DOCSLIB.ORG

Annual Health Data Report 2009

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Annual Health Data Report 2009 MINISTRY OF HEALTH REPUBLIC OF THE MARSHALL ISLANDS “KUMITI EJMUUR" ANNUAL REPORT FY 2009 2 3 4 A Joint Message from the Minister and Secretary of Health We are pleased to present the Annual Report for the Ministry of Health Fiscal Year 2009. Based on the MOH vital statistics, there were 1,603 registered births in FY2009. Out of these registered births, 232 births were born to mothers under 20 years of age showing teenage pregnancy rate of 14%. There were 43 babies with low birth weight born to teenage mothers, and 18 premature teenage pregnancies during the fiscal year. Although there is improvement in submitting the vital statistics reports, 106 of the birth registration forms did specify age of mothers during births, which may explain the decrease in the percentage of teen pregnancy rate during the fiscal year. The need to improve completion of vital statistics forms submitted from health centers is a continuing barrier for the Ministry. Mortality and morbidity statistics indicated 339 deaths during the fiscal year with 38 infant deaths and four (4) maternal deaths, the highest number of maternal deaths since 1988. Infant mortality rate is calculated at 24/1,000 live births during the fiscal year. Leading cause of infant death is prematurity. Diabetes related diseases remain the number one cause of death followed by all types of cancer during the fiscal year. In reproductive health services, the percent of pregnant mothers who visit prenatal clinics during the first trimester of their pregnancy remains low at 18%. Although the Ministry encourages pregnant mothers to attend prenatal care during the first three months of pregnancy, most pregnant mothers seek prenatal care during the second trimester, and this accounts for 33% of the first prenatal care visits during the fiscal year. Additionally, the contraceptive commonly used by women who visited the family planning clinic was the three‐month hormonal injection followed by oral contraceptives. The family planning clinic recorded 2,305 female clients during the fiscal year, and out of this number 204 women visited the clinic because they wanted to get pregnant. Most women in the 20‐34 age are the regular users of the family planning program. Condom distribution is carried out not only in the family planning clinics but to other designated areas such as the Youth to Youth in Health clinic, STI program, outer islands health centers, businesses sites on Majuro, 177 HCP and Kwajalein Atoll Health Care services. Similar to previous two fiscal years, the number of male clients that visited family planning services was very low at 199 and only one case of vasectomy. One of the challenges that MOH faces during the past two years is the discrepancy of the immunization coverage rates for the RMI. The definition of immunization coverage rate is based upon having a child age 19‐35 months completing 1‐4‐3‐3‐3‐2 (BCG‐DTaP‐OPV‐HepB‐HIB‐ MMR) immunization protocol. Three vaccines have been included during the fiscal year into the immunization program against pneumonia, diarrheal diseases and meningitis. The vaccination schedule has been modified based on needs and new vaccines added to the program and still in compliance with recommended schedule by WHO and CDC. Since the immunization program was introduced in 1980’s, the denominator used for calculation of coverage rate is the number of MOH registered children 19‐35 months that have completed their required vaccination. This formula was developed for the RMI based on the distance and isolation of population in the RMI. The Immunization Program attempts every year to reach 95% immunization coverage rate. However, unexpected circumstances such as transportation to reach all the children in the outer islands are a constant challenge. During the fiscal year the program managed to reach 21 atolls. Based on the definition and formula used by MOH, the immunization coverage rate for RMI is 89% for FY2008. All babies born in the two hospitals continue to receive the first dose of Hepatitis B during the first 24 hours after delivery and the BCG shot against TB. Because of the distance and the lack of necessary equipment to keep cold chain of vaccines intact, not all children born in the outer