Health Needs Assessment of the Marshall Islands - Page 3 6. Were you sick or hurt very badly during the past year? [ ] [ ] 7. Yes No (continue) (skip to question #11) How long were you sick? CHECK CATEGORY 1-3 days 4-7 days 8-14 days 15 or more days 8. Is that the only time you were seriously sick? [ ] [ ] Could you tell me how you felt when you were last sick? del (ee eee ee eee eee ee ee ee ee ee ee eee ee eee ee ee ee ee ee ee oe emcee emcee em epee Reve ee fine me ee bee ferme eed tome beret heme Nil te Ree Reel feed CHECK SYMPTOMS AS THEY TALK. DON'T PROBE TOO DEEPLY BUT ENCOUNAGE THEM TO TALK FREELY. AFTER EACH RESPONSE SAY: "CAN YOU REMEMBER ING ELSE?” | Vm 9. Yes No (please specify) Blurry vision Fever (hot feeling) Gain or loss of weight (more or less than 10 pounds in on@ Shortness of breath : Chest pain ~ Chills (cold feeling) Cough that won't go away Upset stomach Vomitting Diarrhea Abnormal bleeding Fainting spells Dizziness Rash on skin Abnormal mass Excessive loss of hair Excessive urination Jaundice Excessive thirst Sores that won't heal Other (please specify) Other (please specify) month)