PRIVACY ACT MATERIAL REMOVED cel Etove. Yerosene. fe sterilizing instruments .... 7 tech EE. Carbzson® CaPSUleS 2... eee cee ee ee ee cece ewe u 66. Flagy] tablets ...... 2. cece wee ecw e newness 0 67. Ampicillin capsules ~.....-.. esse eee e ee eee eens -. O 68. I.N.H. tablets ............ oe ccc e cece en esee ane O 69, Chioromycetin 250 mg cap -.. cece cnvccnecccntcccee O 70. Solu-cortef 100mg or 250 mg amp ........2c-cecoee O 71. Antepar tablets ........... occ cecceseccccce ane-ee 0 72, Tylinol tablets .....-.......-.e008- seecececesoee O Next day I met again with the DistAd Rep., Japtan and the Health Assistant to reemphasize the referral proceedures to be followed. I also asked them to try to contact us at Majuro or the Distad Rep. Kwajalein before sending any patients to Kwajalein. I also asked Dr. Thorpe to give me a list of al] Micronesian patfents that were seen and treated at the USAF Clinic on Enewetak for the pertod of October 2, 1977 to November 3, 1977. The only significant thing about this list is the fact that 20 visits were made by the Marshallese working and live on Enewetak, tyvo stool examinations but patients were treated by the Health Assistant on Japtan, three patients ware referred to USAF Clinic by the Health Assistant for further evaluation and treatment, one patfent visited USAF Clinic twice without the Health Assistant ‘s knowledse, and six emergency medical referrals who were evacuated to Kwajalein except one died before medical evacuation. refused to be treated by the Health Assistant and she © requested treatment at efther Kwajalein or Majuro. which could have been treated on Japtan. She had pneumonia Recommendations: 1. Hass deworm of the populace cf Japtan soon as possible. 2. A team of two sanitarians from Hajuro to Japtan to construct three water-sealed toilets for the community of Japtan and to reduce or elininate the rat population on Japtan for a period of one week. 3. Upgrade the {nunization program on al] pre-school and school children on Japtan. Initial vaccination be done by Public Health team from Hajuro so that records can be documented. Arrangenent for storage of vaccines for the second and third series ismunization be requested through Colonel Mixan and his medical staff, including thet advice ‘andséssistance where it is appropriated. 4. ‘hen medical emergency occurs and evacuating the patient becozes necessary, the health assistant on Janptan after thorough consultation with the docter USAF Clinic on Enevetak may refer the patient to Kwajalein or Majuro for further treatment. 5. Hedical referral patients who have not attained 18 years of age may be permitted to have one adult parent or quardian accompany them. 6. Ko member of the family will be permitted to accompany an adult patient at Government expense unless permission is reeuested and aranted by the District Director of Health Services, Marshalls. 7. All unauthorize medical escorts will be responsible for their ov hotel accotmodation on Ebeye, including meal. 8. Al] medical emergency referrals must have a referral form with PRIVACY ACT MATERIAL REMOVE D