The Marshall Islands Director of Planning, Carl Hacker, is calling for a revolution in public health after the release of figures showing alarmingly high incidences of infant mortality, diabetes, t.b. and gastro-enteritis.
The infant death rate of those aged under one in the outer islands is 90 per 1,000 births compared to under 20 per 1,000 in the capital, Majuro.
Mr Hacker is attributing this to both a lack of post-natal care and cultural issues where women may be reluctant to see medical officers and health assistants on outer islands who are mostly male.
He says diabetes is well beyond epidemic proportions with more than 80 percent of inpatients presenting with it.
Mr Hacker also says there are high rates of tuberculosis due to the cramped housing, large families and overcrowding.
"We really do need a revolution in the way that we think and regard public health in this country because with the resources we have, we just shouldn't be having some of the problems that we do have. The financial resources are not the constraint. We need to be able to go into peoples' homes and not wait for people to come to the hospital."
Mr Hacker says there are also declining life expectancy rates.