Exxon's operations in Chad presented difficult medical and organizational challenges, leading to the installation of a full time company physician. This paper addresses the nature of these challenges, the procedures and training developed for the selected doctor, the working relationships with management/contractors, and the medical outcomes of the operation.
Among the medical concerns in Chad were: its remote?ness from Europe, serious inadequacies in the public medical care system, tropical diseases and resistant malaria. Major organizational concerns were the varied quality of the contractor medics/ doctors, and their lack of a coordinated approach to the medical and occupational risks to be faced in Chad.
The paper describes how the doctor was specially trained, and how he established his new role in Chad by working closely with his U.S.-based medical management and his local Chad-based exploration management. Among his major objectives were the development of quality standards for contractors' field medics/doctors, attention to environmental and industrial hygiene issues, and the building of a new clinic in the capital city.
Special problems faced included a malaria epidemic. The paper describes measures taken (including site analysis by a malaria consultant) to improve diagnosis, increase employee/contractor compliance with prophylactic regimens, and establish an environmentally-safe vector control program.
Conclusions include recommended: changes in medical management of remote exploration sites, methods to coordinate diverse contractor approaches to medical care, and improvements in field-based malaria diagnosis and control.