The greatest mistake in the treatment of disease is that there are doctors for the body and doctors for the mind, although the two cannot be separated. - Plato

Dr. Rally Jim directs the public health operations on Pohnpei- a monumental task considering the island is dealing with a chronic disease epidemic (obesity, diabetes, hypertension) in addition to a high prevalence of communicable diseases that are virtually eliminated from developed nations (i.e. tuberculosis, Hansen’s disease, and many more). While communicable disease control is constantly improving on the island, the chronic diseases have become the silent killer. Managing these chronic diseases is not easy because there is no single treatment; they are caused largely by lifestyle choices and therefore require massive behavioral modifications which is never a simple undertaking (ask anyone that has tried a weight loss diet). Dr. Jim has a thorough understanding of the situation and some great ideas that may help Micronesia fight this epidemic. He used this analogy to describe the role his office can play in this fight:

“Health care on this island used to consist of a person falling from a cliff with an ambulance waiting for them at the bottom. Today we have put up fences to prevent people from falling from the cliff in the first place. Going forward however, we need also to push these people back, far from the edge of the cliff.”

Dr. Jim’s ideas of preventative medicine are nothing new, but the way in which he plans to implement this practice is, in what I have seen, more creative than anything we have in the States. Often people are not motivated to make significant changes to their lifestyle by the threat of bad health alone. It take something more personal, maybe even sacred, to elicit this change. Having lived on the island his entire life, Dr. Jim understands what makes the local people tick. He has already begun to use traditional healing methods (massage therapy, herbal medicine, etc.) in conjunction with modern medicine. The traditional methods provide the patients with a source of motivation- they believe in it and are passionate about it. The modern medicine provides the scientifically proven therapeutic technique. Together, the result is an effective treatment that also preserves the local culture, all with a personal touch. Something similar would clearly be much more difficult to implement in the United States because of a very heterogeneous population. But by calling on local leaders and health care professionals that live in, care about, and understand the people and places in which they practice, it is not impossible.

A personal excursion led us to the campus of a private school in Pohnpei. After meeting many of the faculty/staff of the school we came across Mona. She has committed herself to making the transition to a healthy lifestyle as easy as possible for the people of Pohnpei. As a lifelong resident of the island, she understands the importance of self-sufficiency and local resources. She invited us to stay for a dinner consisting of fresh caught fish, rice, and the native staple taro. No spam, no grease, no processing, and totally self-sustained- a stark contrast from Chuuk. She is the founder of a non-governmental organization whose goal is to promote the awareness and consumption of local foods. There are many more like her on the island.

With the efforts and ideas of public health leaders like Dr. Jim and the drive of passionate citizens who care about their own people and land, like Mona, Pohnpei appears set to battle the obesity, diabetes and hypertension epidemic that is threatening all of Micronesia.