They have most frequently of the country's outstanding researchers. has been primarily on a 1:1 basis - using many Academic liason - the pattern of professional Liason established over the preceding 25 years been unpaid, highly qualified sub-specialists with a primary interest in the area of thyroid pathology. throughout the U.S. period have been volunteers recruited from leading medical centers and research centers The remainder of the staff over this 25-year Recently, a full-time Marshallese nursepractioncr has been adcec to the staff in the Marshalls and a technician previously based at Brookhaven National Laboratory has been transferred to the Marshall Islands. The plan will be to develop a core of innovative Therefore we have contacted the dean of the medical shool at the University of Southern large academic and contractural centers who are able to mount and maintain major field surveys. It is the opinion of a number of experts in this field that the medical programs for the low level radiation groups be university based with a non-nuclear identity. characteristics of the current logistic support system, i.e., at present the medical team is limited to 16 shipboard personnel who are able to examine approximatly 500 people in a 5 week period, it becomes obvious that multiple field teams must be developed and logistic The new liasons will therefore involve cooperative efforts with support must be refined. 4) with the incremental increase in the population under study (from 400 to 2000) and These Marshallese will health educators te train Marshallese from the affected atolls. The goal of this program is to establish a fully in turn, train a cadre of Marshallese. competent and independent Marshallese training group using a Brookhaven National Laboratory health educator as a resource person. to provide effective communication. 3) such a program will necessitate the close integration and cross-cultural ties necessary health risks. 1) to explain the role of each medical/radiation programs 2) discuss openly and freely radiation risks and to put them in an understandable cultural context and in turn to put those risks in relationship with the indigenous primary be given to developing a health education program designed: In addition, the need for a full-time, highly qualified, innovative health educator has been This request has come not only from all segments of the Marshallese people and identified. government but also from the affiliated academic institutions and consultants. Since one of the primary criticisms repeatedly brought against the US Department of Energy program has been the lack of communication the present principal investigator feels that initially top priority should essential to the program. in a compensatory pay status, rapid hard copy communication and coordination is Secretary - since the vast majority of the staff will continue to be voluntary and in many cases, 2. and resident at Brookhaven National Laboratory during the absence of the principal investigator. This individual should be supported by: it is mandatory that some individual familiar with the intricacies of the program be available primarily on delivering dental care and performing ancillary studies..., i.e., diabetes, etc. The staff is as before with the substitution of a dentist for the pediatrician. The rapidly expanding character of this program has made it necessary to add the following positions: 1. Research Coordinator - since the principal investigator has been traveling 60% of the time since assuming direction of the program, and there has been a marked increase in the complexity of the program involving multiple governmental agencies and academic institutions, The third survey occurs two and one half months later in mid-September and concentrates inissed on the January survey. The staff is essentially the same with the substitution of a pediatrician for a thyroid specialist. pediatric care but designed also to follow-up on abnormal thyroid findings and to examine patients Two and a half months later, a five week survey begins in mid-May, directed primarily toward to balance the field survey staff so that the basic adult screening protocol can be obtained in a five week survey, beginning in mid-January, including a staff of 14 professionals (4 MD's and 2 RN's).