health nurse would be emsloyes= to conduct health education programs, sanitary
evaiuations, maternal and child health preventive programs, immunization procrans,
etc.

The

manpower needs for this plan would require the following:

i.

Four medical assistants

2.

One public health nurse/health educator

3.

One physician (general practitioner)

4.

Cne pharmacist/locistics supply/transportation officer

5.

One part time dentist

6.

One dental hygienist/dental assistant

.

The objections to this limited plan are as follows:

1.

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 people of the four atolls and to make any other designation of
additional persons to be included results in an inability to do anything

other than a comprehensive medical care program, e.g. What is the rationale
for selecting care for the people now living on Keli but excluding those
on Ujelang?

Why should the large number of people from Bikini who live

on Ebeye and Majuro be excluded?

The only equitable answer to the coverage

problen is to provide comprehensive care to all people living in the
Marshall Islands.

This plan would not provide even the basics of primary care specialty
services such as care provided by a Pediatrician, Internist, Obstetrician/
Gynecologist, or General Surgeon.
* Without adequate hospital facilities in the Marshall Islands, there is 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 would be too late for emergency care to be
effective.

There would be no speciality services for even the non-emergency care needed
such as radiologic services, psychiatric examinations, orthopedic evaluations,

opthalmologic evaluations, etc.

It is highly inappropriate to refer

non-English-speaking people to Honolulu for any evaluation required by one of
the medical specialists and it is impractable to transport the specialists
to the Marshall Islands for consultations on such a small population base.

Select target paragraph3