d. Location of “Health Centers" M. The present location of clinics is given on the maps fund in Appendix A minimum of one "Health Center" should be located onl each of the 21 atolis/islands listed under “health manpower". The mai clinic-health center should be on the island within the atoll that as the largest population concentration, and be near to the either existling or proposed airport (for medical evacuation of patients). Where thelfatol]l: does not foresee getting the "lagoon boat service" implemented (as planned by the government), or, where the distance is too large and weather times of the year, then an additional @angerous during “nealth center" may be warranted, Where to place them should be decided in 5-7 years when thefinitial centers are well established. In the meantime health assistants} working out of existing clinics should continue to function in these remotd B. Hospitals 1. Physical plant Majuro: square The Armer Ishoda Memorial Hospital is apprqximately 53,000 feet in area with 88 beds. Because of poor environmental problems, not all beds are available for use. hold true for the facility itself. climate conditions. U.S. areas. standards. in As compared to other third world hospifals, disrepair, the facility itself could There have been funds that the consideration it should goint of view. e upgraded rovided to in the This appears not to be an option, howevey, as the ground lease expires in two years and the owner is not willing to recommended The same would No attempt was made to compare or evalidjate in terms of adequately support the level of care anticipated to be Marshall Islands. and The facility design jis qufte good for the probably receive a fair rating from a design and condition Although aintenance given ($8,000,000) new hospital in the menew the lease. granted for a new hogpital. be design a 100 to meet bed hospit cultural with fneeds [It is careful and the environmental (climate) issue. A U.S. type hospital would mot be effective in meeting these concerns. The hospital must not be ovpr-designed but designed for a level provided. of health care delivery consistent with that to be An example of the type off issue that must be ddalt with in the design is the need for a larger than normal recovery and rehafilitation area. This is due to the large referral area being served and the 1 ck of following cn care available away from the hospital.