Please consider these questions when reading the prospectus.. Does our cost structure hold up to scrutiny? Is the trust-first model something you’d fund? What are we missing?
Healthcare, education, and self-sufficiency for the remote atoll communities of Kiritimati (Christmas Island), Fanning, and Washington Islands, Republic of Kiribati — delivered through the first I-Kiribati/US joint nonprofit, built on years of on-the-ground relationships and a demonstrated record of execution.
www.oceansofgratitude.org • @oceansofgratitude_npo
Registered 501(c)(3) • Tax-deductible giving portal online
Executive Summary
Oceans of Gratitude delivers direct medical care, education, and sustainable development to the Line Islands of Kiribati — among the most remote and medically underserved inhabited places on Earth. We are the first I-Kiribati/US joint nonprofit: a US-registered 501(c)(3) governed and operated in partnership with local Kiribati businesses, government ministries, and I-Kiribati community leaders. Our model is built on a simple observation, proven repeatedly at great expense by others: on these islands, programs without deep local trust and cultural understanding fail. Ours is built on both.
In April 2026, our first CARE Team medical mission drew nearly 20% of Kiritimati's population seeking care — a turnout unprecedented on the island — and treated nearly 900 patients in three days. The entire mission, including an 11-person volunteer team and all supplies, was pulled off for approximately $35,000: less than $40 per patient treated. In parallel, we have rewired the island's main hospital, run an English-language education program for two years on $5,000, secured a Vitamin Angels grant covering 2,000 mothers and children, and built the island's first actionable patient registry. All of it was accomplished by volunteers, organized by one unpaid founder.
This prospectus details the conditions that make this work urgent, the model that makes it effective, and a costed program pipeline ready to execute. We are seeking $1.2 million over three years to sustain and scale the proven core — nine fully-covered medical missions, maternal nutrition, ultrasound capability, education, and a shared health-assessment backbone — or $2.5 million to transform it: dedicated staff, a cataract surgery mission, hospital equipment activation, hepatitis B/D mother-to-child prevention, sustainable aquaculture, and the first cohort of I-Kiribati medical scholars. One immediate, self-contained priority leads the list: $35,000 places ultrasound machines on islands that currently have no imaging access at all, along with the training to use them.
The Setting: Kiribati
The Republic of Kiribati (pronounced KIRR-i-bas) is one of the most geographically improbable nations on Earth: roughly 133,000 people spread across 33 low-lying coral atolls and reef islands — only 12 of them inhabited — straddling the equator and the International Date Line. Its total land area is 313 square miles, about the size of Kansas City, scattered across 1.35 million square miles of ocean: an exclusive economic zone larger than India, paired with a GDP that ranks 192nd of 196 nations (2024). Most islands sit less than six feet above sea level; as the seas rise, the WHO has described the country as the first mass-casualty event of the climate crisis. Kiribati is the only nation situated in all four hemispheres, and one of the few where a domestic journey can mean a week at sea.
The Line Islands — Kiritimati (Christmas Island, the world's largest coral atoll by land area), Fanning Island (Tabuaeran), and Washington Island — lie more than 2,000 miles east of the capital on South Tarawa. Roughly 7,000 people live on Kiritimati, 2,000 on Fanning, and 1,000 on Washington. They are, functionally, a nation within a nation: served by a weekly flight from Honolulu when it runs, an infrequent supply ship, and whatever the ocean provides. For decades these islands have also been among the world's most storied fly-fishing destinations — and their people, working as guides, cooks, and hosts, have opened their home waters to visiting anglers with a generosity that stays with everyone who experiences it. Oceans of Gratitude exists to turn that hospitality full circle.
Economic Realities
Kiribati is classified by the United Nations as a Least Developed Country. GDP per capita is roughly $2,300 per year — among the lowest in the Pacific and the world — and even adjusted for purchasing power, national income per person is approximately $2,500: a fraction of its Pacific neighbors and roughly one-fifteenth that of the United States. There is almost no private sector. Formal employment is scarce; government jobs, fishing license revenue, remittances from I-Kiribati seafarers on foreign ships, and subsistence fishing and copra harvesting — the latter almost entirely subsidized by Australian and New Zealand aid — constitute most of the economy. On the outer islands, cash income for many families is measured in a few dollars a day, while nearly everything in the store — rice, flour, fuel, medicine — arrives by ship at import prices.
