An example of this last problem occurred in March of 1976. It was decided by the program directors that as part of the March survey three patients from Rongelap and one from Utirik would return to Honolulu for detailed examinations. Arrangements were made and plans drawn up without consulting the people if March would be a good time or what would be done for each family while the mother was away. They were told one month prior to the survey to stop their medications and asked if there were any objections to the outlined plan. When it was discovered that the woman at Utirik failed to comply with instructions, harsh words were expressed that she had ruined expensive plans and was unreliable. When the three women at Rongelap objected, the medical grou got upset, again thinking that the people were just causing trouble, preparations were being upset, etc. When the three ladies requested a meeting to discuss their objections and work out a solution, Dr. Conard refused the request. Instead each lady was confronted individually such that each felt intimidated and threatened such that all she could do was accept. However, none of them were really pleased to go and all freely expressed their ill feelings to others. , The people on all the islands feel that the program fails to understand and accept their local traditions and culture. They claim that things are done according to American standards rather than Marshallese. The problem creates only another gap of understanding between the doctors and the people. By tradition the Marshallese are a food gathering society. Their daily activities center on food collection and its preparation. Now food coilection has been replaced to some degree by copra production as a cash source to purchase foodstuffs. March is a month of low food availability. it is a month near the end of the dry season and local crops are not producing well, Inthe past, it was atime when people depended on preserved foods. When the tee 7 comes in March, it totally disrupts the daily activity of the island for up to one week. For their examination, people are taken away from their daily chores for up to an entire morning or afternoon. Women are taken from cooking, washing, or tending children and men from food or copra collection. In the past, people at Rongelap have asked for food to be supplied when the examinations force people away from their families and food chores. Such a request has been repeatedly refused. When the people asked for a meeting to discuss this issue in March, 1975, this request was refused as well. The people are very humble and generous. They would much rather be polite and answer with what they think would be pleasing rather than give a negative response. At the same time, they will express their true feelings to their friends. They are easily intimidated by authority, particularly an American. The American is looked at as being all powerful, full of resources, and virtually able to provide anything he desires. This concept is similar to the view of the king in ancient times. To be openly critical of the power is not done because the Marshallese fears the loss of the rich resources the American possesses. Recently, the people have been more open in their criticisms, as shown by recent letters from Rongelap and Utirik. The program tends to reinforce this concept, as virtually anything the doctors want from tractors to trailers to electricity to a ship (that serves only the program} ~ a never 1d42209 6