d. Location of “Health Centers" The present location of clinics is given on the maps found in Appendix M. A minimum of one "Health Center" should be located on each of the 21 atolls/islands center listed should be on under the “health manpower". island within the The main atoll that clinic-health has the largest population concentration, and be near to the either existing or proposed airport (for medical evacuation of patients). foresee getting the "lagoon boat service" Where the atoll does not implemented (as planned by the government), or, where the distance is too large and weather dangerous during times of the year, then an additional “health center” may be warranted. Where to place them should be decided in 5-7 years when the initial centers are well established. In the meantime health assistants working out of existing clinics should continue to function in these remote areas. B. Hospitals 1. Physical plant Majuro: square The Armer Ishoda Memorial Hospital is approximately 53,000 feet in area with 88 beds. Because of poor maintenance environmental problems, not all beds are available for use. hold true for the facility itself. climate conditions. U.S. standards. and The same would The facility design is quite good for the No attempt was made to compare or evaluate in terms of As compared to other third world hospitals, it should probably receive a fair rating from a design and condition point of view. Although in disrepair, adequately support the Marshall Islands. level the facility itself could be upgraded of care anticipated to be provided to in the This appears not to be an option, however, as the ground lease expires in two years and the owner is not willing to renew the lease. There have been funds recommended that consideration the given ($8,000,000) new in hospital the environmental (climate) issue. in meeting these concerns. designed for a level provided. granted for be design a to 100 meet a new hospital. bed hospital cultural with needs It is careful and the A U.S. type hospital would not be effective The hospital must not be over-designed but of health care delivery consistent with that to be An example of the type off issue that must be dealt with in the design is the need for a larger than normal recovery and rehabilitation area. This is due to the large referral area being served and the lack of following care available away from the hospital.