. 4 Introduction A. Scope and Purpose P.L. 96-205 requires the Department of Interior (DOI)| to develop an “integrated, comprehensive health care program" with respectIto the peoples of the Marshall Islands. Pursuant to P.L. 96-205 and the requlting request for proposals from the Department of Interior, there has bedn considerable discussion on the exact scope of the law and what people should be included. land activities Further clarification with DOI has stipdlated that the contractor (Loma Linda University) prepare two health plans 1. as follows: “Comprehensive Care (Primary, Secondary, and Terfiary) for the peoples of Rongelap, Utirik, Bikini, and Enewetak J" 2. “Comprehensive Care as inl. .. ., plus compreha@nsive care for the peoples of all other atolls of the Marshall Iqlands." In addition, comments and estimates will be provided redarding use of different types of U.S. personnel. It is clear, however, hat extensive use of expatriates in primary care roles is both impractical nd politically unacceptable. _ To avoid excessive duplication, the current situation and regarding the comprehensive plan for all presented first. Then the of the Marshall recommendations Isfands will components of that plan necessar primary, secondary and tertiary care for the people of Rongelap, be for adequate irik, Bikini, and Enewetak will be identified. B. Sources of Information The Loma Linda University team of 22 members spanned ma&hy disciplines and backgrounds, with a considerable depth of experience an expertise in health care planning and delivery in the developing world (s appendix E). In gathering background and source material for this s vey and plan, many organizations were contacted. Among the most important were: Trust Territory governmental headquarters in Saipan currentl¥ Brookhaven National Laboratory, Lawrence Livermore the phasing down, Laforatory, the University of Hawaii/East-West Center, University of the Sobth Pacific in Fiji, College of Micronesia in Ponape and Saipan, and a n@mber of other institutions and organizations involved in work in the Marshalls.