community health worker for every inhabited island and for those islands
with larger numbers of people that there be one worker for approximately
every 50-75 inhabitants living in the area surrounding the community
health worker.
Their training would primarily be that of “on-the-job training"
usually with a one month course of instruction at the beginning of their
career followed by ongoing continuing education given by the medical
assistant along with his supervisory role such that they eventually have
the equivalent of approximately six months of training.
Selected well-
qualified community health workers should receive sufficient training
to be eligible to become health assistants.
2.
Health Assistant
At present primary care is delivered on the outer islands by about
55 health assistants, the majority of which were trained after World War
II by Navy corpmen in a short (6 to 9 month) emergency medical course in
Majuro.
Many of them are elderly and approaching retirement.
Their
educational level is low, averaging 3-5 years of elementary schooling,
and their perceived role is limited almost exclusively to "clinical"
medicine.
In
recent years
some
additional
health
assistants were
trained through the public health division on Majuro.
assistants
are younger,
have a secondary school
probably stay in the system much longer.
approximately 9 months also.
These health
education and wil}
Their course of training was
All of the health assistants work in the
smal] clinics on the islands and see very few patients.
Health assistants are able to provide more primary care services
than that of a community health worker but still must rely heavily on
the support and consultation of medical assistants who supervise them.
They will utilize more medications in treatment because of a greater
ability to diagnose the simple and common health problems.
Many of them
are able to care for minor wounds including suturing, conduct obstetric
deliveries and care for minor orthopedic injuries as well as carry out
the preventive services such as immunizations, health education, well
child care, antenatal and post partum care, family planning services,
and the prevention, detection, and treatment of malnutrition.
The supervision of the health assistant is the same as that of the
community health worker with whom they have daily intralagoon radio