Secondary and selected tertiary care wil] be made available within the hospitals on Majuro and/or Ebeye. This will require improvement in the physical plants, equipment, and manpower, but should decrease the expensive referrals to Hawaii. The current contract between the Guam-Micronesia Mission of Seventhday Adventists and the Marshall Istand Government will] be continued, but limited to secondary and tertiary care. The Seventh-day Adventist Church has demonstrated competence in hospital management and has won the confidence of the Marshallese Government. It would have difficulty adequately developing and staffing the other components of the health care system. Though specific timetables are not developed, the assumption in this proposal is that the MarshallIslandGovernmentshould push towardself- sufficiencyinmanpower, This requires a strong emphasis on training mene pe ee ee ee ee a which is detailed.