(Editor's note: This is a letter from former Public Health Director James Gillan in response to the Sept. 25 editorial by The Guam Daily Post on Director Linda DeNorcey's trip to Maryland in the middle of Guam's dengue outbreak.)

I read your comments on Director DeNorcey’s absence while “a crisis” is raging. I have to take issue with this. Director DeNorcey is a very hardworking and focused person. Her quick action after the first case was confirmed is classic, textbook management. She immediately convened the DPHSS incident command group, she conferred with the governor and major stakeholders like Guam Homeland Security, Civil Defense, CDC in Atlanta, hospitals, and physicians.

The swift engagement of all these entities is the best practice. Engaging DOE and village mayors is also a very wise and practical move. With the swift declaration of an island emergency, the governor made $250,000 available.

Our partnerships with CDC provided immediate 24/7 access to CDC experts. Dr. Thane Hancock, who is an expert in the epidemiology of these diseases, has had Guam as his assignment for at least five years. This resource is priceless and Director DeNorcey has used his knowledge and real-world experience to bolster an already classic and excellent response. Attending the Association of State and Territorial Health Officials annual meeting has inestimable value. While she is there she has met with key CDC senior management, as well as the surgeon general. Several of the ASTHO alumni are now in key positions at CDC. Jerome Adams, the surgeon general, is also an ASTHO alumnus.

Director DeNorcey has built an efficient and effective response to the dengue outbreak. This collaboration is working well and now that acting Director Laurent Duenas is, there will be no loss of momentum. Ms. Duenas brings years of Public Health nursing experience to the table. The mechanisms seem to be well-organized and do not require the presence of one particular person.

It’s easy to sit up on the balcony and point out what could be done better, but when you are down on the floor working in real-time, sometimes things might get missed. I think that the quick response, the establishment of the Incident Command Center and the collaboration with key government and private groups, the use of CDC resources, and Guam’s influence with ASTHO, make the response a classic case study of how to do it right.

You take issue with the director being off island to attend the ASTHO annual meeting. You say that perhaps teleconferencing might have been a better way. I contend that Director DeNorcey, as a new member of ASTHO needs the face-to-face encounters in order to build the relationships that prove to be invaluable. My personal interaction with ASTHO brought many resources to Guam and the region. A meeting with the then-director of CDC where I made the case for the region to be more involved with Cooperative Grant Agreements resulted in the direct involvement of the Pacific Island Health Officers Association – or PIHOA which is made up of U.S. flag territories and Palau, the Federated States of Micronesia and Republic of the Marshalls – with ASTHO in these cooperative agreements. Millions of dollars have come to the region through this partnership and have had positive results. One key element has been that PIHOA has more positive standing with federal funding agencies. These partnerships are difficult, if not impossible to have without real face time with the major players.

You cannot fault Director DeNorcey for taking advantage of this opportunity to meet in person the people who have much to say about where and how federal money gets spent. The fact that the team that she has built, in response to dengue, is running so smoothly without her presence also speaks to her organizational skills, and the faith that the governor has in her abilities.


James Gillan is a resident of Barrigada and the previous director of the Guam Department of Public Health and Social Services. 

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