9. Regular preventive maintenance must be scheduled. 10. An inventory of spare parts for field repairs should be obtained and maintained. ll. Replacement of equipment and instrumentation should be planned and budgeted for an average life of 3 to 5 years. Some instruments may need replacement even earlier due to the effects of high humidity and salt from the sea spray. 12. As superclinics become staffed with Medex or higher level personnel, they should be equipped to do stool exams for parasites, complete blood counts, urinalysis, and blood sugars. 3. Radiology Present System Diagnostic x-ray facilities are operational at both Majuro and Ebeye. Fixed instruments processed by hand. are modern; portable equipment obsolete. only. are X-ray technicians were trained initially in Saipan and are now giving on the job training to their assistants. studies Films Films ordering physician. are interpreted and They do non-invasive brief reports written by the Super clinic x-ray facilities are not operational. Recommendations: Shielding in x-ray examination areas should be extended sufficiently to prevent patients and employees in adjacent areas from being exposed to more than the allowable dose. of x-ray personnel Film badge services or other appropriate monitoring should be provided. Arrangements should be made for periodic review of technical quality and accuracy of interpretation of films. 4. Supplies Up to the present time the hospital at Majuro has been the central depot for all supplies both organizationally and physically. With the suggested upgrading of health services at the primary and secondary levels this will become increasingly more difficult. As a result it has been suggested that a completely separate division be established to handle all the supplies of both the primary and secondary health services. While this represents a change organizationally it is suggested that the physical location of the central depot remain at the Majuro Hospital. This would mean that the hospital would no longer order supplies directly from the suppliers but would