To assist in reaching out to these remote locations, a U.S. Army medical outreach team educated the populations of Angaur and Peleliu, at their local elementary schools and city centers, during scheduled Global Health Engagements April 15 and 16, 2019.

The engagements are a part of Pacific Pathway's Exercise Palau that runs from April 14 - 19, during which U.S. service members will participate in multiple health engagements to provide medical education for Palauan residents.

The outreach team, consisting of a pediatrician, dentist and nutritionist, provided valuable mental health, oral and nutritional education tailored to the needs of the Angaur and Peleliu populations. These engagements are designed to further understand the needs of the population by using the data they obtain for future operations.

"From a health point of view, through our assessments we're realizing that some of the health concerns the population has are not too dissimilar from those of the United States," said Col. Keith Lemmon, who serves as a pediatrician and chief of the Department of Soldier and Community Health, at Madigan Army Medical Center, Joint Base Lewis-McChord. "So we have tools and education that we can provide, and if we have the opportunity to come back in the future we could provide more comprehensive education and even some treatment services."

The team's mission required them to coordinate closely with Palau's Ministry of Health, to schedule the event's times and locations, and also required the participation of Palauan MOH workers during the engagements, which encouraged the sense in partnership in establishing a more robust healthcare infrastructure.

"This is my second year working with the U.S. Army, doing medical engagements, said Palauan native Elchesel Wilfred, who goes by El, who works for the Palau Community Health Center as a quality improvement and quality assurance coordinator. "This year they've reached out further than last year and have brought the community additional services they wouldn't otherwise have, which we really appreciate." El continued her sentiment, "We don't have a lot of specialties on the islands. We have very few dentists, and no veterinarians. We always would like more services, partnership and continued support from Pacific Pathways, not only for the community but for the workforce as well."

Exercise Palau is the first U.S. Army exercise of its kind in decades on the islands, which reinforces U.S. commitments to our Indo-Pacific Treaty allies and other regional partners.

"What these medical outreaches do, is enhance the partnership between the United States and Palau," said Maj. Roger Garcia, who serves as a civil affairs section chief with the 405th Civil Affairs Battalion, and exercise planner with the 18th Medical Command, out of JBLM. "We have a Compact of Free Association (COFA) between Palau and the United States, and as a part of that agreement, the United States is the military force and protection for Palau's citizens."

Exercise Palau reflects strategic value in that it places a concentrated focus on the commitments outlined in the COFA, to U.S. Indo-Pacific Treaty allies and other regional partners. Through it, Palau will improve its resilience to natural disasters, increase domestic food security and build economic growth through fair and reciprocal trade and investment.

"Any exercise that we do in Peleliu, Angaur or any state for that matter really helps us identify gaps that we have in their response system and in disaster awareness or disaster relief," Garcia said. "Understanding where the people are at in their infrastructure really paints a clear picture as to where we can assist down the road, and by maintaining those strong relationships, we can assist them with establishing capabilities, respond to natural disasters, and we can also partner with them to react in an emergency."

In turn, Exercise Palau allows individual U.S. Soldiers to benefit on a personal level from their direct interactions with the citizens of Palau, whom they serve through the compact.

"It's been a remarkable experience," Lemmon said. "Palau is beautiful, and the people are kind and generous. I've been able to do several missions like these in other parts of the world, and each time I do it, it gives me an increased understanding about the world that we live in. It's been a pleasure to be a part of this."