Rural Medical Libraries: Yap Updates its Medical Library through Intra-national Help

Posted by Allison S. Bybee

Concluding this blog’s mini-series on the U.S. Associated Pacific Islands, we will be examining how one island in the Federated States of Micronesia has re-shaped their medical information access potential.

At once both very small (the country’s total land mass is only 271 square miles - about four times the size of Washington, DC) and very large (it has official legal claims to more than a million square miles of sea) - Micronesia is a paradox of size. Divided into four states, FSM is a country which is quite diverse in not only culture, language, and landscape, but also in terms of access to quality health care. While the country is made up of 600 islands, citizens can only reach secondary and tertiary health services on the so called “high,” or main islands, of Kosrae, Chuuk, Pohnpei, and Yap. This means that rural and remote residents must travel for hours and sometimes days to reach emergency, preventive, and chronic care services that may or may not be of high quality.

Like other U.S. Associated Pacific Islands, FSM faces trouble in financing health care, difficulty in retaining health professionals, and healthcare access issues for citizens who do not reside on main islands. Another issue that Micronesia recently faced was the loss of one of its major medical libraries. With limited sources of up-to-date medical information freely available in FSM, this library, housed at the Yap State Hospital, was a key channel between insular health providers and the global medical community. Destroyed by Typhoon Sudal in 2004, medical professionals on the islands requested help from a variety of off-island sources in re-building a better, more accessible source of information. A Robert Wood Johnson Foundation grant financially supported a technology upgrade, while major human resource assistance and training came from dedicated staff at the U.S. Naval Hospital and the University of Guam’s medical library system. After nearly three years of public-to-public sector development, the Yap State Hospital is now a functioning source of medical information for physicians, nurses, and public health workers on the remote island of Yap, FSM.

The expansion of this type of public-to-public partnership could further assist struggling Pacific Island hospitals which might be in great need of technological and logistical assistance. Further congressional legislation should encourage and financially support (through grant programs) the development of bilateral Pacific hospital to U.S. hospital partnerships. Exchanges of information and technology might start small, but can have a lasting impact on the patients, physicians and hospitals administrators of both partner hospitals. Policy makers must not forget that rural and remote health care professionals need access to information resources if they are perform their medical duties to the very best of their abilities.