that a greater emphasis both in time and moncyis devoted to the rescarch effort than the general health program. They are aware of the imbalance of the efforts and fail to understand it. IV. Trust Territory Health Care The delivery of health care in the Marshall Islands, particularly that provided to the outer islands, is sporadic at best. Health care is concentrated at Majuro, the District Center, and Ebeye, where a sub hospital is located, Both hospitals are understaffed and suffer from lack of broperly trained personnel, lack of medications, and inadequate facilities. The outer islands, such as Rongelap and Utirik, are served by a health aide on each island. He is inadequately trained, lacks proper or sufficient medications. Territory physician rarely gets to visit the outer islands. A Trust Discussions with physicians in Majuro indicated that a physician accompanying a field trip ship has not occurred in over two years. The islands are totally dependent on the Trust Territory field trip ships to bring in supplies and transport referral cases. Major emergencies can, in some instances, be air evacuated but it is on a limited basis only. . The Brookhaven program has identified that upwards of 30% of the population has adult onset diabetes mellitus. Here is one area that Brookhaven could expand its work by providing diabetes clinics forthe people. Current therapy in the islands is oral hypoglycemics, which admittedly are controversial ‘but still used in the United States. Oral hypoglycemics offer some help to these people where insulin cannot be used. The vaccination situation in the islands is totally inadequate. A review of immunization records of children on Utirik, Rongelap, and Bikini revealed no children under 5 with completed series for polio, diphtheria, tetanus, or purtussis. Children who have lived in the district center are the exceptions. Vaccination serum provided by the Trust Territory has often been out of date. There is no refrigeration on field trip ships to permit adequate transport of the serum without deterioration. Public Health nurses from the Trust Territory had not visited these islands for over 2 years until I asked them to accompany my medical surveys. Family planning and contraception are needed throughout the district. Other areas of concern are nutrition education, amebiasis control, all of which can be dealt with by the Brookhaven physician conducting public health programs. V. Peoples Expectations l. Rongelap. These native people all express that their greatest need lies in the general health area. It is the problems that effect their daily lives and the lives of their children that hold their greatest concern. They all fear what effect the radiation might have on their lives and tie it in to their general health needs. The concept of research is totally meaningless to them. The people all see a doctor as a man giving care to all their problems and not focusing on only one small area of concern. 1d 15689 4 They fail to understand how a doctor