Consequently, with

to the PI,

frequently provided more problems that help

based in the Marshall Islands, however those
physicians, with one notable exception, have

time technicians. Over the last 6 years there
have been intermittent resident physicians

ted of 1 full-time MD/director and 1-? full

8. Staffing - for the last 24 years the
full-time staff for this program has consis-

dilu tion of the research dollar.

essentially level funding there has been a

provide primary care.

compelled by the lack of TT services to

screening for radiation related disease will
detect this other group of health problems
and pathologic conditions and that we are

of the program have realized that adequate

the comparison group.
;
Over the last 10 years, there has been an
ever-expanding concern with primary care
problems that have been detected in this
population who have not been taken care of
even after referral to the TT health care
The program has therefore
delivery system.
become more and more enmeshed in primary care,
diagnosis and treatment of conditions not thought
to be related to radiation, t.e., diabetes and
high blood pressure and severe dental disease,
Both the field and the departmental directors

location) plus a group of 209 individuals in

7.
The study population now consists of
the 244 originally exposed (minus the individuals lost to the study by death or dis-

Since the condition for return to Enewetak involve the voluntary restrictions of movement
by the

Likiep

Wotje
Metjit

400 +
300 +

400 +

For the last 2 years there has been an

Staffing - over the last year there have been major changes in the scope and responsibility

replacement will not be available for another six months.

The annual surveys have been re-designed

Brookhaven National Laboratory for US - Department of Energy in December 1978.
Since that time,
recent developments have necessitated a re-evaluation of personnel needs.
The program has been
without a resident physician in the island for six months and it is anticipated that a functional

considering the projected increase in the study population, a position paper was developed by

lastsix months, concurrent with the establishment of a new Marshall Islands government there has
been a concerted effort by all parties concerned to develop a highly integrated and cooperative
effort to serve the medical needs of the Marshallese people.
In line with this effort, and

increasing perception of the critical role that communication (health and radiation education)
plays in the delicate interface between the Marshallese and the US representatives. Within the

8.

of the Brookhaven National Laboratory medical program,

independent variables and consider the need for/or availability of a comparison population.

indeterminate low.
If this population is included in the study group, a careful epidemiologic
protocol will need to be provided to characterize the populations, identify the dependent and

Bikini
6-800
Enewetak
4-500
{
TOTAL
2100 +
This population has received a variable amount of background radiation ranging from ambient to

»
.

.
-

1.

7.
In addition to the group outlined in the traditional program, the expansion of the program
to include the following islands would increase the study population as follows:

the possibility orf a situation developing analogous to that of Bikini exists.
Because of this possibility the US - Department of Energy feels that it is mandatory that careful base line body
burdens be obtained on all people returned to Enewetak and that this be done in conjunction with
a careful medical examination.
Subsequent WBC and medical examination will be necessary to detect
any significant accumulation of radioactivity.

people among the islands of their atoll and prohibition of consuming specific foods from chose areas

NO war WM

Select target paragraph3