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    experienced in site selection and expertise in ATH erection could
    have possibly resulted in a better ATH site without expenditure of
    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
    incorporate the service provision and space allocation for Mental
    Health providers. Also there is no TA for Mental Health
    




    

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