as circumstances permit. The program will, as a consequence, complement exist- ing efforts in the field to the extent that time permits during the medical missions even though primary care is curtailed. to offer the same examinations and diagnostic The BNL program will continue and therapeutic options to all inhabitants on the island at the time of the visits to Rongelap Utirik. The one difference between exposed and unexposed former will be eligible for direct referral the costs will be borne by the medical (Mejato) and is that only the outside the Marshall Islands, and program. A hallmark of the BN} program has been the high rate of &ipli%nce among the ; ,.rf__ : ,:< .,..,., , exposed persons for annual medical examinations which remainh: as the~ have sin~e the 1950s$ voluntary. To assure continued availability of the examina- tions to all exposed persons who desire them, a second medical mission will be -!--+.. wr=r.ied.out several months after the first. all exposed persons desiring examinations single mission. to think that will be available at the time of a’” - ‘“”-- . ,,.. The second trip is designed will comprise a physician, nurse, laboratory Their work will be performed at Marshallese Nevertheless, It is unrealistic to inclu~e~these technician, individuals and and administrator. facilities on Ebeye and Majuro. if travel situations permit and clinical justification ,? :/ ,...,,’ .._ the optio~,j~totravel to Rongelap and Utirik should be available. islands would be visited to ensure adequate nostic and therapeutic problems. exists, The latter medical follow-up of special diag- It cannot be expected that the 4 Atoll Health Care Program (4AHCP) will be able to adequately attend to all the special needs of the exposed, even though a medical needs may be on hand. record system indicating A third visit in the course of a year will be carried out by one or two of the BNL staff to distribute information, those and collect medical record document adequate follow-up of special medical problems, and maintain close working relations with the 4AHCP, DOE/PASO, and the Marshallese Health Services. ;4. .L. . . , As the scope of medical care provided to the exposed .,nowincreases, the previously defined program directed at neoplastic diseases 8 and other unique problems possibly