diabetes education, which has includeddistribution of a brochure on diabetic care that was translated into Marshallese for patients, is an ongoing process, as diabetes is a serious medical problem in the Republic of the Marshall Islands. A surveyfor folic acid and vitamin Bie deficiencies has been completed. Dental care has been redirected toward preventive dentistry; repairs and restorations are now the main thrust rather than extractions which can be managedby local personnel. A major effort has been directed at the inclusion of a wide variety of specialists and subspecialists as participants on the medical teams. Participants have been chosen from excellent medical centers through-. out the United States. These physicians not only perform the required routine physical examinations; they greatly increase the diagnostic and therapeutic capabilities of the team in handling unusualor difficult problems. Their services are also offered to the Republic of the Marshall Islands Health Services as time permits. The specialties and subspecialties utilized in 1980-1982 are listed below: Dentistry (adult and pediatric) Endocrinology Family Practice Hematology Internal Medicine (including Fellows in Rheumatology and Pulmonary Medicine) Nuclear Medicine Obstetrics and Gynecology Oncology Ophthalmology Pediatric Cardiology Pediatrics Surgery Tropical Medicine and Parasitology ws! co co a~ cD jane) cm For the 3-year period covered by this report, medical surveys have been conducted semiannually. The “Spring Survey” offers complete medical examinations to all exposed individuals, the comparison population, and all persons 15 years of age or older residing on Rongelap andUtirik Atolls. In addition, a daily sick callis available to anyone in the younger age group. At the population centers of Ebeye and Majuro, complete examinations are available to all exposed persons and to membersof the comparison up. The “Fall Survey” permits examinations persons missed in the spring and followup of medical problems. It also enables and facilitates pediatric/dental coverage. Complete examinationsare offered to all individuals under 15 years of age residing on Rongelap and Utirik Atolls, and a sick call serviceis available daily to all others. At Ebeye and Majuro, examinationsare offered to children of the exposed and comparison populations. Followup care for people with chronic medical problems such as diabetes and hypertension is a focus of both major surveys as well as the periodic visits of our physician-in-residence (see below). Persons with identified problems clearly unrelated to radiation exposure and beyond the capabilities of the medical team are referred to the Republic of the Marshall Islands Health Services. Radiation-related illnesses, possibly radiation-related illnesses, and medical evaluations which could conceivably lead to the diagnosis of a radiation-related or possibly radiation-related illness are handled through medical channels established with the help of the Department of Energy Pacific Area Support Office in Honolulu. In the early 1970s, some Bikini families resettled Bikini Island. The peak population during this period was about 140. Because of the remoteness of Bikini and the apprehensions of the settlers, the medical team was authorized to extend its Rongelap/Utirik surveys to provide sick call visits to Bikini. These settlers were again relocated to Kili and Ejit (Majuro) in 1978. At the requestof the Departmentofthe Interior, followingthis relocation, these Bikinians have been seen twice a year during the Majurovisits. An attempt to provide medical coverage between the semiannual medical team visits has been continued. A Brookhaven National Laboratory physician is stationed on Kwajalein, and office hours and laboratory services are maintained on Ebeye, to which the physician commutes daily. In addition to providing primary medical care for persons holding a Brookhaven National] Laboratory identification card on Ebeye, the physician undertakes periodic visits to Rongelap and Utirik. Such visits mustbe performed within limits set by available transportation to these remote atolls. A Brookhaven National Laboratory nurse and/or technician, both Marshallese, accompanythe physician. A Brookhaven National Laboratory technician