Recently, a full-time Marshallese nurse- They have most frequently of the country's outstanding researchers. has been primarily on a 1:1 basis - using many Liason esteblished over the preceding 25 years Academic liason - the pattern of professional been unpaid, highly qualified sub-specialists with a primary interest in the area of thyroid pathology. throughout the U.S. period have been volunteers recruited from leading medical centers and research centers The remainder of the staff over this 25-year Marshalls and a technician previously based at Brookhaven National Laboratory has been transferred to the Marshall Islands. practioner has been adcew to the staff in the Secretary - since the vast majority of the staff will continue to be voluntary and in Since one of the The new liasons will therefore involve cooperative efforts with It is the opinion of a number of experts in this field that the medical programs Therefore we have contacted the dean of the medical shool at the University of Southern for the low level radiation groups be university based with a non-nuclear identity, surveys. large academic and contractural centers who are able to mount and maintain major field support must be refined. 5 week period, it becomes obvious that multiple field teams must be developed and logistic is limited to 16 shipboard personnel who are able to examine approximatly 500 people in a health risks. 3) such a program will necessitate the close integration and cross-cultural ties necessary to provide effective corffmunication, The plan will be to develop a core of innovative health educators to train Marshallese from the affected atolls. These Marshallese will in turn, train a cadre of Marshallese. The goal of this program is to establish a fully competent and independent Marshallese training group using a Brookhaven National Laboratory health educator as a resource person. 4) with the incremental increase in the population under study (from 400 to 2000) and characteristics of the current logistic support system, i.e., at present the medical team be given to developing a health education program designed: , 1) to explain the role of each medical/radiation programs 2) discuss openly and freely radiation risks and to put them in an understandable cultural context and ia turn to put those risks in relationship with the indigenous primary primary criticisms repeatedly brought against the US Department of Energy program has been the lack of communication the present principal investigator feels that initially top priority should government but also from the affiliated academic institutions and consultants. Many cases, in a compensatory pay status, rapid hard copy communication and coordination is essential to the program, In addition, the need for a full-time, highly qualified, innovative health educator has been identified. This request has come not only from all segments of the Marshallese people and 2. it is mandatory that some individual familiar with the intricacies of the program bd available and resident at Brookhaven National Laboratory during the absence of the principal investigator. This individual should be supported by: complexity of the program involving multiple governmental agencies and academic institutions, Two and a half months later, a five week survey begins in mid-May, directed primarily toward pediatric care but designed also to follow-up on abnormal thyroid findings and to examine patients missed on the January survey. The staff is essentially the same with the substitution of a pediatrician for a thyroid specialist. The third survey occurs two and one half months later in mid-September and concentrates primarily on delivering dental care and performing ancillary studies..., i.e., diabetes, etc. The staff is as before with the substitution of a dentist for the pediatrician. The rapidly expanding character of this program has made it necessary to add the following positions: 1. Research Coordinator - since the principal investigator has been traveling 60% of the time since assuming direction of the program, and there has been a marked increase in the and 2 RN's). to balance the field survey staff so that the basic adult screening protocol can be obtained in a five week survey, beginning in mid-January, including a staff of 14 professionals (4 MD's