“R.Ray, AM/E&S ,NV -6- September 22, 1975 (7) Ali hings with a shelf life should be kept in the refrigerator to The refrigerator should not be used for (8) isnsure their preservation. the family's cooling of drinking water and preservation of family food. The family of the aide and others should not use the dispensary area (9) Children, and pets should not be permitted (10) as part of their home. A half door-Dutch door type of arrangefree access to the dispensary area. the top half of the door and let open could One ment would be helpful. people communicate but control traffic and still have adequate ventilation. The dispensary needs a wash basin. Antiseptic soap and water should (11) be available for the aid to wash with. (12) Antiseptic solution should be available to sterilize instruments used for examining patients. Again the sterile instruments could be maintained sterile in little packs after (13) An examining table is essential. sterilization in pressure cooker. Perhaps a gynecological examination table would be appropriate. I came back the second day to the dispensary to find it much transformed. Simulating at least some balance of order. The suitcase containers were ciosed, the drugs were lined up on the shelves, although with little relation- ship to each other, and there had been much work done to police up the area and clean out the dispensary itself. The first day I saw a number of patients with Jendrik. There is nothing really remarkable to note except the aide's daughter. She had a cyst on the lateral aspect of her left knee a ganglion type cyst that seemed to be a dumbell sh..ped just under the collateral ligament or bulging .through the collateral ligament on the lateral aspect of the knee. Someday it might require surgical attention, but at this time it was considered not to be an emergency. On the 18th of June I went to the dispensary and there were no patients at all. I insisted that the outdated penicillin injectables be discarded. [In the medical records there were about 63 people listed on Bixini, of whom 30 were away at the moment but would return. I found that were 6 people with asthma, 3 were diabetic and three had eye trouble. It seemed that eye problems are related to cataract surgery. I saw one old lady, I believe it was Jendrik's mother, who had cataract surgery and was complaining about not being able to see. She did have cataract corrective glasses which she couldn't wear because they were so heavy. There were 6 people with what was called bronchitus and 13 people that had had diarrhea the previous week. They were all okay at the moment because they had been treated with Kaolin and Kaopectate. I noted that Jendrik considers diarrhea an indication for streptomycin by hypo. He said the reason he uses streptomycin was because of watery bowel movements. Streptomycin is a dangerous drug often causing deafness. Tetracyclene could be used. There may be something about the diarrhea that is unique on Bikini that he knows and I don't. By way of suggestion, off the top of my head, a few immediate needs of the dispensary at Bikini are (1) an Scabacide, something that would work for crabs, lice and scabies ~ (Possibly a benzyl benzoate something relatively JUS Lb,