Speculations on medicine in the Republic of Palau *
The Republic of Palau consists of a group of small islands in the Pacific Ocean in Micronesia. Recently, some Japanese Palau Society members and I visited Palau as medical volunteers and presented medicine and a fire engine to the country as gifts. We discussed the medical conditions in Palau with its President, Kuniwo Nakamura, and the Minister of Health, Masao Ueda. This country achieved nationhood status in 1993, but is still a developing country. We considered the most important thing to be how to develop this country without destroying its beautiful environment. However, this country is lacking in medical equipment and medicine, and it needs more support from Japan. I visited the Palau National Hospital to carry out physical examinations and to treat 26 patients with respiratory diseases. Twenty-one of them were in a bronchial asthma-like status or had interstitial pneumonia. However, I could not make a definitive diagnosis because no chest CT and equipment for a pulmonary function test were available. Furthermore, usually transbronchial biopsies are not performed, and even when they are, there are no pathologists to analyze transbronchial biopsy specimens and make a diagnosis. There are 17 physicians, and approximately 150 nurses to treat a population of about 18,000 people. We think the number of physicians is sufficient, but most of them are general practitioners, so some specialists are needed. There are two hospitals in Palau, the Palau National Hospital and the Seventh-Day Adventist (SDA) Hospital, In comparison with Japan, the number of cases of leprosy, gonorrhea, hepatitis A and amoebasis is high. In this report, I have described the medical situation in the Republic of Palau, including the kinds of diseases found there, the numbers of live births, birthrates, death rates and infant mortality rates. (Accepted on March 21, 1997) Kawasaki Igakkaishi 23(1) : 51―57, 1997
