Recompression Facilities in Palau and Chuuk

Not long ago, the hyperbaric facilities of the Belau (Palua) National Hospital and Chuuk State Hospital were inspected by Dr. Timujin A. W. Wong, a hyperparibic physician in Montreal. This is a synopsis of his report, which originally appeared in the journal of the South Pacific Underwater Medical Society.

At the modern Palau facility, 46 diving patients had been treated in a 34-month period (during the same period, 6 divers died, including a group of 5 Japanese who were swept out to the open ocean by strong currents and lost).

During a typical peak-season week in Palau, about 2,400 dives are logged, which means the reported incidence of DCS is from 0.1 percent to 0.01 percent, far below the 0.4 percent estimated by DAN in its American statistics. Eighteen (39 percent) were U.S. citizens. Although more than 50 percent of the divers visiting Palau are either Japanese or Taiwanese, only seven (15 percent) of the cases were Japanese and two (4 percent) each from Palau, Hong Kong, and the Philippines.

The stress of completing an expensive diving vacation and connecting with international flights may explain why many divers with DCS symptoms do not present themselves in Palau. Divers often deny the possibility of DCI being the cause of their symptoms, and tourists commonly mistrust local medical facilities. Furthermore, affected Asian divers may be reluctant to go to the Palau hospital for treatment because of language and social barriers.

The conditions at Chuuk State Hospital, in contrast to Palau, are very primitive. The hospital is run down and there are severe shortages of medical supplies and equipment. Although the U.S. Navy installed a new, multiplace recompression chamber in 1990, it has never been used because no one there knows how to operate and maintain it.

Most diving occurs in deep water, where many repetitive and decompression dives are done. As a result, the DCI rate is much higher than normal. Unfortunately, the nearest recompression facility is in Guam, a two-hour flight by commercial airline.

When traveling to such areas for diving vacations, limit the number of repetitive dives, avoid decompression dives, do safety stops, avoid deeper dives, do not mix alcohol with diving, and do not fly until 24 hours after diving.

J. Q.