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Nov 22

Health fair helps connect COFA Islanders to care

Posted on November 22, 2019 at 8:50 AM by Kari Bray

The COFA Islander Health Fair was set to start at 11 a.m. on November 2.

By 9 a.m., guests had started arriving. Volunteers were still setting up tables and donning vests – insurance navigators in yellow, translators in green, Medical Reserve Corps in blue, Snohomish Health District staff in purple.

More guests arrived over the next couple of hours. The fair officially kicked off with a welcome and prayer in Marshallese. The Marshall Islands are part of the Compact of Free Association, often abbreviated as COFA.

COFA Islander Health Fair on November 2, 2019Throughout the day, about 70 families received help enrolling in health insurance, 11 women were screened for breast cancer, and 84 people had their cholesterol and glucose levels checked. Volunteer dental professionals screened 37 people, and more than 30 of them went on to one of two dental vans for cleaning, extractions or fillings. Public health nurses from the Health District also provided tuberculosis testing.

Wintha Joran is a U.S. Army veteran and part of the local Marshallese community. He estimates that he talked to more than 200 people that day. Having interpreters was key, he said.

“A lot of people don’t know what’s going on. They don’t have insurance. They don’t know if they qualify or not,” Joran said. “I’ve seen a lot of people with illness like cancer or they’re diabetic, but there is a lack of communication. There is a language barrier.”

The health fair was a way to overcome barriers and connect people with insurance options that are newly available as of last year.

COFA Islander Health Fair on November 2, 2019In 2018, the Washington State Legislature passed a bill so that the Washington Health Care Authority will cover premium and out-of-pocket expenses for COFA islanders who enroll in a qualified plan through the Health Benefit Exchange.

Washington has the second largest population of Kosraeans (from the Federated States of Micronesia) and third largest population of Marshallese and Palauans in the U.S., according to the 2010 census.

The U.S. signed the Compact of Free Association in 1986. Under the agreement, people from the Republic of the Marshall Islands, Republic of Palau, and the Federated States of Micronesia (Pohnpei, Chuuk, Kosrae, and Yap) may live, work and study in the U.S. without a visa or green card. However, after reform in the 1990s, they didn’t qualify for Medicaid or similar programs. While other immigrants may qualify after a waiting period, there was no such option for COFA islanders.

Meanwhile, the population has high rates of cancer and other complications related to nuclear testing conducted by the U.S. from 1946 to 1958.

During those 12 years on the islands, the U.S. detonated the equivalent of 7,200 bombs the size of the one dropped on Hiroshima, Japan during World War II.

The testing exposed islanders to radiation and contaminated the fish and other natural food sources. Today’s medical complications include cancers linked to radiation and diabetes aggravated by the need for imported, processed foods.

Last year, the Health District held its first Marshallese Health Fair to help people enroll in the new COFA Islander Health Care.

COFA Islander Health Fair on November 2, 2019This year, the fair expanded to emphasize inclusion of all COFA islanders. The event was held at Everett Community College, who donated the space. Washington State Employees Credit Union, Coordinated Care, United Health Care, Latinos Promoting Good Health, Community Health Plan of Washington, and Molina Healthcare also sponsored the event. Dental services were provided by Arcora and Healthy Smiles Northwest.

Sharon Sussman volunteered at the event as a translator in Yapese, the language spoken on the island of Yap (part of Micronesia). She had hoped to see more Yapese there.

“I think it’s great that there’s a lot of Marshallese here, but people from my island are not very involved this year,” she said. “I think it’s important to get the word out. The amount of people who actually need it and aren’t here, that makes it matter more.”

She knows firsthand how families can get caught in the middle, unable to afford private insurance and unsure how to navigate COFA Islander Health Care.

“A lot of people don’t really know the details,” she said. “I think education is the biggest thing, and having options.”

She plans to do more outreach in the Yapese community before next year’s health fair, she said.

Planning for that fair has started.

COFA Islander Health Fair on November 2, 2019“Part of the mission of public health is to address equity in our communities,” said Katie Curtis, assistant director of prevention services for the Snohomish Health District. “COFA Islanders have a unique set of challenges and we have been able to address some of those through our COFA Islander Health Fair. One of the biggest successes we have had is the engagement with community leaders. We are beginning to build relationships that will benefit the community and public health in the years to come.”

To learn more about COFA Islander Health Care, visit


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