The six U.S.-affiliated Pacific islands issued a statement Thursday formally asking the U.S. Department of Interior to recall the audit they said “failed to honor” appropriate standards and protocols for reviewing health care in the islands.
The Pacific Island Health Officers Association — which represents the Marshall Islands, Federated States of Micronesia, Palau, Guam, Northern Marianas and American Samoa — issued a strongly worded statement critical of a September 2008 Department of Interior Inspector General’s report titled, “Insular Area Health Care: At the Crossroads of a Total Breakdown.” The PIHOA statement was signed by CNMI Public Health Secretary Joseph Kevin Villagomez along with health leaders from the other five islands.
PIHOA said the “spirit, tone and content of this report were starkly at odds with the spirit, tone and content of the September 2008 Department of the Interior Insular Area Health Leaders Summit and further at odds with the compassionate and supportive leadership displayed during this successful meeting by then U.S. Interior Secretary Dirk Kempthorne.”
Dr. Gregory Dever, the director of clinic services at Palau Hospital, said island health officials were particularly chagrined that they did not have an opportunity to comment on the results of the Interior Department audit before final release of the report. He said this is standard practice in all governmental audits. “It was very superficial and contained many factual errors,” he said of the Interior health report.
The U.S. government provides tens of millions of dollars in grants to the health departments in the six islands.
PIHOA’s main point was that if the goal is to improve health systems, evaluations need to follow objective criteria, reference reputable data, state clearly the standards being used, allow those being evaluated the chance to review and comment on draft reports, and demonstrate a commitment to a review identifying both strengths and weaknesses.
But, said PIHOA, the Interior Department’s inspector general’s report failed to follow these requirements.
“The failure to honor the above-mentioned standards and protocols is to risk damaging rather than aiding the health system,” said PIHOA.
“The report is inconsistent with respectful diplomacy, practices and protocols which govern the relationship between sovereign nations and U.S. Flag Territories and the U.S. government.”
PIHOA formally requested the Interior Department withdraw the report and review and change its policies, standards and protocols for assessments conducted in U.S.-affiliated islands by the inspector general’s office.
PIHOA also urged Interior to partner with it and its member states to “develop, fund and implement an effective strategy for assessing the health and health systems of the U.S. Insular Areas.” As part of this strategy, PIHOA urged its many partners, including Interior, to support developing a “new report on Pacific health by the U.S. Institute of Medicine, whose last report — ‘Pacific Partnerships for Health: Charting a Course for the 21st Century’ — has served as a guiding document for Pacific health but is now more than 10 years old.”
