C: ( A TRIP REPORT OF THE ANNUAL MEDICAL SURVEY IN THE MARSHALL ISLANDS - MARCH 25-APRIL 25, 1978 During the period from March 25-April 25, 1978, the islands of Majuro, Ebeye, Utirik, Rongelap and Bikini were visited by the BNL team for medical examinations of the Marshallese exposed to radioactive fallout in 1954 and unexposed populations in the study group including, in addition, people residing at Bikini. 8 physicians and 11 other medical personnel, including a practitioner, nurse and three technicians from the Trust Territory Health Services, comprised the medical tean. In addition, a group of 4 others from BNL accompanied the medical team for the purpose of carrying out environmental and personnel radiological monitoring at Utirik, Rongelap and Bikini islands. We were most fortunate in obtaining the services of specialists in several medical fields for the survey, including a gynecologist, endocrinologist (thyroid specialist), tropical medicine specialist, internist, pediatrician and ophthalmologist. The voluntary assistance of these physicians (without pay) contributed a great deal to the success of the survey. The Rongelap, Utirik and Bikini people were all cordial, friendly, and most cooperative. They had parties for the group and presented gifts of shells and native handicraft. Examinations included medical histories and complete physical exaninations, with examinations of the blood and urine. Blood samples were brought back for more sophisticated analyses at U.S. laboratories. Emphasis was placed on studies for possible late effects of radiation exposure, particularly with regard to the thyroid and malignancies of other organs. In view of the thyroid problems in the exposed populations, examinations of the thyroid were also carried out in a number of unexposed Rongelap and Utirik people as part of a study to determine the incidence of thyroid tumors in unexposed Marshallese people. In the outer islands, in addition to regular examinations, "sick call" was held daily. Treatment was administered to the degree possible under field conditions and in some cases patients were referred to the Trust Territory Health Services for hospital- ization at their medical centers. Health care of the people living on Bikini has remained a responsibility of the Trust Territory and the BNL medical team has, in the past, only carried out "sick call" when transiting the island as a "Good Samaritan" gesture. However, on arrival at Bikini this year, since the medical team was to remain for two days on the island, in addition to "sick calls", the people were invited to come aboard ship for complete medical examinations blood work) if they wished. (including Almost one hundred percent of the people opted to have the examinations, and all of the children and babies were examined by the pediatrician. opportunity. They appeared to be extremely grateful for this The number of people examined on the various islands was as follows: