Majuro Hospital, Marshall Islands
Chief Pharmacist ... this also means only pharmacist!!
Where on earth are the Marshall Islands?! They are just north of the equator near the date line. The country consists of 1229 islands spread over 1,950,000 square kilometres of ocean. Why am I telling you this? ... start thinking of the logistics of transport of medications, vaccines, etc via plane and boat across this vast area of the Pacific Ocean!
Majuro, is the capital atoll and houses the major hospital for the country. This 90 bed hospital is where the main pharmacy for the country lies. It is also the main referral point for patients from the primary health care facilities on the outer islands.
The pharmacy position had become available after the local Marshallese pharmacist accepted the job of Hospital Administrator. I was appointed to the job via Australian Volunteers International (AVI), and was accompanied by my wife, an Occupational Therapist, who was also employed at Majuro Hospital.
Scope of Work:
When I arrived, the department was struggling with supplies. Clinical pharmacy had to wait, as there was no need to practice anything clinical if there were no medications! So my first year was really about setting up a supply system and teaching the local staff the basics of inventory control. This is no mean feat, when the locals are traditionally used to a subsistence lifestyle where they catch the right amount of fish they need for today, with no need to plan for tomorrow. So trying to teach someone that 100 cases of Flagyl injection wasn't enough to last 3 months until the next boat arrives was a bit of a challenge.
After stock control settled down and the hospital was comfortably "full" of medications, we could concentrate on other initiatives, such as newsletters, drug information, formulary control, and education for nursing, pharmacy and medical staff. The Marshallese were eager to learn and attend classes.
Four pharmacy technicians were responsible for the majority of the dispensing and day to day running of the pharmacy department. During my time I developed and taught a pharmacy technician's training course to boost their skills. They too were very keen to learn more skills of their chosen trade.
After our two year contract with AVI ended, we decided to extend our stay for a further year. We felt that even after two years we still had a lot more to contribute and that the third year would consolidate some of what we had achieved so far.
Who got more out of the placement - the Marshallese or ourselves? I think many people doing the same sort of role would argue that all parties benefit from this sort of work. I personally found the job very rewarding and felt that I had a lot to offer. By working together in partnership with the local staff we were able to achieve some great rewards.
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