Outline for Discussions Between the Userda and the Trust Territory of the Pacific Islands Regarding Medical Care of the Rongelap and Utirik People

Page 1

THE UNITED STATES ENERGY FOR DISCUSSIONS BETWEEN THE TRUST TERRITORY Ol?THE PACIFIC ISLANDS REGARDING NEDICAL CARE OF THE RONGELAP AND UTIRIK l?EOPLE The United States Energy Research and Development Administration (ERDA), formerly AEC, has for more than 20 years conducted a program of medical surveillance of the people of Rongelap and Utiri.kthat were expased to fallout from a weapons test in 1954. In the course of ~his activity, and with the knowledge and consent of the Trust Territory of the Pacific (TTPI), the ERDA medical teams have provided limited medical care for’ail of the people of Rongelap and Utirik. The ERDA intends to continue this program provided this can be achieved ~~itllthe consent of the TTPI and the people of Utirik and Rongelap. ‘Ihepeople of Utirik and Rongelap, independently,have recently indicated a desire for changes in the type of medical care under the ERDA program. Specifically, they have recluestedthat ERDA e’xpandsand improves medical care of all the people on their isl?.nds. It is recognized by the U.S. (ERDA) that general.medical care of the people of the llarshallIslands is a responsibility of the Administration of the TTI?I. At the same time, it appears that the request for extended mcclicalcare under the EP~A program stems from a change in the perception on the part of the people of Utirik and Rongclap of the manner and extent to ~..-hchchpast ERDA activities have affected their lives psychologically, socially, and economically. It appears, therefoue, to be.in the interest of both the TTP1 and the U.S. (ERDA) to explcre ways in which these perceived needs ~an best be met by both parties within fran)ework of their respective responsibilities. For the purpose of the discussion between the TTPI and ‘theU.S. (ERDA) in t,he discharge of its health care responsibili~ies to the people

Page 2

of Rongelap and Utirik. It is agreed that be provided in response to Trust Territory this assistance will requests and may include a. ERDA will invite TTPI medical personnel (medical officers, nurses, health aides, technicians) to participate in the ERDA medical visits in order to facilitate expanded programs such as well baby clinics, family planning> etc. , and will assist with logistic support of these activities. b. ERDA will assist in arranging for additional U.S. medical doctors to participate in the ERDA medical team visits, as ‘may be required to assist the TTPI in providing general medical care to the people of Rongelap and Utirik. c. ERDA will, to the extent operationally feasible, extend the duration of its medical team visits to Rongelap and Utirik to accommodate the needs of the Trust Territory medical program.

Page 3

OUTLINE FOR DISCUSSIONS BETWEEN THE UNITED STATES ENERGY RESEARCH AND DEVELOPMENT ADMINISTRATION THE TRUST TERRITORY Ol?THE PACIFIC ISLANDS REGARDING MEDICAL CARE OF THE ROtiGELAPAND UTIRIK PEOPLE The United States Energy Research and Development Administration (ERDA), formerly AEC, has for more than 20 years conducted a program of medical surveillance of the people of Rongelap and Utirik that were exposed to fallout from a weapons test in 1954. In the course of this activity, and with the knowledge and consent of the Trust Territory of the Pacific (TTPI), the ERDA medical teams have provided limited medical care for all of the people of Rongelap and Utirik, The ERDA intends to continue this program provided this can be achieved with the consent of the TTPI and the people of Utirik and Rongelap. The people of Utirik and Rongelap, independently,have recently indicated a desire for changes in the type of medical care under the ERDA program. Specifically, they have requested that ERDA expands and improves medical care of all the people on their islands. It is recognized by the U.S. (ERDA) that general medical care of the people of the Marshall. Islands is a responsibility of the Aclministration of the TTPI.. At the same time, it appears that the request for ex~ended medical care under the ERDA pro~ram stems from a change in the perception on the part of the people of Utirik and Rongelap of the manner and extent to which past ERDA activities have affec~ed their lives psychologically, socially, of bath the T’I’I?Iand the U.S. (ERDA) to explore ways in which these perceived needs can best be met by both parties within framework of their respective responsibilities. For the purpose of the cliscussionbetween the TTPI and’the U.S. (ERDA) it is proposed that the U.S. (ERDA) is prepared to assist the TTPI in the discharge of its health care responsibilities to the people

