6. Subcontract the purchas‘ng of supplies to a or organization, With the current contract between the Marshall Islands and the Seventh-day Adventist Church a likely organization would be Adventist Health Services West in Glendale, California, Although there are other organizations who could also serve this function. should result in lower prices and better servicing. At regular delivery schedule should be worked out for t This e same time a delivery of supplies to the Marshall Islands via Matson Lines and NBuru Shipping. By using both of these carriers maintained. with adequate supply lev@ls should be Should any emergencies occur air freight could be utilized either Continental Airlines or Military Air C Kwajelein. C. Maintenance One of the factors limiting the level of health care ddlivery is the inadequate maintenance provided for the physical plants. has led to such problems as Lack @f maintenance leaking roofs causing damage] to supplies; deteriorating machinery in laboratories and other departments qausing poorer quality reakdown tests and services (i.e. hemodialysis); and refrigerators resulting in decreased storage capacity for p ishables and therefore a decrease in activities which depend on the use (i.e. lab tests, medications). emergency electrical system, of perishables Other areas which have suffered are the the plumbing system at Ebeye,} conditioning at both hospitals, to name only a few. air In a climate such as the one found in the Marshall Islands where the salt air is highly the general quality of public utilities and the qorrosive, and is substantially ld@ss than that generally encountered on mainland U.S., it becomes increasingly important and in fact imperative that a top quality maintenance programj be developed for the hospitals in order to maintain the desired level of heplth care and keep capital costs to a minimum. Currently Department of the maintenance is being the Marshallese Government. unsatisfactory from the hospital's understandable since the Public provided by the This, however, perspective although Works department has responsibilities, limited budget and it would be difficlt for t the special service which the hospitals require. Go Public has Works been probably many other m to provide