1. METHOD OF EXAMINATION OF THE PEOPLE OF RONGELAP AND MEDICAL TEAM The annual examination of the exposed people of Rongelap and Utirik Atolls is considered adequate for the detection of radiation-induced diseases, the result of fallout exposure in March 1954. This method of examination has detected serious thyroid abnormalities in 21 Marshallese in the past and resulted in the discovery of two additional cases at this most recent examination. The first case of acute myelogenous leukemia was discovered at this examination and the patient taken to the Hospital of the Medical Research Center at Brookhaven National Laboratory, Upton, New York, and subsequently transferred to the National Institutes of Health, Department of Health, Education, and Welfare, for observation and treatment. Examinations performed by the Brookhaven National Laboratory Medical Team are considered technically adequate for its purpose. The history and physical examinations are performed under difficult circumstances on the islands with the lack of any facilities on Utirik compounding the problem. The permanent facilities available in the trailers on Rongelap are much more adequate for the examinations. The blood and urine tests performed by the American and Marshallese technicians are adequate and accurate. Additional examinations not related to radiation-induced disease could be added as clinically indicated. In regard to the treatment of radiation- induced disease and, in particular, the thyroid abnormalities occurring in exposed persons who were under the age of 10 at exposure, all available records indicate the treatment to have been excellent. The surgical care rendered to these individuals in Guam, Hawaii, and the United States is comparable to the best afforded in this country. An annual medical examination with diagnosis and treatment of diseases endemic to the Marshall Islands not related to radiation is inadequate to protect the health of the people. Much more medical training of the Trust Territory Health Aides with standardization of the facility, surgical supplies, and medications is necessary before much improvement is to be expected. Frequent visits by Medical Officers of the District Headquarters are imperative. 198