a, i bt Lo IN CONFIDENCE -~6of many of the islanders, or because the further tests would bel vie) memset themselves involve appreciable additional radiation, or specialized linear scanning equipment which is not available in many centres. On the three additional points on which the Committee requests comment : 1. It is inevitably difficult to assess the likelihood that further tests, after the return of the Rongelapese and Utirikese, might ‘have added substantially to their radiation exposure, if only because this assessment would depend upon the detailed planning arrangements ene — i Pe TSLrLJ te th laid down for conducting these tests in the light of current meteorolo- gical reports, height and power of detonation, fission/fusion yield, etc. In retrospect, however, the measurements of background radiation and body burden of radionuclides appear to indicate that in fact the amount of whole body radiation was little increased, probably by less than 3% of that initially received, following the return, either from a raised background or from subsequent tests. The percentage increase in thyroid radiation is likely to have been even smaller. I have not attempted to make any exact determination of this increase, but the above estimate shows that the decision did not increase substantially the ex>osures received. 2. The team's general medical examinations, both of the exposed people and of the unexposed people attending "sick call" illustrated the value that periodic medical examinations always have for people living in relatively isolated small communities in any part of the world. Your present practice and development of periodic medical visits to the Marshallese and other islands is thus of obvious importance in detection and treatment of chronic illnesses. I was impressed hovever by the frequency of recent or "acute" illnesses or minor epidemics, the manage- ment of some of which would be beyond the facilities of Health Aides. This point is not strictly within my remit as your consultant. I wondered however whether the development of simple and reliable radio links, and appropriate arrangements for discussion when necessary between dispensaries and nospitals in the area, might not give help which could be economically practicable and rapidly introduced, and which would not nly allow discussion of difficult problems, but migiit also provide a valuable form of continuing training and stimulus, particularly for Health Aides in the more isolated situations. I appreciate, however, the problems of supplving and maintaining equipment, and of implementing advice that might be given by hospitals, and that questions of this type will certainly have been reviewed already by your Congress. 3. I cannot comment as an expert on the purely physical estimate of external radiation exposure or the data from which they are derived. Tnese dose estimates, however, appear to have been reliably based on early and subsequent readings, on conventional calculations as to thie decrease in fallout radioactivity with time, and on reasonable estimates 227