each case to provide immediate treatment if possible, and to refer the patients to the Trust Territories health care system. Unfortunately, little has been done to treat and to follow-up these patients. Consequently, the BNL medical team BY _ has become the de facto primary health care provider to an ever expanding group of Marshallese. wn afeRs austere = The rationale of the Marshallese in the BNL program for their claim to the "right ° ;,/5 HAS ere for all medical care" is their association of practically all getlidnens ‘ illness with radiation. 3. . fA pos , BF 2% The BNL medical team, because of its frequent surveys has, in the;4 vert aX? . feo . ood eyes of the Marshallese, come to represent the U.S. "presence" in LAE yt the islands. The BNL Medical Program has, therefore, become the target of many attacks directed towards the United States agencies responsible for other programs in the Marshall Islands. These un- warranted attacks have, on several occasions, seriously compromised the goals of the Medical Program. Two major problems of health care delivery for all of the Marshallese involve: (a) communications, and (b) transportation. To the best of our knowledge, these problems have not been addressed independently as health care problems. DISCUSSION With the slow growth of the medical program and the development of this matrix of compounding variables, Dr. Burr and Dr.Wyzen requested a position).¢ “f- paper that would outline for DOE the alternatives for the support of a study of radiation relatedinjuries in the Marshall Islands. These options should in- clude a wide spectrum of alternative programs, keeping in mind the inextricable 9052217 aye pont pee Oe