ell- (e) Current sractice Annualcosts for the medical monitoring, folicw up care, and monitoring frogram of tne Depar=ment of Enersy for tha secple and Utirik currently are in the range ef $3-4 mitiion. FY 80, che entire health Sucget of the Marsh Sh.2miliisn. tn con zslands_Gov This amount had to provide curative and preventi Care and programs for a population of over 30,000 seople, many On cuter islands. This amount supported the major hospital at which serves as the only major in-patient facility in the Marsh The current hospital facility in Majuro has 90 beds and is in v condition, but foranewhospitalhavebeenaporopriated addition to the Majuro hospital and an Zheve sub-hospital, the Health Deparsment supports some 56 ocut-isiand dispensaries. these are uncer-manned and ili-equipped. 5§ Administrative and professicnal staffing of the health services Marshalls basrot-met—minimim_acceptable health standards in thg In an attempt to improve health care, the Marshall Isiands Gove sase. recently concludedanagreemenrwitha“medicalcare_adiunc=” a Seventh-DayAdventistMissioninGuam to take over the control management.of-health services f=om. the Ministryof HealthServiges. This new health care_service agency should be brought_intsany_ exercisebythe.contractor-at.an earlystage. (f) Special Problems Related to Diversity of zesiden Monitoring and special health care for the people of Roncelap, Bikini, and Enewetax mis=_providednot_only_in their _home_at in_othexMarshallislancs whereconsicerable numbe individuals cow reside_eizher temporary_or permanent Por example, there often are as many Rongelarese and Otirikese Ebeye and/or Majuro as are in resicence on Rongelap and Ctirik The past and current medical program under the auspices of the of Energy has had to be tailored to the placeswheresheresice living. at the_time.cf.the quarterly or_annual.surveys. Tis 5a be expected to continue in_she_futureandmst_be_an_inteera proposedcare. Large numbers of Bikinians also are scattered throughcut the } and these individuals also will be entitled to sedical care. the people of Snewetak, Raving iived on tae isolatedatoll of 0 for the past 34 years, are the most cohesive qroup, under the return program to the atoll of Fmewetak, four communities will existence. There will be new communities on (1) Enewetak Isian Madren Island, and on (3) Japtan Island in the southern farc of Enewetak Atoll. Distance between these islands is too great to permit Local health facility. For the foreseeable fsture also, there likely will be an Enewetak community of varying size on (4) Oje Atoll, which ‘s 124 niles southsast of Enewetak, and this must be provided with nedical care.