The Honorable Wallace 0. Green Acting Deputy Assistant Secretary Territorial & International Affairs August 8, 1980 Page Nine help them. And this was the sum of the investigation and treatment of the eye problems,--of what I think iS a unique epidemic of cataracts. The follow-up care of patients with total ablation of the thyroid also appears inadequate. Some had stopped their medicine because of side reactions and appear hypothyroid to my eyes. No regular follow-up has been pursued to allow change of thyroid medication, or increase or decrease of dosage." Dr. Merliss makes several recommendations which we believe merit serious consideration in connection with the proposed medical surveys to be conducted in the Marshall Islands in the course of implementing Public Law 96-205. We request that you and other appropriate United States govern- ment officials review Dr. Merliss' findings and recommendations and meet with us to determine how his recommendations can be implemented and the medical problems which he identifies can be treated in the most expeditious manner. In order to obtain useful information from the outside contractor which the Interior Department proposes to use to assist in aeveloping the health care plan, the contract document must be carefully drafted and the questions to be answered clearly stated. We request that the contractor be asked to address the following questions: 1. In light of the fact that no dose assessment was carried out in the Marshall Islands at the time of the nuclear weapons testing program, how can it now be determined whether certain atolls of the Marshall Islands were “exposed” to radiation from the nuclear weapons testing program? 2. What level of radiation exposure can be definitively medically determined to have zero potential effect on the natural or human environment of an atoll?