“ Some of the patient load. newer 4ill-Burton clinics were built where is no veal trdre The possibility of dismantling and moving some of these misplaced Hill-Burton clinics should be explored. Clinics will probably need rebuilding. At least 1/2 - 2/3 df the present At all “health center" sfite additional upgraded housing for the medical assistant and the group meeting elter will be needed. Thus it is estimated that 21-25 atolls and islands wil] need (some may need two because of the size and remoteness of lagoons). Health Centers islands within the Probably 5-7 of them are presently adequate except for|minor repair, leaving 16-18 needing total replacement. Some of the smaller atolls and islands (which will only have health assistants due to low populations) will need only a small clinic and many already have one i.e. Ujae. Some criteria ame stated below for the physical facilities, along with preventive maintenance sliggestions and some equipment recommendations. Recommendations: 1. It is recommended that the clinic size be maintained Bt about 1,000 Square feet maximum. 2. Alumninum (preferably) roofs should be used where Furthermore this roof should be used for water catchment] possible. draining to a cistern of sufficient dimensions to provide for dependatile fresh water year round. 3. Water seal toilets must be provided, both for patients in holding beds, and outpatients who need a separate facility. 4. Windows and doors must be of a low maintenance type and durability. Plastic is strongly recommended. considerable Fibergfass products, especially in the medicine cabinet areas, are the desirable choices. 5. Plumbing must be plastic, with all the fittings preferably plastic also. Pumps to raise water to tanks must be the simplest] possible and materials for maintenance must be available locally. 6. The two present superclinics are oversized and underut}lized. It is recommended that a standard size clinic-health center befbuilt to serve Jabor on Jaluit and the Superclinics are now present. Wotje/Wotje population [center where The existing physical plant on Wotje could be used for other community services. Preventive Maintenance needs: l. A preventive maintenance schedule must be provided with the equipment, and the health worker trained to maintain the equipmer t. Occasional preventive maintenance checks from the central support service section on Majuro are needed also. 3