September 22, 1975 -3- R.Ray, AM/E&S, NV I did see a number of other patients with minor complaints however these thr e or four’stated above stand out in my mind as examples of what can This concept of treating be done on the scene to help a medical aide. patients and teaching or helpin; the health aide to understand why things are done that way and in that manner, gives him the tools to work with in an actual situation which reinforces his knowledge and gives him a better feeling of security. He needed encouragement and appreciation for what he was doing. He was working diligently and doing the very best he could but he needed someone to come in and, more or less, "“ather"the situation to reinforce his confidence. I believe suggestions were not offensive to Jaramia and he was most appreciative. I was discouraged about the total amount of medication available to the people at that time. “here was a military type aluminum container, in it were medications lying around and mixed up along with catheters, gloves Slithering around in this box were cockroaches that and sterile packaging. had eaten the lables off many of the things we were looking at. We were able to discern, from the label fragments that were left, what the medications realy were. One of the ti ags that struck me was that there needed to be some way of keeping drugs cool so that their expiration date time would be valid and even lengthened. I thought that perhaps a subterranean storage place would probably give an average temperature of around 77° day in and day out. This would be preferable to the situation with the drugs on shelves and temperatures ranging from 77° during the night and as much as 110° on very hot days. Also,'I felt that he needed some insecticide spray to control the insects, mostly cockroaches and ants. Jaramia understood this. He touched me very much by giving me some shells to take home in appreciation for the help that I had given. He said, and Tf quote I believe fairly accurately, that "if you come to Bikini I will give you an island - my island" and he indicated across the lagoon someplace where he must have had a small island. you can have it. He said "if you will come and live, I will give it to you." This practically brought tears to my eyes to think that here is a man that is this willing cto try to get help and it made resolve, that if it was possible I would help him. This was the basis for, probably the main basis - for my desire to return to Bikini: To work with Jaramia and realize that my work would not be in vain. looked forward to returning to see him. About this time there were several things that came to mind. I One was that it would be great if there were an Intern's Manual or "Marshallese Medical Cookbook." Perhaps the medicines could be grouped for such ailments as skin troubles, eye trouble, bowel trouble, and cross indexed by number for reference. The manual, "The Marshallese Medical Cookbook," is something that could be worked up by an interested person and basically include all of the known Marshallese native therapies that are valuable, such as how to manage a Portugese Man of War sting on the skin. The local native therapy here in Hawaii is to crush papaya fruit, seeds or leaves and put them over the sting of the Portugese Man of War. The proteolytic enzyme in papaya does 905 Fy