4 . Introduction A. Scope and Purpose a % P.L. 96-205 requires the Department of Interior (DOI) to develop an “integrated, comprehensive health care program" with respect to the peoples of the Marshall Islands. Pursuant to P.L. 96-205 and the resulting request for proposals from the Department of Interior, there has been considerable discussion on the exact scope of the Taw and what people and activities should be included. Further clarification with DOI has stipulated that the contractor (Loma Linda University) prepare two health plans, as follows: 1. "Comprehensive Care (Primary, Secondary, and Tertiary) for the peoples of Rongelap, Utirik, Bikini, and Enewetak," 2. “Comprehensive Care as inl. .. ., plus comprehensive care for the peoples of all other atolls of the Marshall Islands." In addition, comments and estimates different types of U.S. personnel. will be provided regarding It is clear, however, use of that extensive use of expatriates in primary care roles is both impractical and politically unacceptable. To avoid excessive duplication, the current situation and recommendations regarding the comprehensive presented first. Then the plan for all of the Marshall components of that plan Islands necessary for will be adequate primary, secondary and tertiary care for the people of Rongelap, Utirik, Bikini, and Enewetak will be identified. B. Sources of Information The Loma Linda University team of 22 members spanned many disciplines and backgrounds, with a considerable depth of experience and expertise in health care planning and delivery in the developing world (see appendix E). In gathering background and source material for this survey and plan, many organizations were contacted. Among the most important were: the Trust Territory governmental headquarters in Saipan currently phasing down, Brookhaven National Laboratory, Lawrence Livermore Laboratory, the University of Hawaii/East-West Center, University of the South Pacific in Fiji, College of Micronesia in Ponape and Saipan, and a number of other institutions and organizations involved in work in the Marshalls.