islands receive Hepatitis B and BCG during the first 24 hours. However, they are vaccinated at a later date with visiting teams. Diabetes Mellitus remains the highest health challenge during the fiscal year. The changes in lifestyles which include eating habit and lack of exercise have contributed to the high prevalence rates of diabetes, disabilities due to diabetes related causes and number one causes of death in the country. The prevalence rate of diabetes continues to be very high at 368 per 10,000 populations. The number of surgeries for amputation remains high at 57 for the fiscal year and cases presented with gangrene complications was 92. Diabetes is a disease that can be controlled, and individuals need to take charge of their own health to live a healthy life regardless of diabetes. Although the Ministry can provide educational information for promoting healthy choices and lifestyles, taking charge is one’s responsibility. We encourage every individual in the country to take charge of their own health and change their lifestyles. Like diabetes, cancer of all types is the second leading cause of death in the RMI. Prevalence of Tuberculosis (TB) remains high with number of new cases found due to aggressive screening and contact tracing. With funding from the Global Fund, the Ministry was able to hire more staff for the TB program for contact tracing and strengthening of the DOT program in the community. However, there are still patients who refuse treatment, and there are still those who defaulted from treatment because they relocate to outer islands or to the states without informing the program staff. The ministry alone cannot be successful if the patients themselves do not take the initiatives to comply with treatment. Even though the course of treatment for TB is extensive, but it is an illness that is curable if the patients comply with treatment. We need the support of our stakeholders and partners to encourage individuals to complete treatment and/or refer patients for treatment if necessary. 6 Last but not least, although the Ministry conducted a nationwide leprosy screening in 1997, the prevalence rate of leprosy has continued to increase during the last fiscal year. Increase in the prevalence rate from 8/10,000 population in FY2006 to 21/10,000 is a grave concern. The increase in prevalence rate indicates transmission of the disease is on‐going within various communities. The Ministry has already identified atolls with high prevalence rate to target for aggressive screening, treatment and follow‐up. Detailed information and tables for other program areas and services is inclusive in this report, and we do hope that this report is useful. For the next fiscal year, the Ministry will be going into the first phase of reorganizing its structure to strengthen areas in public health and preventive services. Thank you. 7 TABLE OF CONTENTS I. Geography and Demography 11 II. Financial Support 15 III. Workforce 19 IV. Statistics 23 V. Maternal and Child Health 29 VI. Immunization 35 VII. Oral Health 45 VIII. Mental Health 47 IX. Non‐Communicable Disease 51 X. Communicable Disease 55 XI. Medical Referral 61 XII. Hospital Services 67 XIII. Organizational Chart 75 XIV. Acknowledgement 76 9 10 GEOGRAPHY AND DEMOGRAPHICS 11 GEOGRAPHY AND DEMOGRAPHICS The Marshall Islands consists of 29 atolls and five major islands, which form two parallel groups‐ the “Ratak (sunrise) chain and the “Ralik” (sunset) chain. The Marshallese is of Micronesian origin. The matrilineal Marshallese culture revolves around a complex system of clans and lineages tied to land ownership. The Marshall Islands has an area of 1826 square kilometers and is composed of two coral atoll chains in the Central Pacific. The Marshall Islands is a parliamentary democracy, constitutionally in free association with the United States of America. It has a developing agrarian and service‐oriented economy. Table 1: RMI Population Developments, 1999, 2006‐2010 Year Total Male Female 2010 54,305 27,843 26,462 2009 54,065 27,741 26,324 2008 53,889 27,643 26,246 2007 52,701 27,022 25,679 2006 52,163 26,746 25,417 1999 50,840 26,026 24,814 Table 2: RMI Projected Population by Age Age Group 2008 2009 0 ‐ 4 7,949 8,011 5‐9 7,471 7.371 10‐14 6.949 7,200 15 ‐ 19 6,351 6,152 20 ‐ 24 6,384 6,370 25 ‐ 29 4,275 4,491 Table 1 indicates the RMI Population Estimate of April 2009. EPPSO released 30 ‐ 34 2,626 2,639 a new population estimate different 35 ‐ 39 2,304 2,212 from the Projected Population done in 40 ‐ 44 2,180 2,103 July 2007. MOH updated the table 45 ‐ 46 2,068 2,043 based on the recent release. As per 50 ‐ 54 1,790 1,784 2007 and 2008 data, it was calculated 55 ‐ 59 1,479 1,525 on the population released on July 60 ‐ 64 897 971 2007. 