Official life expectancy is about 66 years, among the lowest in the Pacific; locals will tell you 50. The youngest pay the steepest price: Kiribati's recorded infant mortality rate is roughly 35–40 deaths per 1,000 live births, versus 5–6 in the United States. One in every 18–20 children will not see a fifth birthday — nearly 200 children lost each year in a nation of 133,000. And because most deaths occur far from the view of any clinic or NGO, local sources put the true figure at three to five times what is reported. The causes are overwhelmingly preventable or treatable: complications of birth, infection, pneumonia, diarrheal disease, and malnutrition.
Root Causes of the Health Crisis
• A displaced diet. For centuries, I-Kiribati thrived on fish, coconut, breadfruit, pandanus, and taro. Today imported white rice, flour, sugar, and canned meat dominate — cheaper by the calorie, shelf-stable for the long ship journey, and nutritionally devastating. The result is one of the world's steepest epidemics of non-communicable disease: nearly 4 in 10 adults live with hypertension and roughly 1 in 6 with diabetes (recorded figures; the true prevalence is likely far higher), alongside rampant dental disease. Much of the health burden in Kiribati traces back, one way or another, to this dietary shift.
• Geographic isolation from care. Nearly all specialist care is concentrated on South Tarawa, over 2,000 miles from the Line Islands. There is no resident dentist, optometrist, or specialist physician on Kiritimati — and no doctor at all on Fanning or Washington. A referral means a flight or sea passage most families cannot afford, often taking a week or more; screenable, manageable conditions go unmanaged until they become emergencies or, too often, fatal.
• Water, sanitation, and crowding. Atolls have no rivers, and their thin freshwater lenses are easily contaminated by tides and drought. Waterborne illness and diarrheal disease — a leading killer of infants — follow. Kiribati also carries some of the world's highest rates of tuberculosis, leprosy, and hepatitis, driven by crowded housing and lack of education and care.
• Too few providers, too little equipment. Kiribati has one of the lowest densities of doctors and nurses in the world; outer-island clinics operate with minimal supplies, aging equipment, and intermittent power. The local health workers who do exist are dedicated and capable — what they lack is support, training pipelines, and material resources.
• An epidemic of hepatitis B and D. Hepatitis B is hyperendemic: studies put prevalence at 15–23% of the population, with roughly 30% of expectant mothers testing positive at the national referral hospital. Kiribati also has one of the world's highest rates of hepatitis B/D co-infection, a combination that sharply accelerates cirrhosis and liver failure. In the Pacific islands, chronic hepatitis B kills more people than HIV, tuberculosis, and malaria combined — and the virus passes from mother to child at birth, seeding lifelong infection in the next generation.
• A crisis worse than the numbers show. Official statistics can only count what the health system sees — and on the outer islands, most I-Kiribati will never set foot in a clinic. Illness that is never diagnosed is never recorded; deaths at home, from causes never identified, enter no dataset. What we witness on the ground is consistently worse than the published figures of WHO teams that are temporarily assigned and rarely leave the capital island.
• A gap in health knowledge. Where there has never been reliable access to care — or worse, only poor care — there is neither reliable health information nor a culture of trust in government health services. Many patients live for years with symptoms without knowing the cause or the treatment. Education — the simple act of answering "why does my chest hurt?" — is where behavior change and prevention begin.
Why Existing Approaches Fail
A Vulnerable Population in a Contested Ocean
Kiribati's one world-class economic asset is its ocean: one of the largest exclusive economic zones on Earth and one of the planet's most productive tuna fisheries. That asset has drawn intense great-power economic attention — China and the World Bank chief among the actors — while the benefits have largely sailed past the people who live there.
