ce-? E. Communication The very large geographic territory served by the health care system of the Marshall Islands creates unusual communication requirements. Health Assistants need consultation hours with their supervisory medex (medical assistants). Typically these can be scheduled at specific regular times. Supply requests may be forwarded to a central logistics support facility at similar scheduled times. The community health aids also need to communicate with their supervisors in emergencies at unexpected and unscheduled times 24 hours a day. Communication links must be reliable and available at all times. Present System Telephone systems exist only in the urban areas and do not extend to the outer islands. system. High Written communications are restricted by the transportation frequency single side band transceivers powered by gasoline generators were installed in many of the outer island clinics and in magistrate's offices. The harsh marine environment and operating conditions have resulted in rapid deterioration of equipment. repair. The highest priority has been given to the magistrate's radios. None of the clinics now have radios. radio. Most units have been returned to Majuro for Those clinics near a magistrate depend on his A few borrow (rent) privately owned walkie-talkies to relay requests to the magistrate on their atoll for forwarding via his radio to Majuro. But many are now without communication capability except by word of mouth or field ship. Reliable communications using the current high frequency equipment is possible only part of the time because of atmospheric disturbances from storms and varying skip disturbances caused by variations in the ionosphere. messages can be relayed from one station to the next. at scheduled communications messages. net at times other when times al] stations only one are unmanned Under these conditions But this is practical only attended. station blocks For emergency the relay of No attempt is made to man all of the stations except at the weekly scheduled net times. Plans to restock the clinics with new high frequency transceivers will not resolve these problems. A multichannel solar powered VHF system is being discussed, but will still have incomplete coverage, requiring relaying of messages. health. Highest priority will still be for services other than