65 ‐ 69 473 498 70 ‐ 74 331 333 75+ 361 363 Total 53,889 54,065 Source: EPPSO RMI Population Estimate April 2009 12 GEOGRAPHY AND DEMOGRAPHICS Table 3: Health Care System by Main Islands Table 4: Number of Beds in Two Major Hospitals Majuro Number Leroij Atama Zedkeia Medical Center Hospital of beds Laura Health Center Leroij Atama Zedkeia Medical Center 101 Rongrong Health Center Leroij Kitlang Kabua Memorial Hospital 45 Ebeye, Kwajalein Leroij Kitlang Kabua Memorial Hospital Santo Health Center Outer Islands Ratak Chain Ralik Chain Table 5: Specialized Program Milli Ebon
Load more

Recommended publications
  • Statistical Yearbook, 2017
    REPUBLIC OF THE MARSHALL ISLANDS STATISTICAL YEAR BOOK 2017 Economic Policy, Planning and Statistics Office (EPPSO) Office of the President Republic of the Marshall Islands RMI Statistical Yearbook, 2017 Statistical Yearbook 2017 Published by: Economic Policy, Planning and Statistics Office (EPPSO), Office of the President, Republic of the Marshall Islands Publication Year: June, 2018 Technical support was provided by Inclusive Growth Thematic cluster, UNDP, Pacific Office, Suva, Fiji Disclaimer The opinions expressed herein are those of the author and do not necessarily reflect the views of the UNDP or EPPSO. The pictures used in this publication are mostly taken from the Google search and some from the respective organization’s websites. EPPSO is not responsible if there is any violation of “copy right” issue related with any of them. 1 RMI Statistical Yearbook, 2017 TABLE OF CONTENTS PREFACE ...................................................................................................................................... 5 FOREWORD .................................................................................................................................. 6 LIST OF ACRONYMS ...................................................................................................................... 7 SUGGESTED NOTES PRIOR TO READING THIS PUBLICATION .......................................................... 10 BRIEF HISTORY OF REPUBLIC OF THE MARSHALL ISLANDS ............................................................. 12 REPUBLIC
    [Show full text]
  • Atoll Research Bulletin No. 503 the Vascular Plants Of
    ATOLL RESEARCH BULLETIN NO. 503 THE VASCULAR PLANTS OF MAJURO ATOLL, REPUBLIC OF THE MARSHALL ISLANDS BY NANCY VANDER VELDE ISSUED BY NATIONAL MUSEUM OF NATURAL HISTORY SMITHSONIAN INSTITUTION WASHINGTON, D.C., U.S.A. AUGUST 2003 Uliga Figure 1. Majuro Atoll THE VASCULAR PLANTS OF MAJURO ATOLL, REPUBLIC OF THE MARSHALL ISLANDS ABSTRACT Majuro Atoll has been a center of activity for the Marshall Islands since 1944 and is now the major population center and port of entry for the country. Previous to the accompanying study, no thorough documentation has been made of the vascular plants of Majuro Atoll. There were only reports that were either part of much larger discussions on the entire Micronesian region or the Marshall Islands as a whole, and were of a very limited scope. Previous reports by Fosberg, Sachet & Oliver (1979, 1982, 1987) presented only 115 vascular plants on Majuro Atoll. In this study, 563 vascular plants have been recorded on Majuro. INTRODUCTION The accompanying report presents a complete flora of Majuro Atoll, which has never been done before. It includes a listing of all species, notation as to origin (i.e. indigenous, aboriginal introduction, recent introduction), as well as the original range of each. The major synonyms are also listed. For almost all, English common names are presented. Marshallese names are given, where these were found, and spelled according to the current spelling system, aside from limitations in diacritic markings. A brief notation of location is given for many of the species. The entire list of 563 plants is provided to give the people a means of gaining a better understanding of the nature of the plants of Majuro Atoll.
