[Health problems in an insular territory: the EVASANS in French Polynesia]

During the past three decades, French Polynesia has experienced a tremendous economic boom: GDP has multiplied by 30 in thirty years, whereas the population has only doubled in size. Health resources may nowadays be compared to those of a developed country. But as the "territory" is composed of a large number of islands, the availability of services is very uneven. The "Iles sous le Vent" are well staffed and well equipped, but other islands are under privileged. The small population of several small islands does not justify the permanent presence of a medical doctor. In this context, a system of health air-lifting was established. The system is classified into three groups: non-emergencies (scheduled for a later date), emergencies (immediate airlifting), and extreme emergencies (immediate airlifting with a doctor on board). Patients are airlifted to another island in the "territory" (mainly to Papeete, Tahiti), to New Zealand, or to France. The cost of this system (known as EVASANS) is extremely high. It raises the issue of improving local health care facilities and of promoting preventive medicine.