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Te Marae Ora Newsletter - Karere Ora

Kia Orana

Secretary of Health Bob Williams. Image courtesy of

From the Secretary of Health Kia Orana te katoatoa i te aroa ranuinui ote Atua. Ko te au nuti potopoto mua teia na roto i te Karere Ora, kia kite te katoatoa i tetai au angaanga e rave ia nei e Te Marae Ora. For this first release, I have decided to focus my message in what will be our regular newsletter, on all staff, volunteers and the New Zealand Medical Assistance Team to express my congratulations and thanks to you all for your efforts in working together to keep our country and our people safe from COVID-19.

I know it has not been an easy task, it has been very demanding on you and your families, and while we have been successful to date, we also know that this ‘delta’ version of the virus is very virulent and spreads quickly, much more quickly that the original version; and we can expect other mutations to follow.

What we are dealing with is the most serious pandemic to hit our world and the human race since the influenza pandemic of 1918 – 1921, which killed millions of people around the world.

We have been fortunate so far in that firstly the mighty Pacific ocean acts as a protecting moat around our islands; but also because we have restricted entry from all countries except New Zealand, we have reaped the benefit of New Zealand’s strict border controls and managed isolation and quarantine measures.

But if you follow the news from overseas, you will know that the battle against COVID is changing, even in New Zealand.

We are fortunate in that we have the vast majority of our population aged 16 and over double vaccinated against the virus. We will be rolling out vaccines for our children aged 12 to 15 from October to December, with Pfizer vaccine once again generously provided by New Zealand.

Vaccinating that age group will further enhance our protection from the virus.

Which is just as well because the writing is on the wall, the world is beginning to open up again. New Zealand is moving that way too, there is mounting pressure to get business and commerce up and running again; and we need to be mindful that that will overflow into our economy too.

So I really appreciate the efforts that has been given so far, but I think we need to be aware that we still have much to do.

Te Atua te aroa e kia manuia.

Bob Williams

Secretary of Health

Upoko Tuatua

Cook Islands COVID-19 Vaccination - Leading the way

The success of Te Marae Ora Ministry of Health Cook Islands (TMO) COVID-19 vaccination programme - Operation Pfizer can be directly attributed to the support of the Cook Islands government; private and public sector support (volunteers); leadership by senior TMO management; astute planning and operations; and communications. By the end of Operation Pfizer 97.6% of the eligible population in the Cook Islands had been vaccinated.

Nurse Kristen Atingakau administering Pfizer vaccine at vaccination site on Rarotonga. Image courtesy of

Planning for the Cook Islands mass COVID-19 vaccination roll-out began in January 2021, with the writing of the Vaccination National Deployment and Vaccination plan by the Secretary of Health - Bob Williams and the Director of Hospital Health Services (HSS) - Dr Yin Yin May. The plan was reviewed by the World Health Organisation (WHO), Ministry of Health (MoH) New Zealand and United Nations International Children's Emergency Fund (UNICEF).

On 17 March 2021, Cabinet approved the vaccination of the Cook Islands eligible population aged from 16 years and over with Bio-Tech Pfizer vaccine.

In late March 2021, the Secretary of Health - Bob Williams and a team of six TMO staff (Dr Yin Yin May, Dr Nuhisifa Williams, Nga Manea, Rufina Tutai, Karen Ngata and Tutai Mauke) travelled to Wellington as part of a delegation led by Prime Minister Mark Brown. The purpose of the visit for the TMO team was to finalise health documents for quarantine free travel and the COVID-19 vaccination rollout. In Wellington the team worked with MoH New Zealand counterparts on documents. The team returned to the Cook Islands in mid-April and adapted what they learnt in New Zealand to the Cook Islands context.

Public information meetings were organised by TMO and commenced on 8 May 2021 – starting with Rarotonga and then moving to the Pa Enua. These information meetings were an essential part of vaccination roll-out plan as it gave the public an opportunity to be informed and to ask questions about the vaccine.

In the weeks leading up to the roll-out on the 17 May in Rarotonga; staff across TMO was deployed to the vaccination site at Rarotonga Hospital; transport to the hospital was organised from a central meeting point at Nikao for the public; and communications to the public re vaccination was stepped up.

Visibly present throughout this period in Rarotonga and in the Pa Enua was the Secretary of Health; the Minister of Health and government MPs; community leaders who would often speak with people waiting for transport at Nikao or at Rarotonga Hospital. The Minister of Health also accompanied the TMO team to the Pa Enua.

Mayor of Aitutaki Tekura Bishop having temperature checked by TMO staff Bobby Strickland at vaccination site on Aitutaki.

The Minister of Health, Honourable Vainetutai Rose Toki Brown went on to say:

I’m really pleased with the turnout of people who have come forward to be vaccinated. Doing so is not only providing a shield for yourself from serious illness or death; but also your family, friends, our vulnerable people and our country. I also want to thank everyone who came forward for acting so responsibly. I particularly want to thank our staff and volunteers, the Cook Islands Maritime Police, the New Zealand Navy, Air Rarotonga, MFEM, MFAI, Cook Islands Red Cross, the Mayors and Island Councils from the Pa Enua, Crown Law, Cook Islands Tourism and the Cook Islands Child Welfare Association. Each of these organisations and government ministries has helped Te Marae Ora carry out this massive task which places us amongst the most vaccinated nations on earth; and further reinforces our COVID-free status. In particular our thanks are also extended to the New Zealand government for allowing us access to the Pfizer vaccine.

By the end of the vaccination period TMO staff, with the help of the New Zealand Medical Assistance Team and volunteers, was able to successfully vaccinate 11,132 eligible Cook Islanders.

Tangata akarangatu

		 Ngatamariki says I am blessed to be a Nurse and praise God at all times for the continuous support, guidance, wisdom and knowledge He bestowed upon me to continue to serve HIS people.
Ngatamariki Manea Hospital Nurse Manager. Ngatamariki says I am blessed to be a Nurse and praise God at all times for the continuous support, guidance, wisdom and knowledge He bestowed upon me to continue to serve HIS people.

Ngatamariki Manea, commonly known as Nga to most, hails from the Island of Mitiaro - Mighty Arrow. Nga was the recipient of the Woman of the Month award on December 2019. On her days off Nga loves to garden, listen to Cook Islands music, spend time with her grandchildren and just relax at home. Nga has been working for TMO since 1982. Nga began as a nursing student and from there progressed steadily up the nursing management ladder. She has worked as a staff nurse – 5 years, nurse practitioner – 9 years, Midwife – 2 years, charge nurse of Outpatient and Emergency department – 14 years. Nga is currently the Hospital Nurse Manager and also the current President of the Cook Islands Nurses Association - 10 years. Nga has served the people of the Cook Islands for an amazing 39 years at TMO. Nga also played a big role in Operation Pfizer, in a leadership role alongside the Director Hospital Health Services - Dr Yin Yin May and the Secretary of Health - Bob Williams. While Nga now occupies a senior management role she believes that although she is no longer directly involved in patient care, she still makes an impact through educating and supporting her nursing staff.

Nuti Purapura

The frontline

The nursing workforce plays an essential role in the TMO COVID-19 vaccination efforts. As frontline workers the nurses not only administered the Pfizer vaccine to the population, they also continued their duties of care at Rarotonga Hospital, Tupapa Outpatient Emergency Department and Punas.

In the lead up to the vaccination roll out senior nurse managers were involved in the planning phase of the vaccination roll out. Hospital Nurse Manager Nga Manea and Public Health Charge Nurse Rufina Tutai went to Wellington New Zealand as part of a group of seven people from TMO in March 2018. There the two teams worked collaboratively to plan and write processes for quarantine free travel (QFT) and the vaccination roll.

Rebecca Brown, Mariah Kimi, June Punua, Villiama George and Ngatupuna Tauraa on vaccination site in Aitutaki.

The TMO team also visited three vaccination sites in Wellington to observe practices. The site visits were valuable as it taught the TMO team how to manage and operationalise the vaccination roll-out. The team were impressed with what they saw and confident that the TMO vaccination roll-out process planned for the Cook Islands was on track.

On their return to the Cook Islands the TMO team worked with colleagues across TMO and other public sector and private sector agencies to prepare for the QFT and vaccination roll out. Online training was held to accredit nurse vaccinators. The training enhanced the nurse’s knowledge base and skills to administer the Pfizer vaccine successfully.

TMO team (left to right Karen Ngamata, Tutai Mauke, Rufina Tutai, Dr Yin Yin May, Ngatamariki Manea and Secretary of Health Bob Williams) at Trentham Army Vaccination Centre, Wellington.