    [Show full text]
  • Ground-Water Resources of the Laura Area, Majuro Atoll, Marshall Islands
    GROUND-WATER RESOURCES OF THE LAURA AREA, MAJURO ATOLL, MARSHALL ISLANDS By Scott N. Hamlin and Stephen S. Anthony U.S. GEOLOGICAL SURVEY Water-Resources Investigations Report 87-4047 Prepared in cooperation with the REPUBLIC OF THE MARSHALL ISLANDS Honolulu, Hawaii 1987 UNITED STATES DEPARTMENT OF THE INTERIOR DONALD PAUL HODEL, Secretary GEOLOGICAL SURVEY Dallas L. Peck, Director For additional information Copies of this report write to: can be purchased from: District Chief, Hawaii District U.S. Geological Survey U.S. Geological Survey, WRD Books and Open-File Reports Section 300 Ala Moana Blvd., Rm. 6110 Federal Center, Bldg. 41 Honolulu, Hawai 96850 Box 25425 Denver, Colorado 80225 CONTENTS Page Abstract ------------------------------------------------------------ 1 Introduction -------------------------------------------------------- 2 Purpose and scope ---------------------------------------------- 5 Setting -------------------------------------------------------- 5 Previous investigations ---------------------------------------- 6 Acknowledgments ------------------------------------------------ 8 Methods of study ---------------------------------------------------- 8 Surface geophysical survey ------------------------------------- 8 Installation of driven-well network ---------------------------- 8 Test holes and collection of lithologic samples ---------------- 11 Collection of water samples ------------------------------------ 11 Measurements of water levels ----------------------------------- 13 Geohydrologic framework ---------------------------------------------
    [Show full text]
  • An Assessment of the Impact of Climate Change on Agriculture and Food Security in the Pacific
    SUB-REGIONAL OFFICE FOR THE PACIFIC ISLANDS An Assessment of the Impact of Climate Change on Agriculture and Food Security in the Pacific A Case Study in the Republic of the Marshall Islands Prepared by: Muliagatele Joe Reti FAO Consultant February 2008 FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS AN ASSESSMENT OF THE IMPACT OF CLIMATE CHANGE ON AGRICULTURE AND FOOD SECURITY IN THE PACIFIC A CASE STUDY IN THE REPUBLIC OF THE MARSHALL ISLANDS Prepared for FAO SAPA By Muliagatele Joe Reti Pacific Environment Consultants Limited (PECL) Apia, Samoa February 2008 1 Table of content Acronyms and Abbreviations 3 Executive Summary 4 Summary of Recommendations 6 Map of the Marshall Islands 7 Introduction 8 Physical and natural environment of the Marshall Islands 8 Social and cultural setting 12 Economy 15 The Agriculture Sector in the Marshall Islands 18 Climate change – its significance to the Pacific islands 22 Climate change scenario in the Marshall Islands 24 The likely impact of climate change on agriculture in the Marshall Islands 26 Typology of likely impacts 28 Other factors contributing to the vulnerability of the agriculture sector 30 Climate change related activities of other Organizations in the Marshall Islands 32 Existing Institutional Mechanisms and Policies 35 National Strategy to mitigate and adapt to climate change 40 Success stories and lessons 43 Recommendations – General 45 Conclusions 47 Annexes 49 Bibliography 56 2 Acronyms and Abbreviations EEZ Exclusive Economic Zone NEMS National Environment Management Strategy
    [Show full text]
  • 2020, Pp. 339-358 Being the President: Hilda Heine, Gender and Political Leadership In
    Small States & Territories, 3(2), 2020, pp. 339-358 Being the President: Hilda Heine, Gender and Political Leadership in the Marshall Islands John Cox School of Humanities and Social Sciences La Trobe University Australia [email protected] Jack Corbett School of Social Sciences University of Southampton U, K. [email protected] and Ceridwen Spark School of Global, Urban and Social Studies RMIT University Australia [email protected] Abstract: The literature on gender and democratic politics in the Pacific Islands is dominated by a deficit model that seeks to explain the dearth of women candidates, of MPs and of women holding senior political positions. A small body of recent scholarship has focused on the experience of a select few women who have defied the odds to win high office. Specifically, this work has focused on the strategies that women leaders employ to win election in male dominated environments. This article extends these studies by focusing on how women govern and lead. Drawing on interviews with President Hilda Heine, the first and only woman elected head of state in a small Pacific Island country, her staff and network of supporters, we outline seven strategies for women politicians. Documenting these strategies serves three distinct purposes: 1) they add to our understanding of how Pacific women leaders undertake intentional action to shape male dominated environments; 2) they contain important primary source material that adds to the historical archive of this period in Marshallese politics; and 3) they inform efforts by reformers, including international donors, aiming to equip women leaders to serve in senior positions, both in Marshall Islands and the wider Pacific island region.
