-16- Any program cf health care for the reople affectec Sy radiatien should be integrated, to the maximum extent possible, with a future healch care program of the Government of the Marshall Islands. Thecsentractor, accorgingly._will be recuired coexamine current facilities and propesed hospital and dispensary facilities and staff to determine how such local staff_andfacilities can beutilized to srovide.comorenensive heal=n 4 Care forthe_reovles of the affected atolls. (5) Primary care. Because many of the peoples concerned will be living in an "“out-island" context, the contractor should set forth recommendations on how "primary care” can best be provided to the people in such a context. This sheuld include recommendations on the type of staff, facilities, tzaining.afpractitioners, ate. It will be necessary to determine whether cresent out-island facilities and sorccraxs Maintained by she Government of the Marshalls Yslands can be upgraded and subsidized to provide this essential primary care for the seoples (6) Secondary and Tertiary care. ‘The contractor will be ‘ “\ required to set forth recormendations on where and in what manner secondary ‘ ve i“ Lees concerned, or whether a separate >orimary health care svstem, supsorted, and : erated bythe U.S, will be required? and tertiary care can be most effectively provided, both from treatment and cost standpoints. (7) Cost of Prevision of Comprehensive Health Care for all of the Marshalls. The pecples of the designated affected atolls will require both “on-atoll" and “off-atoll” comgrehensive care. Many of the individuals requiring the comprehensive care will be in the sresent major populated centers. The numbers away from the home atolls may well | ron into several thousand. The contractor will be requested to draw up Gost estimates of a comprehensive health care program for all of the Marshalls that would give the type of comprehensive care recuired for the peoples of the affected atolls.