MINISTRY OF HEALTH IN THE REPUBLIC OF THE MARSHALL ISLANDS
Ebeye Community Health Center is the sole healthcare provider to over 15,000 Marshallese residents of Kwajalein Atoll in the Marshall Islands. The main health center is located in Ebeye but we also provide health services to all other communities along the chain of islands within the atoll through our outer-island dispensaries and periodic outreach visits.
The purpose of our IDS grant project is to expand our services to the medically-underserved by improving health center staffing and core service capacity in the outer-islands.
Lack of Personnel Capacity:
For the past several years, our center has been lacking in adequate manpower to fully implement our programs. Our few doctors aside from performing clinical work are also tasked to provide primary health care work, outreach duties, and administrative functions. We only have one nurse staff working full-time on each public health program ? responsible for clinical work, data encoding, reporting, and outreach activities for their specified field of work. Although we encouraged multi-tasking and integrated work amongst our personnel, the workload itself oftentimes are overwhelming to our staff and as a result, expanding their programs to serve more people seems insurmountable. Furthermore, professional staff turnover is high. Retaining good health care providers is difficult because these professional tend to seek employment to other places where they can be adequately compensated for their work.
The Need to Expand Services in the Outer-Island Communities:
Our Community Health Center?s current scope of project include service delivery sites to the island communities of Ennibur (Santo), Ebadon, and Guegeegue which are all within the Kwajalein Atoll. These communities are well under-served compared to the people living in Ebeye. There are great disparities in terms of health outcomes within these sites compared to Ebeye. Complication rates of Diabetes and Hypertension are higher. Many patients often come with kidney failure, foot gangrene, and retinopathy - common Diabetes complications that could have been delayed or prevented with adequate Diabetes screening, control and management during regular primary health care consultations. Perinatal outcomes are also relatively worse compared to Ebeye. Pregnant patients don?t have regular prenatal care and if ever they do decide to be seen by the Obstetrician ? they have to travel most of the time to Ebeye and they usually have late entry into prenatal care. Because most of these islands are only accessible by boat, access to healthcare relies heavily on the core capacity of the dispensaries and to the quarterly visits by our outreach team. Currently, our outer-island dispensaries are only manned by health assistants who have limited capacities in assessing and treating patients who come in for help.
In a nutshell, our Community Health Center has continually identified the changing needs in our community in terms of health care services. Our health center face manpower and funding limitations needed to expand its medical service capacity.
The IDS project will enable us to retain one medical provider to work in Ennibur Dispensary; hire two registered nurses to work on two other dispensaries; hire four practical nurses from our training program to work in the main health center; and hire two new support/facility staff (boat operator and mechanic) to improve outer-island outreach services. On top of this, the IDS funding will also be used to acquire minor equipments and essential medical supplies to support the service expansion in the outer-island dispensary units for the new staff manning these units.