REPUBLIC OF PALAU â€” The small Pacific island nation of Palau is known to most Americans as a perilous jungle, full of reptiles and natural dangers, surrounded by stunning beaches and landscapes delivered on weekly network television through challenges and tribal councils in the hit television show â€œSurvivorâ€.
For Col. Jeffery Greene, a medical doctor and adolescent pediatrician at Tripler Army Medical Center, his three-month mission in Palau is about more than surviving; itâ€™s about influencing and promoting health to bring together cultures for lasting positive relationships.
â€œThe majority of the patients that I encounter are Filipinos that traditionally view physicians with high regard,â€ said Greene in correspondence. â€œAny service that I am able to provide is appreciated. They understand the role we play and pay us the utmost respect,â€ Greene added.
This is nothing new for Palau residents residing just outside Camp Katuu, where Greene serves side-by-side with military engineers and residents.
â€œThis mission has been recurring for over 30 years and has become integrated within the local culture. We are considered subject matter experts in our functional areas, and local agencies seek every opportunity to work with us, learn new skills and adopt programs to improve the current status within the community,â€ Greene explained.
As the resident â€œdoc,â€ Greene is chief medical authority on the ground, dividing his time between U.S. service members and residents who cannot afford local health care.
â€œThe engineers are tasked with various missions to improve infrastructure (plumbing, carpentry, road construction) from requests that are vetted, and if appropriately funded, approved,â€ explained Greene.
â€œAs the only medical officer, my primary duty is to the maintain health and conserve the strength of our working force. Secondarily, I provide health care to the local community, as well as assist with training to promote lifestyle modification and improve proficiency of ancillary services,â€ he added.
These ancillary services in which Greene refers to, include passing on knowledge to residents in a formal, but hands-on apprenticeship program.
â€œAn apprenticeship program offers the opportunity for local individuals to apply and work side-by-side with a specialist in an area of interest. I am even assigned an apprentice, Mr. Ulai Kinto, who is responsible for the triaging of patients and maintaining orderly flow during sick-call hours,â€ said Greene. â€œUpon graduation from the program, his training will make him more competitive for employment as a nursing assistant, beginning at a higher wage than others who have not gone through the mentorship program, but seeking similar positions.â€
Greene has even taken his work outside the camp and onto the airwaves. On a weekly basis, he provides medical tidbits on a radio program that is well received by the community. This opportunity allows him to bring comprehensive health plans like the Armyâ€™s Performance Triad (sleep, activity and nutrition) to the masses in Palau.
â€œThe primary focus of the radio show is to alert residents of identified medical trends, such as hypertension. However, the discussion of the Performance Triad on the radio has the largest listening audience, and perhaps motivates people to seek medical care, identify problems and make lifestyle modifications,â€ said Greene. â€œThen face-to-face encounters with residents, as patients can allow for motivational interviewing and promotion of behavioral change in terms of sleep, nutrition and exercise,â€ he added.
While Greene is not in favor of Palau changing over completely to American medicine, he believes military medicine can build partnerships and improve quality health care.
â€œI believe medical missions to remote locations, such as the Republic of Palau, that are continuous and sustained, have the potential to improve the quality of care rendered by local physicians and other providers, and build trust and capacity with the community and with our American team,â€ said Greene. â€œI do not think that we should take over the care, per say, but supplement what is available locally, identify health trends and offer funding to improve the health care system, one that can be trusted by the local populace.â€