    [Show full text]
  • Marshall Islands Adoption Treaty
    Marshall Islands Adoption Treaty Glimmery and dissymmetrical Thaxter always deionize incessantly and skunk his funfairs. Sasha remains wriggling: she whipsawing her luminosities honing too indestructibly? Acaroid Jehu never vilified so ungravely or unfasten any blusters spiritually. An online forum for rigorous discussion and analysis of current issues in human rights law. Easiest Countries To grain From 2021 World who Review. States under this section may not be made when incorrect payment has been made to an individual who is without fault and when adjustment or recovery would defeat the purpose of this title or would be against equity and good conscience. Since the indictment in October, Petersen was suspended from his elected position and subsequently resigned in January. Visit our fee schedule, when adjustment in a long term. The women later told authorities that they were headed to Arkansas to put their children up for adoption. In some instances, domestic insolvency proceedings have amounted to a breach of IIA obligations. Nuclear Age Peace Foundation. It was not always that way. To activate this feature, you will need to add a parameter to your apstag. Funding for groundwater monitoring. This balancing act is exacerbated by limited access to water, electricity, technology, and internet for Marshallese students. When traveling during the adoption process, we encourage you to enroll with the Department of State. Sciences under which the National Academy of Sciences shall conduct an assessment of the health impacts of the United States nuclear testing program conducted in the Republic of the Marshall Islands on the residents of the Republic of the Marshall Islands.
    [Show full text]
  • Marshall Islands Chronology: 1944-1981
    b , KARSHALL ISLANDS CHRONOLOGY - ERRATUM SHEET Page 12. column 1 and 2. “1955 - March 9 United Xations. .‘I and “May Enewetak . .” This should read. L956 - IMarch 9 United Nations..,“and IMay Enewetak .--*‘ Marshal ACHRONOLOGY: 1944-1981 LISRARY - ~ASHINCTGN, D.C. 2054-5 MICRONESIA SUPPORT COMlITTEE Honolulu, Hawalt F- ‘ifm ti R.EAD TICS ~RO?OLOGY: Weapons Testim--even numbered left hand pages 4-34; destruction of island home- Lands and radioactive wntamination of people, land and food sources. Resettlement of People--odd numbered right hand pages 5-39; the struggle to survive in exile. There is some necessary overlap for clarity; a list of sources used concludes the Chronology on pages 36 and 38. BIKINI ATOLL IN 1946, PRIOR TO THE START OF THE NUCLEAR TESTS. 1st edition publishe'dJuly 1978 2nd edition published August 1981 “?aRTlEGooDoFM ANKlND..~ Marshall Islands people have borne the brunt of U.S. military activity in Micronesia, from nuclear weapons experiments and missile testing to relocations of people and radio- active contamination of people and their environment. All, as an American military com- mder said of the Bikini teats, “for the good of mankind and to end all world wars.” Of eleven United Nations Trusteeships created after World War II, only Micronesia was designated a “strategic” trust, reflecting its military importance to the United States. Ihe U.N. agreement haa allowed the U.S. to use the islands for military purposes, while binding the U.S. to advance the well being of the people of Micronesia. Western nuclear powers have looked on the Pacific, because of its small isolated popu- lations, aa an “ideal” location to conduct nuclear activities unwanted In their own countries.
    [Show full text]
  • Report of the United Nations Visiting Mission to Observe the Referendum in the Marshall Islands, Trust Territory of the Pacific Islands, March 1979
    REPORT OF THE UNITED NATIONS c "' ••• ' VISITING MISSION TO OBSERVE THE REFERENDUM IN THE MARSHALL ISLANDS, TRUST TERRITORY OF THE PACIFIC ISLANDS, MARCH 1979 TRUSTEESHIP COUNCIL OFFICIAL RECORDS: FORTY- SIXTH SESSION . (May- June 1979) SUPPLEMENT No.3 UNITED NATIONS T/1805 REPORT OF THE UNITED NATIONS VISITING MISSION TO OBSERVE THE REFERENDUM IN THE MARSHALL ISLANDS, TRUST TERRITORY OF THE PACIFIC ISLANDS, MARCH 1979 TRUSTEESHIP COUNCIL OFFICIAL RECORDS: FORTY- SIXTH SESSION (May-June 1979) SUPPLEMENT No. 3 UNITED NATIONS New York, 1979 NOTE Symbols of United Nations documents are composed of capital letters combined with figures. Mention of such a symbol indicates a reference to a United Nations document. T /1805 CONTENTS ~hapter Paragraphs Page Letter of transmittal . vi I· TERMS OF REFERENCE AND COMPOSITION OF THE VISITING MISSION . 1 - 3 1 II. MARSHALL ISLANDS 4 - 21 2 A. Land 4 6 2 B. History 7 - 15 2 C. People 16 - 18 4 D. Economy 19 - 21 4 III. SEARCH FOR FUTURE POLITICAL STATUS IN THE MARSHALL ISLANDS . 22 - 40 6 A. Quest for separation from the rest of the Trust Territory . 22 - 31 6 B. Referendums conducted in 1975 and 1977 to ascertain the wishes of the people concerning their future political status ..... 32 - 33 8 C. Decision by the Administering Authority to hold talks on the future political status of the Marshall and Caroline islands on a multilateral and bilateral basis . 34 - 37 8 D. Referendum on the draft constitution of the Federated States of Micronesia, 12 July 1978 38 - 4o 9 IV. DRAFT CONSTITUTION OF THE MARSHALL ISLANDS 41 - 69 11 A.
