community health worker for every inhabited island and for those islands with larger numbers of people that there be one worker for approximately every 50-75 inhabitants living in the area surrounding the community health worker. Their training would primarily be that of “on-the-job training" usually with a one month course of instruction at the beginning of their career followed by ongoing continuing education given by the medical assistant along with his supervisory role such that they eventually have the equivalent of approximately six months of training. Selected well- qualified community health workers should receive sufficient training to be eligible to become health assistants. 2. Health Assistant At present primary care is delivered on the outer islands by about 55 health assistants, the majority of which were trained after World War II by Navy corpmen in a short (6 to 9 month) emergency medical course in Majuro. Many of them are elderly and approaching retirement. Their educational level is low, averaging 3-5 years of elementary schooling, and their perceived role is limited almost exclusively to "clinical" medicine. In recent years some additional health assistants were trained through the public health division on Majuro. assistants are younger, have a secondary school probably stay in the system much longer. approximately 9 months also. These health education and wil} Their course of training was All of the health assistants work in the smal] clinics on the islands and see very few patients. Health assistants are able to provide more primary care services than that of a community health worker but still must rely heavily on the support and consultation of medical assistants who supervise them. They will utilize more medications in treatment because of a greater ability to diagnose the simple and common health problems. Many of them are able to care for minor wounds including suturing, conduct obstetric deliveries and care for minor orthopedic injuries as well as carry out the preventive services such as immunizations, health education, well child care, antenatal and post partum care, family planning services, and the prevention, detection, and treatment of malnutrition. The supervision of the health assistant is the same as that of the community health worker with whom they have daily intralagoon radio