Island bureaucracy triumphs over charitable medical care provider; the message seems to be, “We don’t want you here”
Dr. Michael Leppert went back to school at the age of 32 to earn a medical degree in dentistry. Up until then he had been an electrical and mechanical engineer. After graduating in his late 30s, Dr. Leppert built a large, successful dental practice in Germany before selling it in 2006. “If I can do it, anyone can,” he exclaims. “Never give up!” It’s an inspiring message he delivers everywhere he goes.
But Dr. Leppert has given up on one thing – the Federated States of Micronesia.
An avid sailor, Dr. Leppert began circumnavigating the globe after retiring, but he wanted to do more than visit remote islands on his catamaran, the “Mariposa.” He outfitted his solar and wind-powered vessel to provide free dental services to people who live on isolated islands where dental care is unavailable. On board is a complete dental practice fully equipped to perform everything from routine exams and fillings to root canals, extractions, minor repairs to dentures, periodontal treatments, surgeries and medical emergencies. Surgeries have included repairing cleft palates and reconstructing rotted teeth. He has treated several thousand patients free of charge since beginning his voyage, many of whom had never seen a dentist.
in 2016 Dr. Leppert added the FSM to the list of islands he had visited over the past ten years – the Marshall Islands, New Caledonia, Fiji, New Zealand, the Mediterranean, the Canary Islands, Panama, French Polynesia, Tonga, Cook Islands, Kiribati, Vanuatu, New Caledonia, and Niue. He was welcomed with open arms and government support at each stop while also volunteering at clinics in the larger islands that he visited.
From June 2016 to May 2017, the Mariposa and its dental team traveled from Kosrae where Dr. Leppert helped at the state clinic, onward to Pingelap, Mwoakilloa and Pohnpei where he again worked for free with government approval at the state dental clinic. Continuing to the outer islands of Chuuk and Yap, he checked the teeth of all the school age children and provided tooth care demonstrations, handing out toothbrushes and toothpaste before treating them. Most required fillings. After the children were treated, the adults were next. A total of 1,500 patients were seen during the two days a week that he set aside during his stay. Every day, 40 to 50 patients are treated from early morning to late at night during his island stops. When not seeing patients, the doctor often uses his electro-mechanical engineering skills and experience captaining large ships to help with technical problems for outboard motors, boat repairs, solar installations and electrical problems.
The plan was to return to FSM’s outer islands during 2018-2019 to follow up with cases that his records showed needed additional treatment. After spending some time in Europe in mid-2017 organizing the trip with other medically equipped yachts that would provide an x-ray machine, CT and ultrasound scanners, cardiogram machine, blood laboratory and six doctors, all of whom are friends of Dr. Leppert from Europe, the US and Japan, the team prepared to make a joint tour from Kosrae to Yap to help at state clinics and supply medical assistance to the outer islands. The doctors included specialists in ophthalmology, ear nose and throat, cardiac, diabetes, gynecologists, surgeons, urologists, dermatologists, internists. Two medical technicians were to go along to help in the clinics.
Documents were researched and submitted to the authorities and the required medical licenses were applied for. But Dr. Leppert had learned during preparations for his first visit to the FSM that applying months in advance was no guarantee that his applications would be processed on time or at all. He used his email thread as evidence of his applications when he arrived in Pohnpei in 2016, but it was several more months and many inquiries before they arrived. “Most yachts have experienced these difficulties [in FSM],” he says, as posted on www.noonsite.com, a popular resource used by cruisers all over the world to report and get information on “the safety, enjoyment and security of the global cruising community.” Email sent to FSM immigration by cruisers is routinely “never found” by the authorities.
Nonetheless, for the 2018 FSM visit, arrangements were made in advance with DHL in Germany to send all the necessary equipment and materials to Pohnpei and the surrounding islands. Spare parts for the technical equipment was to be included in the shipment. Several companies offered four digital x-ray machines, two orhopantogram x-ray machines and other equipment for installation in the state clinics.
All of this changed when Dr. Leppert arrived in Yap, their first stop, on July 18, 2018.
Before sailing from Palau on July 16, Dr. Leppert informed the FSM Immigration Offices in Yap and Pohnpei via email that he was coming. “I sent all the necessary documentation for cruising and entry permits,” he explains. “For the passenger entry permit, I found a form on the FSM immigration website. However, there was no form for a cruising permit. It doesn’t exist on the FSM website.” However, he optimistically submitted the required, supporting information for a cruising permit as detailed on noonsite.com that explained that yachts entering FMS may either bring a permit with them or receive it at the first landing point. The Australian Embassy in Pohnpei assisted with the paperwork as they have in the past.
