167 has been importantin enhancing growth in the growth-retarded children and preventing clinical evidence of thyroid hypofunction. PSYCHOLOGICAL MANIFESTATIONS The organization and conduct of the medical m on these tiny islands in this remote area of the world has been a formidable undertaking. The medical teams have had to face many unexpected and unique problems.‘ On arrival in the Marshall Islands in 1954, the team was faced with the medical care of a population whose ethnic background, life style, and language were quite different from ours. The language barrier proved to be one of the mostdifficult problems we had to face. The exposed people, quite understandably, developed strong psychological and psychosomatic reactions to their exposure. They had sustained the definite radiation effects described above. Because it was necessary for the team to carry out numerous examinations and tests to detect possible radiation effects associated with a type of radiation exposure about which little was known, the interpretation was naturally that the exposure andits effects must indeed be serious. The people developed exaggerated and unfounded fears aboutthe effects ofthis mysterious “poisonous powder” to which they had been exposed. These fears were not only related to their initial exposure, but to the low levels of radiation that contaminatedtheir islands when they returned to live there. Their fears were expressed in many ways. Unexposed people moving to the islands also voiced these complaints. The complaints were not substantiated by clinical findings. They claimed that their exposure made them feel weak, as did drawing blood. Almost all illnesses and deaths were believed to be associated with their radiation exposure. About one year after their exposure, the Rongelap women becameparticularly upset about a rumorthat they were not going to be able to have children. (This rumor was shortlived when there were increasing numbers ofbirths of normalbabies.) In spite of our assurance that there were no detectableeffects in the children of exposed parents, they continued to worry aboutthis possibility. Although we saw no evidence for it, some of the people claimed that the products of miscarriage were abnormal. They believed that some ailments commonto the Marshall Islands, such as fish poisoning and irritation of the mucous membranes from eating arrowroot flour (an effect produced when the flour is improperly prepared), had been made worse by the fallout. Numerous meetings were held with the people, and through Marshallese interpreters, the team tried to correct the misconceptions and to explain the effects of radiation and the need for the examinations. The results were disappointing. Explaining a complicated subject to an unsophisticated people was very difficult, particularly when hampered by a language barrier. A numberof complex outside influences aggravated the reaction of the Marshallese to their radiation exposure and adversely affected the medical program.“** Localpoliticians, lawyers representing the people, and antinuclear groups becameincreasingly vocal in their criticisms of the United States’ handling of the accident, and these criticisms received extensive publicity. A