expansion beyond this limited involvement meant they would not be able to supply such materials. The people's confidence was gained by dealing with them as people and not just someone ona list. A close doctor-patient relationship was created. More time was spent on each island and the people treated equally with no selectivity. Public health personnel accompanied the trips to provide direct people contact and to assist in the examining room with translations and patient procedures. A young Maishallese laboratory technician was also utilized to improve patient relations. The response from the people was overwhelming. Brookhaven, although enjoying the good work, still responded that the project was still research directed and that general health care responsibilities were up to the Trust Territory. The resident physician could only assist in providing general health care but not take responsibility for such work as part of the Brookhaven program. As a clinical physician I could not operate a health care program one handed. I could not diagnose a problem and then respond by saying it is not my responsibility, but Trust Territory to take care of it. Especially, when I knew I] could manage it _ better than the Trust Territory ‘health system. A close check would reveal that ERDA had funded a general health care project during my year asiresident physician as that was the priority need of the neonle. Tt accomnlished the same fesulis as ine old narrow research program but achieved snore in that the people got better care and it developed a better response from the people The Marshallese people have become remarkably sophisticated over the past few years. The Amcrican political and economic systems have taught them the importance of the dollar as well as giving them aspirations for better homes, food, health care, and employment. They are not to be viewed as "children" as was the opinion of some people. Their aspirations will continue to increase in the future. The medical project that is conducted in the islands should be the best one the U.S. govemment can provide. At present that does not occur. The people feel that the United States has a moral and legal responsibility to provide care for them as a result of the fallout accident. The program should operate free of interference from Washington or Majuro. The desire of Drs. Conard, Knudson, and Kotrady is an intense cffort to improve the quality and quantity of medical care delivered to the people. Physicians in the past have supported general health care efforts but have been stymied by the lack of official sanction and limited assistance, I chose to ignorethe rigid policy and in doing so demonstrated that a better program could be accomplished in the islands. 7 50113 q8 12