Lt. Cmdr. Adam Strong, an entomologist with NEPMU-6, walks across the Ebeye dump with local government officials to place a mosquito trap. (U.S. Army/Jordan Vinson)

KWAJALEIN, Marshall Islands - Stomping through layers of trash, a group of intrepid vector control specialists marched across the Ebeye dump with a mosquito trap in hand in mid-September. They swatted away small armies of flies, skirted around pungent patches of refuse and reached a small alcove green with low-lying vegetation and shade trees: a perfect breeding spot for mosquitoes.

Abon Arelong, Kwajalein Atoll Local Government’s (KALGOV) disaster response manager, and his team positioned the trap, switched its power on and made their return trip across the plateau of smelly refuse, where they boarded a pickup truck. The next stop was the Ebeye dock, another location identified by the Center for Disease Control as a prime location or mosquito breeding.

It was a hands-on training opportunity managed by Navy entomologist Lt. Cmdr. Adam Strong, part of the Honolulu-based Navy Environmental and Preventive Medicine Unit (NEPMU) 6. The Navy team came to Ebeye to work with local responders to stand up a defense against mosquitoes and other disease-carrying pests. The mission was a timely response to the recent outbreak of dengue fever on the island, which peaked in recent weeks.

Along with setting up mosquito traps, Strong and Arelong’s team conducted training on how to assemble and operate mosquito spraying equipment, how to spray for mosquitoes in these areas and how to properly don the personal protective equipment needed to do the job safely. Other training involved properly fitting respirators to vector specialists’ faces, how to dilute mosquito spray to cover the correct square footage of land for maximum impact and how to diagnose technical problems with the equipment.

The Ebeye community responded quickly to the recent dengue outbreak, Strong said, noting residents’ continual efforts to get rid of debris capable of holding standing water around their neighborhoods. Yet, the local vector specialists will keep fighting by paying close attention to the waste management facility and other areas thick with vegetation to ensure the island will continue itssuccessful rebound against the dengue virus.

The outbreak of dengue on Ebeye wasn’t the sole reason for the NEPMU-6 visit. The timing of the planned visit simply encouraged a strong emphasis on vector training, said Lt. Cmdr. Joe Moralez, a Navy environmental and industrial hygiene officer, and the team lead for NEPMU-6 in the Marshalls.

“Fortunately we’ve been able to help pick up where CDC left off. So, we’ve been able to help provide the Marshallese with training and also some spraying equipment and a solid foundation of knowledge,” he said.

The NEPMU-6 team worked with KALGOV staff, business owners and island residents throughout the community of Ebeye during the group’s nine-day mission. The training Moralez’s team provided was part of a greater Navy and inter-agency effort to completely stand up new programs on Ebeye and Majuro designed to improve and maintain water and food sanitation and medical laboratory practices, in addition to vector control.

“Every single one of these programs...are all being stood up as brand-new programs within the Marshall Islands,” said Moralez.

Equally important to the team’s vector mission was protecting the island’s water supply from contamination, Moralez said. While Strong trekked around the island in the back of pickup trucks with the local vector team, Moralez and other team members collected water samples.

They interviewed public and for-profit drinking water providers on Ebeye, interviewed staff and got close looks at what steps KALGOV and businesses take to ensure drinking water is collected and stored safely for consumption.

“One of our most important goals is to make sure that we help the people here get a clean source of water and maintain it,” Moralez said. “Sustainability is probably the key word for our mission.”

Meanwhile, in the Ebeye Hospital’s laboratory, Navy Hospital Corpsman and Lab Technician Gian Molina discussed with laboratory staff a wide array of topics, ranging from how they dispose of medical waste, how they collect blood samples, perform testing and more. He provided recommendations the staff can follow to improve their safety and that of their patients, an overarching goal being to help staff develop a standard operating procedure that will help the lab take and submit samples, and perform tests more effectively, Moralez said.

The local teams employed by KALGOV and the Navy team conducted hands-on training and worked to perfect the local programs.

“The number one thing we’re here to do is just make sure there’s guidance and support provided for the public health programs in the Marshall Islands,” said Moralez. “So, we’re here to make sure that we improve [their] knowledge.”

NEPMU-6’s efforts in support of the RMI Ministry of Health has been made easier by the individuals the team has trained and worked with on the ground. From microbiologists at the Ebeye Hospital laboratory and local disaster managers, to staff at the water plant and local businesses, everyone had been proactive and understanding of the importance of the work the team is performing, Moralez said.

“It’s a really rewarding thing for us to be able to help these folks get on their feet and put them in the right direction from day one,” he said. “And they’re very receptive. They’re really receptive and active participants, and it’s been a real joy working with them.“

Hospital Corpsman 2nd Class Michael Aberin works with Kwajalein Disaster Manager Abon Arelong, left, and an Ebeye Hospital microbiologist to perform respirator fit tests. (U.S. Army/Jordan Vinson)

Lt. Cmdr. Joe Moralez inspects a local businesses’ water filtration system. (U.S. Army/Jordan Vinson)

Lt. Cmdr. Adam Strong and Lt. Cmdr. Joe Moralez meet with an Ebeye Hospital doctor. (U.S. Army/Jordan Vinson)

Lt. Cmdr. Adam Strong demonstrates mosquito sprayer equipment use. (U.S. Army/Jordan Vinson)