Steering the canoe forward: WHO Regional Director’s visit elevates FSM Office and health partnerships

"Our vision is clear: resilient health systems that leave no island behind,” said Dr Saia Ma’u Piukala, WHO Regional Director for the Western Pacific, during his first official visit to the Federated States of Micronesia (FSM) on 24–28 November 2025. His journey combined high-level diplomacy, cultural immersion, and firsthand experiences of the challenges faced by communities across FSM’s islands.

A warm welcome for WHO Regional Director Dr Saia Ma’u Piukala by the Government of FSM and WHO country team. All photos by WHO / Eugene Darsy.

The visit also marked a historic milestone: the elevation of WHO’s presence in FSM from a Country Liaison Office to a full multi-country WHO Representative Office, with WHO veteran Dr Roderico Ofrin introduced as the new WHO Representative for the Federated States of Micronesia, Republic of Marshall Islands, and Republic of Palau.

Dr Piukala marked a historic milestone – the elevation of WHO’s presence in FSM from a Country Liaison Office to a full WHO Representative Office.

Celebrating a milestone: WHO team with Regional Director Dr Piukala and WHO Representative Dr Ofrin at the inauguration of the newly elevated WHO Representative Office in FSM.

Strategic dialogues in Pohnpei State

In Pohnpei, one of FSM’s four states and the seat of the federal government, Dr Piukala engaged in pivotal discussions with national and state leaders:

• Governor Stevenson A. Joseph and Lt Governor Herolyn S. Movick. The conversation focused on health as an economic investment and implementing a Health in All Policies (HiAP) approach. 

• Acting Secretary of Foreign Affairs Ricky F. Cantero. Dr Piukala reinforced FSM’s global climate diplomacy with a call to put health at the center of climate advocacy and policy.

• Secretary of Health and Social Affairs Dr Marcus Samo. Priorities included accelerating action to address the enormous burden of noncommunicable diseases (NCDs), expanding digital health to better reach populations even in the most remote areas, and integrating environmental health into policy. Dr Piukala and Minister Samo – one of the most senior health ministers in the entire Western Pacific Region – also discussed operationalizing outcomes from the seventy-sixth session of the WHO Regional Committee for the Western Pacific, held in Fiji in October, where the main agenda items included strengthening climate-resilient health systems, boosting health emergency preparedness, prioritizing alcohol control policies and, not least, elevating the importance of oral health.

Dr Piukala discussed health as an investment and the importance of a Health in All Policies approach with Governor Stevenson A. Joseph and state leaders.

Dr Piukala met with Secretary of Health Marcus Samo and his team (left photo), and with Acting Secretary of Foreign Affairs Ricky F. Cantero (right photo). 

Pohnpei State Hospital visit

A key highlight was the meeting with Mr Stuart Penias, Director of Pohnpei State Hospital, and his team. Dr Piukala toured the hospital’s units, gaining insight into the challenges of delivering care across FSM’s dispersed islands. Discussions focused on:

• Strengthening primary health care – taking health to where the people are – as the most cost-effective approach to ensuring health for all.
• Improving hospital infrastructure and workforce capacity, amid concerns that the current generation of doctors, nurses and other health care providers are approaching retirement age and the country urgently needs to replenish its human resources for health.
• Exploring digital health tools to enhance service delivery.

Dr Piukala toured Pohnpei State Hospital, gaining insight into local health challenges and opportunities for strengthening primary health care.

Presidential commitment

During his meeting with President Wesley W. Simina, Dr Piukala emphasized the importance of mobilizing all sectors to improve health outcomes and integrate health into FSM’s national climate adaptation plans covering water security, resilient health infrastructure, and vector control. He also highlighted the elevation of WHO’s presence from a Country Liaison Office to a full WHO Representative Office, reaffirming WHO’s long-term commitment to FSM and its role in strengthening health systems across all states.

Dr Piukala met with President Wesley W. Simina to reinforce cross-sector collaboration and WHO’s commitment to FSM through its newly elevated Representative Office.

WHO team with President Wesley W. Simina

Feeling the journey

The visit wasn’t confined to boardrooms. Dr Piukala and Dr Ofrin visited the Madolenihmw Health Dispensary, where they met frontline health workers and observed the realities of delivering care in remote settings. This hands-on experience highlighted the importance of strengthening primary health care and ensuring services reach even the most isolated communities.

Later, the team journeyed by boat to the historic and mysterious UNESCO World Heritage Site of Nan Madol, a striking reminder of FSM’s unique geography and the long, challenging routes many residents from outer islands take to access essential services. The experience underscored the need for resilient health systems that leave no island behind.

Connecting with communities: Dr Piukala visited Madolenihmw Health Dispensary to meet frontline health workers and understand rural health realities.

From ancient ruins to modern challenges: Dr Piukala visited Nan Madol, underscoring the importance of resilient health systems for remote communities.

Chuuk: Health and education in action

Dr Piukala and his delegation continued their mission in Chuuk State, focusing on health systems and youth empowerment.

Chuuk State Hospital

Key discussions with the Director of Health Dr Bosco Buliche and team addressed follow-up on leprosy training and support for lymphatic filariasis elimination, demonstrating FSM’s determination to tackle longstanding neglected tropical diseases. Other priorities include strengthening school health programmes in light of alarming data on tobacco and alcohol use among adolescents, along with improving primary health care data systems, as well as formulating and implementing legal frameworks for anti-vaping laws and hospital renovation.

Dr Piukala with the Director of Health and team in Chuuk to discuss disease elimination, school health programmes, and strengthening primary health care.

Meeting with Governor Alexander Narruhn

The Governor, a longtime advocate for integrating health across government sectors, commended WHO’s support for NCD prevention and youth health, reiterating the state government’s emphasis on a life-cycle approach to health incorporating physical activity at all stages. 

Dr Piukula with Chuuk State Governor Alexander Narruhn

Visit to High School Nursing Programme

A highlight was getting to know the Certified Nursing Assistant (CNA) programme, re-launched under the FSM Skills and Employability Enhancement Project, and implemented at Chuuk High School. It equips promising students with health care skills and hands-on experience, paving the way for careers in nursing, thereby strengthening the local health workforce.

Empowering youth: Dr Piukala visited Chuuk High School to learn about the Certified Nursing Assistant programme preparing students for health careers.

Looking ahead

Dr Piukala’s visit reinforced a shared vision held by leaders across FSM, and indeed across the Pacific: stronger primary health care, integrated climate resilience, and empowered communities. "Our vision is clear: weaving resilient health systems that ultimately leave no island behind,” he reiterated, vowing to return to FSM at the earliest possible opportunity to visit its other two states – Yap and Kosrae – as well, and review progress being made on multiple fronts.