II. Executive Summary A. Because of significant time limitations and an already existling 5-year plan for the Marshall Islands (1981-86) developed by the Trusq of the Pacific Islands, Territory Loma Linda University concentratdd more on developing a health strategy proposal than a detailed hedlth plan. Particular attention was paid to the issues involved in a national vs. 4 atoll health care system. B. The Trust Territory of the Pacific Islands is currently phaBing down. Many functions previously covered by that office, i.e. flicensing, planning, personnel, etc. wil] need to be assumed by the Marshal] Island Government. C. Existing. health care financing in the Marshalls comes partl# U.S. and partly from internal Marshallese sources. from the It is r commended that additionalmonies available from P.L. 96-205 be combined viththese_ existing funds rather than components oof the health care syst m receive monies from different unrelated budgetary sources. D. There are minimal Marshalls. radiation related heaith effects evide t in the The primary need is for a basic health care syst m capable The sys em should of providing primary, secondary and tertiary care. have an awareness of a radiation effects as an integra! and id component of comprehensive care. E. The Government of the Marshall Islands is seeking to rapidly air, ship and radio communication with the outer atolls. R attempt to develop a distribution referral and supervision health ahead of outer sectors, at an exorbitant cost, it is r that the health care system be built around these current ina equacies. F. One of the biggest detriments to basic health are, even on ajuro and Ebeye, is lack of adequate supplies and maintenance. mperative It is that a strong support system be developed to meet this need. G. The primarycarewill be built on medical assistants agd health Ne helen la assistants on Majuro andEbeyeas well as the outer islan Smal] populations with minimal work loads are adequately covered] by these workers, with consultation from the hospital physician verbally via radio or by referral, for the more difficult cages. either