    [Show full text]
  • Glimpses Into Pacific Lives: Some Outstanding Women (Revised). INSTITUTION Northwest Regional Educational Lab., Portland, Oreg
    DOCUMENT RESUME ED 280 923 UD 025 428 AUTHOR Simon-McWilliams, Ethel, Comp.; Green, Karen Reed, Ed. TITLE Glimpses into Pacific Lives: Some Outstanding Women (Revised). INSTITUTION Northwest Regional Educational Lab., Portland, Oreg. SPONS AGENCY Department of Education, Washington, DC. PUB DATE Feb 87 GRANT 008401776; 008401784 NOTE 175p.; For previous edition, see ED 270 542. PUB TYPE Reports General (140) -- Historical Materials (060) EDRS PRICE MF01/PC07 Plus Postage. DESCRIPTORS *Achievement; *Community Leaders; Elementary Secondary Education; *Females; Foreign Countries; *Minority Groups; Role Models IDENTIFIERS American Samoa; Federated States of Micronesia; Guam; Hawaii; Marshall Islanth:; Northern Mariana Island5; *Pacific Islands; Palau (Belau) ABSTRACT This booklet provides brief biographies of women who have made outstanding contributions to the social and economic development of these Pacific islands: American Samoa, the Republic of Belau, the Federated States of Micronesia, Guam, Hawaii, the Marshall islands, and the Northern Mariana Islands. The 66 women profiled include educators, health care providers, political leaders and government officials, lawyers, scientists, and social workers. (KH) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** GLIMPSES INTO PACIFIC LIVES: SOME OUTSTANDING WOMEN Compiled by Ethel Simon-McWilliams Program Director
    [Show full text]
  • Aspects of Coastal and Marine Areas Management in the Pacific
    • Aspects of coastal and marine areas management in the Pacific UNEP Regional Seas Reports and Studies No. 157 UNEP 1994 CONTENTS Editor's Preface . v 1. INSTITUTIONAL APPROACHES TO COASTAL AND MARINE AREAS MANAGEMENT The Regional SeaS' Programme: Current Activities in Integrated Coastal and Marine Areas Management (ICAM) Margarita Astralaga . 1 Integrated Coastal Zone Management in the Pacific Island Region: SPREP's Responsibilities and Initiatives Andrew J. Smith . 5 Managing Marine and Coastal Resources for Sustainability in the Republic of the Marshall Islands Kasuo Helgenberger . 15 An Initiative in Marine-Area Planning for Sustainable Development in Indonesia Graham B. K Baines . 23 2. BIO-PHYSICAL RESEARCH Pacific-Island Mangrove Swamps: Monitoring Their Responses to Sea-Level Rise Joanna C. Ellison . 31 Natural Colonization of Man-Made Lagoons by Reef Communities: A Model for Assessing Reef Response to Sea-Level Rise Chou, L. M. 45 The Introduction of Aquaculture Animals to Pacific Islands L. G. Eldredge . , . • . 49 3. HEALTH AND POLLUTION Sewage-Disposal Management in the Bay of Panama Bogdan Kwiecinski . 63 Pyrodinium Red Tides: How the Philippines Has Coped with a Recurrent Problem Ma. Andrea Santos-Mendigo . 69 4. A LONG-TERM VIEW OF COASTAL MANAGEMENT Coastal Change and Coastal Management John Bardach . 79 iii PREFACE This volume is the fifth in a series that provides a record of meetings sponsored by the United Nations Environment Programme (UNEP) for the purpose of encouraging inter-regional cooperation and communication among scientists and administrators concerned with the three Regional Seas Programmes and their Action Plans in or adjoining the tropical and southern Pacific (South Pacific, South-East Pacific, and East Asian Seas).
