Geographical Locations - Palau

• (Statistical) Number of Inhabitants per Doctor:
• CIA - World Factbook: Micronesia, Federated States of

Organisations and Networks

UN and Multinational

• WHO Regional Office for the Western Pacific (WPRO) in Manila (Philippines)
  - WHO - Environmental Burden of Disease: Country Profile – Palau

Government

• Republic of Palau National Government
  - Palau Office of Planning and StatisticsRepublic of Palau State Literacy Resource Center - conducts services to the out-of-school population of the Republic of Palau. These services range from "quality of life" trainings such as making earth stoves, cooking and recipes, etc., to conducting literacy and certificate courses such as beginning English, GED, etc. .

Non-Government

Academic Institutions

National Policy and Related Documents

• Palau National Environmental Health Action Plan (NEHAP) 2004-2007
  "For many people in Palau, environmental health means sanitation that is associated with poor living conditions, outside latrines and vermin infestation. This was true many decades ago but does not apply to Palau today where our society has become urbanized, more populous, and where lifestyles have dramatically changed. While many of the infectious diseases of previous eras have been successfully addressed (i.e. polio, helminthiasisis, hair lice, vitamin A deficiency), other environmental hazards have emerged such as global climate change, air, water, and soil contamination, chemical pollutants, etc. Our Palauan society has become more populous and urbanized. In addition, Palau’s geographic proximity to Asian countries, with tourism as the main economic source of revenue, travel activities have greatly increased at border points and as a result, we are experiencing re-emergence of tuberculosis and new, emerging diseases such as SARS and other zoonotic diseases. Recently in Palau, we experienced an outbreak of a new environmentally related disease known as scrub typhus. Palau is undergoing rapid changes in its ecosystem, socio-economic development and especially the health of its population due to Capitol Relocation, Compact Road Construction and a surge of Global Urbanization. Palau needs to adequately address these emerging issues."

Reports, Guidelines, and Projects

• Economic Cost Scenarios for Solid Waste Related Pollution in Palau – draft report
  "Palau is renowned for its pristine natural environment which supports tourism, fishing and extractive industries and the lifestyles of residents. Effective solid waste management is crucial to ensuring the ongoing quality of Palau’s natural environment. This report estimates the economic cost of solid waste related pollution to Palau. It asks the question: What costs could be avoided in the absence of solid waste pollution in Palau? The result is an estimate of opportunity cost, which is the value of financial resources that could be ‘freed’ for investment elsewhere were they not being spent to manage and mitigate solid waste pollution problems." [CSIRO Sustainable Ecosystems (Australia), October 2005]
• Outbreak of dengue fever in Palau, Western Pacific: Risk factors for infection
  Between January and June 1995, an outbreak of dengue fever occurred in Palau, an island nation of 32,000 inhabitants in the Western Pacific. To determine the magnitude of this outbreak and to determine modifiable risk factors to guide control strategies, we established active surveillance at the national hospital and private clinics, reviewed available clinical records, and conducted serologic and entomologic surveys. Between January 1 and July 1, 1995, 817 case-patients with acute febrile illness with body or joint aches and one of the following: headache, rash, nausea, vomiting, or hemorrhagic manifestations presented to health facilities in Palau. The epidemic peaked in the second week of April 1995. Of 338 case-patients tested, 254 (75%) had positive serologic results by an IgM capture enzyme-linked immunosorbent assay. Dengue 4 virus was isolated from 78 (51%) of 154 serum samples tested. Blood samples collected during a cross-sectional survey were tested for IgM antibody and yielded an attack ratio of 27% (95% confidence interval = 23–31%). Potential vectors included the introduced species Aedes aegypti and Ae. albopictus, and the native species Ae. hensilli. Significant risk factors (P ≤ 0.05) for infection included age < 20 years, the presence of food or water pans for animals on the property, taro farming, the presence of Ae. aegypti on the property, and presence of Ae. scutellaris group mosquitoes (Ae. Hensilli, Ae. albopictus, and a native species). This was the first outbreak of dengue 4 virus in the Western Pacific, and the first documented epidemic of dengue in Palau since 1988. [author abstract] [Am. J. Trop. Med. Hyg., 69(2), 2003, pp. 135–140]
• Palau: Country Profile
  "SPC country profiles document the nature and extent of the organisation’s services to individual members. This country profile presents basic country facts and a synopsis of Palau's development background and a narrative summary of the Secretariat’s assistance during the period 2006-2008. Annexes include specific country activities and human resource development activities in 2008, and a financial summary of assistance during the period 2006 to 2008." [Secretariat of the Pacific Community, October 2008]
• Republic of Palau: UNGASS 2008 Country Progress Report (Reporting period: January 2006 – December 2007)
  "Since testing and surveillance were implemented in 1989, only seven persons have been identified as HIV-positive in the Republic of Palau. This has remained unchanged since the last report in 2006. Given these small numbers, we will present cumulative prevalence case data for the Republic of Palau since 1993 when the first case was detected in the following tables. All of the cases are of Pacific Islander race, so most tables and graphs will not include the race/ethnicity variable." [UNAIDS (Joint United Nations Programme on HIV/AIDS) and UNGASS (United Nations General Assembly Special Session on HIV and AIDS), January 2008]
• Scrub Typhus in the Republic of Palau, Micronesia
  In October 2001, an outbreak of febrile illness began in the southwest islands group of the Republic of Palau. Through October 2003, a total of 15 southwest islanders experienced fever >39.5°C and abdominal distress, both lasting >7days. Orientia tsutsugamushi, the agent of scrub typhus, was subsequently identified as the cause. [publication summary] [Emerging Infectious Diseases, Vol. 10, No. 10, October 2004, pp.1838-1840]
• The Effects of an Indigenous Muscarinic Drug, Betel Nut (Areca catechu), on the Symptoms of Schizophrenia: A Longitudinal Study in Palau, Micronesia
  Objective: This study tested the findings of a prior study indicating a therapeutic relationship between consumption of betel nut and symptoms of schizophrenia. Method: The subjects were 65 outpatients with diagnoses of schizophrenia or schizoaffective disorder. Symptoms rated with the Positive and Negative Syndrome Scale were compared between high- and low-consumption betel chewers in a repeated-measures design. Movement disorders were assessed with the Abnormal Involuntary Movement Scale and Simpson-Angus Rating Scale. Global health and social functioning were assessed with the Medical Outcomes Study 12-item and 36-item Short-Form Health Surveys, respectively. Results: Male high-consumption betel chewers had significantly milder positive symptoms than low-consumption chewers over 1 year. Betel chewing was not associated with global health, social functioning, or movement disorders. Betel chewing was associated with tobacco use but not with cannabis or alcohol. Conclusions: These findings have clinical significance in betel-chewing regions and broader implications for theory of muscarinic neurophysiology in schizophrenia. [author abstract] [Am J Psychiatry 2007; 164: 670–673]

Educational Resources

• CDC - Travel Information: Australia and the South Pacific
• Full Moon - The Magazine of Palau
• Palau - a site which focussed on the touristic aspects of Palau, though it also provides statistical information
• Palau Visitors Authority - governmental tourist agency providing information on history, culture, and tourism
• Remeliik's Homepage - an interesting homepage made in Palau with the best selection of links available, check it out
• Republic of Palau - information provided by the World Travel Guide; it's useful and one of the few sites that deal exclusively with Palau