need for continued examinations when nosignificant findings were reported. In spite of such prob- ther compensation for injuries received, although, on the basis ofthe effects of their previous compen- except on one occasion(a case of political inter- and another paymentmight push them further towardthestate of welfare and perpetualdole. Dr. William Peck, the former Director of Health Services in the Trust Territory, has put this situation lems, the people have always been friendly, and, sation in 1965, the ultimate benefits are doubtful, ference, described below), have generally cooper- ated in the examinations. Psychological reaction to the fallout has beerrreflected at various times in fears regardingfertility, a belief that fish poisoning was dueto radioactivity rather than to the poisonous natureof thefish, feelings of weakness attrib- nicely: ‘“To withhold further funds and thus deepen the grievance, or increase the compensation and therebythe dolor of dependence -— either course of action seems only to compoundtheir original injury, and our dilemma!” Further problems in the Marshall Islands are associated with the return of the formerresidents uted to radiation, and fear of thyroid cancer and leukemia(following the death of the Rongelap boy). A major concern for the past 5 years has been local political interference and questions concerning the medical examinations. The Trust Terri- to live on Bikini and Eniwetok, which were con- taminated during the testing program. Numerous radiological surveys have indicated that with certain restrictions these atolls can be habitable again. Since a number of concrete homes have been completed on Bikini, about 40 people have tory now has a Congress of Micronesia (not connected with the U.S. administration), which has appointed a Special Committee to investigate the health status of the Rongelap and Utirik people. Unfounded accusations were madebycertain local politicians that the United States deliberately exposed the people to fallout so that they could be used as “guinea pigs”to study theeffects, and that the medical team was concealing deaths from radiation and wasnot reportingall ofits findings. returned, but they must be subsidized becauseit will be several years before the coconut and other trees bearfruit. A numberof people are expected to return to Eniwetokto live in the near future. The medical team as well as other radiological safety personnel at BNL have been assigned the responsibility of personnel and environmental monitoring to assure the radiological safety of the returning people. Personnel monitoring and environmental surveys at Bikini were instituted a few years ago, and only very low levels of inter- In March 1972 the survey was interrupted by the politicians and had to be aborted at Rongelap. Afterwards the Congress of Micronesia appointed medical observers to accompany the team on survey in September 1972. Two prominentphysicians from Japan (Drs. H. Ezaki and T. Kumatori), one from England (Dr. E.E. Pochin), and one from the nally absorbed radionuclides have been noted. U.S. Public Health Service (Dr. W. Cole) accompanied the team andparticipated in the examinations. Their report to the Congress of Micronesia was most favorable and has done muchto quiet the political accusations. The Special Committee on Rongelap and Utirik published a lengthy report?* ofits investigations, including the report of the observers, andthis also has helped bring about a more favorable attitude to the medical examinations. Two majorbills have been initiated by the Congress of Micronesia. One concerns payment of travel and living expenses for any patient from Rongelap and Utirik on our examinationlist who needs hospitalization. This bill has been approved by U.S. authorities and is being implemented. The other concerns compensation for the Rongelap people forill effects of fallout exposure and provides also for a payment to the Utirik people andfor special compensation to the parentsof the boy who died of leukemia. (See Appendix 1.) We believe that the Rongelap peopleare entitled to fur- ERDAis sponsoring continuing surveysofthese atolls, being done byseveral institutions. The medical surveys have been a rewarding experience for all the personnel who haveparticipated. We have been fortunate in obtaining the services of talented specialists and technicians and in having the continued staunch support and assistance of many people at Brookhaven National Laboratory, ERDA, and the Trust Territory, and the authorities at Kwajalein, without which the success of the surveys would not have been possible. The medical team has developed a deep friendship for the Marshallese over the vears. In spite of the injuries and hardships resulting from the 1954 accident, they have cooperated with us even through the period of political disturbances. With the improved political climate and attitude toward the examinations we look forward to continuing these important and challenging missions and to offering specialized health care to these Marshall Islanders in future years. R.A. Conard, M.D. vu