army Medical Center in Hawaii, performs a basic hearing test on a Nauruan first grader. Dr. Dai is part of a 12-person joint-force U.S. Pacific Command team deployed to the south Pacific Island of Nauru to provide assitance and training to the island’s medical professionals. (US Air Force photo/Tech. Sgt. Chris Vadnais)

by Tech. Sgt. Chris Vadnais

07/24/2007 - REPUBLIC OF NAURU (AFPN) - Life is unique in the world’s smallest island nation-the tiny South Pacific island of Nauru.

It sits just slightly south of the equator, so most of the day is uncommonly hot. Electricity flows in a given facility for no more than 12 hours a day; it comes on for about six hours at a time on the good days. Time seems to move a little slower; no one seems to be in any hurry. And shoes are optional.

But Dr. (US Army Col.) Joseph Dai, a pediatrician based out of Tripler Army Medical Center in Hawaii, is finding other differences-differences he wants to change.

Dr. Dai is part of a 12-person joint force team deployed to Nauru by U.S. Pacific Command (PACOM).

After seeing more than a hundred Nauruan first graders, talking with school administrators, and holding question-and-answers sessions with teachers, Dr. Dai realized there was one thing he’d like to see change immediately.

“Unlike our system, where the education and health systems work together,” said Dr. Dai, “there really doesn’t seem to be that connection in Nauru.”

There is no pediatrician living the island, nor does one visit regularly. There is no school nurse, either.

Of the 111 children Dr. Dai saw on his first day of visits, 20 had ear infections. An ear infection can adversely affect a child’s hearing, but the proper, inexpensive antibiotic can quickly clear it up. However, because there is no school medical program, they have gone unnoticed.

To change this, Dr. Dai will suggest setting up a school medical program. He figures a team of two nurse practitioners could see each of the island’s 3,000 children at least once annually for screening examinations. There would also ideally be some kind of “sick call” for children in each of the ten schools.

“These school ‘doctors’ would prescribe antibiotics and medication, as nurse practitioners can do, and it would be far les costly than hiring physicians,” said Dr. Dai.

“I think that would be a major upgrade for the children of this community,” he said.

Suggestions like Dr. Dai’s are the intended outcome of this mission. Rather than simply addressing symptoms of problems, the goal is to suggest long-term easily sustainable solutions to the island’s issues and help the Nauruans get started in making necessary changes.

Another example of this is in the asbestos abatement program. An overwhelming percentage of the island’s buildings-including most of its schools-are built from materials containing asbestos. Instead of removing it for them, team member Tech. Sgt. Jeremy Brignac, a bioenvironmental technician from Hickam AFB, is showing Nauruans how to build negative pressure chambers, so they can safely dispose of the asbestos building materials themselves.

Other team members are teaching health care providers about dialysis, diabetes, and reviewing basic lifesaving techniques.

“We’re trying to build capacity and sustainability with these very focused activities we’re doing,” said Air Force Maj. Brad Cogswell, an International Health Specialist at Hickam Air Force Base, Hawaii, and the Nauru team coordinator.

“We hope that what we leave behind they can use to improve their quality of life for the long term,” he said.