*hapter XI — Closing Remarks This report has presented an historical -ccount of the experiences of the Brookhaven ‘fedical Team in the examination and treatnent of the Marshallese people following their iceidental exposure to radioactive fallout in -954.*! This is the first time that a population ias been heavily exposed to radioactive fallout, and even thoughthis was a tragic mishap, the medical findings have provided valuable infor- mation for other accidents involving fallout such as the recent reactor accident at Chernobyl. Noteworthy has been the unexpected importanceof radioactive iodine in the fallout in producing thyroid abnormalities. The organization and carrying out of these examinations over the 36 years proved to be a complex and formidable undertaking. Many of the problems were unique to a medical program. ‘Fortunately, many of us had had previous experence with radiation effects, some having participated in atomic tests. The mission could not have been successfully carried out without the participation of someof the finest specialists in the various fields of medicine and the staunch support of many agencies, particulariy Brookhaven National Laboratory;Depétment of Energy,** Department of Defenemiand the Trust Territory of the Pacific Islands, Jtigfor- tunate that since my retirement the medical | programis continuing under the abi¢'diféction of William Adams and his medical team. Some of the difficulties in carrying out these examinations in a distant area of the world have been described, including organization of the medical teams, scope of examinations, triage problems related to assembling and shipping of medical supplies and equipment, and establishment of examination facilities on tiny, remote islands in the Pacific. 21) Appendix II, a chronological outline of the principal events ifpresented. T have pointed out that the AEC/DOE necessarily had to call on their National Laboratories for assistance in radiation problems since there were no other agencies with the required caps- bility and facilities. It should be repeated that although our program was under the segis of BNL and funded by AEC, there was hever any attempt to influence the conduct of the examinaons which we carned out independently with the advice and parnapation of medical peopie from outstanding insututions wn the United States. ) Q lu | 0 ty When we arrived in the islands, our medical team was facedwith the medical care of a popu- lation with ethnic background,life style, customs, and language that are different from ours. In retrospect, due to a certain naivety on our part, we did not at first appreciate how these differences might apply to the conductof our examinations. The language barrier madeit difficuit for us to communicate with the people and help them understand their radiation exposure and the need for the examinations, particularly blood tests. (Later, when they began to develop - thyroid abnormalities, they cameto realize more fully the importance of the examinations.) Unfortunately, they were never able to understand very much about radiation andits effects on them. They were afraid of this unseen, unfeilt “poisonous powder’ and its effect, and this becamea strong psychological factor. They continued to believe that every ailment and every death was somehow related to radiation exposure. It is understandable that with the disruption of their lives, the developmentof radiation effects, and the contamination of their isiands, there was increasing bitterness towards the United States about the accident and,justifi-_ ably, increasing demands for compensation. The local polititiansand lawyers representisg:the: people becameever:more vocal in their criticisms of the United States in handling the post- accident problems. og it The criticisms increasedand the years 1972 to about 1977 were troublesome onesfor us. Unexpectedly, the Japanese anti-A and H-bomb _ groups becameinvolved with the Marshallese politicians in criticizing the way the fallout vic- tims were being handled. These groups were very active in Japan and created much publicity concerningthe fallout exposure of the Japanese | _ fishermen on the Lucky Dragon. The Marshallese politicians were greatly angered when the Trust Territory Governmentrefused to allow a Japanese group that they had invited to visit Rongelap to examine the exposed people and the group had to return to Japan.This action precipitated a cascade of events: the abortion of our 1972 medical examinations after the team bad arrived at Rongelap dueto political interference; the formation of a specidl investigative committee on Rongelap and Utirik 45