3. 9 ~ ‘ be ee ee esrer wet Sbyre SpN ee be te eee ee eee ee Dr. John R. Totter -2- . April 28, 1970 possible between surveys. We have therefore run into the serious difficulty of insuring adequate thyroid hormone therapy in the exposed population. Some of these people, particularly those that have had thyroidectomies, will become hypothyroid if a strict treatment schedule is not maintained. We have made every effort to insure continuity of the treatment program but medical personnel at the District centers charged with the treatment program responsibility just have not always been able to take the time to ferret out those people who have not shown up for their weekly medication. I do not intend that the above statements should be interpreted as criticism of the Trust Territory. They have been laboring under great difficulties of budgetary restrictions, shortage of personnel and transportation facilities particularly for outer island medical care, Though definite progress is being made in the Marshalls and marked improvements in medical care can be seen, it will probably be some time before the medical care of the exposed Marshallese will be satisfactory. It would be unrealistic, of course, to expect medical care anywhere near on a par with American standards in the near future. Drs. Bond, Cronkite and I feel that the above facts should be brought to the attention of the AEC in view of the possibility of criticism by activist groups. As I see it the only possible partial solution to this problem would be having a responsible individual with medical training directly responsible to us in the islands. With the shortage of medical personnel in the Trust Territory it is not likely that they will be able to furnish such an individual. In the past I have attempted unsuccessfully to get two health aids stationed on Rongelap. It is unlikely that we could get a physician that would be willing to fulfill these responsibilities. However it might be possible to obtain someone with medical training such as a retired Navy pharmacist's mate or his counterpart in the other services though I am not sure that we could find anyone that would be willing to fill this position. I had an opportunity to informally discuss these problems with the High Commissioner of the Trust Territory, Mr. Edward Johnston, during my recent trip to the Marshall Islands and he is in sympathy with our problem. Sincerely, 32h ° Robert A. Conard, M.D. RAC: jr cc: V.P. Bond E.P. Cronkite Dog