Mes. Ruth G. Van Cleve Page -2- Included in our figures are all thyroid patients referred to Guam and Hawaii. However, we cannot be more specific on the actual number of referred cases as our Headquarters files do not contain this information. We are in the process of obtaining this information from the Marshalls hospital records and we will forward it to you shortly. It should be noted that the actual referred cases will be less than the number indicated in the statistics appended hereto as not ali diagnosed cases were referred to external clinics. Attachment #1 shows the number of cases from the Marshalls from 1973 to 1977. Attachment #2 shows the number of thyroid cases from Ponape District for the five-year period from 1974 to 1978. Attachment #3 is a breakdown by age, sex and home islands of these 16 patients.from the Marshalls. As may be noted in the first two attachments, the number of cases from both the Marshalls and Ponape show a fluctuation during these five-year periods. However, the overall rates during these periods for both areas were almost the same, with a rate of 5.7/10,000 population in the Marshalls, while in Ponape the rate is 6.4/10,000. The rates were calculated using the latest populations for both areas~--the Marshalls, 27,880, and Ponape, 21,780. In other words, the comparison of thyroid cases between the Marshalls and Ponape in a five-year period of time was almost the same, with Ponape somewhat higher, although not significantly so. A copy of the Whidbey survey is enclosed. A point that I feel should be cleared relates to the medical care afforded all the people of Rongelap and Utirik who were exposed to radiation. ‘These pecple were treated by the Brookhaven National Laboratory staff, and usually thyroid cases were initially referred directly to Tripler Army Medical Center in Honolulu. Many of them then went on for further treatment. to NIH in Bethesda, Maryland, We have found nothing that shows the surgical logs in Majuro Hospital, have been “pruned”. The Department of Health Services in the Marshalls never handled surgical cases with thyroid problems of the people from Rongelap and Utirik. This area will also be addressed by thea Attorney General during his trip to Majuro. Sincerely yours, lle, ak) Adrian P. Winkel High Commissioner Ene losures 5011904