Palau's current and future capacity for disaster management.

Despite the challenges of geographic isolation, a small population and limited financial resources, the Republic of Palau has been able to significantly improve its ability to address disasters through establishing an emergency health program funded by US Federal Grants. The ability to prevent and respond to ordinary emergencies and disasters has been bolstered by creating electronic Public Health and Hospital Emergency Operations Plans, improving and creating hospital surge capacity infrastructure in all units beyond recommended minimums, initiating a database of volunteers with disaster response related skills, creating pharmacy caches, developing a national HAZAMT team, teaching critical incident stress debriefing skills, creating and expanding communications networks, improving the pre-hospital care system, conducting active disease surveillance, and improving the scope and quality of lab services. New policies and procedures are implemented and sustained through an active education system incorporating drills, exercises and didactic teaching sessions. These improvements are being made in accordance with local and international legal standards.

The Palau AHEC--academizing the public health work plan: capacity development and innovation in Micronesia.

The Palau Area Health Education Center (AHEC)--a program of the University of Hawaii's John A. Burns School of Medicine (JABSOM) and based at Palau Community College--was established in 2001 in response to the recommendations of the 1998 Institute of Medicine (IOM) report--Pacific Partnerships for Health--Charting a New Course for the 21st Century1. One of IOM's core recommendations was to promote the training of the primary health care workforce among the U.S.-Associated Pacific Islands. Since its inception in 2001, the Palau AHEC has coordinated overall 37 postgraduate and undergraduate courses in General Practice and Public Health taught by the University of Auckland Faculty of Medicine and Health Sciences and the Fiji School of Medicine's School of Public Health and Primary Care (SPH&PC) in Palau, Yap State, and the Republic of the Marshall Islands. Currently 139 physicians, nurses, health administrators, and environmental health workers are registered as active students in Palau (58), Yap State (22), and the RMI (59). Notably, the Palau AHEC and the SPH&PC have worked in an innovative partnership with the Palau Ministry of Health to operationalize the MOH's public health work plan to implement a comprehensive community health survey of all 4,376 households in Palau, interviewing 79% of the total population, to determine Palau's health indicators. To accomplish this, the SPH&PC developed and taught a curriculum for Palau physicians and public health nurses on how to design the survey, gather, and analyze data in order to develop and implement appropriately responsive intervention and treatment programs to address Palau's old and newer morbidities. In early FY2005, two other Micronesian AHECs--the Yap State and Commonwealth of the Northern Mariana Islands AHECs--were funded through JABSOM administered grants which will also address the primary care training needs of Micronesia's remote and isolated health workforce.