Palau is a small island/large ocean nation in the Pacific with a population of approximately 18,000 and a high level of vulnerability to natural or climate-related disasters. In June 2022, Palau became the smallest nation in the world by population to establish a national Emergency Medical Team (EMT). The team is named “Klemat,” after the rope that holds the sails of Palau’s traditional canoes.

To establish a national EMT capable of self-sufficient, high-quality clinical response to disasters and outbreaks that may occur locally or in neighboring jurisdictions.

The development of Klemat required a multi-step process with support from technical and funding partners. Online orientation webinars and meetings were held in 2019 and 2020, and a national Technical Working Group (TWG) was formed in 2022. A national EMT coordinator was jointly hired by the WHO and the Ministry of Health and Human Services of Palau in 2022, and EMT Standard Operating Procedures were drafted.

Klemat is the nation’s deployable clinical response capacity, capable of fully self-sufficient tented out-patient and emergency care in the most austere disaster or outbreak circumstances. There are now 18 fully trained clinical and support team members. Klemat is working with relevant stakeholders to be codified in the national disaster risk management framework of Palau.

Palau’s development of a national EMT demonstrates that even the smallest of countries can establish self-sufficient EMTs capable of national or regional response.