periodic visits to Marshall Islands for specialized surgery or medical consultations. ophthalmology, dermatology, With this plan otolaryngology, etc. can special problems urology, also be in the orthopedics, adequately treated in areas of cardiology, the Marshalls ‘thereby reducing the number of referrals for tertiary care. Ebeye: The hospital at Ebeye (50 beds) will be staffed and equipped to provide secondary care but at a lesser level than at Majuro. Whenever possible complicated cases will be referred to Majuro or provided by the Majuro staff commuting to Ebeye. 2. Tertiary Care With the upgrading of medical services at Majuro, it is anticipated that the referral costs for tertiary care to hospitals outside the Marshall can Islands be presently go to Tripler substantially in Hawaii. reduced. It is Most recommended referrals that other facilities, such as Queens, Castle Memorial, and Straub Clinic in Hawaii be considered as alternatives. These facilities were evaluated and can provide complete tertiary care, including cardiac care and open heart surgery. Specialty and Rehabilitation Services 1. Dental Currently the three dental Majuro are providing prophylaxis, x-rays dental and officers and their supporting staff in examinations, treatment extractions, and health education. of jaw basic restorative fractures, minor care, surgery, In addition, the dental public health section has attempted three additional services - dental maternal and child health services, school dental programs, and field treatment programs. maternal and child health services are primarily educational, providing young mothers with information that hopefully will their The child rearing practices. examinations, education. extractions, The school flouride mouth be incorporated into and field programs washer for include children, and Though a stated objective, these latter services have not been made available on the outer islands because of manpower, budgetary, and equipment limitations. The short and unpredictable duration of field ship stops (1-2 days) has made them an unreliable transport mechanism for these services. 23