Dr. Leppert, now 70 years old, proudly displays the many letters of appreciation for his services during the time he spent in FSM during the 2016 voyage. The letters are on official letterhead and others are framed certificates. One letter is from Dr. Payne Perman, then the Acting Director of the Pohnpei Department of Health Services, stating, “His current presence in Pohnpei State visibly help (sic) alleviate the burden we have for the shortage of staff, and furthermore his contribution by bringing in his own instruments and materials to supplement what we have in the division. While he is in the clinic he take (sic) time to educate our new employed staff on different procedures and management of materials usage.” Other letters of thanks were sent to Dr. Leppert by Martina Reichhardt, Director of the Yap Department of Health Services, as well as mayors, teachers and health assistants in the islands that he visited. A proclamation of “sincere gratitude” was issued by the Satawan Municipal Council.
There was no reason to expect that the Mariposa’s arrival back in Yap would be met by any less than a warm welcome and the customary flower leis for their necks and nunus placed on their heads.
On July 18, prior to his arrival in Yap, the national government authorities sent an email saying they had sent Dr. Leppert the permit the night before and had forwarded it to Pohnpei for approval. The email thanked him for his patience and stated, “Unfortunately, your vessel permit is still in process at IMHQ [Immigration and Labor]. Please bear with us, for we also are awaiting response from IMHQ.” He was puzzled since he had never received the permit form and had not found it on the official website before leaving Palau despite having sent the required documentation. In the meantime, however, friends of the doctor in the US finally found a link to the form which he filled out with the same information that he had submitted already and forwarded it to the Yap authorities. He assumed they had received what they needed due to the email informing him that it was in process.
Attempting to push it along, Dr. Leppert also wrote to the Yap Transportation authorities and IMHQ noting that the Australian Embassy, “[which makes] all of my paperwork for my arrival and dental work for me,” spoke with IMHQ in Pohnpei and confirmed that all the necessary information for vessel entry clearance had been sent July 15. They referred to the clearance provided for the Mariposa’s prior visit in 2016-2017 and followed up by sending the required information to IMHQ again. Dr. Leppert asked IMHQ to send the clearance form to Yap based FSM immigration to ensure that it arrived.
Upon reaching Yap on July 18 at 3 p.m. the boat was given a place to dock and “the customs, bio- security and port authorities came aboard.” Everyone, he reports, was “very professional and friendly.”
He told the authorities that it was his understanding that he could obtain a cruising permit upon arrival. He also made note of the 2016 EU/FSM short-stay visa waiver agreement that allows a 90-day stay in any 180-day period for citizens of the European Union. The agreement is aimed at increasing people-to-people contacts, tourism and business links, according to the EU.
Then FSM immigration showed up and asked for Dr. Leppert’s cruising permit.
After explaining the situation again, his passport was stamped for three months and a fine of $1,000 was suddenly added for illegal entry into FSM by the FSM Immigration. The EU/FSM waiver agreement “seemed to be of little interest to Ricky Falcam, the head of the FSM immigration in Pohnpei,” Dr. Leppert notes. Dr. Leppert did not want to sign the illegal entry document but was told it was only a form that they needed and in three to five days all would be okay, and they would bring the entry form to fill out. Dr. Leppert signed the document based on this assurance but did not pay the fine.
“On the following day,” Dr. Leppert continued, “due to the fact that I did not pay this fine, my passport entry permit was stamped invalid, on order of a senior officer from [the] Pohnpei-based Immigration Office by the name of Dickson David who decided to arrest us for three days.” Dr. Leppert says he was not a stranger to David who knew him from his 2016 visit to the country when he treated “over 900 people” in Chuuk and Yap alone “for free” as well as several hundred more in the other two states.
A letter handed to Dr. Leppert dated July 20 and labeled “Citation Result” was signed by Robert Yinmed, Acting Officer of the FSM immigration in Yap. It states, “I am providing this communication to inform you that the result of the citation that was issued to you on July 18, 2018 has been withdrawn due to the fact that there were (sic) enough evidence presented during the hearing in terms of communications from you to our main office that you did in fact attempted (sic) to contact our main office for clearance to enter the State of Yap FSM.” The letter continues, “With the citation being withdrawn, I must advise you that you are hereby to fill out a vessel entry permit application at the earliest time possible and send it to our main office for final review and possible approval. In the meantime, you are hereby instructed not to conduct any business in the State of Yap until your permit is approved. Rests (sic) assured that this office will monitor your movement from time to time until the permit is approved by our main office. Furthermore, you must understand that we have laws that are in place and being enforced here in our country for undesirable aliens that underestimates (sic) the supreme laws of our land so please respect our laws and make sure you abide to what is required out of you during your stay here in Yap. You must also keep in mind that you must secure an entry clearance before entering any FSM ports in the future.”
