to Some of the newasr Yill-Burton clinics were built wnere trere patient load. is no ‘eal The possibility of dismantling and moving some of these misplaced Hill-Burton clinics should be explored. clinics will probably need rebuilding. At least 1/2 - 2/3 of the present At all “health center" site additional upgraded housing for the medical assistant and the group meeting shelter will be needed. Thus it is estimated that 21-25 atolls and islands will need Health Centers (some may need two because of the size and remoteness lagoons). of islands within the Probably 5-7 of them are presently adequate except for minor repair, leaving 16-18 needing total replacement. Some of the smaller atolls and islands (which will only have health assistants due to low populations) will need only a small clinic and many already have one i.e. Ujae. Some criteria are stated below for the physical facilities, along with preventive maintenance suggestions and some equipment recommendations. Recommendations: 1. It is recommended that the clinic size be maintained at about 1,000 square feet maximum. 2. Alumninum (preferably) roofs should be used where possible. Furthermore this roof should be used for water catchment, draining to a cistern of sufficient dimensions to provide for dependable fresh water year round. 3. Water seal toilets must be provided, both for patients in holding beds, and outpatients who need a separate facility. 4. Windows and doors must be of a low maintenance type and of considerable durability. Plastic is strongly recommended. Fiberglass products, especially in the medicine cabinet areas, are the desirable choices. 5. Plumbing must be plastic, with all the fittings preferably plastic also. Pumps to raise water to tanks must be the simplest possible and materials for maintenance must be available locally. 6. The two present superclinics are oversized and underutilized. It is recommended that a standard size clinic-health center be built to serve Jabor on Jaluit and the superclinics are now present. Wotje/Wotje population center where The existing physical plant on Wotje could be used for other community services. Preventive Maintenance needs : 1. A preventive maintenance schedule must be provided with the equipment, and the health worker trained to maintain the equipment. Occasional preventive maintenance checks from the central support service section on Majuro are needed also. 3