11. patients returning to the U. S. should always be accompanied by an interpreter for the cntire journey, preferrably one of the same sex. Passports and other immigration documents arranged prior to departure. 12. be more culturally aware - do not set time constraints, allow a meeting to begin when all people have assembled. Do not refuse to meet with the people for any reason. 13. during the examination, have a Marshallese nurse in the room for direct patient doctor communication. It would provide a more thorough examination and the patient feels in this way he/she has "spoken" with the doctor. 14. given assurances to the members of the control group that onc: included in the group they will receive the same type of care as the exposed population. Even if control members move, follow up arrangements are to be made. 19156949 14