B. The difficulties are compounded by the fact that valid pre-exposure health care statistics are difficult or impossible to obtain. The Medical Program is in the untenable position of wi wer < having to deal often with the probability that a specific nts pathologic condition isor isnotrelatedtoradiationexposure, since a cause-effect relationship is impossible to establish definitely for any given case. C. The people are intellectually and emotionally unable to deal| wes? with the concept of “probability” without an intensive, highlysophisticated educational program designed not only to transfer the information intellectually regarding the role of radiation in their lives, but to concomittantly incorporate that new under— standing into their behavior, i.e., the ability to place radiation in its proper perspective for the present and the future. Such a program has already been initiated by Jan Naidu, Ph.D., BNL, with promising results. 2. The Marshall Islands medical “system" under the Trust Territories is underfinanced. The professional staff is undertrained and overloaded. Critical supplies are usually not available. A. oa renete In the absence of a satisfactory primary care referral base, the,” BNL Medical Program has expanded its mandate to include such things ; as a "diabetic study” (which has revealed a high incidence of "maturity onset diabetes") but has set up no mechanism for treat-— ment and follow-up of this disease. B. In addition, at the request of the people, a large number of Marshallese who were not in the exposed or control groups have gone through the screening examination with the detection of a variety of pathologic conditions. 9052216 An attempt-has been made in ownpg eo) PE «