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Generally speaking the number of people served by each clinic is small,
thus the patient load per health assistant is low.
The number of people
served per day at the clinics vary between none to 2-3 perfday (unless a
flu epidemic is being fought).
The low numbers of births
month further confirm this fact.
homes by house call.
dnd deaths per
In fact, most care is] delivered at
Many ciinics have a total population
to be served
of less than 200, few attain 500 or more.
The most frequent types of problems seen by the health
those problems
common
to
children
and mothers,
plus
problems of older people (among which diabetes and hypert
most common).
apsistants are
[some
chronic
sion are the
It is not surprising then that health assis ants list as
most common symptoms the following: flu (upper respirato
), headache,
stomach,
[and
fever,
diarrhea,
skin
problems,
toothache,
diabetic
problems (insulin shots).
Though from the patient loads it would appear there are to
many clinics
for number of people served, remoteness, bad weather, lack
f transport,
and poor supervision are all commonly a problem making effEctive access
to health care, even to another island clinic on the same atoll, not
always possible.
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Real medical emergencies needing immediate evacuation t
a secondary
care facility are uncommon.
low as once
in three years.
For some clinics it has been
Waiting times and access in such cages has been
extremely variable but usually lengthy and costly, if at
Bll possible.
The frequency of visits by supervisory staff for continuigg education,
resupply of medicines,
atoll]
to atoll.
and special clinics varies tremq@ndously from
It has been totally dependent on the I"field ship”
schedule (see transportation-communication section).
Medical records at clinics vary between none at some, poer to fair at
the majority,
and good at very few.
The forms
are
complicated and the system has broken down due to lack of
nerally too
supervisory
Support and encouragement.
Most of the health assistants visited in the survey are
old.
middle age to
Most received their training in Majuro from navy corgsmen shortly
after World War II.
Their educational
elementary school).
Some of
the
level
is
newer recruits
low (B-5 years of
havefhigh
school
education and have been trained in a nine-month health assigftant program
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