of a Medical Referral Board that now screens and approves
all referrals. But the point of major, eurrent importance
is that the Marshall Islands Govermaent has funds for outside
referral costs. If emergency situations result and the fund
is exhausted, additional funds could be made available to
this account by reprogramming or by special appropriations
of the Marshall Islands Legislature, the Nitijela.
The Majuro Hospital now is run by a medical care contractor.
Part of the contract calls for up-grading of medical staff
at the Majuro Hospital, and specialized staff is being made
available. Conditions are improving at the Majuro Hospital.
Obviously, a Rongelapese who requires emergency open-heart
surgery would have to be referred to Honolulu, but this also
would be the case for any Marshallese individual in a similer
eondition regardless of residence.
The Bikini situation you cite is wnique in thet the agreement
to provide special medical care was connected with the
emergency evacuation of the group of 144 Bikinfans from
Bikini Island in August of 1978. These individuals believed
that they had received contamination by living on Bikini
Island, and the agreement was made wnder these very special
circumstances. It did not provide for special medical
coverage for Bikinians who were living on Kili Island or
elsewhere in the Marshall Islands.
Until a special comprehensive health care program ia in
effect pursuant to P.L. 96-205, non-radiation related medical
cases that require treatment should be referred to the
appropriate medical authorities in Majuro. The Medical
Review Board there has the authority to refer cases that
cannot be treated locally to Honolulu.
Sincerely yours,
(Signéd
Billy Lee Hart
Acting Deputy Assistant
Secretary - Operations
Territorial and International Affairs