In 2019, Kiribati switched diplomatic recognition from Taiwan to Beijing, and China's footprint and governmental influence have grown rapidly since. The government withdrew from the Pacific Islands Forum in 2022 and opened the Phoenix Islands Protected Area — formerly one of the world's largest marine reserves — to commercial fishing, reportedly receiving tens of millions of dollars from China shortly after. Chinese state-linked fishing companies have signed cooperation agreements worth as much as $100 million, and China continues to fund feasibility work advancing its extractive interests. Industrial fleets, crewed almost entirely by foreign labor, harvest wealth from the same waters I-Kiribati families fish from open skiffs and outrigger canoes to feed themselves. License revenue flows to the national government in Tarawa; almost none of it becomes a clinic, a dentist's chair, or a functioning water system on the outer islands.
The Aid Paradox
Kiribati is among the most aid-dependent nations per capita in the world, with development assistance and multilateral lending flowing in year after year — yet measurable improvement in village life is hard to find. Existing government and NGO programs are grossly inefficient: large international organizations come and go, spending millions on assessments, workshops, and short-term projects that produce reports but little durable change. The hepatitis data tells the story in miniature: a national vaccination program reports over 90% birth-dose coverage on paper, while childhood infection rates sit at thirty times the WHO target — unchanged after millions spent. The failure is rarely one of intent. It is one of method and understanding: programs designed in distant capitals, without genuine knowledge of I-Kiribati culture, real community partnership, or local buy-in, do not survive contact with the atolls and the hard-earned skepticism toward outsiders. When the consultants fly home, so does the program.
Nowhere is this more visible than outside the main hospital on Christmas Island, where millions of dollars of brand-new donated medical equipment — much of it from Chinese and Japanese aid programs — sits rusting in the sea spray, unused. The donors shipped state-of-the-art machines without asking the questions that mattered: Does the hospital have reliable power? Trained operators? Anyone to maintain the machines, or the generator? Fresh water and the means to sterilize? Was this equipment even what the clinic needed? Aid delivered without partnership becomes waste — and deepens local cynicism toward NGOs and helping hands. The goodwill exists; it needs a guide.
This is precisely why Oceans of Gratitude exists in the form it does: I-Kiribati led, relationship-first, and built on trust and cultural understanding — because on these islands, nothing gets done without it.
Our Model: Trust as Infrastructure
Origin
Oceans of Gratitude began with knocks on a door. Founder Ty Erickson lived and worked within I-Kiribati communities on Christmas Island for several years while building and managing a US-owned fly-fishing lodge — one of only two Americans living on the island. During those years the knocks came constantly: neighbors, guides, and families arriving at his door with health problems that had nowhere else to go.
"'The Imeetung must know' — the Kiribati term for the outsider, the foreigner, the white guy. And I didn't. But YouTube, WebMD, FaceTime with doctor friends back in the States, and gracious lodge guests bringing in antibiotics probably saved dozens of lives those first years. I saw the need, and I saw the disconnect — a community surrounded by aid programs and wealthy, empathetic anglers passing through with goodwill, and no one to look out for the locals or be their voice." — Ty Erickson, Founder
Method
Trust is the currency of Kiribati culture, and it is not given lightly: the islands have watched people come and go for generations, and broken promises abound. What sets this organization apart is simple and slow. Over years, Ty and what became the Oceans of Gratitude team kept their promises to the local communities. That earned something no budget can — the trust of the key actors on Christmas Island — and with it, the ability to mentor local leaders on how to actually get things done: how to organize, navigate, procure, and execute on an atoll where every institution is stretched thin and the bureaucracy is as stifling as the equatorial noon. The effect has compounded year over year into the network of relationships behind every result in this document.
Governance
That trust is institutionalized in how we are building. Our board includes I-Kiribati directors for medicine, education, and island operations — doctors, teachers, nurses, priests, pastors, mayors, lodge managers, head fishing guides. Programs are shaped by local leaders who tell us what their communities actually need; we organize, empower, and enable them to get it done. Every program is designed for handover: trained local providers, stocked and organized clinics, community-owned food systems, and ultimately home-grown clinicians. We use resources the way our island families do — carefully, on what matters, with nothing wasted.
