.,;

B (Health and Sanitation)1 (Hospitals and Dispensa~ies) 1 Jan 48 (Rep. 7) Majuro Diet •

.:.,

1

1

121

~ l

23

117

GastritisGU InfectionConstipationYawsMyositis

Puncture woundsSprain, joint

Surgical CasesMinor BurnsLacerationsAbrasions

1. USNC AU Hospitals and Dispensaries(a) U.S. Naval Civil Administration Unit, Dispensary, Majuro, (Uliga Island) Marshall

Islands. .(b) Present Bed Capacit~ - 50. All beds devoted to native Care. Ten (10) of these

are beds available for Tuberculosis cases and are Located in a separate andisolated building.

(c) Number of Marshallese Treated:(1) Medical Cases Treated (Out Patient)

Fungus Infections 46Other Skin Conditions 11Common Colds 103Headaches 4EENT 25

TOTAL 208Treated (Out Patient)

104211

TOTAL 81(2) Number of Marshal1ese Hospitalized:

CLASS I Diseases of BloodIBe.mla, Chronic Deficiency

CLASS II Diseases of Circulatory SystemThrombos is, Artery, Cord

B (Health and Sanitation)1 (Hospitals and Dispensaries) - 2 1 Jan 48 (Rep. 7) Majuro Dist.

CLASS III

CU.SS IV

CLASS V

CLASS VII

CLASS VIIIA

CLASS VIIIB

CLASS XI

Diseases of D:lgestive SystemGastro Enteritis, AcuteAppendicitis, AcuteHemorrhoidsVomitingDiseases of Ductless Glands and SpleenHypopituitarismDiseases of Ear. Nose. and ThroatOtitis Media, AcuteOUtis ExternaD:lseases of GenUo Urinary SystemVaricoceleCommunicable Diseases Trans missablebv Oral and Nasal DischargePheumonia, LobarCommon Infectious Diseases of theRespiratory TypeCatarrhal Fever, AcuteTonsillitis, AcuteTuberculosis. (All Forms)Tuberculosis, EKtra Pulmonary,Cervical Gland

4111

1

21

1

1

11

1

r.,r

B (Realth and Sanitation)1 (Rospitals and Dispensaries) - 3 1 Jan 48 (Rep. 7) Majuro Diet.

CLASS XII

CLASS XIII

CLASS XIV

CLASS XVII

CLASS XVIII

CLASS XIX

CLASS XX

CLASS XXI

Venereal DiseasesGonococcus Infection, UrethraOther Diseases of t he Infectious TypeCellulitis, Leg, LeftCellulitis, PenisCellulitis, Arm, LeftDiseases of Lymphatic SystemLymphadenitis, CervicalDiseases of Nervous SystemNeuritis, SciaticDiseases of Respiratory SystemPleurisy, Fibrinous, AcuteBronchitis, ChronicDiseases of Skin. Hair. and NailsImpetigo, ContagiosaImpetigo, HerpetiformisHerniaeHernia, Inguinal, IndirectMiscellaneous Diseases and ConditionsDU(Perinephritic, Abscess)DU(Medical Observation)No Disease (NewBorn)Absence Acquired, ~e, Left

1

211

1

1

12

11

1

1141

B (Health and Sanitation)1 (Hospitals and Dispensar1es) - 4 1 Jan 4B (Rep. 7) Majuro Dist.

111

1Tibia 1

1

51111

1

22

CLASS XXII

CLASS XXIII

CLASS XXIV

CLASS XXV

CLASS XXVII

Parasitic Diseases (Fungi and Certain AnimalParasftesAscariasisParasitic InfestationTinia ImbricataTumorsLf. poma , BackTumor, Mixed, Activity Unknown,Carcinoma, Cervix, Grade FourFemale Diseases and ConditionsPregnancy at TermPregnancy with HydramniousSalpingitis, AcuteDysmenorrheaSalpingitis, ChronicInjuriesFracture, Simple, Radius, LeftDental Diseases and ConditionsAbscess, ToothCaries, Teeth

TOTAL 58

B (Health and Sanitation)I "(Hospitals and Dispensaries) - 5 1 Jan 4S (Rep. 7) Majuro Dist.

(3) Dental - Total - 4Tooth, Uncomplicated extractions -------------------Oral Examinations-------------------------------··--­Local Anaesthesia-----------------------------------Restorations----------------------------------------

242o

This activity does not have a Dental Offieer attaehed. In theDental Offieer, neeessary emergency treatment is given by the Medical

(d) Number of hospital days furnished to natives-----------­Number of native patients on last day of month----------

(e) Native hospital training program:(1) Marshallese Nurse Aides.

absence of aOfficer.90'7

24

5.15.

Dec$30.

Nov$30.

5:5.

15.15.

or Paper mo.per mo.per mo.per mo.

