Pacific Cancer Programs

Yap Cancer Coalition

Mission Statement

To conduct public awareness activities on cancer, cancer risk factors, the impact of cancer and its risk factors on overall health and the importance of screening and early detection. Ensure availability of adequate and affordable medical supplies necessary for cancer screening and treatment efforts.

Background

Yap, the western-most state of the Federated States of Micronesia (FSM) is located in the western Caroline Islands midway between Guam and the Republic of Palau and is some 8,410 miles west of California. Yap has a population of 11,200 (Year 2000 Preliminary FSM Census).It is the second least populated of the 4 FSM states. Sixty-five percent of the population resides on Yap Proper, which consists of four islands connected by roads, waterways and bridges. YapProper includes the town of Colonia, Yap's capital, which has a population of about 1000.Stretching 600 miles east of Yap Proper are 78 outer islands, of which 18 are inhabited.Including the outer islands, the state of Yap covers approximately 500,000 square miles of ocean yet consists of only 45.8 square miles of land area. Transportation between Yap Proper and 3 of the outer atolls is via small airplanes. The other islands are serviced by cargo ships and/or the Micro Spirit which runs every 6 weeks. There are four indigenous language groups in Yap State: Yapese, Ulithian, Woleaian and Satawalese (GRIMES 1996). Communication between island groups most often takes place in English. Traditional Yapese society still dominates and is organized as a complex system of clans, castes and village units ruled over by chiefs. Today, the chiefs share power with elected leaders. The state constitution gives chiefs, and in particular the Council of Pilung and the Council of Tamol, veto power over much of the legislation passed by Legislature, while the traditional leaders in the village councils make most of the policy decisions at the village level. Most of the population is Catholic and the influence of the church remains strong. Each church has an established working council of members who are responsible for organizing and coordinating church activities in their respective communities.

Healthcare System

Yap Memorial Hospital in Colonia is the only hospital in Yap and is directly accessible only to those residents who live in Yap Proper. According to the Yap 2000 Census 91% of the Yap Main Island population is uninsured. Residents who live on the outer islands find access difficult due to limited transportation. The field ship (MS Microspirit) sails about every 6 weeks when in service originating in Yap and takes about 2 weeks for a roundtrip with designated stop over in some major island groups, not all. Other cargo ships that can also carry passengers sail infrequently. Only three of the outer islands (Woleai, Ulithi, Fais) have runways. These islands are serviced irregularly by Pacific Missionary Aviation (PMA), which offers reduced fee medical evacuations. While this air service is a travel option for residents of the islands mentioned, most Outer Island people prefer to travel on the cheaper field-trip ship. With the exception of two islands, which have electricity, none of the 18 outer islands has running water, electricity or proper sanitation.

Yap Memorial Hospital has 25 beds, 10 doctors including 1 obstetrician/gynecologist, 1 anesthesiologist and 1 surgeon. The hospital has an emergency room, outpatient clinics, inpatient wards, surgical suites, a dental clinic, pharmacy, laboratory, X-ray services, physical therapy services and health administration offices, including offices for data and statistics. The hospital does have a ventilator but no dialysis unit. Plain film x-rays and ultrasound are the only tests performed by radiology. There is no mammography equipment in the state. Additional diagnostics include a colposcope, endoscope, laparoscope and hysteroscope but no flexible sigmoidoscope or colonoscope.

There are no private health providers or other clinics in Yap or the outer islands, only the main central Yap State Hospital in Colonia and the 17 dispensary sites in the outer islands and the four newly established community health centers on Yap Proper.

Yap has 17 outer island dispensaries, of which two – Ulithi and Woleai - have been designated "super dispensaries". In May 2004, doctors were posted permanently to each, and more extensive pharmacy stocks have been provided. The other 15 outer island dispensaries or aid posts are served by health assistants with limited backgrounds. In fact, most were trained on the job by people who were trained on the job. Only the most basic health care services are available at these sites; consultation with the doctors at Ulithi, Woleai or at the hospital is necessary for any complicated medical care. Services of the two “super dispensaries” include dispensing of medications, minor suturing, deliveries and patient admissions. They have equipment for limited or basic laboratory work but no lab technicians. Meanwhile, the other dispensaries primarily dispense medications to treat common ailments. The doctor assigned to Ulithi conducts daily morning reports by radio with the outer island dispensaries and has used a combination of radio and face-to-face sessions to deliver six College of Micronesia dispensary manager program courses since August 2004. A major upgrade of solar and radio systems in the outer island dispensaries was completed in July 2006 and has improved radio contact, which is sometimes weak for some of the stations. Communication by the outer island dispensaries with the central or main hospital on Yap Proper is by radio or VHF.

The Yap State health budget is supported by three sources – US Compact of Free Association Health Sector grants, US Federal programs and local revenue. Yap’s comprehensive cancer control (CCC) efforts, as part of the FSM National and Regional CCC efforts, also supports the recommendations of the Compact of Free Association Health Sector Strategic Development Plan (SDP). CCC efforts include enhancing existing Department of Health Services (DHS) infrastructure through collaboration, coordination, sharing and efficient utilization of limited resources while evaluating the process and outcomes throughout.

Comprehensive Cancer Control (CCC) Plan Download

Cancer Council of the Pacific Islands (CCPI) Members

Mr. John Gilmatam

Mr. John Gilmatam

  • Title: Yap CCPI Director
Dr. Athanasius Richter Yow

Dr. Eric Lirow

  • Title: Yap CCPI Director

Contact Information

Martina Reichhardt

Martina Reichhardt

  • Title: Yap CCC Program Coordinator
  • Email: mreichhardt@hotmail.com
  • Tel:  (691) 350-2110
  • Address:
    Yap Cancer Program C/O WCHC
    P.O Box 1010
    Colonia, Yap,96943 FM
Cecilia Leechugen

Cecilia Leechugen

  • Title: Yap Cancer Registrar
  • Email: cleechugen@fsmhealth.fm
  • Tel:  (691) 350-2110
  • Address:
    Waab Community Health Center - Cancer Program
    P.O. Box 1010
    Colonia, Yap, FSM 96943

Funding for this website was made possible by a cooperative agreement from the Centers for Disease Control and Prevention, through the following:
Pacific CEED, award #: 5U58DP000976,USAPI Community Health Interventions Project (CHIP), award #: 1U58DP005810,
Pacific Regional Central Cancer Registry, award #: 5U58DP003906; Regional Comprehensive Cancer Control Program, award #: U55/CCU923887.
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Funding Sources: PRCCR: #: 5U58DP003906  | Pacific REACH: #: 1U58DP005810 | RCCC: #: U55/CCU923887 

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