STAN wa Sie ee the most pressing problems facing the DOE/BNL Medical Survey. In thats I attempted to present a spectrum of solutions, ranging From purely a rese. Mee commitment to tota] medical care for the Marshallese affected by atomic weapons testing in their islands. Since that time, a number of new problems have arisen and should be addressed in the context of the original systems analysis format. These new problems will not basically change the options presented in the flow sheets but will modify some of the constraints,and require a reassessment and/or restatement of the priority of some of the objectives. Historically, this program has had rather a narrow focus, Looking for radiation-related pathology, particulurly in the thyroid, c.g., thyroid adenomas, carcinomas, and biologic hypothyroidism, and in the hematopoietic system, @.f., blood dyscrasias in the study group. Over the last year a number of new problems have emerged that will probably require a sizeable increase in the scope of the program. They are: 1) New data (previously secret) has revealed that Likiep Atoll received detectable fallout after the 1 March 1954 detonation. Mr. Anton DeBrum, Secretary of State of the new Marshall Islands government, designed and circulated a medical questionnaire to the residents of Likiep. The results of that questionnaire were delivered to the U.S. Covernnent and the U.N. with a demand that "something" be dene to evaluate the situation on Likiep. are currently working with an verify Mr. DeBrum's findings. independent Ff, We epidemiologic consulting group to in tact, Likiep shaws a sipniffeant increase in birth defeets or selected cancers, then the DOE feels a full wnedical survey of the islands in the Likicep Atetl should be undertaken. An ancillary problem that mist be considered of Likicp. If Likiep shows an inereased related patholopy, is the peographical locatioa incidence of possibly radiation- then a number of atolls Tyjnug, between Likiep and the a