402269 BROOKHAVEN NATIONAL LABORATORY MEMORANDUM DATE: September 22, 1971 TO: E. P. Cronkite, M. D. FROM: R. A. SUBJECT: Physician Assistance in Marshallese Program Conard, M. D. (ge I would like to outline my ideas concerning the need for a physician to be stationed in the Marshall Islands in association with our program, his responsibilities, and the possible logistics of the program. Responsibilities: The major responsibilities of the physician would relate to several problems. The most serious problem concerns imple- mentation of our thyroid treatment program among the exposed Rongelap people. The Trust Territory medical personnel have not had the time to give this program the attention necessary to enforce the treatment regimen. As a consequence, there have been many Rongelap people on treatment who have not been regularly taking their weekly dose of thyroxin. This is borne out by the finding of T-4 serum levels below normal in several people. This is of serious import since some hypothyroid children and some cases with thyroidectomies had low values. The next most pressing problem concerns medical care and documentation of the Rongelap and Utirik people under study during the interim between surveys. The lack of or improper diagnosis and correct treatment in people who become ill results not only in loss of valuable medical information but deprives those with illness of good medical care. The lack of autopsy data in case of death has been a serious omission. A physician representing our interest in the islands could help correct these shortcomings. In addition, such a physician could also assist in carrying out our responsibilities concerning monitoring of the Bikini people on their return for possible body burdens of radioisotepes which they might absorb from the Bikini environment. Difficulties: There are several difficulties that we must face at the start. The wide separation of the people under study (at Bikini, Rongelap, Utirik, Ebeye, Majuro), the relative isolation of Bikini, Rongelap and Utirik Atolls and transportation difficulties. Base of Operations: It is recommended that the physician be based at Kwajalein where comfortable quarters and good schooling are available. REPOSITORY BALBeco ddaven Mar. Lae) COLLECTION “Dey r Lecords BOX No. On kno FOLDER DeBowaf; GFL