2. May 18, 1973 fone, 4 Ss Senator Olympio T. Borja out that this decision had nothing to do with scientific curiosity, but was the considered opinion that it was the best management. Another example concerned the delay in starting thyroid treatment in the retarded children, as related to scientific curiosity. It is a statement of fact that the early growth retardation in the children was not recognized as being related to thyroid injury until abnormality of that gland was noted. Treatment was instituted as soon as this fact was apparent. It should be the hormone levels in the Marshallese were in error, since at that time it was not known that the plasma of the Micronesian people had abnormal levels of blood proteins which’masked true thyroid hormone levels. If the specific Nearer realized-that there was no reason for the doctors at first to suspect that had been available at that time, hormonal deficiency could undoubtedly have been recognized and treatment in the children started earlier. I believe that the criticism of certain other procedures such as use of tetanus toxoid, fertility test, etc, have been adequately commented upon in our answers to your questions which we recently submitted to you. foes eee ‘laboratory methods for evaluation of thyroid status which are available today I believe the Committee and observers were justified in their criticism in the area of communication and education of the people about the examinations. We realize that we have not been able to get the people to understand fully the nature of the radiation effects, the need for the continued examinations, the need for rationale of treatment used, etc. Also, we have failed to get the unexposed Rongelap people in the comparison population to understand the importance of their contribution in the examinations of their exposed brethren. We will make every effort to follow the Committee's recommendations by attempting in each case examined to: 1) verbally explain our findings at the finish of the examination; 2) and later submit a written statement in Marshallese to the individual about the results of the examination. In addition, summary copies of examinations will be furnished the home island as well as each district medical center. We will be glad to cooperate with the Trust Territory in educational programs designed to help the people better understand the nature of radiation and its effects. During the surveys we will attempt to observe carefully aspects of Marshallese culture in relation with our dealings with the people. I am in complete accord with the recommendation that services of a physician be provided in the Marshalls to give special medical care to the Rongelap and Utirik people. If Dr. Knudsen, who has been doing an excellent job, cannot be persuaded to stay on, he should be replaced, if at all possible. Due to transportation difficulties in the Marshalls, the recommendation concerning procurement of a medical ship to implement the travel of such a physician to the outer islands is deemed highly desirable. Dr. Kumatori's suggestion that further cytogenetic studies be done on the Marshallese in order to detect late effects of radiation will be duly considered, I am in agreement with his suggestion that the United Nations sponsor an international scientific meeting on the effects of radiation on exposed populations. Perhaps the World Health Organization might better sponsor such a meeting. e067 ee