Page 4

of Rongelap and Utirik. It is agreed that this assistance will be provided in response to Trust Territory requests and may include ERDA will invite TT.PImedical personnel (medical officers, nurses, health aides, technicians) to participate in the ERDA medical visits in order to facilitate expanded programs such as well baby clinics, family planning, etc., and will assist with logistic support of these activities. ERDA will assist in arranging for additional U.S. medical doctors to participate in the ERDA medical team visits, as may be required to assist the TTPI in providing general medical care to the people of Rongelap and Utirik. ERDA will, to the extent operationally feasible, extend the duration of its medical team <isits to Rongel.apand Utirik to accommodate the needs of the Trust Territory medical program.

Page 5

ENERGY RESEARCH AND DEVELOPPJENT ADMINISTRATION To the People of Rongelap I wish to thank you for your letter of Octobey 1, 1976, bringing to my attention your views on the medical care of those of you who were exposed to the radiation from the fallout. I have carefully considered your views and appreciate the opportunity to answer your questions. First, I would like to comment with regard to travel of Marshallese patients to the United,States. Since only very few Americans know your language, it is indeed necessary for Marshallese attendants to accompany patients that come to the U.S. for treatment. Unfortunately, on two occasions, this did not occur for various reasons. I have been assured, however, that every effort will be made in the future to have all patients accompanied by English-spealcingMarshallese attendants. Also, when traveling outside the Trust Territory adequate travel funds will be provided. In addition, I wi].1urge the Trust Territory off+.cials to arrange necessary papers, such as passports, well Nhenever the Brookhaven doctors are at Rongelap, they give anyone with sickness the best treatment available under the circumstances. As in the past, any exposed person with a disease that appears to be caused by radiation exposure will be taken to the U.S. for treatment if necessary. In tl]ecase that adequate facilities are available locally, patients who require hospita~ization will be treated in the Trust Territory hospitals. Dr. Knudsen will assist in the treatment of the patients at these hospitals. Medicines needed for treatment at Rongelap that are not available from the Trust Territory Department of Health Services will, if possible, be provided by ERQA doctors.

Page 6

We are sorry that there have been conflicting reports about the future health of the exposed people of Rongelap, Specifically, I strongly disagree with the Japanese newspaper report that it is necessary to leave Rongelap because of the radiation levels on the atoll. There have been many tests of soil, ,plants, and water on the island, and measurements of urin’eand radiation in the people living on Rongelap. These tests show that the levels are .low and they are getting less and less. I share the opinion of the Brookhaven doctors that the little bit of radiation left on the island would not be expected to cause any health effects. I hope to be able to make arrangements for several scientists, not from the U.S., to visit Rongelap in the near future and discuss with you their findings. We are pleased with the remarks made in your letter about the Brookhaven medical team. -I have a great deal of confidence in Drs. Conard and Knudsen and the other fine doctors that have. taken part in the medical program. I am sure they always had your welfare at heart. I am convinced that the medical examinations of thz Rongelap people have been very thorough and complete with many tests on the people and on their blood, urine, etc. Some of the most skillful doctors in the U.S. and from other countries have taken part in these examinations. They have used the best equipment possible that can be taken to the island. You can be sure that the examination program ensures early diagnosis and treatment of all disease. Currently, arrangements are being discussed to permit all the people living on Rongelap, including children, to have an examination at least once a year by the Brookhaven doctors. I am also discussing plans with the Trust Territory to provide further education for the Health Aides in the diagnosis and treatment of radiation effects. I realize that at the time of the annual examinations, there is sufficient disruption of life’and that the team should provide addi~ional food. I am, therefore, recommending that a sufficient amount of food be furnished by the team during the perioc!of the Members of my staff and I have l~adseveral discussions with Dr. Conard regarding the past and future mec[icalcare of the Rongelap people. From these discussions, it has become clear to me that effective medical care can only be provic{ed if the doctors can spend enough time with the people of Rongclap to talk to them and answer their questions. I am, therefore, asking Dr. Conard and the other doctors to make arrangements to stay on at Rongelap for as long as necessary to make sure that all people get a chance to talk to them.

