A medical resident in Ponape

The University of Hawaii has an elective two-month primary care rotation in Ponape, in the Eastern Caroline Islands, for senior medical residents. Many diagnostic and therapeutic situations provide unusual challenges because of the tropical environment and the paucity of medical facilities. Parasitoses, tuberculosis and trauma are common, and certain diseases, such as cholelithiasis and coronary artery disease, have a low incidence, reflecting the socio-economic conditions. The local intoxicant, sakau, seems to be responsible for dermatologic, pulmonary, and possibly hepatic and neurologic disorders. The rotation has proved to be a worthwhile educational experience for residents and a benefit to the people of Ponape.