KukiMAT: Ready to respond when every minute counts

For the Cook Islands, emergencies do not always happen close to the capital. A cyclone, disease outbreak, or emergency can affect communities in the Pa Enua (outer islands), separated by hundreds of kilometres of ocean. When that happens, having the capacity to quickly deploy trained personnel, equipment, and supplies to provide an initial clinical response is essential.

That is why the Cook Islands Medical Assistance Team (KukiMAT), the emergency medical team arm of Te Marae Ora (TMO) – Cook Islands Ministry of Health, has been steadily building its readiness to respond. Made up of doctors, nurses, public health professionals and support personnel, the team is preparing to be able to rapidly deploy wherever help is needed, whether in Rarotonga, the Pa Enua, and one day perhaps beyond the country’s shores.

In Rarotonga, we met with Dr Deacon Teapa, Medical Specialist and Director of Hospital Health Services at TMO. He explained how important it was to build the capacity of their team to be able to respond to disasters and emergencies. He acknowledged the support of the World Health Organization (WHO) and other partners including the New Zealand Medical Assistance Team (NZMAT).

“WHO has been a great partner in developing and establishing KukiMAT here in the Cook Islands. They provided training to our staff and personnel,” he said. WHO has also provided the KukiMAT’s emergency medical team (EMT) cache, a pre-positioned collection of equipment, medical supplies and deployment gear designed to support rapid emergency response operations whenever KukiMAT is called upon.

^{Dr Deacon Teapa checks on their EMT cache in Rarotonga, Cook Islands. Photo: WHO / Nancy Wong}

Since its establishment in 2019, KukiMAT members have participated in multiple training programmes covering EMT operations, logistics, communications, deployment procedures, emergency coordination, and field readiness. Exercises have included practical deployment scenarios, cache familiarization, flight safety training, outbreak response, and simulation exercises designed to test how the team would perform during real emergencies.

In 2024, for example, the team participated in a week-long training programme and simulation exercise involving deployment to the outer island of Mauke. The exercise tested the team’s operating procedures, deployment cycle, leadership, coordination, and logistics, while also strengthening implementation of the Cook Islands’ National Pandemic Preparedness Plan.

^{Members of KukiMAT and WHO training facilitators board a plane on the way to Mauka for a simulation exercise. Photo: WHO/Lepaitai Blanche Hansell}

Training and preparedness activities have continued this year, including work to strengthen deployment readiness through roster development, equipment maintenance, emergency planning, cache management and ongoing exercises. The team has also added new equipment to its cache as readiness efforts continue.

The team recently put that readiness into practice during the Pacific Heads of Health (PHOH) Meeting held in Rarotonga, where KukiMAT members deployed to provide medical support throughout the regional gathering. KukiMAT’s PHOH deployment is an example of how emergency medical teams can provide clinical support not only during disaster and outbreak response, but also at large-scale events and mass gatherings where medical preparedness remains essential.

“The KukiMAT team has been deployed to the Pacific Head of Health Meeting here in the Cook Islands over the last three days. And we did use some of our gears. It was sponsored and provided by WHO, so that’s been of tremendous help,” said Dr Teapa.

The deployment followed another KukiMAT training supported by WHO facilitators and trainers, continuing the team’s journey towards verification as a Type 1 Mobile National Emergency Medical Team in the coming years.

“It’s very important that we have trained medical personnel that can react and respond in a timely manner because life and death is within a matter of minutes,” Dr Deacon explained.

“The hope for KukiMAT in the future is that we continue to train our personnel and also attain the ability for our team to respond to other countries if we are called upon, such as the other Pacific Island countries,” he added.

In a region where countries often rely on one another during times of crisis, this aspiration is grounded in Pacific solidarity: building a team capable of helping not only their own communities, but their neighbours as well.

“It is inspiring to see the commitment of the KukiMAT team. KukiMAT members are health professionals who already have demanding day jobs, yet they continue to dedicate their time to training, exercises and preparedness because they want to be ready when their communities need them most,” said Dr Wendy Snowdon, WHO Representative to Samoa, American Samoa, Cook Islands, Niue and Tokelau. “Over the years, we have seen KukiMAT grow from an idea into a team that is increasingly putting its skills into practice. WHO is proud to support that journey, and we look forward to seeing the team continue to develop and contribute not only to the Cook Islands, but to the wider Pacific.”