Asia, Featured Post, Palau

Helping Palau’s Hospital Get a Better Picture of Health

CT scan at Belau National Hospital

Belau National Hospital (BNH) is the only hospital in the small island nation of Palau. Despite the compassionate care its doctors, nurses, and other staff are working to provide, it faces major challenges due to shortages in equipment, staffing, and training. Peace Winds is helping BNH strengthen its capabilities through a training program for hospital technicians.

Although BNH has obtained X-ray, CT scan, and MRI equipment, some of this from overseas donors, Palau does not have doctors who specialize in diagnostic imaging. This makes it more likely for patients to be given the wrong type of scan for their condition, increasing the risk they can receive the wrong diagnosis and treatment. Adding to this challenge is the fact that the radiology department at BNH only has a small number of technicians. Staffing often gets stretched thin when technicians are needed to work in other departments or if they take a sick day. 

Dr. Hamano is a clinical radiologist from Japan who is working at BNH thanks to a Peace Winds program. He is helping the team establish guidelines and learn techniques for safe and effective medical imaging. 

Dr. Hamano next to MRI machine at Belau National Hospital in Palau

For example, while many countries have regulations around how much radiation should be used in an X-ray, there are no regulations in Palau. Not only is this unsafe for patients and staff; X-ray images taken with the wrong amount of radiation are much more difficult to interpret correctly. Dr. Hamano is raising awareness about radiation exposure and teaching technicians and doctors how to take clearer X-rays with just the right amount of radiation.

X-ray image taken with insufficient (left) vs correct (right) radiation

BNH’s radiology department has received support in the past from Japan, the United States, Taiwan, and other countries. The most expensive item it received is its MRI machine, which was donated by Japan in 2023. Although a brief training was provided at the time, the reality is that most staff were not fully versed in how to use it. Many felt uncomfortable doing so and would instead opt for CT scans, even when an MRI might be more appropriate for a patient’s condition. 

To help technicians and doctors feel more comfortable with the MRI machine, Peace Winds hosted a training session in December 2024. Participants learned which situations are best suited for an MRI, how to perform an MRI without contrast, and how to delete unnecessary parts of an image. Dr. Hamano says that staff members are now using the machine more and more, and he and the Peace Winds team continue to collaborate with technicians, nurses, and doctors to make improvements.

MRI (left) and CT scan (right) machines at Belau National Hospital 

The CT scanner at BNH broke down about two years ago, so Japan also helped replace this last year. Staff are generally comfortable performing these, but Dr. Hamano is also helping them establish a standard practice for taking CT scan images. 

As part of the Peace Winds program, a Palauan doctor is also participating in training in Japan, and he will become the first radiologist in Palau. Dr. Hamano says that he and the Peace Winds team are excited to support him, and that the dedicated staff at BNH have been enthusiastic about learning new skills to help their patients. Click here to make a donation to this program and learn more about our work to support healthcare in Palau.

Patient receives care at Belau National Hospital