Chapter V — The Continuing Medical Surveys continued under contract with BNL. I was A. Need for Continuing Medical Surveys - asked tobethe program director.® AEC Mandate for the Examinations Following the initial medical examinations. the people of Rongelap were reexamined Trust Territory under the Departmentof by medical teams headed at six months by V. P. Interior and, more recently, the Republic of the Marshail Islands. The participation of the Bond (Naval Radiological and Defense Laboratory) (A-3), at one year by E. P. Cronkite (Brookhaven Nationai Laboratory) (A-4) and at two years by me (A-5). In 1956, I resigned from the Navy andjoined the staff at Brookhaven. The Rongelap peopie had moved to a temporary village constructed for them at Ejet Island, Majuro Atoll. For the examinations, the people were transported by boat to the main island at Majuro, several miles away. An unexposed population of Rongelap peopie living at health service personnel ef the Marshall Islands has been indispensable to the success of this project. During the early phases of the examinations, the need for, and extensiveness of, the examinations had te be clarified with the Trust Territory officials. Also, there was con- cern that the Rongelap people were not adjust- ing satisfactorily since returning to their island and that the crew going ashore from the Navy LSTs at the time of the examinations might have a disrupting influence. Subsequently, the situation improved when Trust Territory ships were used and the numberof survey personnel reduced. Majuro was selected as a comparison group and given the same examinations as the exposed people. This population was blood relatives of the exposed peopie, living under the same conditions, and matched reasonably well for age and sex. Examinations during the first two years showed that the initia] acute effects of the radiation exposure had largely subsided (see next Section). The people were reasonably heaithy and no deaths could be attributed to radiation romee) | - B. Limitation and Expansion of Program The Brookhaven medical program in the Marshall Islands was designated by the AEC as a research program with a mandate to examine and treat the Marshallese people who had been exposed to fallout. The responsibility for the oo. thai antra rationexpal uate CHaeons cere seersHower ere in¥iew of:een agomic bembs at Hifsaiims and qm th of otherirradiated populations, Marshallese were at greater than normal risk of late effects, such as leukemia and other types of cancer (B-31). Therefore, we recommended that annual examinations of the Rongelap people be continued indefinitely. Looking at the small’ radiation exposure of the Utirik population, we considered that examinations every three years would be adequate. (Later, when thyroid abnormalities appeared in that population, annual examinations were carried ot). The Division of Biology and Medicine of the AEC agreed with these recommendatiogs; and in 1957, with the concurrence of the Trust Territory, requested that the examinations be neg ~ I0G8 fbb * Kenda KiDetinruersomseant edings be | The examinations by the Brookhaven medical team have been a joint project with the generalhealthcareoftheMarshallese, includfrig the éxpesedpopulations;haddeen catab- — lished as a responsibility of the Trust Territory Governmest..Aatimewent.op,it became... increaaingly apparent that the primary health care afforded by theTrust Territoryiin the Outer Islandswasinadequaté.andthémedial team attempted to increase medical care. Our team was later criticized for not assuming . greater responsibility for general health care of the Marshallese. Another criticism was that the people were being treated as “guinea pigs’, which was probably related to the fact that numerous examinations and tests were being carried out by the medical team because of the limited knowledge about the effects of fallout *Tt abould be pointed out that the AECnaturally turned to agen Cies under contract to them, principally the National Laboratories, for essiatance in radiation problems. Except for the military laboratories, there are few other agencies that have the capabilities for such assistance.