ACOSO 7 4 REPORT ON VISIT TO RONGELAP AND UTIRIK ATOLLS At the request of the Special Joint Committee Concerning Rongelap and Utirik Atolls, Congress of Micronesia, I participated as an observer of the Brookhaven National Laboratory - AEC Medical Survey Team and made observations at Ebeye Island (8 September), Rongelap Island (11-13 September) and Utirik Island (16 and 18 September). In the following, I wish to report my findings in sequence by item of the questions put to me by the Committee. As I stated at the meeting with the congressmen held on board the Militobi on the morning of 10 September, I would like to limit my opinions mainly to thyroid diseases which is my specialty, and not attempt to answer items outside of my specialty. Further, as I do not have the results on the specimens obtained during the survey, it is requested that it be understood I shail present my opinions on the basis of past medical literature and my current observations on these islands. 1. a. Detailed physical examination as is being held on an annual basis is appropriate. However, on such remote islands with limited hygiene facilities, it is desirable to conduct in addition 3 to 4 physical examinations per year for health consultation. At the same time, it is necessary to strengthen the health and hygienic facilities for the local residents, independent of the H-bomb casualty survey. b. The contents of the past surveys have been modified slightly in accordance with special requirements. The present policy is considered satisfactory, except for one grave defect. This is that almost no autopsies are performed. Autopsy is one of the most effective methods to detect the effects of the H-bomb. Though there may be technical difficulties involved in performing such in this remote district and difficulties in securing the consent of the local people, it is hoped that the medical survey team and the Government of Micronesia can cooperate in overcoming these difficulties. If it is not possible to perform autopsy on the whole body, I strongly recommend study be made of the thyroid glands at least, where disturbances are most obviously present. c. The examinees willingly underwent physical examinations and their attitude was friendly. It was observed that members of the medical Survey team were making efforts to explain the results of examination in full detail so that they might be easily understood. However, when the opinions of those examined were sought later, I received the impression that some of them did not seem to have a complete comprehension of the results. This is considered not due to inadequate efforts on the part of the medical survey team, but due to the problem of language and lack of knowledge by the examinees. It is necessary to devise a mechanism whereby the results of examinations can be fully utilized for the health preservation of the examinees. d. From the above point of view, the following countermeasure can be considered. A mechanism whereby a medical record containing the contents 208 mt