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Medical evacuations costly

By Giff Johnson

MAJURO, Marshall Islands (Marianas Variety, May 12, 2008) — The high-profile stranding of international scuba divers at Bikini Atoll in the Marshall Islands has attracted headlines, but the halt of all domestic air service for one month is causing medical evacuation costs to skyrocket for the Ministry of Health, which has been forced to resort to ships to transport seriously ill patients over long distances to get medical treatment.

The ministry has been hard hit by the suspension of air service since Oct. 10, according to the director of outer island dispensaries.

Costs for medical evacuations from the outer islands have more than doubled while Air Marshall Islands has been grounded, and one girl died as she was being transported by ship to Majuro from a remote outer island.

Arata Nathan, director of the outer island dispensary system, said Thursday that the costs for long-haul distances from Majuro — most atolls in this nation range from 100 to more than 500 miles distant from Majuro – have more than doubled now that the Ministry must charter boats to get critically ill patients into Majuro.

"When we charter Air Marshall Islands to Utrik it costs $4,000," he said.

"When we chartered a boat, it cost almost $9,000. Our costs are way up."

It’s been more than a challenge for the Ministry, which has handled about half a dozen medevacs by boat since Oct. 10.

"We’re using small speed boats for the atolls close by Majuro," he said.

But for the more distant atolls, the Ministry has turned to Sea Patrol’s marine surveillance vessel and other privately operated vessels.

Most people on the remote islands have access to only rudimentary health services through a government-provided health dispensary and health aide.

Anyone seriously ill is generally flown to one of the two hospitals in the urban centers for advanced treatment.

Nathan said they’ve had to be creative in diverting vessels already at sea to pick up sick patients. "Last week we requested Sea Patrol’s vessel to divert from Bikini to take an Ailinglaplap Atoll patient to Ebeye Island (hospital)," Nathan said. On Monday "we had to divert Lomor to Likiep to pick up another patient."

A patient on Mejit Island who needs to be medecaved but who has been stabilized is now waiting for a ship that’s in the vicinity to come into Majuro, he said.

"It’s complicated, but it’s working," he said.

Nathan and Bikini officials confirmed that an 11-year-old Bikini girl died before she could reach Majuro.

Nathan said that the Ministry chartered a vessel to bring back teams from the Ministry that had flown to many outer islands to conduct an immunization survey. The vessel was coming back from southern islands when the girl needed to be medevaced from Kili Island, where the displaced Bikini Islanders live, so the ship was diverted to pick her up.

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