Summary Sheet, Subject: Action Regarding Payment of Costs of Special Medical Care for Inhabitants of Rongelap and Utirik Atolls.

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IMIABITANTS OF RONGEUP AND UTI RIK ATOLLS Purpose : This paper provides the background for and recommendations ' regarding an impending decision as to whether or not the AEC should assume costs of special transportation and medical care for Kongelap and Uti rik people in the Harsh all Islands. The paper further relates this issue to an anticipated later request for compensation for personal and property damage t o the Pacific Islands and their inhabitants. Discuss ion : The Micronesian Congress has passed a bill to improve year - round care of persons exposed to radioactive fallout on Rongelap and Uti rik atolls in ?larch 1954, to their offspring and to controls. the Trust Territory to seek an executive agreement whereby expenses incurred under the act will be defrayed by the Atomic Energy Commission. Three alternatives,presented and discussed in section9 and 10, are : a. Refuse to offer reimbursement on graounds that government rather than agency 2ction is appropriate. b. Unconditionally agree to payment as requested in the bill. c. Propose provisional agreement under which costs will be shared The bill directs the High Commissioner of with Department of Interior pending revision of bill in nexc session of Micronesian Congress and fully assumed by AEC subsequent to acceptable revision. Issue : Payment of medical costs as requested in Micronesian S.B. No. 89 Recommendation: That the Commission approve alternative c.,ne got ation of a provisional agreement to share costs with Department of Inferior until certain provisions of bill are revised at a later date and assume all costs subsequent to acceptable revision of the bill. Coordination : In addition to the offices of the Controller and General Counsel, the following AEC Division cm cur : No further coordination appears warranted. Scheduling: To be filled in later

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ATOMIC EN ERG I CO'.!?fISSION I. TO consider the response of the Atomic Energy Commission toa forthcoming request by the High Commissioner of the Pacific Islands Trust Ter rf tory for reimbursement of expenses incurred under Micronesian Senate Bill No. 89, which provides to inhabitants of Rongelap and Uti rik atolls exposed to radioactive fallout in 1954, their offspring and their controls, transportation to and medical care at hospitals in Majuro o r Ebeye. 2. The inhabitants of Rongelap and Uti rik atolls in the Marshall ,Islands were accidentally exposed to fallout radiation following a detonation of a high yield thermonuclear device during tests at Bikini in the Pacific Proving Grounds i n March 1954. The radiation exposure ranged from 14 rad s of whole body radiation to persons on the Uti rik Atoll up to an estimated dose o f 175 rad s of whole body gamma radiation to the population on the Rongelap AteL .The Rongelap inhabitants also incurred internal deposition of radioactive isotopes,esp ecF ally including those of iodine ; the latter resulted in the onset of thyroid abnormalities several years after the event. were first detected nine years after the detonation and ultimately affected 23 of 67 persons who were exposed on the island cf Rongelap at the time of the and Uti rik populations. Rongelap male during the Brookhaven medical survey in September 1972; the boy died two months later. accordance with U. S.Public Law 88-485, passed on August 22, 1964. made in full settlement and discharging all claims against the United State8 Four malignant thyroid tumors have been diagnosed in the Rongelap Acase of acute leukemia was detected in a19year old Compensation was provided to the people of Rongelap i n arising out of the detonation,provided to each exposed individual or his heirs approximately $11,000 as a lump sum payment. additional information concerning the radiation exposure, medical seqwlae 3. Because of the physical geography of the area (many small islands

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in!!abited b y few persons s pre3dover a considerable region of the Pacific Ocean), medical care for inhabitants of the outlying islands such as Rongelap and Ut iriX is provided by medical aides who have a level of competence equivalent to that of pharmacist mates or medical assistants. The regional hos pti al at Ffajuro provides better care than that available on the outlying islands,but the care a t Majuro is probably below the level bc are delivered in an average hospital on the mainland. The Rongelap population has benefited from the excellent annual medical surveys conducted by the Brookhaven survey tearn,which are tobe supplemented by midyear he mato logic surveys in the future. In providing medical care,the Trust Territory has not distinguished between the population exposed to fallout and the unexposed residents of other Pacific island. However, we understand that the Trust Territory is now willing to recognize that the exposed population is distinctive from a medical stand pot nt and entitled to closer medical surveillance than unexposed populations. Micronesian Senate Bill is designed primarily to improve the year-round care o f the exposed and related pop ul at i oy ' o f Rongelap and Uti rik. 4. A special joint committee of the M€cronesian Congress was created by Public Law No. 4C-33 early in 1972 " to in sure that the people of Rongelap and Ut t rik Atolls receive...the best medical treatment available and ...c o qe nsa tio u €or the injuries that they have suffered. " In February 1973, Senate ?ill Xo. a9 (Enclosure 3) was passed by the Micronesian Senate ; i t was signed into law by the Deputy High Commissioner on April12, 1973 as Public Law No. 5-52. It provides benefits in the form of regular or emergency transportation to hospitals at Majuro o r Ebeye (the latter underconstruction),per diem expenses,housing and medical care to exposed persons from Rongelap and Uti rik atolls,their offspring and control persons and a n accompanying member of the family. illness covered by the bill is restricted by the statement that " this section (6 in the bill)shall not be construed to allow persons the aforesaid benefits if the ailment.or complaint could have been treated at the person ' s place of rest den ce The class of by the health personnel available. " government under the bill is projected at not the Special Joint Committee of the Micronesian The annual cost to the more than $9,000 per year by

