Marshall Islands Medical Insurance
Marshall Islands is a group of remote islands and atolls that lies almost 3,000 kilometers north of Fiji. The country is comprised of 29 atolls and 5 islands, making up its total land mass of 181 km². Only a small population of around 67,000, which was a 2011 estimate, actually lives in the country, a majority of which are Marshallese. Marshall Islands, formally known as the Republic of the Marshall Islands, gained its independence in 1986 under a Compact of Free Association (COFA) with the United States. The COFA partnership means that the U.S. will provide financial support over a period of 15 years in exchange for complete international responsibilities and defense authority. In 2003 the US created a new COFA that would provide the country with $3.5 billion over the next 20 years, which was also shared with Micronesia. The capital of the country is Majuro, and is located in the south east of the collection of islands and atolls.
Marshall Islands, also called the Pacific Proving Grounds, were used as a testing area for the United States nuclear weapons testing program. The program was called Operation Crossroads and was mainly located on Bikini Atoll. From 1946 to 1963, when the Partial Test Ban Treaty was signed, there were about 105 nuclear weapons tested within the islands. Due to the unexpected amount of nuclear fallout from atmospheric testing, many of the islands continued to be contaminated after the testing finished. Many who lived on the outer islands suffered from an increase in incidence of multiple types of birth defects and cancers. It wasn’t until 1996 when radiations levels dropped low enough to allow tourism to reopen in the Bikini Atoll. As of 2009 the country offers a wide experience for diving, from WWII wreck diving around Bikini atoll to beautiful nature dives in Rongelap.
The Ministry of Health (MoH) is the responsible agency for administering and regulating health care within the Marshall Islands. The MoH mission statement is to supply a high quality, affordable, efficient, and effective health care; its services are primarily provided to the citizens of the Marshall Islands. In April of 2000 the MoH, called the Ministry of Health and Environment before 2002, created a health policy document which set out a strategic plan for the next 15 years, from 2001 to 2015. Some of the main goals of which are: to strengthen and develop the capabilities of the indigenous personnel and the health information system; institutionalize primary health care strategies and decentralize health. Health care services are provided to the people through 2 hospitals and 61 health centers.
The 2 hospitals of the Marshall Islands are the Armer Ishoda Hospital in Majuro, with an 81 bed capacity, and the Ebeye Hospital. These facilities are able to provide generally sufficient treatment for routine medical procedures. The other 61 health centers are spread across the islands and are able to provide for basic medical care and are mostly staffed with nurses. As of 2008 the Marshall Islands medical work force was comprised of 2 pharmacists, 7 dentists, 38 physicians and 172 nurses.
Like many of the islands in the Pacific, Marshall Islands has dengue fever. As there are also other insect borne diseases present, people should take measures to avoid being bitten while in the country. The Marshall Islands also has occurrences of Tuberculosis. In 2011 there have been reports of people being infected with multi-drug resistant TB as well. It is important for expatriates to have up to date vaccinations against TB before traveling to the Marshall Islands. The CDC has also recommended vaccinations for Typhoid, Hepatitis A and Hepatitis B as there is a small presence of these diseases within the islands.
The Republic of the Marshall Islands is in an isolated location, just west of the international dateline and barely north of the equator. Its remote location means that any country with high quality medical facilities is at least 3,000 kilometers away. For an expatriate or tourist it is important to consider the options for evacuation from the Marshall Islands, in case you find yourself in need of treatment that local hospitals cannot provide. Marshall Islands medical facilities also do not contain a decompression chamber, meaning that any scuba diving emergency would require you to fly out of the country to the nearest decompression chamber for care. Medical air evacuation to Hawaii or Fiji from the Marshall Islands will be needed if someone is ill or has become injured in any serious way. Discuss with an international health insurance provider about your options with medical evacuation from the Marshall Islands.
Marshall islands remote location within the pacific make it highly susceptible to natural disasters. The country has been affected by disasters, such as cyclones, floods, hurricanes and severe droughts. The actual rate of incidence is rather low but as an expatriate or tourist in the country it is important to keep up to date and monitor local and international weather updates. The most recent of such serious disasters was in March 2007 and December 2008. In 2007 Marshall Islands had to declare a state of emergency from a prolonged period of drought. In 2008 the islands experienced a series of swell waves that pounded the area multiple times in short succession. This then caused large amounts of flooding within the capital and other areas, which only sit one meter above sea level.