    [Show full text]
  • 2Nd Day Journal Pt. 1 2016
    Page 1 of 18 (37th CRS-2016 Day 02 P-I) NITIJELA OF THE MARSHALL ISLANDS 37TH CONSTITUTIONAL REGULAR SESSION, 2016 2nd Day (Monday) P-I January 11, 2016 CLERK: Jemaron ke aolep jouj im jutak? Please rise? SPEAKER KEDI: Kwelok kein an Nitijela renij wonmanlok ilo jibonin rainin. Jej kamolol Anij kin juon jerkon raan eman kile aolep ilo an jeded armej ilo an mwiin ej juon aiboujoj elaptata ilo ad iton komone ien kojeramon ak inaugural ceremony eo an President eo an armej in aelon kein His Excellency Casten Nemra kab cabinet minister ro mottan. Im ilo torein kwelok in an Nitijela ej ijino. Rainin ej January 11, 2016 ej raan eo kein karuo in an Nitijela jijot. Im mokta jen ao wonmanlok ne jemaron bar jutak juon alen non an Uliga Choir letok al eo kilen aelon kein, National anthem eo. Jen jutak. NATIONAL ANTHEM: Uliga Choir SPEAKER KEDI: Ilo ad jutak wot inij kile ri kaki eo adwoj im jemen aelon kein Chaplain im rikaki Enos, kobellok eo an jibonin. REV ENJA ENOS: JEN JAR. RAAN EO KEIN KARUO IN MOKTATA KEMIJ BA GOOD MORNING AM IROJ IM AM ANIJ BWE KE EN MARON BELLOK NITIJELA IN ILO RAAN KEIN KARUO JUON ILO RAAN EO LAK WEEK EO LAK, RAININ ILO MONDAY IN IMAANTATA ILO WEEK IN KEMIJ ITON KOBELLOK RAAN EO KEIN KARUO NON AN ITON FORM IM EJAAK GOVERNMENT EO EKAAL AN REPUBLIC IN AN AELON KEIN AM. BWE ILO NAAN KO RAININ IM KAB MEJATOTO IM AOLEPEN PART IN PROGRAM IN ILO JIBONIN RAININ KIN AIBOUJOJ EO AN NEJIN.
    [Show full text]
  • Annual Health Data Report 2011
    Ministry of health Republic of the Marshall Islands “KUMITI EJMUUR" ANNUAL REPORT Fy 2011 1 2 3 4 Joint Message from the Minister and Secretary of Health We are pleased to present the Annual Report for the Ministry of Health for Fiscal Year 2011. Although there is so much data and statistics collected for every single program and services in the Ministry, this report is presented for a better understanding of the type of resources allocated for the Ministry such as human and financial resources, and the utilizations of its resources or expenditures incurred during the fiscal year. Section on data and vital statistics presents the health status of RMI in terms of morbidity and mortality just for that fiscal year. Non-communicable Diseases (NCDs) or lifestyles diseases, tuberculosis and leprosy remain the three prioritized areas, and update on activities and data are included in this report. The last section is the Cost Analysis and Expenditures for the fiscal year in selected areas or services. It is important to note that actual costs of services provided by the Ministry are not charged accordingly. If the Ministry was to charge patients according to the costs of services, high revenues will be generated every fiscal year. Because of the high rates of lifestyles diseases or chronic diseases and identified communicable diseases, the Ministry continues to shift its focus on preventive or primary health care’s services in compliance with the Declaration of Primary Health Care by World Health Organization (WHO) on September 12, 1978 in Alma Ata. The Declaration called for urgent action by all governments, all health and development entities and the world community to protect and promote quality health practices for all peoples.
    [Show full text]