RMI Nuclear Justice Documents

Although a Western governmental model has been set up for the Marshal]

Islands, the old stratified model of governance still exists, exerting a
very real influence on decisions affecting the new nation. In establishing
any comprehensive health plan for the Marshalls this duality of influence
and decision must be taken into consideration, with proper provision made
for the positive influence of the traditional leadership group.
It

would

be

difficult

to

over-emphasize

the

importance

of

being

sensitive to Marshallese culture in the planning of any health care system
for the islands.

Care in this respect at least equal to that expressed in

Article 16, Section C of the health contract between the Government of the
Marshall

Islands

and

the

Seventh-day Adventist Guam-Micronesia Mission

should be expected:
“The Contractor hereby agrees to take Marshallese
custom
and
tradition
into
account’
in_
its
administration of the health services system and to
respect the same. ..
"On question of custom and tradition the Contractor,
as the party responsible for management and control
of the health services system, shall have the same
right as any department or agency of the Government
to seek advice of the Traditional Rights Court of
the Marshall Islands on questions of custom and
tradition."
As the Chief Secretary of the Government of the Marshall Islands recently
said:

"The Western world does not always understand us and
our culture. They may mean well, but they are often
unsuccessful because,. ..
in the past they have

been planning for people instead of planning with
people."
~~
B.

Government Policies and Perceptions
The perceptions and policies of the Marshallese Government are colored

by the traditional social structure.
family and to his
followers.

chiefs.

The

Each person has duties to his extended

Iroij,

or chiefs,

have duties

to their

This responsibility applied to health care has been formalized

in the constitution as a right of the individual to health care provided by
the government.

The implementation of this governmental duty is through the

U.S. model of medical science-based technology and practice, modifed to meet
local

geographic

and

sociologic

conditions.

The

individual's

symbolized by a nominal fee at the time care is required.

2

duty is