cf
It
is
suggested
that
the
hospitais
develop
separate
maintenance
departments completely dedicated to the maintenance of the hospitals and
their equipment.
They can be trained to handle the special equipment found
in the hospital and be ready to deal with the emergencies which invariably
come.
Some equipment will obviously need to be sent out to be repaired;
however,
much of the routine
preventive maintenance
should
be
provided
locally.
In support of this, the budget which has been allotted to Public Works
for maintenance of the hospital should be reallocated to the hospital for use
in the support of its own department.
An alternative to the health care system providing its own maintenance
would be to contract out to an organization such as Global Associates for al]
maintenance work or some of the maintenance on certain more technical pieces
of equipment.
A study should be done to see which would be the more cost
effective
efficient.
and
A
third
alternative which
could
be
done
in
conjunction with either of the preceeding two would be that a contract could
be arranged for the training of specialized repair technicians.
The latter
would facilitate the ability of the Marshallese to eventually handle their
own health system by themselves.
Recommendations
1.
Separate
the
maintenance
budget
from Public
include it in the health care budget.
Works
Department
and
Work performed by Public Works
would be paid from the health care system.
2.
Examine potential for a training contract with Global Associates to
prepare personnel to perform more technical maintenance activities.
3.
Capital expenditure should be made to bring the facilities and the
equipment up to an acceptable standard in each health delivery location.
4.
Outer
atoll
clinics
should
be
equipped
to
perform
simple
routine
maintenance on their equipment and facilities, and one person on each
atoll should be trained to perform the necessary duties.
5.
The hospital in Majuro should be established as the central location to
send the more difficult repair problems which cannot be handled on the
outer atolls.
(It is expected that some repairs cannot be handled in
Majuro will need to be sent out of the Marshall Islands.)