Palau is a small island/large ocean nation in the Pacific that is vulnerable to natural or climate-related disasters. The national emergency medical team (EMT) was developed following a World Health Organization initiative to facilitate EMT training and cache procurement in the Pacific. As a result of the WHO initiative, Palau's EMT, known as KLEMAT, is fully self-sufficient and able to rapidly deploy in response to any local/national disaster or emergency. Imperative to any team development is the challenge of maintaining skills and motivation. Palau's experience is that by providing KLEMAT with regular education and training exercises, the team continues to advance as a cohesive, highly skilled group, which in turn ensures their ongoing preparedness for disaster/emergency response.