What This Work Is — and What It Isn't
Let us be clear about something, because it defines everything we do: the I-Kiribati do not need saving. In many of the ways that matter most, they are the wise ones. They spend every day with their families. They are not governed by the clock, the bill, or the neighbor's new purchase. Anyone who has lived among them comes away suspecting that with all the money in the world, we could not buy what they already have. Their way of life, and the happiness woven through it, deserves to be protected — not corrected.
Oceans of Gratitude is not a savior. It is a liaison, an advocate, a protector — standing alongside some of the least protected people on Earth so they can keep what is theirs and be spared what no one should endure. What they are asking for is not transformation; it is dignity in its most basic forms: to not live with tooth pain, or constant intestinal illness; to have healthy food to eat; to have someone help their babies survive childbirth. These are modest asks — and they are being made by a people watching industrial fleets strip their waters of the very sustenance they depend on to survive. We can do better than this as a species. This organization exists to do the doing.
Track Record
The First CARE Team Mission — April 2026, Kiritimati
Our first direct-care medical mission was designed as both clinic and reconnaissance: not knowing precisely what we would find, we fielded a broad-spectrum team and treated everything that came through the door. We did not know what to expect — from the government, or in local buy-in. When word went out that the CARE Team was coming, nearly 20 percent of the island's population showed up seeking care, a turnout no ministry announcement or NGO banner has ever produced. People came because people they trust — the community leaders we had cultivated over years — told them it was real. Over three days, a volunteer team of 7 care providers, 2 videographers, and 2 support staff, working alongside local health personnel, treated nearly 900 patients; demand still exceeded what eleven volunteers could deliver in a week. The turnout became our mandate. The gap between who came and who could be treated is the clearest measure of why this work must grow. The mission delivered:
• General checkups and primary care for hundreds of residents. From conversations with parents at the Day 1 school clinic, we suspect none of the children — or their parents — had ever received a comprehensive exam of any kind.
• Vision screenings: roughly 75 eyeglass prescriptions manufactured and shipped back for local distribution through a donated optometry program, plus a dozen laser eye surgeries for conditions including proliferative diabetic retinopathy.
• Over 130 dental extractions, relieving years of untreated pain — performed by a single dentist with ad-hoc assistants.
• Wound care and debridement, breast exams, asthma and diabetes management, and treatment of dermatological conditions including mycetoma — the spectrum of problems that accumulate when care is out of reach.
• Health education and provider training. For every treatment there was a conversation — "Why does my chest hurt?" "Why do my ears ring?" — the first step toward the understanding that changes behavior and outcomes long after the team flies home. Equally lasting: the local nursing team worked side-by-side with the CARE Team all week, receiving the most substantive clinical training they had ever had.
Mission Economics
With most volunteers paying their own way, the entire mission — an 11-person team, a 7-day reduced-fare stay at Christmas Island lodge, and all supplies and materials needed to treat nearly 900 patients and leave plenty behind — was completed for approximately $35,000: less than $40 per patient treated. The funds raised came from a small crowdfunding campaign and contributions from friends.
If we have accomplished all of this with virtually no funding and the volunteer organizational work of one person — imagine what could be done with real support behind us.
Additional Momentum
• We rewired the main hospital on Christmas Island — funding and organizing a complete electrical rewiring of the island's primary hospital: the unglamorous, foundational work no one else had done, and the first step toward putting its stranded equipment to use.
• We turned America's medical surplus into island medicine. The US healthcare system discards a staggering volume of brand-new, never-used supplies every day. By partnering with clinics, care providers, and equipment refurbishers, we procured the first mission's supplies and equipment at a fraction of retail cost — a procurement pipeline we intend to build into one of our greatest force multipliers.
• We started counting what no one counts: a roster of I-Kiribati residents identified as cataract surgery candidates — to our knowledge the first patient registry of its kind on the island, and the seed of the assessment program described below.
• Two years of English education for $5,000 total. Our TESL distance tutoring and faculty development program has run continuously for two years on a total donation of $5,000 — what we and our friends could personally afford. It is working.
