The Rubekul Belau’s First Traditional Leaders Forum held last month touched on four key topics in four sessions. The first session titled “Nurturing Resilient Communities” brought about complex issues that are faced by communities and families today – suicide, elderly care, and noncommunicable diseases (NCD), among others.  The session was facilitated by Mudelong Salvador Tellames and included two presenters, Dr. Sylvia Wally and Dr. Emais Roberts.

The session called attention to the recent rise in the number of self-inflicted deaths in the past couple of years, particularly among young men in Palau. The presenters highlighted recent studies conducted in 2019 and 2021 on the causes of self-inflicted death among young people. 

“It was not an easy presentation to listen to, let alone participate in the discussion. But this is the first time that we, as male traditional leaders, all sat down to look at the problem. You cannot fix what you do not allow yourself to see. It is such an important step to take as family, as community, as leaders, and I am glad that this conference opened with such a strong session that made us realize the tragedy of suicides in Palau,” says former educator and now Senator, Tmekei Andrew Tabelual. 

Further to the two studies, Dr. Sylvia Wally spoke on some key causes of self-inflicted deaths to be drastic changes in family dynamics and child neglect that create mental and social growth challenges in children that continue into their adulthood. It is in these instances that the victims choose to cope with drug and alcohol use, further deterring the family’s (and the victim’s) ability to cope. Other underlying causes of self-inflicted deaths presented by Dr. Wally were the rising costs of living and mounting responsibilities of adult Palauans to fulfill customary obligations. Challenges in academics and in the school environment including bullying were also highlighted as underlying causes leading to suicide, along with having family history of suicide.

“There seems to be a gap in our efforts to address these serious issues –  that when challenges cannot be managed or shouldered by the victim within their immediate family, it becomes a government problem either in the hospital or jail. Family efforts to include the extended family within the clan can really contribute to solutions needed. That is why we are here in this forum to help you, our traditional leaders, to bring that responsibility forward to care for the child or victim as a clan and as a community,” pleaded Dr. Sylvia Wally 

The issues of health management, medical services, and the ever-prevalent NCD epidemic were widely discussed in the forum with Dr. Emais Roberts, Governor of Peleliu State, leading the discussions. The session highlighted that although Palau has come a long way in recognizing NCD as a major health issue in Palau, it is still not a priority. Despite having set into law tax dollars earmarked to fight NCD, Palauans are still dying of NCDs and the numbers are not decreasing. 

The issue of medical services and bringing primary care to the people was discussed.  The presenters and participants established that much has been done to ensure that the hospital is provided with doctors and nurses, as well as equipment to ensure care is possible, but a majority of the people are provided secondary care, instead of primary care. 

“There is a great need for primary care especially for those who reside in remote areas and are unable to access primary care due to cost of travel. Thus, most of those who are sick tend to delay seeking medical attention until it is too late and major treatment is needed such as surgery or overseas referral for treatment simply to prevent immediate death.” said Dr. Emais Roberts. It was noted in the session, that local doctors who have been trained in Cuba, whose area of expertise is in community health care, have been assigned to secondary care and not in the fields where their services are most needed.

The panel discussed elderly care as an ever-growing concern for families and government. The issue was discussed at length as “elderly care” has traditional and customary implications. The panel of doctors highlighted a practice that is becoming common place at the national hospital – providing services that should otherwise be provided in assisted living facilities. Whether it is a simple lack of capacity or negligence or both that prevent elderly patients from being taken home after being discharged from the hospital, the need of an actual assisted-living facility in the country is undeniable. The chiefs and the panelists also recommended that the planning and establishment of such facility requires the advice of traditional leaders. 

“Special attention is given to celebrate birth and honor the dead, while neglecting the living, especially the elderly and those who are in dire need of help. We must care for the living, much like we care for the dead”, emphasized Dr. Sylvia Wally.

The forum reaffirmed the commitment of each of the participants, on behalf of their clans and states, to establish closer ties, strengthen cooperation, and agree on recommendations and initiatives for the benefit of families and communities of Palau.

This is the second of a series of articles forthcoming from the Council of Chiefs on the topics covered during the Traditional Leaders Forum that was held on June 14-15, 2022.     ENDS

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