help the Marshallese to understand the relative risk of exposure to radioactive material in perspective to their overall health status. Both programs would be carried out initially by Brookhaven National ? Laboratory personnel, the effects of radiation program being taught by a member of the health physics team while the medical program being carried out by a RN in con-junctionwith a MD. — / To be successful, however, the program should involve Marshallese as much as possible from the beginning. The pro- gram should eventually be run entirely by Marshallese with U. S. scientific and/or medical personnel serving only in an advisory capacity. In essence, it should be understanding. synthesis of two worlds and two frames of a To bridge this cross cultural gap, Marshallese with the re- quired qualifications, such as a degree of science for the environmental aspect and for the medical programs local residents should be hired. In the latter case, the BNL Marshallese nurse practitioner will be available to avoid any cultural bias. The key liaison on each island could be provided through the president of the women’s club, the queen, the health aide, the minister and the schoolteacher. As the medical program progresses, a health educator/RN ? or Medex (trained either in the U. S. of Fiji) could be recruited for each island, to work with the local resident to maintain the continuity of the -. program. Both programs would have to be constantly evaluated to ensure that they are culturally sound and realistic. Ultimately, the goal would be to have a Marshallese working full-time on each island who would be responsible for the medical program and who would also be familiar with the environmental program. The importance of the health education program is realistic because medical problems are usually the first ones to be recognized with environmental problems being less clearly defined. -11- Therefore, the environmental monitoring ?