d.
Location of “Health Centers"
M.
The present location of clinics is given on the maps fund in Appendix
A minimum of one "Health Center" should be located onl each of the 21
atolis/islands
listed
under
“health manpower".
The mai
clinic-health
center should be on the island within the atoll that as the largest
population concentration, and be near to the either existling or proposed
airport (for medical evacuation of patients).
Where thelfatol]l: does not
foresee getting the "lagoon boat service" implemented (as planned by the
government), or, where the distance is too large and weather
times of the year,
then an additional
@angerous during
“nealth center" may
be warranted,
Where to place them should be decided in 5-7 years when thefinitial centers
are well
established.
In the meantime health assistants} working out of
existing clinics should continue to function in these remotd
B.
Hospitals
1.
Physical plant
Majuro:
square
The Armer Ishoda Memorial Hospital is apprqximately 53,000
feet
in
area
with
88
beds.
Because
of
poor
environmental problems, not all beds are available for use.
hold true for the facility itself.
climate conditions.
U.S.
areas.
standards.
in
As compared to other third world hospifals,
disrepair,
the
facility
itself
could
There have been funds
that the
consideration
it should
goint of view.
e
upgraded
rovided
to
in the
This appears not to be an option, howevey, as the ground
lease expires in two years and the owner is not willing to
recommended
The same would
No attempt was made to compare or evalidjate in terms of
adequately support the level of care anticipated to be
Marshall Islands.
and
The facility design jis qufte good for the
probably receive a fair rating from a design and condition
Although
aintenance
given
($8,000,000)
new hospital
in
the
menew the lease.
granted for a new hogpital.
be
design
a 100
to
meet
bed
hospit
cultural
with
fneeds
[It
is
careful
and
the
environmental (climate) issue. A U.S. type hospital would
mot be effective
in meeting these concerns.
The hospital must not be ovpr-designed but
designed for a level
provided.
of health care delivery consistent
with that to be
An example of the type off issue that must be ddalt with in the
design is the need for a larger than normal recovery and rehafilitation area.
This is due to the large referral area being served and the 1 ck of following
cn
care available away from the hospital.