When Dr. Leppert informed Yinmed that the permit was nowhere to be found on the official website and there is nothing about it being required prior to entry, Yinmed replied that it was the law and not his problem.
Dr. Leppert was then informed that he would receive the cruising permit to fill out that afternoon or, it being Friday, on Monday.
Later that same afternoon, an officer came aboard and asked for a new copy of the Dr. Leppert’s and his crew’s passports. A short time later, the officer reappeared and said he needed a better copy in color. Even though they had been sent before, Dr. Leppert re-sent them. Then the officer appeared again and told Dr. Leppert that he and his crew and staff were to go to the office with him with their passports and the “blue entry paper.” Upon arrival at the immigration office, the officer from Pohnpei and four local officers were in attendance and “told me they have to invalidate the stamp of arrival for FSM in our passports.” They were all to be confined to the ship and not allowed ashore. They were, he says, “prisoners on our yacht.”
The FSM Immigration officer also informed Dr. Leppert, “I need an invitation from the clinic or an official organization and a new dental license from FSM.” Otherwise, they would not get the vessel permit and a new stamp in their passports.
Dr. Leppert’s dental license had not yet arrived despite being ordered through the Australian Embassy several weeks before. He had been informed that it required the signature of Dr. Kennedy Remit, chairman of FSM Health Services, who knew Dr. Leppert well from his 2016 visit. But Dr. Remit was on holiday on his home island with no internet access and there was no acting chairman.
On the permit, Dr. Leppert wrote “dental work” as the purpose of entry. But he told the authorities that he also intended to spend time as a tourist since the 2018 Micro Games were going on and they would like to go ashore purely as visitors. He explained that his dental unit was in Germany for repair, “so I cannot work [until it arrives] and wanted to make a holiday here, enjoying the lovely Micronesian people here in Yap during the festivities.” As a tourist, it was not necessary to have an invitation from anyone.
The FSM Immigration officer replied that it was too late for that. Falcam had given him his order. Dr. Leppert and his crew were to be confined to the boat and not allowed to go ashore for any reason.
Several days later, an interrogation was conducted by Dickson David that “made us feel like criminals in a novel. He asked irrelevant questions like where did I get the money for my ship and the yearly donations for materials; what was I earning as a dentist; what savings did I have, etc.”
Then Yinmed suddenly arrived at the boat on July 28th and asked Dr. Leppert what he would do “if pirates came on board, what weapons I would use and how many of those I had on board. After I told him that we don’t have weapons on board, he kept asking more and more questions before finally departing.”
The next day, “the gatekeeper from the harbor came and asked whether I had a weapon for sale since I should have many. Twenty minutes later, another person came and asked whether I had drugs for sale, shortly after that another person came and asked whether I had cigarettes and alcohol for sale.”
Dr. Leppert was alarmed and, for his safety, informed the Australian embassy.
While in Yap, Dr. Leppert met with some of the chiefs and teachers from the outer islands with whom he had been in contact previously. “They were all very happy about my return,” he said. “The same impression was expressed to us from the Yap State Clinic and Yap State Protocol.” But the following day, after Yinmed’s interrogation, “I cleared out without a cruising permit after both immigration officers from Yap, Robert Yinmed, and the senior officer from Pohnpei, Dickson David, told me several times that I should get out of Yap and no one there wanted my help.”
In addition to the harassment experienced by Dr. Leppert, there are other challenges for cruisers to Yap that are counter not just to medical professionals, but tourists interested in visiting the state. To visit Yap’s outer islands for more than a month requires a return to the main island within four weeks in order to extend the stay for another month. Permission is given for one month entry at a time. This is counter to the EU/FSM visa-free agreement that states that a boat can travel for three months within all of FSM, including Yap. According to Dr. Leppert, “Falcam’s ruling means if you want to visit Lamotrek/Satawal (Yap) as well as Puluwat (Chuuk) which is 130 nautical miles distance, on a tack west to east always against the wind, it means you keep tacking against the wind, three times the distance for a total of 5,600nm, the distance from New Zealand to Alaska.”
Reports of similar harassment and unreasonable behavior by FSM immigration authorities abound. One Canadian couple with a baby reported to Dr. Leppert that they requested a brief stop to purchase milk and medicine but were denied entry by Pohnpei immigration. Increased tourism is a country-wide goal and mandate that is severely limited by authorities who do everything possible to turn cruisers away. Online posts warning other cruisers to stay away increases the damage to FSM’s reputation even more.
