Bebe ’ m Y wn 4 ef Public Health Loma Linda University This plan would provide primary care on each of the four atclls delivered by a mecical assistant who would be supervised by a medical doctor (general practitioner). Tris physician would be stationed in Ebeye or Kwajalein * . but most of the time would be doing itinerant work aboard - -* * ghip visiting the four atolls. Since this plan would se provide no upgrading of the hospitals at Majuro or Ebeye, it would be necessary to send virtually all patients requiring hospitalization to Honolulu. Dental care would be provided by a part time dentist aboard the ship with assistance of a dental hygienist. One public health nurse would be employed to conduct health education programs, Sanitary evaluations, maternal and child health preventive programs, immunization programs, etc. Manpower Requirements The manpower needs for this plan would require the following: 1. 2. 3. 4. 5. 6. Four medical assistants One public health nurse/health educator One physician (general practitioner) One pharmacist/logistics supply/transportation officer One part time dentist One dental hygienist/dental assistant The plan is not recommended by the Loma LInda University tean. The limitations of this plan are as follows: TT i. The arbitrary selection of people to receive care being only those actually living on the four named atolls is unfair as it represents only a portion of the “affected” people of these four atolls. 2. This plan would not provide at the local level even the basics of primary care specialty services such as care provided by a Pediatrician, Internist, Obstetrician/Gynecologist, or General Surgeon. . " “hy -: t ‘aa. * : Mh oe: -a tees a TRL, ae 3. Without adequate hospital facilities in the Marshall Islands, there would be no real emergency care available that would adequately fulfill the required needs; e.g. by the time a patient is evacuated from his home atoll and transported to Kwajalein to await a scheduled flight to Honolulu with an additional long transport, it could well be too late for emergency care to be effective.