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UH doctor touts improving
Micronesians’ health care


The United States can shoot a rocket from California's Vandenberg Air Force Base into a lagoon at Ebeye in the Marshall Islands, but it can't install a water system there, said Dr. Neal Palafox.

The University of Hawaii professor drew that comparison at a recent Global Health Conference at the Hawaii Convention Center, showing slides of islanders lined up to get potable water from the island's military base.

There is a public hospital but patients have to take their own linens and water, he said.

These are a few examples cited by Palafox to illustrate how the U.S. government has failed to keep its commitments to provide a health and education system in the Republic of the Marshall Islands.

Now chairman of the UH Department of Family Practice and Community Medicine, Palafox spent many years in the Marshall Islands and he's a strong advocate for improved health and education for the islanders.

He went there as a National Health Service Corps physician and co-founded a program caring for radiation-affected people. The United States set off nuclear explosions there from 1948 to 1956. Palafox also was medical director for Preventive Health Services and Public Health there from 1987 to 1992.

He gave U.S. Sen. Daniel Inouye a special report in 1995 on what he called the dismal health status of the U.S.-Associated Pacific Island jurisdictions.

He also has been involved in health issues in Compacts of Free Association negotiations between the U.S. and Republic of the Marshall Islands.

He said the compacts aren't designed by the government to meet health and education needs or provide social justice, only to provide a fixed sum of money.

Palafox described severe health conditions in the islands, with malnutrition, high rates of infectious diseases and the highest male adolescent suicide rates in the world.

It's difficult for women there to get pap smears or for the people to get preventive care or treatments taken for granted in Hawaii, he said. Thus, they come here with advanced cancer because "early stuff is not taken care of."

The whole compact for health and education in the Micronesian islands is $55 million, about the size of Wahiawa General Hospital's budget, he said.

Many islanders displaced from atolls because of the nuclear tests still haven't been able to return home, Palafox said.

"The islands are still hot and they are largely ignored by (federal) bureaucracy."

The people were asked to move "for the good of mankind," and the result has been contamination of their land and destruction of their communities and culture, Palafox said.

Many have migrated to Hawaii, "causing huge debts at hospitals," he said.

"There is a negative attitude about Micronesians in Hawaii. Doctors say they shouldn't be here but they're here for the assistance we were supposed to give them a long time ago."

After listening to Palafox, Frank Johnson, with the National Cancer Institute, said the issues "are so overwhelming" that "there is no choice but to join hands and resources."

He said a needs assessment is being done that "will allow the communities to lead us with what they want to do ... and we'll do our best to get it done."

Betty Hawks, assistant to the director of the federal Office of Minority Health, Department of Health and Human Services, said, "We are trying to leverage where we can and listen to ... the needs expressed to us."

The global conference was initiated last year after the demise of the UH School of Public Health to provide a forum for public health professionals to share information and concerns, said Pratisha Budhiraja, Hawaii Public Health Association president.


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