VI. Recommendations The following recommendations are made as a first step in impro ving the quality of the program. 1. emphasis total health care for the people of Utirik, Rongelan, and Bikini rather than the constant stressing of research. The Brookhaven program should assume full responsibility for all the health care needs of the people on these islands until an adeauate local program is established to provide the care. The data collection of the research component can be accomplished in the broad general health care program. 2. continue to develop the doctor-patient relationship such that people feel invited to see the doctor not forced. 3. expand the program such that all the people at Utirik are included for yearly examinations and quarterly survey medical care. 4. expand the program to permit children of the exposed people to have examinations on a regular yearly basis. 5. expand the health care program so that people living at Bikini and eventually those réturning to Enirvetok be included in the quarterly MCaicai Visits ror nealth care. 6. provide funding to improve the education of the health aides at Rongelap, Utirik, and Bikini. This education would provide better care for the pecple when the doctors are not on the island. Beiter records would be kept. Make the resident physician more responsible for daily health care problems via a radio network. 7. complete health records of all the people should be transferred to a permanent file system based in the islands and carried on each trip. Secretarial help should be made available to maintain and update this record system. | 9. at Rongelap, allow the people to use the tractor stored there to hs clear the island and general island improvements. 10. provide adequate food so that when people are removed from their activities for examinations they and their families will be fed. Similarly, when a patient is returned to the United States, provide food assistance for the family left behind. 13 1045698 ‘Gd 8. at Utirik, arrange to have one of the metal AEC buildings converted into a new dispensary.