This article highlights the vital role of affordable satellite communications during health emergencies. Drawing on examples from Vanuatu and Tonga, it underscores the importance of integrating satellite technologies into disaster preparedness for effective communication and response.

This article describes the Western Pacific Region’s participation in the Emergency Medical Team Global Meeting held in November 2024 in Abu Dhabi, United Arab Emirates. Participants from the region actively contributed to various panels, discussions, working sessions and abstract presentations throughout the 3-day meeting, highlighting the increased strength of the Western Pacific to respond to health emergencies.

Problem: While the COVID-19 pandemic threatened the entire world, the extremely remote Pitcairn Islands faced unique vulnerabilities. With only a physician and a nurse to care for an ageing population of fewer than 40 residents, and with very limited referral pathways, Pitcairn encountered distinct challenges in preparing for and responding to the COVID-19 pandemic. Context: The Pitcairn Islands is an overseas territory of the United Kingdom of Great Britain and Northern Ireland consisting of four islands in the South Pacific: Pitcairn, Henderson, Ducie and Oeno. Pitcairn is the only inhabited island with a local resident population of approximately 31 people, around half of whom were over 60 years old in 2023. The islands are only accessible by sea and are located more than 2000 km from the nearest referral hospital in French Polynesia. Actions: Pitcairn’s Island Council took aggressive action to delay the importation of SARS-CoV-2, vaccinate its small population and prepare for the potential arrival of the virus. Outcomes: As of May 2024, Pitcairn was one of the only jurisdictions in the world not to have had a single COVID-19 hospitalization or death. Nevertheless, the pandemic presented the islands’ population with many economic, social and health challenges. Discussion: Pitcairn’s population avoided COVID-19-related hospitalizations and deaths despite its elderly population’s vulnerability to COVID-19, a significant level of comorbidities, and limited clinical management capabilities and options for emergency referrals. The pandemic highlighted some of the population’s health vulnerabilities while also underscoring some of their innate strengths.

Objective: The Commonwealth of the Northern Mariana Islands (CNMI) is a remote Pacific island territory with a population of 47 329 that successfully prevented the significant introduction of coronavirus disease (COVID-19) until late 2021. This study documents how the response to the introduction of COVID-19 in CNMI in 2021 was conducted with limited resources without overwhelming local clinical capacity or compromising health service delivery for the population. Methods: Data from COVID-19 case investigations, contact tracing, the Commonwealth’s immunization registry and whole genome sequencing were collated and analysed as part of this study. Results: Between 26 March 2020 and 31 December 2021, 3281 cases and 14 deaths due to COVID-19 were reported in CNMI (case fatality rate, 0.4%). While notification rates were highest among younger age groups, hospitalization and mortality rates were disproportionately greater among those aged >50 years and among the unvaccinated. The first widespread community transmission in CNMI was detected in October 2021, with genomic epidemiology and contact tracing data indicating a single introduction event involving the AY.25 lineage and subsequent rapid community spread. Vaccination coverage was high before widespread transmission occurred in October 2021 and increased further over the study period. Discussion: Robust preparedness and strong leadership generated resilience within the public health sector such that COVID-19 did not overwhelm CNMI’s health system as it did in other jurisdictions and countries around the world. At no point was hospital capacity exceeded, and all patients received adequate care without the need for health-care rationing.

This article describes the development of a formal national Emergency Medical Team (EMT) in the Republic of Kiribati. It details how Kiribati’s Ministry of Health & Medical Services committed to establishing this deployable clinical response capability, and how support from the World Health Organization and United States Agency for International Development enabled the establishment of the Kiribati Medical Assistance Team, or KIRIMAT.

This article describes the development of national emergency medical teams in Pacific island countries and areas.

This article describes the development of a national emergency medical team training package for Pacific island countries and areas. The training incorporates the logistical challenges faced in the Pacific and applies a mixed-method approach to training, with lectures, group discussions, hands-on activities and a simulation exercise.

This article describes the development of an online, remote and interactive emergency medical team (EMT) training series to engage current and prospective Pacific EMT team members during the COVID-19 pandemic. This was done incorporating talanoa sessions. In many Pacific languages, talanoa means to tell a story or have a conversation.

Palau is a small island/large ocean nation in the Pacific that is vulnerable to natural or climate-related disasters. The national emergency medical team (EMT) was developed following a World Health Organization initiative to facilitate EMT training and cache procurement in the Pacific. As a result of the WHO initiative, Palau's EMT, known as KLEMAT, is fully self-sufficient and able to rapidly deploy in response to any local/national disaster or emergency. Imperative to any team development is the challenge of maintaining skills and motivation. Palau's experience is that by providing KLEMAT with regular education and training exercises, the team continues to advance as a cohesive, highly skilled group, which in turn ensures their ongoing preparedness for disaster/emergency response.

Problem: The undersea Hunga Tonga-Hunga Ha’apai volcano erupted on 15 January 2022, causing a tsunami that affected Tonga as well as other countries around the Pacific rim. Tonga’s international borders were closed at the time due to the coronavirus disease pandemic, but clinical surge support was needed to respond to this disaster. Context: Tonga’s Ministry of Health formed the Tonga Emergency Medical Assistance Team (TEMAT) in 2018 to provide clinical care and public health assistance during disasters, outbreaks and other health emergencies. TEMAT was activated for the first time in January 2022 to respond to medical and public health needs following the eruption and tsunami. Action: On 16 January 2022, a five-person TEMAT advance team was deployed to conduct initial damage assessments and provide casualty care. Subsequently, TEMAT rotations were deployed to provide clinical care and public health support across the Ha’apai island group for over 2 months. Outcome: TEMAT deployed to the islands most affected by the volcanic eruption and tsunami within 24 hours of the event, providing emergency clinical, psychosocial and public health services across four islands. TEMAT reported daily to the Ministry of Health and National Emergency Management Office, providing critical information for response decision-making. All TEMAT actions were documented, and an after-action review was conducted following the deployment. Discussion: TEMAT’s deployment in response to the 2022 volcanic eruption and tsunami highlighted the importance of national emergency medical teams that are prepared to respond to a range of emergency events.