periodic visits to Marshall Islands for specialized surgary or medical consultations. ophthalmology, dermatology, With this plan otolaryngology, etc. special problems urology, can also be in fEhe orthopedics,| adequately treated in areas of cardiology, fhe Marshalls thereby reducing the number ofreferrals for tertiary carp. Ebeye: The hospital at Ebeye (50 beds) will bé@ staffed and equipped to provide secondary care but at a lesser level than at Majuro. Whenever possible complicated cases will be referred [to Majuro or provided by the Majuro staff commuting to Ebeye. 2. Tertiary Care With the upgrading of medical services at Majuro, it that the referral costs for tertiary care to hospitalgq Marshall Islands can be substantially presently go to Tripler in Hawaii. reduced. It anticipated outside the Mast is recommendei referrals that other facilities, such as Queens, Castle Memorial, and Straub Clinic in Hawaii be considered as alternatives. These facilities were evaluated and can provide complete tertiary care, including cardiac care ahd open heart surgery. Specialty and Rehabilitation Services 1. Dental Currently the three dental Majuro are providing prophylaxis, x-rays dental and officers and their supporting staff in examinations, treatment extractions, and health education. of jaw basic restorBtive fractures, minpbr In addition, the dental care, surgery, plblic health section has attempted three additional services - dental materral and child health services, schoo! dental programs, and field treatment programs. maternal The and child health services are primarily educational, providing young mothers with information that hopefully will be incorporated into their child rearing practices. examinations, education. extractions, The school flouride mouth and field proggams include washer for children, Though a stated objective, these latter services and Mave not been made available on the outer islands because of manpower, buflgetary, and equipment limitations. The short and unpredictable duration field ship stops (1-2 days) has made them an unreliable transport mechaniBpm for these services. 23