af
It
is
suggested
that
the
hospitals
develop
separate
maintenance
departments completely dedicated to the maintenance of tha@
hospitals and
They can be trained to handle the special
Equipment found
their equipment.
in the hospital and be ready to deal with the emergencies which invariably
Some equipment will obviously need to be sent out
come.
however,
much of
the routine
preventive maintenance
fo be repaired;
be
shoufd
provided
locally,
In support of this, the budget which has been allotted
fo Public Works
for maintenance of the hospital should be reallocated to the hpspital for use
in the support of its own department.
An alternative to the health care system providing its
@wn maintenance
would be to contract out to an organization such as Global Ass@ciates for all
maintenance work or some of the maintenance on certain more t chnical pieces
of equipment.
effective
and
A study should be done to see which would be the more cost
efficient.
A third
alternative which
cou d
be done
in
conjunction with either of the preceeding two would be that a contract could
be arranged for the training of specialized repair sven
would facilitate the ability of the Marshallese to eventual
The latter
handle their
own health system by themselves.
Recommendations
1.
Separate
the
maintenance
budget
from
include it in the health care budget.
Public
Works
Pepartment
and
Work performed Hy Public Works
would be paid from the health care system.
Examine potential for a training contract with Global] Associates to
prepare personnel to perform more technical maintenance}activities.
3.
Capital expenditure should be made to bring the facijJities and the
equipment up to an acceptable standard in each health delivery location.
4,
OQuter
atoll
clinics
should
be
equipped
to
perform
maintenance on their equipment and facilities, and one
imple
routine
person on each
ato!] should be trained to perform the necessary duties
5.
The hospital in Majuro should be established as the centgal location to
send the more difficult repair problems which cannot be handled on the
outer atolls.
(It is expected that some repairs cannot be handled in
Majuro will need to be sent out of the Marshall Islands.