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Although the bill provides for reimbursement of medical care,tfie major part of the cost will be fortran sp oration since charges for medical and hospital services in the Trust Territory are quite nominal. Section 10 of the bill directs the Office of the High Commissioner " t o seek an executive agreement with the Atomic Energy Commission whereby the expenses under the provisions of this act will be defrayed either directly or on are im burs able basis by The apparent reason for seeking payment of expenses by the AEC rather than the Department of the Interior is the expectation that Interior would betaken from the federal grant to the Trust Territory. AEC payment would provide funds in addition to those normally received whereas Interior Department funding would involve are allocation of existing monies corresponding reduction in some other service. responsible for conducting the tests in the Marshall Islands and, therefore, " for In addition,the AEC is held S. B. No. 89 contains an excessively broad definition of controls ; w e would suggest that it be narrowed by revision of the bill during the next session of the Micronesian Congress. In Section3,controls are defined to include Itthose persons now living in the fir sha11Islands district who were not exposed to fallout from the March 1, 1954, test,but who agree as here in after provided in this act, tobe examined and tested in like manner a s exposed persons." We favor limiting the class of controls to persons accepted by the Brookhaven medical team as members of their control population for purposes of their study. Dr. Robert A. Conard, head of the Brookhaven medical survey team, hasal oA raised a question as to the propriety of including the offspring of the exposed population among persons eligible for benefits under the bill. He feels that, the lack of evidence of genetic damage thus far to the offspring of the Japanese A-bomb survivor population makes it unlikely that the Marshallese offspring will show adverse effects as a result of the exposure of their parents. On the other hand, the exclusion of offspring from the bill may be difficult politically, especially since studies on the offspring of Japanese survivors are quite incomplete 5 . In view of the provision in P. 6 No. 88-485 that the payment made i n 1964 tothe Rongelapese discharged all claims against the United States arising out of the detonation,there is probably no legal basis for providing additional compensation payments to that population in the absence of new enabling in the past. Medical research on the Rongelap population can be justified as Activities funded under the bill could contribute to the Brookhaven

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study the interim observation of disease events that might otherwise not be detected by the Brookhaven survey team o r by medical aides in residence on the out ly iLl g islands.If a decision were reached to provide payment in accordance with S. B. No. 89,it would probably be necessary to state that the funds are research funds and that they are subject to the usual periodic review of research expenditures. 6 . On 2-12-73 the Micronesian Congress passed another bill, S. B. No. 146 (Enclosure 4), which extended the life of the special Joint Committee for two additional years and considerably broadened its scope to include investigation of the " results of irradiation to the people,reef,land and marine life of Rongelap and Uti rik Atolls in the Marshall Islands District and any other effects of atomic weapons testing in the Trust Territory " and obtaining "compensation for the people of Rongelap and Uti rik atolls for their dislocation,injury,deprivation, illness and suffering,both physical and mental, and for damage to the islands, their flora and fauna,reefs, lagoons and sources of food or livelihood as a result of exposure to irradiation. " To date, the Committee has not acted on that parts of its mission concerned with obtaining compensation for the people " for the injuries which they have suffered. " We my infer that postponement of action on the compensation issue was linked to broadening the scope of compensation t o mental as well as physical injury and t o damage to the islands and environment as detailed in the preceding 7. In February 1973, the special Joint Committee issued a 264 page report titled. " A Report on the People of Rongelap and Uti rik Relative to Medical ofthe & rch 1, 1954, Incident - Injury, Examination and Treatment." The report presents a scientific introduction,a historical narrative of the thermonuclear detonation and its aftereffects on the population and certain complaints against AEC and DOD as well as aset of recommendations (see Enclosure 5for further discussion of the Committee report). 8. Any actions or negotiations undertaken by the AEC with respect to the & r shall ese must be considered in the larger context of there la tio ~ 8k tween the U. S. Government and the Pacific Islands. There are a number of issuss under consideration by the Trust Territory such as property negotiations concerning other islands,continued DOD testing in the Marshall Islands, and long-term continuation of the trusteeship.Political influences such as complaints to the Trusteeship Council of the U. N. may b e brought to bear on the situation. issue of personal injury to the Marshallese is perhaps the most net l worthy IO I5bb0 complex picture.

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Committee is instructed to seek broad compensation for a variety of damages. S. B. No. 89 may b e viewed as the first round in a series of negotiations that will involve larger compensation questions later. In the bill providing for continuation of its life,the Special Joint 10. Three alternative actions may be considered for the AEC in negotiating an executive agreement with the High Commissioner. Refuse to offer reimbursement on .grounds that government rather than agency action is appropriate. Unconditionally agree to offer payment as requested in the bill. Propose a provisional agreement under which costs would be shared with Department of Interior pending acceptable revision of bill in next session of Micronesian Congress and then fully assumed by AEC. Refuse to offer reim$P&ement on grounds that government rather than agency action i,s appropriate. (a) The AFX could not be interpreted as assuming responsibility for damage t o the exposed populations. (b) Consultation with other departments or agencies of the government such as the State Department would become possible. (c) The AEC could not be accused of circumventing the intent of Congress as expressed in U. S. Public Law 88-485. In contrast to A press treatment of theAgovernment of the Trust Territory, which signed the bill into Za w,the AEC might b e subjected to adverse publicity for failure to cooperate. The medical care provided in the bill also provides medical information of possible value to the Brookhaven survey team and therefore can b e viewed as a research activity, There are precedents for provision of medical care in support of research as in the activities of the ABLBcc and certain AEC laboratories. There may be advantages in handling this inexpensive item separately from the large compensation package which is likely to come later.