Journal Staff
In a move to enhance healthcare services, Palau and the Philippines have signed a memorandum of understanding to collaborate on medical programs, training, and digital health initiatives. Presidents Surangel S. Whipps Jr. and Ferdinand Marcos Jr. of the Philippines witnessed the signing on Feb. 24.
The MOU includes medical outreach programs in Palau by the Philippine medical team, capacity building, and professional development such as training, fellowships, education, and hospital visits. It also includes enhancing Palau’s electronic and digital health systems, the exchange of best practices, and other initiatives.
Palau’s healthcare system consists of the Belau National Hospital, 10 public community health centers across the archipelago, and five private clinics, including a dental clinic. Two of the nation’s oldest private clinics, owned by Dr. Victor Yano, a general practitioner and former minister of health, and Dr. Emais Roberts, a surgeon, provide residents with alternatives to the national hospital.
Partnerships with the Philippines, Taiwan, the U.S., Australia, Japan, and other allied nations have helped improve medical care for Palau’s 18,000 residents. Private clinics and international partnerships have facilitated grants, equipment, technical support, and other resources to strengthen Palau’s healthcare infrastructure.
Yano’s Belau Medical Clinic was one of the first private clinics in Palau.
The doctor is a strong proponent of healthy living as a means of preventing illness. As chairman of Palau’s Healthcare Fund Governing Board, he has raised concerns about the rising rates of non-communicable diseases in Palau. Government statistics indicate that 80% of deaths in Palau are NCD-related, compared to the global average of 63%.
As a general practitioner, Yano treats patients for a range of conditions, from colds and flu to cancer. “We continue to encourage people to live healthy lives,” he said. This includes exercising, eating healthier traditional foods, and avoiding processed foods — a challenge in Palau, where imported canned foods are common. He noted that similar challenges exist worldwide in motivating people to adopt healthier lifestyles and seek preventive care.
Yano collaborates with community organizations to promote healthier living. He is involved in programs like “The Hive,” where a group of professionals intent of promoting health and fitness provide free community workouts, including bodyweight exercises and yoga.
The Hive and similar programs receive funding from NCD grants administered by the Palau Ministry of Health and Social Services. The grants support community outreach initiatives that promote healthy lifestyles. They also help ensure that activities such as 5K runs, Zumba classes, and other fitness events organized by nonprofits and community groups remain free to the public. Traditional Palauan lifestyles once promoted fitness through farming and fishing, but modern sedentary work environments and processed food consumption have led to declining health outcomes.
Roberts emphasized the importance of preventive care. As a surgeon, he performs procedures on new hemodialysis patients to create the vascular access needed for dialysis. “There are way too many of those,” he said, referring to the high number of dialysis patients.
Roberts, currently serving his second term as governor of Peleliu, highlighted the logistical challenges of providing medical care across Palau’s dispersed islands. Many residents live one to two hours away by boat from Koror, where the national hospital and most clinics are located. The Ministry of Health operates 10 community health centers throughout Palau, but a shortage of doctors and nurses means these centers often function more as pharmacies than full-service clinics.
Roberts advocates for staffing each clinic with a doctor and a nurse, particularly in remote areas such as Peleliu, Angaur, the Southwest Islands, and Kayangel. He also stressed the need for well-staffed clinics in the northern regions of Babeldaob. “Right now, many people living that far away won’t see a doctor until their toes can’t move, and by then it’s too late,” he said.
Palau’s medical clinics and one dental clinic collectively employ more than 20 doctors and nurses. The government aims to attract more medical professionals, whether on a rotational basis or through telemedicine, via partnerships with the Philippines, Taiwan, Australia, Japan, the U.S., and other nations.
With international assistance, Palau has begun infrastructure improvements at Belau National Hospital. Built in 1993 with funding from the U.S. Department of the Interior, the hospital serves the nation’s 18,000 residents. The $7 million Infrastructure Rehabilitation Project includes repairs, renovations, and equipment replacements. These upgrades, along with continued efforts to recruit healthcare professionals, are expected to address short- and mid-term healthcare needs.
Efforts are also underway to improve Palau’s cancer care services with support from Guam Cancer Care. In 2024, Palauan officials signed an MOU with Guam Cancer Care to make cancer treatment more affordable for patients. Cancer is among the top three causes of death in Palau.
Last fall, the government announced plans to conduct a feasibility study to identify potential sites for a new hospital. The current location of Belau National Hospital is vulnerable to storm tides, and patients have been evacuated to higher ground multiple times in recent years. Rising sea levels and increasingly severe storms have heightened concerns about the hospital’s safety. The feasibility study, funded by a $2.37 million grant from the U.S. Trade and Development Agency, will assess suitable locations for a more resilient healthcare facility. mbj