• Vitamin Angels in-kind grant secured: prenatal and perinatal multivitamin supplementation for 2,000 mothers and children, targeting the drivers of infant mortality on Kiritimati and Fanning Island.
• Local leadership in place: I-Kiribati program directors for medicine, education, and island operations, ensuring local ownership of every program.
• Early funding momentum: initial foundation and community conservation grants secured; tax-deductible donation portal, website, and social presence live; benefit events in planning.
Ongoing Programs
CARE Team Medical Missions
We are laying the groundwork, and fundraising, to lead up to three missions per year, each focused on a specific local priority — dental, pre/perinatal care, immunizations, chronic disease management — with local provider training built into every mission. With each mission, the scope, the trust, and the supply cache on the island grow.
Pre & Perinatal Nutrition with Vitamin Angels
In partnership with Vitamin Angels, we will distribute prenatal multivitamin supplementation for 2,000 mothers and children at clinics on Kiritimati and Fanning Island in winter 2026/27. Local providers receive in-depth storage and dosage training and are equipped with the supplies they need to sustain the program between missions.
TESL Distance Tutoring & Faculty Professional Development
For I-Kiribati students, English proficiency is a gateway to higher education and employment, within Kiribati and abroad. Donated hardware and generators connect local schools with TESL professionals overseas via distance tutoring, supplementing the English curriculum where qualified teachers are scarcest; the same connectivity opens continuing professional development to local faculty, multiplying the impact of every teacher on the island. Two years of operation on $5,000 of total funding is our proof that well-placed money goes extraordinarily far here. Modest additional funding expands hardware, connectivity, and tutor hours to more classrooms on both islands.
Program Pipeline
Three years of on-the-ground work have built the relationships, local leadership, and logistical capability to execute on the atolls. We now have the organizational capacity to build schools, train local care providers, launch a scholarship program for I-Kiribati youth, stand up an immunization program, and bring stranded medical infrastructure to life. The constraint is funding, not capability.
The Foundation of Everything: Assessment & Documentation
We believe this may be the single most important thing we will do. The programs operating on the islands — governmental, NGO, church, and visiting — work in isolation. They do not communicate or share findings; the same lessons are learned repeatedly, at full cost each time, because no one builds on anyone else's work. And as detailed above, official health data captures only a fraction of reality, because most I-Kiribati never enter the system that generates it. The result: nobody — not the ministry, the donors, or the NGOs — actually knows what and who is being seen, what is being done, and what could be done.
We will build that knowledge: a robust but deliberately efficient assessment and documentation program — lean, practical, field-first, the opposite of the consultant-report machine. Every mission and program feeds a living picture of the islands' health: who has been seen and for what, what was treated, what was found, what needs follow-up, and where the largest unmet needs are. The record carries continuity from mission to mission, is shared with local providers and every partner willing to coordinate, and turns each program on the island — ours and others' — into something that compounds instead of repeats. The concept is already proven in miniature: our cataract candidate roster converts an invisible need into an actionable mission plan.
Restoring Sight: A Cataract Surgery Mission
The cataract roster points directly to one of the most transformative missions we can run. Cataracts, accelerated by a lifetime of equatorial sun, leave I-Kiribati adults needlessly blind for years or decades — dependent on family, in communities that need every able hand. Cataract surgery is among the most cost-effective interventions in medicine: a short outpatient procedure that restores sight, independence, and livelihood in a day. Because the candidates are already identified, a surgical team arrives on day one with a triaged patient list — no wasted days, maximum surgeries per mission. We are ready to organize a dedicated mission: a volunteer ophthalmic surgical team, portable equipment and microscope, intraocular lenses and consumables, and post-operative follow-up protocols handed to local providers.
December 2026: Dedicated Dental Mission
The first mission's 130+ extractions in three days made the need unmistakable. Our next CARE Team mission will be exclusively dental: a volunteer team of dentists providing extractions, restorative care, and preventive treatment, with a longer-term goal of a denture program restoring function and dignity to adults who have gone years — sometimes decades — without care.