Page 7

1 had hoped to discuss these matters with you at the meeting on Rongelap, Unfortunately, 1.am unable to attend, but have asked Dr. William Burr to represent me at the meeting and read this letter to you. I would like to extend my best wishes to all the people of Rongelap. ivision of Biomedical and

Page 8

ENERGY RESEARCH AND DE VELI)PMENT ADMINISTRATION To the People of Rongelap I wish to thank you for your letter of October 1, 1976; bringing to my attention your views on the medical care of those of you who were exposed to the radiation from the fallout. I have carefully considered your views and appreciate the opportunity to answer your questions. First, I would like to comment with regard to travel of Marshallese patients to the United States. Since only very few Americans know your language, it is indeed necessary for Marshallese attendants to accompany patients that come to the U.S. for treatment. Unfortunately, on two occasions, this did not occur for various reasons. I have been assured, however, that every effort will be made in the future to have all patients when traveling outside the Trust Territory adequate travel funds will be provided. In addition, I will urge the Trust Territory officials to arrange necessary papers, such as passports, well Whenever the Broolcllavendoctors are at Rongelap, they give anyone with siclcnessthe best treatment available under the circumstances. As in the past, any exposed person with a disease that appears to be caused by radiation exposure will be talcento tileU.S. for treatment if necessary. T_nthe case that adequate facilities are available locally, patients who require hospitalization will be treated in the Trust Territory hospitals. Dr. Knuclsenwill assist in the treatment of the patients at these hospitals. Nledicines needed for treatment at Rongelap that are”not available from the Trust Territory Department of Health Services will, if possible, be provided by ERDA doctors.

Page 9

We are sorry that there have been conflicting reports about the future health of the exposed people of Rongelap. Specifically, I strongly disagree with the Japanese newspaper report that it is necessary to leave Rongelap because of the radiation levels on the atoll. There have been many tests of soil, plants, and water on the island, and measurements of urine and radiation in the people living on Rongelap. These tests show that the levels are .1OW and they are getting less and less. I share the opinion of the Brookhaven doctors that the little bit of radiation left on the island would not be expected to cause any health effects. I hope to be able to make arrangements for several scientists, not from the U.S. , to visit Rongelap in the near future and discuss with you their findings. We are pleased with the remarks made in your letter about the Brookhaven medical team. -I have a great deal of confidence in Drs. Conard and Knudsen and the other fine doctors that have taken part in the medical program.’ I am sure they always had your welfare at heart. I am convinced that the medical examinations of the Rongelap people have been very thorough and complete with many tests on the people and on their blood, urine, etc. Some of the most skillful doctors in the U.S. and from other countries have taken part in these examinations . They have used the best equipment possible that can be taken to the island. You can be sure that the examination program ensures early diagnosis and treatment of all disease. Currently, arrangements are being discussed to permit all the people living on Rongelap, including children, to have an examination at least once a year by the Brookhaven doctors. I am also discussing plans with the Trust Territory to provide further education for the Health Aides in the diagnosis and treatment of radiation effects. I realize that at the time of the annual examinations, there is sufficient disruption of life and that the team should provide additional food. I am, therefore, recommending that a sufficient amoun~ of food be furnished by the team during the period of the Members of my staff and I have had several discussions with Dr. Conard regarding the past and future medical care of the Rongelap people. From” these discussions, it has become clear to me that cffectivc medical care can only be provided if the cloctorscan spend enough time with the people of Rongelap to talk to them and answer their questions. I am, therefore, asking Dr. Conard and the other doctors to make arrangements to stay on at Rongclap for as long as necessary to make sure that all people get a chance to talk to tl~em.

Page 10

1 had hoped to discuss these matters with you at the meeting on Rongelap, Unfortunately, I am unable to attend, but have asked I Dr. William Burr to represent me at the meeting and read this letter to you. I would like to extend my best wishes to all the i people of Rongelap. uivision of Biomedical and

Page 11

ENERGY RESEARCH AND II EVELOPM’ENT ADMINISTRATION To the People of Rongelap I wish to thank you for your letter of October 1, 1976, bringing to my attention your views on the medical care of those of you who were exposed to the radiation from the fallout. I have carefully considered your views and appreciate the opportunity to answer your questions. ?lirst, I would like to comment with regard to travel of Marshallese patients …