6.
Subcontract
the
organization.
purchasing
of
supplies
to
a
group
purchasing
With the current contract between the Marshall Islands
and the Seventh-day Adventist Church a likely organization would be
Adventist Health Services West in Glendale, California, although there
are other organizations who could also serve this function.
should result in lower prices and better servicing.
This
At the same time a
regular delivery schedule should be worked out for the delivery of
supplies to the Marshall Islands via Matson Lines and Nauru Shipping.
By using
both of these carriers
maintained.
with
adequate
supply levels
should
be
Should any emergencies occur air freight could be utilized
either
Continental
Airlines
or Military Air
Command
through
Kwajelein.
C.
Maintenance
One of the factors limiting the level of health care delivery is the
inadequate maintenance provided for the physical plants.
has
led
to
such
problems
as
leaking roofs
Lack of maintenance
causing damage to supplies;
deteriorating machinery in laboratories and other departments causing poorer
quality
tests
and
services
(i.e.
hemodialysis);
and
breakdown
of
refrigerators resulting in decreased storage capacity for perishables and
therefore a decrease in activities which depend on the use of perishables
(i.e. lab tests, medications).
emergency electrical
system,
Other areas which have suffered are the
the plumbing system at Ebeye,
conditioning at both hospitals, to name only a few.
and the air
In a climate such as the
one found in the Marshall Islands where the salt air is highly corrosive, and
the general quality of public utilities
is substantially less than that
generally encountered on mainland U.S., it becomes increasingly important
and in fact imperative that a top quality maintenance program be developed
for the hospitals in order to maintain the desired level of health care and
keep capital costs to a minimum.
Currently
Department
of
the
maintenance
is
being
the
Marshallese
Government.
unsatisfactory
from
the
hospital's
understandable
since
the
Public
provided
by the
Public
This,
however,
perspective
although
Works
department
has
has
Works
been
probably
many
other
responsibilities, limited budget and it would be difficlt for them to provide
the special service which the hospitals require.