response to a request from the Republic of the Marshall Islands, has permitted the Brookhaven medical program to continue to supplementlocal health care for the exposed persons,stating ”..the President...shall continue to provide special medical care and logistical support thereto for the remaining 174 members of the population of Rongelap and Utirik who were exposed to radiation resulting from the 1954 United States thermonuclear "Bravo" test, pursuant to Public Laws 95-134 and 96-205." The Marshall Islands Medical Program is a clinical program which exists for the benefit of the radiation-exposed Marshallese. It is a program of radiation-related disease surveillance consisting of periodic examination and treatment of disease. Additionally, clinical investigations have been carried out by the program over the years, the intent being to identify present or future threats to the health of the exposed Marshallese, hopefully in time to prevent or limit morbidity and mortality. For example, based on the medical program’s early findings of numerous thyroid nodules in the exposed population, thyroxine suppression wasinitiated for the Rongelap people in 1965 so that thyroid nodules/carcinoma might be prevented. It is possible that this prophylaxis has met with some success. This will be discussed in detail below. . The Marshall Islands Medical Program is distinct from the Marshallese Government Health Services, which is a national program of health care which encompasses two hospitals and a network of clinics scattered over some 20 atolls. This network serves the entire population of the Marshall Islands, which numbers over 45,000, whereas the U.S.-funded medical program is directed to assist only those individuals who were exposed to fallout radiation from the BRAVO accident. The Marshall Islands Medical Program provides medical care twice yearly to the exposed and comparison populationsby visiting the islands . where most now reside, namely Mejatto, Utirik, Ebeye, Majuro, and, prior to 1985, Rongelap. Any exposed person who has medicalfindings suggesting a malignant neoplasm, or other radiation related disease, is referred to secondary or tertiary medical facilities for definitive evaluation and therapy. Those persons with problems that can be effectively managed in Majuro are referred to the Marshallese Health Services. Those requiring a more 4xtensive evaluation are referred to hospitals in Hon for the special cases of thyroid and pituita the National Institutes of Health in Maryland. Individuals needing referral fr nontreatmentis initiated. During the process of providing surveillance to the exposed Marshaile contact with children and other family me the exposed, as well as other inhabitants islands. It has been the policy of the Department of Energy to support the medical program in it] efforts to provide medical consultations by the [medical specialists on the mission to these individualf on the basis of humanitarian need and as resourcesfpermit. In addition, services of the Brookhaven fnedical team andits facilities are offered to the Ebftye and Majuro hospitals. On mostvisits lectures y team physicians are arranged and patients referrdd from the hospitals are evaluated. The medical direction of the Marshall staff of university-affiliated or government hag and often with past experience with the p Robbins, Chief of the Endocrinology SS Genetics and Biochemistry Branch, Ng medical program. Raytheon Services Nevad§ Honolulu, Hawaii, under contract to DOE, p excellent logistical support to the Depart care workers for each mission. In the interim between the two medical the exposed population has access Marshallese health care system. To expedite exchange of medical information, wit