to the basic medical teams. The original mandate called for cases of illness, not related to radiation causes, to be referred to the Marshall Islands Health Care Program. The success of the follow up for such referral cases is questionable simply because the Trust Territory Government health service in the past has not had the resources to furnish the required care. Annual costs for the medical monitoring, follow up care, and environmental monitoring program of the Department of Energy for the people of Rongelap and Utirik currently are in the range of $3-4 million. In contrast, in FY 80, the entire health budget of © the Marshall Islands Government was $2.7 million. This amount had to provide curative and preventive medical care and programs for a population of over 30,000 people, many scattered on outer islands. It supported the major hospital at Majuro which serves as the only Major in-patient facility in the Marshalls. The current hospital facility in Majuro has 90 beds and is in very poor condition ~ om | although funds for a new hospital have been appropriated. In addition to the Majuro hospital and an Ebeye sub-hospital, the Marshalls Health Department supports some 56 out-island dispensaries. Some of these are manned and equipped in name only. Administrative and professional staffing of the health services of the Marshalls has not met minimum acceptable health standards in the past. In an attempt to improve health care, the Marshall Islands Government recently concluded an agreement with a "medical care adjunct" of the Seventh-Day Adventist Mission in Guam to take over the control and management of health services from the Ministry of Health Services. This new health care service agency must be brought into any planning exercise by the contractor at an early stage. te eee ee