Earlier this year, our team embarked on a transformative journey to Chuuk, a remote island in the Federated States of Micronesia. Partnering with SS&A, an architectural and engineering firm from Montgomery, AL, we aimed to design a replacement hospital that would serve the local community’s needs. As the commissioning agent, our role was to ensure the new facility would be sustainable, safe, and well-maintained.  

  

Preparation and Planning 

Preparing for this trip was no small feat. SSR has robust international travel requirements, which included getting vaccines, stocking up on medicine, and packing special filtered water bottles and safety masks. From a technical perspective, we brought testing equipment and a 360 camera to document the hospital floor plan. We also reviewed previous studies and tropical HVAC guidelines to understand the unique needs of the climate. 

  

The Journey 

Our journey began on a Wednesday, with a flight to Tokyo. After spending two days acclimating to the time difference, we traveled to Guam and finally arrived in Chuuk early Sunday. The island’s relaxed pace, often referred to as “island time,” was immediately apparent. We met with the SS&A team in Guam to discuss plans for the week and set expectations for our site visit. 

  

First Impressions and Site Visit 

On Monday, we visited Chuuk State Hospital. The facility, built in the 1970s and renovated in 2008, was in a state of disrepair. Much of the day on Monday was spent familiarizing ourselves with the facility and doing a general walk through. The rest of the week was spent looking at the mechanical, electrical, and plumbing systems and equipment in detail, documenting general and MEP conditions throughout the hospital and looking closely at each piece of electrical or mechanical equipment to see if it could be reused or what fixes may need to be made.  Issues ranged from exposed electrical wiring to mold and insect infestations. The campus was disconnected, with squatters occupying patient care areas. Despite these challenges, the local staff were dedicated and task-oriented, though their roles were very specialized, which sometimes led to misunderstandings. 

  

Challenges and Findings 

Our investigation revealed that a total replacement of the facility was necessary. The lack of accurate building plans made renovation impractical. We found numerous safety issues, including exposed electrical wiring, improperly operating air handling units due to maintenance knowledge, leaking roofs, and a lack of proper labeling for equipment and wires, among other issues. The existing facility’s condition underscored the need for a new, sustainable hospital that could meet the community’s needs. 

  

Recommendations  

One of the key takeaways from our assessment of the current hospital was there’s much opportunity for improvement. Some suggestions we offered included limiting parts that can fail, including the Chuukese people in construction process to teach and train them for maintenance; and locate electrical receptacles and panels away from water sources. We strongly feel that training will go a long way to ensure the adequate maintenance of a new facility, the facility staff seem to take full ownership of tasks when they have an assigned person to specific systems or equipment. 

  

Cultural Insights 

One of the most striking aspects of our trip was experiencing the local culture. The concept of “island time” permeated daily life, from meals to meetings. The local diet was also unique, with minimal fresh fruits and vegetables available. Most meals were stewed or fried, reflecting the limited availability of fresh produce. 

  

Next Steps 

Following our visit, a design charrette was held to determine the hospital’s future direction. The project will soon move into the schematic design phase, with a 35% set expected by the end of the year. Our commissioning team will continue to be involved in design reviews and, if the project proceeds to construction, will provide construction phase commissioning services with more on-site visits. 

  

Conclusion 

Our trip to Chuuk was an eye-opening experience. It highlighted the challenges and rewards of working in a remote, resource-limited setting. Despite the difficulties, we are committed to helping create a hospital that will serve the Chuuk community for years to come. This journey reinforced the importance of adaptability, cultural sensitivity, and the drive to make a positive impact, no matter where our work takes us.