M ote ites: mi q F ai yah sop ae RO A PU ee One as Petal ere peas ey EL A ae Oe ta E getttie Fay ETE yey a It is important that the MD's participate in the training program so they will know what to expect from their assistants and they can begin establishing a working relationship immediately. These training programs always provide a forum for discussion of concerns regarding personal and family health problems. The BNL team can begin to ascertain what each island perceives its biggest health problem to be from this kind. of exchange. With the exception of the TI M.O.'s who accompany the survey, the majority of the BNL collaborators are unfamiliar with Marshallese customs and the TT “health care delivery system. By assisting with the training and working with the local health aide and the TT medical interpreters, they will become more deeply involved with the community than they have in the past. The result should be a better understanding of one another's strengths and weaknesses. As soon as the local people are trained and used on one survey, should be contacted and used again as soon as possible. should be interviewed to determine why. they Those who drop out The interview should be conducted by the BNL Marshallese nurse-practitioner to avoid any cultural bias. It is important that she be involved with all phases of the program, since her presence will lend credibility when plans for "Marshallization™ of the program are discussed. Based on information generated through village meetings and individual discussions with the newly-trained assistants, a pilot program will be developed to be given on the following survey visit. It will be relatively short, and simple hand-out materials will be devised that can be upgraded by the people who receive the first programs, demonstrating that they retain some control. The new assistants (facilitators) will be encouraged to assist in setting up and carrying out the program, if it is culturally appropriate. Pap an .