Consequently,
the BNL medical team has become the de facto primary health care
provider to an ever-expanding group of Marshallese.
The rationale of the
Marshallese in the BNL program for their claim to the "right for all medical
care" is their association of practically all illness with radiation.
3.
The BNL medical team, becauce of its frequent surveys has,
in the eyes
of the Marshallese, come to represent the U.S. "presence" in 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 unwarranted 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 rapid growth of the medical program and the development of this
matrix of compounding variables, Dr. Burr and Dr. Wyzen requested a position
paper that would outline for DOE the alternatives for the support of a study of
radiation-related injuries in the Marshall Islands.
These options should
include a wide spectrum of alternative programs, keeping in mind the
inextricable interrelationship between BNL screening and the health of the
people of the Marshall Islands.
We feel a failure to deal effectively,
in sone
way, with the primary care requirements of the people will lead to further ill
will,
failure to comply with the research protocol (e.g.,
finally,
thyroid therapy), and,
litigation and a call to foreign and national antinuclear groups to
witness the "mistreatment" of the Marshallese by the U.S. government.
Since
primary medical care is clearly not the mandate of the DOE, perhaps some