On the 17 May 2021 two events occurred concurrently – QFT and the COVID-19 vaccination rollout commenced in the Cook Islands. Over subsequent months (up until 20 August) nurses would work long hours and travel over long distances in the Pa Enua to administer the vaccine. The nurses also continued to vaccinate people in Rarotonga who had missed out the initial vaccination period.

The nursing workforce at TMO is primarily female with 78% being Cook Islanders and 22 % contract workers from other Pacific nations spread primarily across three directorates – Hospital Health Services, Primary Care and Public Health. They are a committed workforce in providing healthcare to the people of the Cook Islands.

Watch our nurses video on our YouTube channel and on our TMO Facebook page.

Pa Enua

Vaccinating the people of the Pa Enua

The success of the COVID-19 vaccination efforts was a national effort. Three of the islands in the Pa Enua Mauke, Palmerston and Nassau achieved 100% vaccination rate of the COVID 19 vaccine during the Operation Pfizer.

Tiare Immanuela, Taniela Tou, Teariki Boaza, Hiawatha Tauia and Dr Zaw Aung.

Mauke recorded 100% vaccination rate of its eligible population of 189 on the 28 June 2021 for the first dose and on 20 July 2021 for the second dose respectively.

Palmerston also achieved 100% vaccination rate of its eligible population of 18 on the 22 July for the first dose and on 20 August 2021 for the second dose.

Nassau recorded a 100% vaccination of its eligible population of 50 on the 8 July 2021 and on 5 August 2021 respectively. The vaccine for Nassau was dispatched from New Zealand arriving a day before the flights departed for Pukapuka. Te Kukupa (Police patrol boat) was deployed at least three days ahead with TMO staff to get to Pukapuka before the arrival of the vaccine and teams on the flight. The vaccine for Nassau was then dispatched to Te Kukupa for transportation to Nassau. This process was used for both vaccination deployments for the island of Nassau.

Te Kukupa Cook Islands Police Patrol boat making its way to Rakahanga. Image courtesy of Dr Zaw Aung.

Dr Yin Yin May in Rakahanga. Image courtesy of Dr Zaw Aung.

Pa Enua – Southern Group Vaccination

Pa Enua – Northern Group Vaccination

Cabinet has since approved the COVID-19 vaccination programme for youth age 12 - 15 years old in the Cook Islands. The youth will be vaccinated with the Bio-Tech Pfizer vaccine. The vaccination of 758 eligible youth, Operation Pfizer, is scheduled to start in Rarotonga in October 2021. Vaccination will commence at the Rarotonga Hospital over the course of 3 days for Rarotonga and 3 months for the rest of the Cook Islands. Information pertaining to the Pa Enua youth vaccination will be released at a later date.

Tuatua akakitekite

  • The public is advised that the opening hours for Tupapa Health Care Centre is from 8am to 4pm, Monday to Friday. For any primary health services after 4pm, please ring the Rarotonga Emergency Department on 22664 for an appointment prior to presenting to the hospital. If you feel ill and experiencing chest pains, please go directly to the Emergency Department at the Rarotonga Hospital. Do not go to the Tupapa Primary Health Care centre or the Puna clinic.

  • The public is advised that the Tutaka programme will begin at the end of November. More information will be released at a later date.

  • The Dental mobile clinic programme for the schools on Rarotonga has started which includes screening and treatment of all students. For enquiries please ring 29312.

  • A notice to the Rarotonga community that the Puna dental clinic will close due to the school dental programme and will recommence services from 4pm. For enquiries please ring 29312.

  • The School Deworming programme for 2 – 12 years old has started and TMO is requesting the parents to sign the consent forms your child brought home and return back to school. Only the children that are consented is eligible for deworming. For enquiries please ring your Public Health Nurses on 29110.

  • A Food Labelling programme will start in October looking at the required components for all pre-packed food products. For enquiries please ring Public Health on 29110.

  • The Tupapa Primary Health Care Centre would like to advise the Rarotonga community that for NCD services like medicine refills, dressings or minor health issues, please go to the Puna clinics first. The Puna will contact the Tupapa PHC centre if you need to be referred. For all high-risk NCD cases and they know who they are, go to Dr Aung at the Rarotonga hospital.

  • October is Breast Cancer awareness month and TMO is promoting Pinktober. For more information call Health Promotion on 29110.

Editor - Nuhisifa Williams, Assistant editor - Michaela Tangimetua, Columnist - Howard Tangimetua and Jaewynn McKay.

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