On an autumn day in Maine, I boarded the 74-foot ship Sunbeam and sailed from Southwest Harbor toward Great Cranberry Island for a walk-in flu clinic. The Sunbeam is the vessel for Maine Seacoast Mission’s outreach services to remote islands. Staff for the 3-day voyage included four crewmembers, a nurse, and me as visiting epidemiologist. I went to offer health education on infectious diseases and observe management for chronic health conditions.

Because it makes visits every 2–5 weeks, the Sunbeam is familiar to residents when it docks at the four islands we visited, Great Cranberry, Long, Isle Au Haut, and Matinicus. Residents quickly boarded the ship, greeted the crew, and headed for the cookie jars. The steward bakes approximately 200 cookies before each voyage, nearly enough for every island resident to have one.

Before the Sunbeam’s arrival, its nurse announced the flu clinic with signs at island post offices and through social media (e.g., Facebook). During a typical clinic visit, the nurse examines each patient to make a preliminary diagnosis and connects the patient with a physician on the mainland by using telemedicine where needed. The Sunbeam’s exam room has telemedicine access to mainland hospitals and clinics for internal medicine and behavioral health visits. The nurse helps coordinate delivery of health care supplies and residents’ prescription medications and also assists with management for chronic conditions.

Each island has a health officer with basic first-aid training and medical equipment. For major illnesses or trauma, health care on the mainland is necessary. Rough weather conditions, especially during winter, can make those >20 mile journeys rather treacherous.

On Matinicus, I joined the nurse for a home visit to an older patient with diabetes and high blood pressure who lives alone. The patient welcomed us with a request to help find a snake that the cat had dragged inside! This showed me how unpredictable providing health care to remote islanders can be.

The nurse arranges for the local health officer to visit the patient for weekly blood pressure checks and to monitor the patient’s blood sugar logbook. The patient said she appreciated the visits, but deflected questions about making regular logbook entries. The exam felt like a typical health care visit between a trusted provider and her patient, with a stunning Atlantic Ocean view from the living room window.

The Sunbeam crew invited island residents onto the ship for evening talks. On two islands, I spoke about common infectious disease conditions in Maine, namely tickborne diseases and pertussis. Residents of one island were especially interested in methicillin-resistant Staphylococcus aureus (MRSA) because local fishermen have had the infection in their hands. I covered the basics of MRSA transmission and treatment.

Seeing these remote islands and their sturdy residents made me appreciate how community members care for one another to manage chronic illnesses. It also made me recognize how vital communicable disease prevention (e.g., flu vaccinations) is for settings with limited health care options. The Sunbeam provides valuable services to people with challenges accessing health care.