The Marshai: 1 i Islands Government has served as a most important source of information, insight, understanding and background. We wewe fortunate to meet with the king, president, ministers of health, finance,l resources and development, communication, the chief secretary, many ministerial secretaries, and personne] in the operational le health department. pf other the Is within the Also brought into discussions were the Gham-Micronesia Mission subcontractors who are currently managing the healthicare system. Half of the atolls and islands were visited, including: ajuro, Ebeye, Enewetak, Rongelap, Utirik, Mejit, Wotje, Likiep, Maloelap, ilinglapalap, Visits on these islands were all wel received and The team was able to visit and study both hospita , both super Arno, Jaluit and Mili. useful. clinics, and over a third of the dispensaries. with local leaders, magistrates, On each islan Iroij, alab, councils, chief secretary representatives, health personnel, and other local people. group meetings were held. the team met Four survey instruments were used any extensive dealing with the health facilities, clinic personnel, general information, environmental and resident needs assessment (samples are in Appendix G). gathered a great deal of information, from which plans These surveys pplicable to currently existing needs and project demands can be built. C. Assumptions The following represent major activities that are being mplemented by the Marshallese Government independent of the existing health budget. obviously impact the health care system and this prop sal, so They its relationship to each is discussed. 1. Majuro Hospital Plans are currently being discussed regarding the buil ing of a new The current hospital is in poor physical ondition and the land where it is located "must" be returned to its owner t the end of hospital in Majuro. the 25 year lease in 1981. The possibility of constructing an “interim” facility is being considered, which could later serve as clinic. n outpatient Neither the advisability of rebuilding vs. renov ating nor the budgetary implications are dealt with in this proposal. 2. Nursing School The Board of Regents, College of Micronesia has recent] y|voted to move its nursing school from Saipan to Majuro. Funding for this m t builiding requirements on Majuro,. available faculty, etc. are unclear the present