R.Ray, AM/E&S,NV -5- September 22, 1975 In the dispensary I was disappointed to discover that there had been a doorway cut into the living quarters through which pets, children, grownups would go There had been a bed at one end of the dispensary that was back and forth. used as an examining area. That bed was no longer there and Jendrik said that Apparently, it had been taken out to be used it wasn't there whi 2 he arrived. I did note that there was a refrigerator which I didn’t by somebody else. There The inside of the dispensary was in disarray. remember from before. There were open storage boxes. were children sleeping on a mat on the floor. One of the little girls was playing with some of the medical supplies in A syringe was standing by its needle in a bottle of what appeared the box. The medications and supplies were in shambles and there to be adrenalin. The cabinets couldn't be closed. It was pleasing storage. the to order no was to see the refrigerator and good to think that now there was a place to store There were three or four thousand tetracycline tabicts perishable drugs. These were new one thousand tablets almost outdated. about and still in date and hadn't been apparent when I was there before. There were also two added aluminum boxes with sterile suture and dressing materials in packages and These were just lying loose in the box which some sterile disposable syringes. I was concerned at the lack of security was open to the children's curosity. control on every thing except the refrigerator which opened and closed with a lock and key. On gétting the refrigerator opened I found no medication in it. There was a box of onions rotting in the bottom. It was a small refrigerator and was being used for cooling drinking water. I asked Jendrik to remove everything from the refrigerator and we put in all of the medication and It filled the major portantibiotics that were perishable or at least dated. ion of the refrigerator. I told Jendrik I would be back the next day and we would go over some of the medications and organize his shelves so that the first things in were the first things out. I suggested that the medications be broken up into some arrangement of injectables, oral 13:dications, perishables. It was suggested that the ice box not be used for cooling drinking water. ‘There were some trays for sterilizing things by liquids, but no sterilizing liquid. One suggestion would be a simple pressure cooker which could be used to sterilize instruments quite nicely even if it were used outside. - I admonished him quite gently: “well really you need to keep the medicine here" and so on - but I didn't seem to be very well received. I had told him I would be back tomorrow to help him clean things up but he showed little interest. So as I went back to my spot, unhappily, on the ship I thought of a number of suggestions for the dispensary. I might list them here. (1) There should be regular observed hours for dispensary care: (No fishing during dispensary hours) (2) The aide at the dispensary should recognize his responsibility to keep the place clean. (3) He should recognize the importance of an alphabetical or other orderly storage of drugs. (4) There should be an adequate record of patient care. Each patient should have at least a6 x 8 individual card. (5) Syringes and needles should be kept ina special place along with the range of injectable drugs that do not require refrigeration. cabinets. (6) All medication should be under lock and key in the