Palau

Palau is the westernmost cluster of the Caroline Islands in the central Pacific Ocean. When the U.S. Trust Territory formed at the end of World War II was coming to an end, Palau elected not to become part of the new Federated States of Micronesia, declaring its independence in 1978 and emerging from trusteeship in the early 1990s. Palau, sometimes called Belau, is comprised of more than 300 islands in 6 island groups, but has a total land area of just 458 square kilometers. The average temperature is 82 degrees Fahrenheit, the average humidity is 82 percent, and rainfall is about 150 inches a year.

The population is 25,600 and growing at a rate of 1.31 percent annually. Unusual for a small island nation, it is actually gaining more residents than losing, with a net migration rate of 1.85 per 1,000. With a stable government and an economy based on tourism, subsistence agriculture and fishing, Palauans enjoy one of the highest standards of living in the Pacific Island region.

Life expectancy is 67 years for males and 73 years for females, with healthy life expectancy at 59 years for men and 61 years for women. Child mortality is 10 deaths per 1,000 for infants under 1 years old and 11 deaths per 1,000 for children aged 1 to 5. Childhood immunization is almost universal. There were no reported maternal deaths in childbirth between 1990 and 2005, and 100 percent of births are monitored by trained attendants. The fertility rate is 2.46 births per woman, despite the fact that only 17 percent of women report using modern birth control methods.

The leading causes of morbidity in Palau in the 2004 reporting year were injuries (including motor vehicle accidents, suicides, and homicides), upper respiratory viruses, ear infections, gastroenteritis and digestive disorders, and tonsillitis. Major causes of mortality were cardiovascular disease, circulatory disorders, injury, and cancer.

About 85 percent of Palauans have access to clean drinking water, and 80 percent have sanitary facilities. Solid waste disposal is a problem on some islands. There are relatively few infectious diseases affecting island residents: for example, in 2004, there were 57 cases of dengue fever, six cases of leprosy, and five cases of hepatitis. Although gonorrhea and tuberculosis are present in the population, there are no knownHIV/AIDS cases.

Per capita government expenditures are $607. As with most island nations, delivering healthcare to a population spread across hundreds of square miles of open ocean can be a challenge. Palau relies on U.S. government funding in the development of new services and facilities. There is one general hospital in Koror, which was recently expanded to accommodate more patients. Medical personnel within the country includes 25 doctors, 111 nurses, 87 nursing aids, and 13 technicians. Most trained professionals are imported from other countries and therefore expensive; there are no medical schools on the islands, although a nursing program is being established at Palau Community College.