Although a Western governmental model has been set up f br the Marshall
Islands, the old stratified mode? of governance still exigts, exerting a
very real influence on decisions affecting the new nation.
[n establishing
any comprehensive health plan for the Marshalls this dualit y of influence
and decision must be taken into consideration, with proper provision made
for the positive influence of the traditional leadership g up.
It would
be
difficult
to
over-emphasize
i
the impor ance of being
sensitive to Marshallese culture in the planning of any hea th care system
for the islands.
Care in this respect at least equal to th it expressed in
Article 16, Section C of the health contract between the Go ernment of the
Marshall
Islands
and
the
Seventh-day Adventist Guam-Micn pnesia Mission
should be expected:
“The Contractor hereby agrees to take Marshallese
custom
and
tradition
into
account
in
its
administration of the health services system and to
respect the same...
"On question of custom and tradition the Contractor,
as the party responsible for management and control
of the health services system, shall have the same
right as any department or agency of the Government
to seek advice of the Traditional Rights Court of
the Marshall Islands on questions of custom and
tradition."
As the Chief Secretary of the Government of the Marshall 141ands recently
said:
“The Western world does not always understand us and
our culture. They may mean well, but they are often
unsuccessful because,. ..
in the past they have
been planning for people instead of planning with
people."
B.
_
Government Policies and Perceptions
The perceptions and policies of the Marshallese Governm nt are colored
by the traditional social structure.
family and to his
followers.
chiefs.
The
Each person has duties
Iroij, or chiefs,
have d
This responsibility applied to health care has
fo his extended
tes
to
their
en formalized
in the constitution as a right of the individual to health cdre provided by
the government.
The implementation of this governmental dut
is through the
U.S. model of medical science-based technology and practice,
difed to meet
local geographic and
al's
sociologic conditions.
The indivi
symbolized by a nominal fee at the time care is required.
2
duty
is