|
By MARK STEGE
The RMI government considers
the 177 Health Care Program for nuclear test-affected
Marshallese as “critical” and has made a commitment to
continue the program into FY2005, according to Deborah
Atwood at the Ministry of Health.
“The RMI government and four atoll leadership had been
pushing for additional funding of $2 million from Congress
to continue 177” in FY2005, Atwood explained, “but that did
not happen.”
In a visit to Washington,
DC by the four atoll leadership and President Note this past
June, according to Atwood, “the best we could have hoped for
was $1 million, which would have been added onto an existing
bill which was being considered by Congress, but that did
not happen either.”
At the moment “there is no
certainty for future US funding for the 177 Program until
after the US national elections in November,” she said.
Meanwhile, new doctors are needed to be recruited, which
takes one-to-two months, and to do that “some kind of
contingency plan or commitment from the RMI government” was
needed, according to Atwood. “I just got back from a
recruitment trip in Nepal, and five new doctors will be
coming in October.”
Atwood, an employee of Trinity Health International which
has been managing 177 now for 17 years, said that “the US
government is failing miserably in fulfilling its
responsibility to the four atolls. This is ultimately their
responsibility.”
“Even before the Compact
existed,” she explained, “under the Burton Bill, which says
this health care program would continue regardless of
changes in government, structure, or relationship, unless
otherwise specifically terminated by an act of Congress,
basic health care services for the nuclear test-affected
atolls was to be provided by the US in perpetuity.”
Already, significant pay
cuts by 177 doctors and cuts to its staff have been
necessary, with still more cuts anticipated, according to
Atwood. Under a “bare bones operating budget” for FY2005
requested by Foreign Affairs Minister Gerald Zachios and
Health Minister Alvin Jacklick, “the Ministry of Health will
have to absorb the costs for tertiary care (off island
referrals) and secondary care” on Majuro for medical
treatment to eligible residents of the four atolls, she
said. The decreased budget in FY2005 would still place
doctors in Majuro and each of the four nuclear test-affected
atoll populations, she added.
“I think the DOI, DOE, and
US government shirked their responsibility. And I hope that
the program can continue at a level of funding closer to the
level in the past after the US elections.”
According to Minister
Jacklick, among the RMI government’s primary objectives in
addition to ensuring the continuation of the 177 program is
getting the changed circumstances (nuclear test
compensation) petition advanced.
A US Congressional hearing
on the petition is expected to take place in the early part
of 2005, according to Minister Zachios in his report to
Nitijela last week.
Outer island doctors a
financial success
The 177 Health Care Program
provides not only basic health care to nuclear test-affected
communities in the RMI, but acts as a model for the Ministry
of Health’s primary care initiative, whereby the Ministry
provides a wide range of medical services on site to outer
island communities in order to avoid costly medical
evacuations while improving the quality of health care
available to these communities.
According to Deborah
Atwood, this initiative thus far used in the four atolls has
“more than paid for physician salaries on money saved” for
medical evacuations and cost for flying out doctors to the
outer islands for one week at a time four times a year.
Now the communities under
this initiative “have the ability to access these doctors 24
hours a day, seven days a week, and it has made a huge
difference in the quality of health care,” she said. |
