OPTION D
i.
Establish the broad objectives
‘As in Options A, B and C but with
atied emphasis on early detection and
treatment ot all significant diseases.
This option offers unequivocable
evidence of the true concern of the
U.:.‘for the comprehensive health care of
t': peoples of the islands contaminated
by the testing program.
���
fn addition, such a program would
aiiow us to develop a mucn more signi-
f'sant "health profile" of the
inorshallese to assist in the deter-
a
mination of petential radiation
tzLated pathological conditions.
II.
Constraints
LII.
Present levels of care
Translation
Restatement of refined
objectives in consideration
of restraints.
As in Options A, B and C — This opticn
exceeds the mandates of our present pregram and would be impossible withouc
an appreciable increase in funding.
As in Options A, B and C,
the restatement af objectives
will be dependent upon:
Existing Policy
As in Options A, B and € ~ In additior
in light of the recent (Gece. 12, 1978) °
DOE/DOI/DOD meeting on the status of the
peoples of Eniwetok and Bikini, it appears
that this option is the one favored by
the Under Secretary of the Interior
Mr. Joseph.
,
1.
The definitions of the
role (moral/fiscal) of the
administrators of DOI and
‘
DOE to carry through on che
statements of principal made
at the Oct. 12, 1978 - DOI/DOE/
Existing needs and demands
This option most closely meets the needs
and demauds of the Marshallese people and
their leaders.
DOD meeting in Washington, D.C.
concerning the status of the
peoples of Bikini and Eniwetok.
2.
%I£ full health care responsibility is assumed - Option D
Projected needs and demands
Since this option provides adequate
health care for all currently and
potentially involved Marshallese, it
3.
If limited health care
responsibility is the choice ~
some compromise between Options
C and D is indicated.
should meet all projected needs and déenaads
Planning at other levels
As in Options A, B and €
Existing facilities
As in Options A, B and C - A major expansion
of existing facilities would be necessary to
Support a medical program more than twice: the
needs no restatement.
.
(aed
ee)
Who: With the expansion of the
the medical staff - work
medical officers and the
patient population, it would
be wise ta set up (2) field
medical teams; (A) the BNL-
acute exposure study team
(covering vecples of Rongelap ' Utirik) and (B) the “low level"
study group - under contract ~
both supported by adequate-1°
=20
care at Ebeye and Majuro-
Where:
Research based upo’ a £
system will provide opti
population of the Marsha]
of these only about 2,00(
The remaining
Option D.
the general improvement
primary centers, - but tl
As in Option C.
When: As in Options A, B and C.
As in Option C - plus
Total cost
Really impossible to d
However, based upon our
C) with a cumulative bud
to Option D shoul cost .
Flexibility
This option gives us t
examinations in the fiel
medical and transportati
Avoidance of untoward co
This option offers the
ment to the people.
Thi
image of U.S. in ail of
In addition, with the ne
might decide to fill the
physicians (with the goo
nuciear MD's might becom
1
Cost/effectiveness
As in Options A,B and
Timnin
This is the optimun t*
reasons:
A} The movemel
the Marshall Islands in
the health care deliver)
in this period of gener:
of Bikini and Eniwetok i
- to their very legitimats
Timing
The time is now optimum for DOE :- lisit of
DOI and Narshaliese scatements of needs.
iy
Full directed data base,
What:
Screening and follow-up of
pertinent findings in population
defined under “Objectives”
Risk
Least risk of a11 opti
then not honored.
IV Analysis of "dow" for manpower requirements.
+
Performance or resuits
trained physicians at Majuro and
Manpower (13)
As in Options A, B and C. = Please see Section
opt bon
Set forth the criteria fo
terms of:
Ebeye - supported by paramedical personnel, Physician
Assistants and nurse
practitioners.
A cost study would need to be instituted as
soon as possible to determing the curren: and
future costs of such a program (please sve
section V Selection Criteria) -— under "Total
Costs".
DemocrannicPooularion Characteristics
VY. Selection Criteri
Develop possible approaches to
attaining the objectives, with
each approach being stated in
teams plus at least 2 U.S.
Financial
Wry
ona ean ee
“S$ i
Optio:
boanmd C - The ary
vie
cavere: .tLL be cuch mare than devi? 2 4. this
Analysis
added manpower to support 2 Field
present effort.
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Ty.
How:
Tie ne emu ree aor
t
ALL radiation related diseases in the exposed and control
por ulations plus full screening of all inhabitants now
living (er scheduled to be repatriated to} Marshall Islands contaminated by ato
n ic fallout
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