indirect fallout radiation rather than direct radiation as most of the Japanese received at Hiroshima and Nagasaki. (Body burdens of various doses of internally absorbed radiation were experienced by the Marshallese). At the same time, the children probably received higher doses of total body gamma radiation than the adults because they are smaller and closer to the ground and the fallout. Theorists claim that the smal! numbers involved mean that it is statistically unlikely for a genetic effect to occur. Yet the people feel that even if there is a small chance of anything occurring they want a program to be able to detect it. At present, they worry because their children are not included as part of the regular examinations. Medical records create another large problem in providing care. Because of the research nature of the program all the detailed examination records on the people are kept at Brookhaven rather than with the resident physician. People complain that they have told the ‘doctor the same problems for several years yet he fails to help them. The doctor cannot recognize the complaints because each patient's chart is over 8,000 miles away. To a clinical practicing physician the patient's chart is an important part of providing good quality of care. In the United States no doctor would think of examining patients in New York and hope to provide good careif all his patient records were in Honolulu. The lack of these records to be readily available impedes patient care. At present, a summary sheet of pertinent data is provided each year but lacks the precise description of a finding as given by a physician that could be important. A request to shift the records or a duplicate set to the islands was considered impossible and a request for a secretary to upgrade the iocai system was met with budget obstacles. 3. Bikini. The people at Bikini wish to be included in as intense a medical care program as conducted at Rongelap just as Utirik desires the same care. The people living at Bikini fear the "poison" (radiation) that might be lingering on the island. The official policy is that there is no reason to conduct a medical survey program on these people as they received no radiation exposure. A massive clean up and replanting operation supposedly eliminated residual radiation. However, environmental studies still show areas of radiation concentration. In addition, the people have been asked not to eat certain - local foods because of the possible danger of radiation. The people worry about the potential danger of secondary doses of radiation received from eating local food, drinking the water, and just ground exposure. Recently, Plutonium was discovered for the first time in significant levels in the urine of residents of Bikini indicating the people are absorbing some radiatlon. The people fail to understand how scientists can say they do not know all the possible late effects the radiation can cause, that indeed plutonium and other lingering radiation exists on the island such that some foods cannot be eaten, and then tell the people there is no danger and a medical program is unnecessary. If in forty or fifty years medical preblems do occur as a4 result of the exposure, it would be better if a well designed medical program wus already in progress to detect the problems. Waiting to devise a program until after the events occur as has happened at Utirik would be contrary to the basic 19 90054916 Z2TA-d 6424-1 889-4 NN “N°1 Oo33a S 7 2280S6cc82