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To the Chiefs and AU. People fn Utirdk Atoll Your letter to Mr. Roger Ray, dated July 1976, -has been received and bringing your dews t o my attentfon. considered your views, atp presented In your letter, and appreciate the opportunity t o answer your thoughtful qtsestions. I wish to thank you f o r seading this letter Even today, there are mamy facts about ra diet ion that are not knovn, despite t h e large number of scientists who have studied this subject for more than 30 years. radiation i n 1954 at the time of the exposure of the people on Rongelap and Utirik. radiation at th t the p and using their beat judgment, the American doctors estimated that t h e people of Utirik were exposed to only a small amount of radiation. agreement among the doctors and the9 told the Uti rik people that they should not show any 211 effects in the future caused by radiation. Also, the relatively low levels of radiation at Uti rik soon diminished sufficiently to germlt the people to return to their atoll before saiae of the other populations. the ather hand, was more heavily cantaflctrasted with radioactivity so the people of this island had to live elsewhere for about three years before they could return to their hemes. In reviewing the data t-mt led to the determinatfan that the Uti rik people were exposed to considerably less radiation than the people of Rongelap, one must conclude t h a t they are essentially correct. This concluslon is based in part on the dose estinates from measurements on t h e Island. Ut5rik people showed only very minor, ff any, symptoms of e a r l y Even less was known about Based on a l l available knowledge on Even more bpporcaxk is that the
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dfeeasa from expoeuxe, fxldkating that t h e i r exposure must hava been consRderably less than the people of Rdngelap faland. Tnere l a one excepc5on, however, and that relates eo t h e radiation doase tothe children's thyroid which ZeWL address later i n this Folleming t h e return t o the island, it was decided that continuad gledicaf. examinations of the expseed pwgh of Ucirlk were t o be done. Such examinations were conducted at regular intthrwrls t o 888ure that they had not beefi harmed. Exarnirultions were done i n 1957, 1959, 1963, 1966, 1969, 1972 and 187s. During t h e past 8fx years, thyroid examinations were done and sick callla were held every year tn addition t o complete physical. examiaatPons. Also, for t h e past several pars, American doctors have vieired Utirik every three months. Xu addlition t o exsnfninzg the people who h8Ve been exposed t o radietfon, t h e doctors selected a control group so that they could compare t h e health of expoeed and non-exposed people. group consists of unexposed people Prom Kongelap and i s considered quite adequate for comparison d th the exposed people of both Rangelap and Utirlk. two popriLations waa not caneidered a sufficient rfmeon t o 8deCt: The slight genetic difference between the One of your questions concerned the fact that the children of the expoeed 2elmdet.s (who were not themselves exposad) have not been he lu dad in the regular examinations. o f exposed parants have been atudfed exsewhere. stud ha rwealed any radiation-caused l lln as s or dafecta. it was expected that the health of t h i s group of children of Uti rik would not be affected. O f course, all children are examined . and Created a8 needed at sick calla whenaver the doctore visit: Large groupe of! children None of these A8 Isaid earlier In this Letter, my facts about radiation were not knm back in 1954 but the best a vau able medical jud pent wae used in deeie9orsca affect hg the peaple of Utfrlk. the 8me pxolr€erasr now and with the knowledge we have today, i e appsare that: rhe doctors at that, time wera not aware of t h e degree of axpoeure of the thyroid due to fallout. W U ~of the children because their thyroids are much smaller.
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i e not eurprising that, with the information then available, thyroid dfseaea was not expected in tire Utirik people. is t h a t only very recently infomation became available from aeveral 8ourcee t h a t the thyroid gland, especially in children, is considerably more eeneitive t o radiation then was anticipated in 1954. these factors together, we believe now, many yeare later, that t h e thyroid cancers in the Dtirik people may be caused by radiation. At thie time we are not able t o predict whether more ca8as are t o be expected $n the exposed Ilrcwabers of the ttt it ik population. therefore, of the greatest importance that the regular medical exdnatiane be continued in the future. cmdnaticms, signa of thyroid diseaee can be detected e a r l y and prompt treatment will avoid unneceseary suffering 011 the part of the Uti rik people. Even more important B y having regular medical For the66 reasons, I believe it i e of great importance that the leaderis o f the people of Uti rik explain to their people the purpose and the iwportance of the regular wd ical examinations. Mamy people lfving in the Marshall Irrlande District suffer from learn more about thie dieease so that they could better treat be used for treatment. I €eel cmfidenrt that the treatment used by Dr. Knudaen, and as recommended by an expert in this disaase, Will benefit the Uti rik people who suffer from this disease. During the visits,the doctors from EBilA have tried t o Not all doctor6 agree about the kind8 of medicine t o With regard to your concern about the arrow-roat plante, I have no reason t o believe that t h e reduced size of the plants is caused affects in plants, the levele of radiation on U t i r i k are far too low to cau ~ eplant daatage. lby radfation. I eay thie beeawe, from what i e known about radiation Conducthg the medical examinations arid creating people of the islands whenevsr necessary have been largely in t h e hands af Drs. Conatd and Knudeen, and during the p a s t year, Dx. Kotrady, expert medical advice was invfted frat the best doctors in the field, many of whom ae you know participated Jht he actual medlcal exsminatfone, Z t ie my belief that Drs. Conard, Knudsm and Itotrady are very capable and conscientious doctors who are deeply comndtttad t o the health and welfare of the people of Utirik. Committee on Rongelap and Utirik, which w a a formed by tha Congress of Mfcronesia, was generally favorable with regard to the examinations. On numy occamiom; Moreover, t h e report by the Special
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In view of t h i s , I am greatly 6urgrb6d to learn about the apparent displea8ure on the part OF the people of LrEirik as expressed in your letter and, more recently, about your request that Dr. Knudsen the feeliags for Drs. Conard and hudsen may be a misanderstand~ng on the part of pour people 8s to the role and reasons for these doatore to come to the S ~ lando.I would like to repeat that it f a my firm ccmvlctPon that the pt l nci pal concern of Drs. Conard and b u d s e n is the welfar~and well-being of all of the people whom they xtsit. Some misunderstanding could result becausle of the difference between our languages. leadership and your roachare to impress up03 Chose who had the misfortune t o be exposed to cadiation the importance of the madical continue Fo receive the best medicai care and tieatmnt that we are able to provide. Together with t h i s letter, X am sending you a copy of “A Twanty-Year Review of Hedieal Bindings in a Urahnllesre Population AscAdentdly Expolled to Radioactive Fallout.” collected during the period from 1954 to 1975, as w e l l a5 more detailed iaformation o f the findings in the past: five years. Tha ffndings in thia report are of great importance in that they have helped the scientdsts in thetr understamiing, of the effects of radiation. Collecting the information in thie report has only been possible through continued cooperation Eram you and your people. I w m r you to know that the contributfon by you and yocr people hae helped the well-being of all people i n the world. A pOS€dbh! explanation for this diEferenee in Again, Z would appeal to your Only then can you and 7 be aceuzed that they w i l l This report contains the data I regret deeply that I cannot ettercd this meeting. have aakad Dr. Will ; Lam Ram, my Deputy, to read thls lettar. Plea8o convey my vary beet d s h e e to the people of Utirik. Jmee L. Liverrean, Director Division of! Biomedical and