Abstract
Video link: https://www.youtube.com/watch?v=FlJd_Mv2ApU
 Introduction: Poor oral health is a significant public health problem in Vanuatu, and in Melanesia more generally. It has a negative impact on overall health and well-being and is linked to heart disease and diabetes. Determinants of health such as poverty, poor diet, geographical remoteness, and limited oral health care are some of the contributing factors of poor oral health in Vanuatu. Vanuatu seasonal workers visit Aotearoa New Zealand annually under the Recognised Seasonal Employer (RSE) Scheme, for the purposes of fruit processing. Fruit of the Pacific (FOP), a charitable trust, has collaborated with Oral Health at Auckland University of Technology (AUT) to provide oral health care to seasonal workers since 2010. Emerging from these relationships, a community-led initiative was undertaken by returning workers to Vanuatu in collaboration with FOP involving good oral health, especially tooth-brushing.
 Method: In 2016, a small-scale study was undertaken of the perceptions of Vanuatu seasonal workers’ of oral health promotion in their community. An exploratory focus group discussion with seasonal workers and a contextual review of sources was undertaken. This paper discusses oral health in Vanuatu and presents the findings of the study.
 Results/Discussion: The seasonal workers are well aware of the poor oral health of their communities, describing important gains from community-led sharing of oral health messages, including cultural knowledge, empathy, and appropriate forms of communication. They noted that stakeholders and funders are needed on an ongoing basis to support such mechanisms. 
 Conclusion: The study presents and discusses a positive case of Pacific community leaders from migrant diaspora taking action on oral health. This can inform similar actions in Vanuatu, Melanesia, and other Pacific island communities. Further research would be valuable to explore community oral health messaging in Vanuatu and in other settings. Given the potential of the ‘digital dividend’ for greater access to the internet in future, ehealth promotion tools alongside appropriate community programming, might provide a low cost and sustainable model of Pacific oral health promotion.
Highlights
Poor oral health is a significant public health problem in Vanuatu, and in Melanesia more generally
Poor oral health is a significant problem in Vanuatu: it has a negative impact on overall health and well-being and is linked to non-communicable diseases such as heart disease and diabetes
The seasonal workers are well aware of the poor oral health of their communities; they described gains from community-led sharing of oral health messages; and they described the lack of resources and the role of stakeholders and funders in ongoing support for oral health promotion
Summary
Poor oral health is a significant public health problem in Vanuatu, and in Melanesia more generally It has a negative impact on overall health and well-being and is linked to heart disease and diabetes. It contributes to morbidity and mortality, but it can affect the ability to eat, speak, smile and socialise due to pain or social embarrassment (Underwood, Birdsall, & Kay, 2015) Determinants of health such as poverty, geographical remoteness, increased eating of processed foods, and limited health care contribute to this serious public health problem (World Health Organisation, 2007). In 2003 WHO estimated a high DMFT score of 4.4 for children under 12 years in Melanesia (which includes Vanuatu), and up to 13.9 DMFT score for adults (World Health Organisation, 2003) This decline in oral health status demonstrates the seriousness of the issue, with Melanesia among the worst affected
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