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excessive evaluation time.

G. (U) Operations - The ATH is up and running. We are basically
providing medicine in a peacetime mode at this time. Outpatient
visits averaged 44.7 and the average daily patient load was 2.7
during September and October 90.

(1) (U) The low productivity compared to unit manning naturally
leaves plenty of free time. We use the extra time to train, exercise
and make improvements to the ATH. We have converted to commercial
power (with generator back-up); added running water; completely
furnished the ATH with CE built desks, shelves and workstations; laid
asphalt to aid in dust control and patient care/movement; erected a
recreation tent; and constructed patient latrines and showers.

(2) (U) Operation of the supply account in this deployed AOR has
been like starting from scratch. There was no vault or secured box
to store the controlled medical items. There were no shelves to
stock supplies to aid storing and retrieval. No formal guidance on
how to operate an ATH field medical supply account was available.
Many Air Force purchased medical supplies did not fit the intended
piece of equipment they were bought for. Establishing a creditable
resupply line with MEDSOM has been disappointing.

(3) (U) Sufficient and reliable vehicles have been a problem. We
have five ambulances. The two field ambulances are used for primary
response, but are not good highway vehicles. The three modular
ambulances are better highway vehicles, but due to maintenance
history are considered unreliable for litter patient transport off
base to other bases for aeromedical evacuation. Only the field
ambulances are equipped with radios. The prepositioned modular units
were not equipped with radios; however, we are pursuing a radio buy.
We also have four automobiles and a six-pax truck. Two automobiles
are used primarily by the commander and his deputy. That leaves two
automobiles and the six-pax to meet all other transportation needs.
They have proven to be insufficient to meet our needs.

(4) (U) Patient referral/consultative networks were nonexistent
upon our arrival. This was very frustrating for both the
professional and administrative staff. Policy and guidance for
OB/GYN care was not established in the theater. By trial and error
plus a lot of hardwork specialty services were identified and used.
The recent addition of a 400 bed Army Evac Hospital to our location
has made specialty consultation much simpler to acquire.

(5) (U) Nursing services discovered a number of defective items
 upon arrival due to marshalled pallets sitting in the sun for an
extended period. Tape was melted, IV tubing brittle, oral
thermometers broken or separated, and dry rotted canvas on patient
beds. Initial operations were hampered, but problems have been
overcome.

(6) (U) Further planning needs to be completed to clarify the role
of mental health under field conditions. ATH designs do not

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