Health Screening Ship to Remote Islands in Palau

With just 18,000 residents, it is no surprise that the remote island nation of Palau faces a chronic shortage of skilled health care workers. There are insufficient numbers of doctors in the country—especially specialists—to treat all of the patients who need care, and there are not enough Palauan nurses to staff the country’s only hospital. Foreign health care workers from the Philippines, Fiji, and other countries help fill some gaps, and periodic medical missions sent by the US military, Taiwanese hospitals, and international NGOs offer specialized treatments one or two weeks a year when they are in the country. But the healthcare worker shortage persists and has a high human cost.

I was delighted to witness how Peace Winds is helping ameliorate the shortage when visiting Palau last week. Peace Winds is currently dispatching three medical professionals from Japan on long-term assignments to work in Belau National Hospital and support the health care system. A senior emergency room physician, Dr. Michiaki Hata, arrived in Palau this week to help fill the hospital’s gap in surgeons, as well as to mentor young doctors. Kaori Murai, a registered nurse, also recently returned to Palau for another six-month stint after previously serving in the hospital’s understaffed surgery ward.

Meanwhile, Peace Winds’ Koji Hamano, the first radiology technician based in Palau, is in his second year of service at the hospital. The hospital had received donated MRI and CT Scan machines, but was unable to use them widely because there was nobody with sufficient training in the country. Since arriving in Palau, Hamano has drastically expanded the use of imaging and provided hands-on training for other hospital staff, significantly improving diagnostics and patient care.

Palau President Surangel Whipps Jr. lauded these contributions in a May 14 meeting at his office, and he encouraged Peace Winds to explore ways of expanding the long-term dispatch of medical professionals. One way to do this would be to regularly rotate an increased number of doctors and other health care workers from Japan, the United States and other countries through Palau for one- or two-year terms, pairing younger professionals with experienced clinicians who can ensure a high standard of care.

While in Palau, I also saw how these health care workers are contributing outside of Belau National Hospital. Kaori Murai has been working with other Peace Winds colleagues and the Ministry of Health and Human Services Noncommunicable Diseases (NCD) Unit to sponsor NCD screenings around the country. NCDs like diabetes and hypertension account for more than 80 percent of deaths and two-thirds of all hospital spending, so NCD prevention and treatment is a top national priority.

On May 14, the team held a half-day NCD screening event in rural Ngaraard State, which provided testing and counseling for 21 residents—representing nearly one-tenth of the households in the state. It was facilitated by Ngaraard Governor Sharp Sakuma, who stayed through the entire event to welcome residents and also to undergo his own screening. He explained that initiatives like this are critical not just to get people into treatment, but also to raise awareness about healthy eating and exercise habits among others so they can avoid developing these conditions. And, ultimately, limiting the number of people who develop severe diabetes and hypertension reduces pressure on the healthcare workforce, helping alleviate the impact of the labor shortfall in another way.

-Jim Gannon, CEO, Peace Winds America

Peace Winds recently began a new health program that will strengthen detection, treatment, and prevention for non-communicable diseases (NCDs) in Palau. The small Pacific island nation has a high prevalence of NCDs, like diabetes, hypertension, and heart disease. A shortage of healthcare workers and facilities makes it difficult to detect, treat, and prevent them. So Peace Winds’ new project builds on our existing work to implement routine health screenings, raise awareness about NCDs, and support healthier lifestyles.

For the last three years, Peace Winds has been working closely with Palau’s Ministry of Health and Human Services, as well as national and local leaders, to strengthen the country’s healthcare systems. This includes organizing routine screenings for Palauans who do not have access to regular care. Our Kensing II health ship even helps us reach the remote Southwest Islands–these take one full day to reach by boat and have very limited healthcare resources.

Now, Peace Winds is collaborating with Palauan government officials to design a sustainable system so that they can keep health screenings running. This will help ensure that NCD detection continues in the long-term. 

Furthermore, patients who have been diagnosed with NCDs often face barriers to continued treatment and care. One challenge is the severe shortage of doctors, nurses, and other medical personnel in Palau. To help address this, Peace Winds is expanding training opportunities for community health supporters. These are nursing students and other local residents who receive training on how to follow up with patients after diagnosis, helping them get the care they need.

Finally, to support healthy lifestyles, the new program aims to make fruits and vegetables more accessible for Palauans. 

“People say they want to have healthy food, but there aren’t that many opportunities to eat it,” said Amma Nobumichi, the Palau Country Representative, in an interview last year. “It’s very expensive.”

So Peace Winds is piloting a community gardening initiative in three states. Local experts in agriculture will help elementary and secondary students, state government staff, and other residents learn to cultivate vegetables at several small gardens. When the vegetables are ready for harvest, they will be used to cook healthy, delicious dishes for children and adults at community harvest events. Students get to be involved in the cooking, too; the program also introduces food science and nutrition classes in the schools.

Later, gardens will be expanded into “model farms.” Training will be available to more residents who want to learn about home gardening, helping to keep healthy eating within reach.

We’re looking forward to bringing updates from Palau as we work to make healthcare stronger and more accessible for everyone. This program is made possible by funding from Japan’s Ministry of Foreign Affairs, as well as contributions from supporters like you. Your donations will help us continue to meet critical needs for communities in Palau.