Number1113

NOTE:One (1) Nurse Aide (Untrained) received during the quarter. One (1) NurseAide (Untrained) was transferred to Guam for a course of instruetion at theSchool of Nursing. Present "On Board" break-down:

1 Nurse Aide (Trained)4 Nurse Aide (Untrained)

I ,

B (Health and Sanitation)1 (Hospitals and Dispensaries)- 6

(2) Marsha11ese Health Aides:

1 Jan 48 (Rep. 7) Majuro Dist.

QuarterlyNumber Rating Rate of PaY Oct. Nov. Dec. EarninFs

1 H.A. (Trained)Interpreter szi. per DlO. $21. $21. $21. $63.00

2 H.A. (Trained) 8. per mo. 16. 16. 16. 48.003 H.A. (Trained) 6. per mo. 18. 18. 18. 54.004 H.A •(Untrained) 5. per mo. 20. 20. 20. 60.00

NOTE: There were no changes in the "On Board" Health Aide Personnel during the quarter.

(3) Others employed - None.The program of instruction to Health Aide and Nurse Aide Trainees i8

continuing, with the first formal six month period drawing to a close. Priorto this reorganized schedule (discussed in previous reports) personnel weretransferred at varying times and no definite class could be maintained, withthe result that some received only part of the requisite studies, while othersrepeated reany times.

Beginning with 1 July 1947, however, a scheduled period of instructionwas begun and there were no transfers during this period. Although this hasmeant that some personnel have been in the field longer than advisable, it isfelt that getting on to a definite schedule has been of great value. It is nowpossible for Health Aides and Nurse Aides to count on returning to USNCAUDispensar~y after a year in'the field, for a six months instruction, which iseagerly anticipated by all concerned.

B (Health and Sanitation)1 (Hospitals and Dispensaries) - 7 1 Jan 48 (Rep. 7) Majuro Dist.

To facilitate this rotation, a plan has been set up whereby the totalpersonnel under this command's jurisdiction are divided into three groups, onegroup at a given time in the Main Dispensary for training while the othertwo groups are in the field, with rotations taking place every six months. Thisplan has necessitated establishing a "numerical relief" system for eachperson to maintain adequate staffing of all SUb-dispensaries. Where loss inthe rotation occurs through transfer to the Practitioner School at Guam or tothe School of Nursing at Guam, new pe~onne1 have been recruited.

The previous poli~ of returning personnel only to their own homes has beendiscarded 88 being cumbersome and unnecessary. It is felt by both theAdministration and the Marsha1lese personnel concerned that the training has beenadequate enough for a man to acquire prestige and confidence through his abili­ties, without having to depend upon his former village status. In some casesthis may prove advantageous in that a man goes to a village as a "governmentemp1oy~e", and not just as a former resident returning home. That this planis feasable has been proven in two instances where it was necessary to "farmout" personnel who have since accomplished far more than anticipated.

No changes in personnel have been effected since the previous report exceptfor the transfer to the School of Nursing, Guam, of one girl in November.Ria, a Japanese-trained Health Aide at Majuro Village, has been relieved for ashort period for a "refresher course" by a trained man of high caHbre.

The recent visits to Jaluit, Ebon and Wotje ~tol1s introduced new prob­lems to this Unit, in that the men found in these dispensaries are very much

B (Health and Sanitation)1 (Hospitals and Dispensaries) - 8 1 Jan 48 (Rep. 7) Majuro Dist.

in need "of further training, but have no "numerical reliefs" at present. Itis understood that there are several Health Aides from these atolls atKwajalein who have not transferred to Majuro since the atoll transfer waseffected. It was also found that each atoll was under-staffed. Recruits forthe tralnine program will be brought in from these atolls for the next class.Generally speaking, the sub-dispensaries in these newly assigned atolls werefound to be in excellent physical shape, with competent personnel in charge,but badly in need of supplies. The native-type Dispensary building at Imroj VVillage in Jaluit Atoll was noted with particular approval. Plans and detailsof this building are being used as a model for other villages needing newbuildings.

Progress in all phases of training has been noted at the Main Dispensary.The English classes have proven more than satisfactory, and it can bestated that all Health Aides and Nurse Aides now have a working knowledge ofEnglish. They understand written and spoken English fairly well, and whilehaving more difficulty in speaking English, can get along. At least fourof the younger men are very proficient in the language, and have been usedas interpreters. One man has voluntarily taken on an extra hour a dayinstruction at the Teacher Training School in an effort to improve even more.

With improvement i n English, instructions in t he other phases has becomeeasier, as, while instruction is given through an interpreter, enough Englishis understood to eliminate most of the misunderstanding which is almostinevitable when working in two languages. This has not been all one-sided inthat t he Medical Officers themselves have ~ade distinct efforts to learn Marshallese

" I I '

B (Health and Sanitation)1 (Hospitals and Dispensaries) - 9 1 Jan 48 (Rep. 7) Majuro Dist.

Instruction in Anatomy, Medicine, Surger , Obstetrics, Dermatology,Elementary Physiology, Mathematics and English is gi ven in formal classes tototal of about ten (10) hours a week, while Physical Diagnosis, Therapeutics,Medical Records, Surgical and Obstetr i.cal technique are given at the bedside orin the operating room to a total of at least another ten (10) hours. .A11Health Aides and Nurse Aides rotate through the various service, i.e. Sick Call,Surgery, Ward, TB, and Sanitation and have definite parts in all procedurecarried out, such as deliveries, operations, reading of X-Rays, treatment, etc.These personnel have proven themselves apt students. A period of rotat jon throughthe laboratory and pharmacy. is anticipated but has not yet been instituted.