(— Major prob:ems include a lack of chemically oure gater, inadecuate reagent supplies, inordinate delay in obtaining supplies and repairs, and no mechanism to develop new staff to fill vacancies caused by hormal attrition. Ebeye Field Hospital has two laboratory assistants anf in procedures The available. x-ray Complete Blood Counts and urinalyses. project laboratories Lab obtained. for service needs has technician is croqs-trained Unofficial assistancd@ its beyond been planned capability for is very limited the to do from DOE and DOD pPccasionally super clincs, are but implementation thus far has not succeeded. Dip-stick or [Clinitest tablet testing for urinary glucose is available in some of the [community health centers. Recommendations : The increased consultants to clinical hospital capability and staff planned providing fdding by some tertiary specialty capability requires major enhancements to the laboratory service. 1. Senior (American technologists (Medical Laboratory Technician) Society or of Pathologists Clinifal are equivalent) at needed both hospitals to expand the types of procedures availablel particularly in clinical chemistry. 2. Chemically pure water must be provided at both hospitBls. multiple cartridge (Barnstead type) recirculating filter should be installed at A permanent deioniz water Ebeye is a system absolutely essential at Majuro. 3. Analytic balances, pH meters, and volumetric glasswarg@ of reagents, standards, and quality control for preparation materials should be available at both hospitals. 4. Both should subscribe to and participate in a prpficiency survey service. 5. Additional equipment and instrumentation should be pr@vided to measure blood gases, enzymes, lipids, and a complete elecrolyje panel. 6. Arrangements should be made for timely suppo by reference laboratories for those tests that remain beyond the qapability of the local hospital laboratories. 7. Normal and abnormal level quality control specimens] must be run in parallel with patient samples. 8. Budget and time for all lab staff to participate in wofkshops and other continuing education activities must be provided.