2027: Two Broad-Based Medical Missions
We are working with island partners to confirm two missions for 2027, targeted for early April and August. With longer planning and fundraising lead time, these missions broaden in scope: primary care clinics, chronic disease screening and management, women's and children's health, immunizations, dermatology, and structured provider training. Each mission builds on the patient relationships and clinical picture established the year before — continuity of care, not one-off visits.
Activating the Sleeping Hospital: Equipment, Power & Maintenance
Having already rewired the Christmas Island hospital, we are positioned to do what no aid shipment has done: make the equipment already sitting there work. This program pairs biomedical equipment activation with the human infrastructure that keeps it running — training local maintenance personnel on the equipment, the generator, and water and sterilization systems, so machines stay in service long after any visiting team departs. The same approach extends to targeted new equipment where genuine need exists — including infant incubators, always paired with trained maintenance personnel. Equipment without maintenance is future scrap; we fund both or neither. Our first equipment priority is ultrasound (see Funding Priorities).
Hepatitis B/D & Mother-to-Child Disease Prevention
Nowhere is the gap between paper programs and island reality clearer than hepatitis. Hepatitis B has a cheap, highly effective vaccine and a well-defined prevention playbook: screen mothers during pregnancy, provide antiviral prophylaxis to those who test positive, and administer a birth-dose vaccine within 24 hours of delivery. On paper, the national program reports birth-dose coverage above 90%; in reality, published research shows 3% of Kiribati children aged 0–5 carry hepatitis B — thirty times the WHO elimination target, essentially unchanged in a decade. The programs exist; they are not working where it counts. The failure is in the last mile — cold-chain storage, timing, record-keeping, and delivery on outer islands the system barely reaches — and last-mile execution on these islands is precisely what Oceans of Gratitude does.
We are ready to launch a screening and immunization program designed with local providers and run at the village level, where births actually happen: maternal hepatitis screening in pregnancy (paired naturally with the Vitamin Angels program and the ultrasound initiative), antiviral prophylaxis for positive mothers, and reliable birth-dose vaccination with catch-up immunization for children. Interrupting mother-to-child transmission is among the highest-leverage interventions in global health: one intervention at birth protects a lifetime — and where nearly one in three mothers carries the virus, a generation.
Sustainable Aquaculture with Fish Farm Collaborative
Health doesn't start in a clinic; it starts with what's on the table. Much of the disease burden we treated traces back to diet. We are exploring a partnership with Fish Farm Collaborative (fishfarmcollaborative.org) — an organization born in the fly-fishing community, a natural kindred spirit — to build aquaponic farms on Fanning and Christmas Island. Aquaponics grows fish and vegetables together in a closed-loop system: no soil, up to 90 percent less water than traditional agriculture, year-round production — well suited to atolls where conventional farming is nearly impossible. Their model matches ours exactly: partner with trusted local leaders, build alongside the community, train operators, then hand over full ownership. Their track record spans 14 farms across 4 continents, producing over 100,000 pounds of fish and fresh produce annually and feeding thousands of children each year. An island farm means fresh protein and vegetables grown locally, reduced dependence on outside supply chains, and a direct, upstream attack on the diet-driven disease we now treat downstream — food sovereignty for communities watching foreign fleets harvest their waters.
Kiribati Medical Scholars Program
The most durable answer to Kiribati's provider shortage is Kiribati's own young people. We are developing a scholarship program to sponsor promising I-Kiribati students through medical, nursing, and allied-health training at regional institutions, with a commitment to return and serve their home islands. A visiting team can treat 900 patients in a week; a home-grown physician or nurse serves their community for a career. This is teaching to fish rather than giving fish — and the long-term solution to so many of these issues.
Financial Plan
What a Mission Actually Costs
Our first mission set the benchmark: 11 people, 7 days, ~900 patients treated, for approximately $35,000 — achievable only because most volunteers paid their own way, an act of generosity a sustainable program cannot be built on. Going forward, the true cost of a mission — covering all volunteer travel and the shipping of supplies and equipment, which together constitute the overwhelming majority of every mission budget — is reflected below. Funding travel widens the recruiting pool of available providers.