Dr. Leppert concludes that “sailors within the FSM immigration are treated like fishing vessels but with even more arrogance and problems. In all countries in the Caribbean, Pacific and Europe, if you need a cruising permit, it is applied for after arrival on the spot in a very short time on the same day. FSM is the only exception.” He added, “The arrogant manner of the FSM Immigration senior office in Pohnpei, Dickson David, clearly indicated a national/state conflict with his macho style in the presence of his colleagues staffing the FSM Immigration Office.”
“With enthusiasm and pleasure, Dickson David told in the presence of an officer from FSM immigration based in Chuuk (who appeared to agree with him) that Chuuk immigration made real problems for travelers/sailors checking in and out. It seems like a contest among them to see which has the worst record,” Dr. Leppert notes. “He smiled and told me if I went to Chuuk my experience would be much worse than Yap and perhaps they should copy what Chuuk immigration does. Indeed, most publications do report on criminal problems in Chuuk and this makes FSM unattractive for travelers and yachts.”
“I planned to sail across the outer islands of Pohnpei, and to stay a bit longer to take care of the teeth of all of the people there. I ordered enough hi-tech filling material from Germany to do 2,800 fillings. “Now,” he said, “I have had to send the materials that are worth $5,000 back to Germany as they have a limited expiration date.” He estimates the total value of the sponsored equipment and materials is $150,000 not including the value of the team’s time and ship maintenance.
“In over 50 countries that I have visited in my many years, I have never been received or treated as I was in Yap by Robert Yinmed and Dickson David. They told me it is prohibited for me to give any medical aid to anybody without the personal permission of David and Ricky Falcam, until I have the dental permit and their personal go-ahead for a work permit. Of course, I agree, and always apply for my license because without it I would have no insurance. [But] In no country in the world do I need a working license.”
Dr. Leppert’s colleagues from Japan, the US and Europe who have medically equipped yachts have told him they will not come to FSM since they fear landing in jail. They intend to issue travel warnings to doctors who consider providing humanitarian medical services in the country. “In Europe and the US, you will find articles about this topic. Yachts are not welcome in the FSM due to the FSM immigration mistreatment,” he says.
When the Mariposa left Yap to sail back to Palau, emergency calls for a police boat were heard by Dr. Leppert and his team as they passed by the island of Ngulu 80nm south of Yap. Having sworn a medical oath in Germany to help in emergencies, their first inclination was to answer the call and check to see if it was a medical emergency. However, “it was not a call to all ships so I did not answer as it could also have been a setup to arrest me again,” he said. Dr. Leppert continued sailing onward never to return to FSM, vowing in writing to officials in both the FSM National and Yap State Government offices, including Governor Tony Ganngiyan, that he “will go to countries where I am welcome.”
In reviewing this matter with other cabinet members of the Yap State Government and the Governor, Francis Itimai, Director of the Department of Youth and Civic Affairs who oversees the state’s public information office and the Division of Media and Protocol, expressed his colleagues’ concern by saying, “this treatment by the FSM Department of Justice, Division of Immigration is not novel. The same treatment was shown by DOJ staff and officials who took the tugboat, MV Ocean Support, and its crew into custody” during the same period of time when it arrived in Yap from the Philippines to deliver catering supplies and equipment for the 2018 Micro Games.
As the spokesperson for the Yap government, Itimai stated emphatically that “corrective measures must be undertaken by the National Government to correct these attitudes and treatment toward people like Dr. Leppert, who go out of their way to help the FSM not only by giving us free medical services, but are also our development partners.“
The Governor, in an email to his staff, wrote, “Dr. Leppert must be thanked tremendously for his valuable assistance and constructive help” to everyone who works in government services “and in so many different beneficial ways.” In line with the Governor’s concern, the other officials noted, “As we all know, we have not only seen and heard of many examples of this sort of ill treatment, but we are victims, too, who wonder why we do not accomplish much in our nation-building efforts. How can we expect our development and donor partners’ willingness to seriously assist us when they receive this kind of treatment? The State Government,” they continued, “expresses its utmost appreciation and gratitude to Dr., Leppert for all his assistance and would like to request his future assistance.” The State Government, they promised, will work with Dr. Leppert directly to provide clearance from the National Government upon his return to Yap. “The State Government expresses its sincere apologies to Dr. Leppert for this ill treatment even though it was not caused by the State,” they wrote.
The Governor and his staff are awaiting a reply from Dr. Leppert and from the FSM DOJ and immigration authorities.