Updated: Nov 23, 2020

Peleliu marks one of the bloodiest battles in the history of the US armed forces. Peleliu is at the southern end in the Palau archipelago chain. When the Japanese took over during WWII they utilized Peleliu for its harbor and airstrip making it a vital point for the Japanese command. As the US pushed into the Philippines there was concern about the stability of their flank to the east. It was speculated that the Japanese could move ships from Palau into the Philippines to intercept US forces. Several Generals disagreed with this threat, but the decision was made to invade Palau anyway. On September 15th 1944 Marine divisions landed on Peleliu. They expected a three day battle to take the island. What they didn’t expect was how dug in the Japanese were. Through an intricate series of caves, tunnels, hidden machine guns, and booby traps, the Japanese had rewired Peleliu into a nightmare for any invading force. As the marines landed on shore the Japanese opened steel doors on the mountain side revealing a wide arsenal of motors and 47mm guns that cut whole marine divisions apart, some losses are quoted to be as high as 70%. The expected 2 day battle dragged on for over two months. Losses were astronomical on both sides as guerrilla warfare was being redefined.

So just imagine the doctor sitting in this clinic. He is used to the same diseases that we see today on Peleliu as mentioned before, but over the last few months he has been treating more and more Japanese. His practice is doing well. He remains neutral in the war, and ultimately enjoys the infrastructure the Japanese have brought to his Island. One rather calm night in September is quickly interrupted with the sound of crackles in the distance that he assumes are local kids playing with fireworks. Suddenly he hears a blast and the whole building shakes, knocking medicine off the counter. He knows something isn’t right. The sky starts to light up with shells and he knows what’s happening. Just then a Japanese solider pounds on the door. When the unsuspecting untrained Palauin doctor opens the door the horror of war is literally brought to his footstep as this 19 year old solider falls into his clinic holding his intestines as they try to escape from his body. The next 48 hours are sheer mayhem for him. Every floor space of the clinic is full with bodies, some with cuts and scrapes, others long deceased. Now as if you had a remote control, hit fast forward. The wounded Japanese are soon replaced by Americans, after several more months things calm down. After several years the clinic is forgotten about. Decades later the indigenous population starts to repopulate and rebuild as it once had. In the 1990s The Palauin Government restores the same clinic. Years later a 4th year medical student from the United States gets on a two hour boat ride with an Air Force PA to staff the clinic for the day that is now only open once a week. They see the same diseases that the now traumatized doctor saw in 1943, only a year before he knew how much blood the human body could hold.

The clinic is actually quite well maintained as far as drugs are concerned. The PA is from the Air Force Civil Action Team, or CAT for short. He is the medical element to this small deployment of engineers, but once a week he leaves the unit and works in some of the distant indigenous clinics. He brings a supply of drugs that he is given through the Air Force and the ministry of health. So actually the remote clinic in Peleliu to some extend has better access to drugs than the hospital in Koror. There are of course quarks in the clinic. I had to blow the spider webs out of the otoscope before I could look in someone’s ear. The diseases for the most part were fairly benign. The most interesting of the 10 patients we saw being a huge ganglion cyst, a case of viral arthritis, and of course fungal infections.

The island is peaceful, the island people seem happy and fat. The battle of Peleliu code named “Stalemate II” is now only held in memory by a small but significant war memorial museum. The museum’s hours of operation are based on calling the rangers to come open it up. There is a single shelf lining a series of hallway that holds rusted pieces of artillery, random articles of clothing, and gear found in the woods. Most impressive are the stories that line the walls. Mostly from news paper articles or the personal memoirs of marines that fought on the island. They tell a graphic depiction of how what seems like a tropical paradise now was at one time the bloodiest battle in the pacific. The battle of Peleliu is also remembered by the unexploded munitions that are peppered throughout the dense jungle all over the island. There has been very little excavation work to uncover some of these caves and battle sights. The jungle has reclaimed most of it anyway. A few years ago a tourist came to the island retracing his father’s footsteps in the war. He found caves full of human remains and Japanese relics of war. I think the Japanese government still has a standing request on the island that if any relic is found to ship it back to Japan.

It would be a fascinating experience to explore the jungles of Peleliu searching unexplored caves for these artifacts. Too bad I don’t have more time.

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