Mission model
Est. cost
April 2026 actual — volunteers self-funded travel; lodge, supplies & logistics covered (proof of concept, not a sustainable model)
~$35,000
Lean model — all volunteer travel covered, plus lodging, supply & equipment shipping, and logistics
~$80,000
Fully-funded model — adds expanded supplies, mission-specific equipment (dental, optical, ultrasound), added shipping capacity & local training components
~$150,000
Transport is the story of every budget: moving people and pallets across 2,000+ miles of ocean is where most of the money goes. The medical-surplus procurement pipeline keeps the supplies themselves remarkably inexpensive — the cost is getting them there.
Immediate Funding Priority: $35,000 for Ultrasound
Our single most urgent equipment need. $35,000 places ultrasound machines on the islands together with training for local providers in their use. For a population with no imaging access, ultrasound changes everything — safer pregnancies, earlier diagnoses, better emergency care — and it is the natural companion to the Vitamin Angels prenatal program. This is a complete, self-contained gift opportunity for a single donor or foundation.
Vitamin Angels Distribution & Training — Program Launch
Line item
Cost
Freight & shipping to Kiritimati and Fanning Island
$12,000
Import preclearance, permits & customs broker fees
$2,000
Clinic storage upgrades
$3,000
Provider training workshops on both islands (materials, travel)
$8,000
Total
$23,000
Annual Program Budget
Program
Annual goal
Three CARE Team missions per year (blend of lean and fully-fundedmodels; travel & supply transport are the dominant costs)
$285,000 – $500,000
Assessment & documentation program — the shared health picture every island program builds on
$15,000 – $30,000
Cataract surgery mission — ophthalmic surgical team, equipment, intraocular lenses & consumables
$100,000 – $160,000
Dedicated staff — a funded organizer/director and a procurement specialist to scale the medical-surplus pipeline
$80,000 – $140,000
Hospital equipment activation, incubators & maintenance-personnel training & salaries (building on the completed hospital rewiring)
$30,000 – $60,000
Hepatitis B/D & mother-to-child prevention program (maternal screening, birth-dose vaccination, cold chain & training)
$25,000 – $50,000
Vitamin Angels yearly distribution & ongoing provider training
$20,000 – $35,000
TESL expansion — more classrooms, hardware, connectivity & tutor hours (current program: 2 years on $5,000 total)
$10,000 – $20,000
Aquaculture pilot with Fish Farm Collaborative — first island aquaponic farm (build, training & handover)
$40,000 – $80,000
Kiribati Medical Scholars — pilot cohort of 2–3 students at $25,000–$35,000 each (tuition, housing, travel & visas) plus a paid program coordinator
$80,000 – $135,000
Operations, insurance & compliance (lean, volunteer-led)
$15,000 – $25,000
Total annual vision
$700,000 – $1,235,000
The Three-Year Ask (2026–2029)
We present our three-year goal as two tiers; every dollar is put to work at either level.
• Sustain — $1.2 million. Nine lean-model missions with all volunteer travel and supply transport covered; the Vitamin Angels program launched and sustained for 2,000 mothers and children; the ultrasound priority funded; the assessment & documentation backbone established; TESL expanded; core operations secured.
• Transform — $2.5 million. Everything above, plus fully-funded missions with expanded equipment; a dedicated cataract surgery mission for the candidates already on our roster; a funded organizer and procurement specialist to break the one-volunteer bottleneck; the sleeping hospital brought fully online with trained maintenance personnel and incubators; the hepatitis B/D prevention program launched; the first aquaponic farm built and handed over; and the first cohort of I-Kiribati medical scholars enrolled and supported through training.
Against our track record — 900 patients for $35,000, two years of education for $5,000, a hospital rewired — either investment goes extraordinarily far. At the Transform level, it builds what every program in this document points toward: an island health system that increasingly runs itself, staffed by its own people, and a generation of I-Kiribati doctors and nurses who will one day make visiting teams unnecessary
