D. Transportation Patients must be moved from out islands to regional clinics and hospitals at Ebeye or Majuro for both routine referral and in emergencies. Occasionally they must be transported to tertiary care centers outside the country. Clinics must be resupplied. Senior medical staff need to make supervisory visits to the clinics and special task public health teams must visit schools and communities. and continuing education. Personnel need to be rotated for vacations Preventive maintenance visits to each facility must be made on a regular schedule. Present System Government field ships visit the out islands on a semiregular schedule to collect the copra crop. On a space available basis, they provide transportation for health personnel and patients. Visits to some islands are made no oftener than every four months or even longer when equipment is not available or weather adverse. With very few exceptions transport between islands of an atoll] must be by private boat or canoe. Marshall Airstrips served by STOL aircraft of the Airline of the Islands are operational on Majuro, Ailinglapalap, Enewetak, Likiep, Mejit, Meloelap, Kwajalein, Ebon and Wotje. is available by AMI from these islands. In an emergency, priority transport Ships within Marshallese waters may be diverted at a cost of $1200/day to transport critical patients either to the nearest airfield or hospital. Transportation available through Air Micronesia. The present to tertiary care centers intralagoon system is is being expanded by the addition of government lagoon boats under the control of the magistrates and available for all government transportation needs including those of the health care system. Airstrips are scheduled for completion within the next 24 months on all atolls with enough space. These expanded facilities will provide transportation most of the time for most of those needing it. Recommendations 1. As far as possible, the Health care system transportation needs should be filled by existing government field ships and airline. may require chartered transport. Special task teams The Marshallese Government should be encouraged to complete the planned airstrips and lagoon boat systems as soon as possible.