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CO VI NGTON & BURLIN Acting Assistant Secretary of International and Territorial Affairs Department of the Interior Marshall Islands, has asked me to forward to ~70u th ing information, which Congressman Robert Duncan re from Secretary deBrum at the conclusion of his test April 2, 1980 before the House Appropriations Commi During his testimony, Secretary de13rum related to t mittee the efforts of the Goverment of the Marshal to determine the health consequences of previous ra exposure and residual radiation in the northern Mar Islands left by the United States nuclear weapons t As Secretary deBrum explained in his testimony, sho after assuming office on May 1, 1979, the Governmen Marshall Islands discovered extremely disturbing da dicating serious medical abnom~,alities of a type of connected to radiation exposure in people of atolls northern Marshall Islands which had been viewed by United States as either uncontaminated by radioacti. out from the nuclear weapons testing or contaminate a low level of radiation as to be of no consequence
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As you will recall, on May 16, 1979 a deleg ation sent by the Government of the Marshall Islands parti cipated in a meeting you chaired with representatives of the Department of Energy, Interior, Defense, State and the Def 2nse Nuclear Agency. On that occasion the Government of :he Marshall Islands requested assistance from the asser 3led agencies in determining the scope of the potentially radiation related medical problems on the northern atolls prev LOusly considered uncontaminated which, unlike Bikini, Enew ~tak, Rongelap, and Utirik, had not heretofore been the su 3ject of focused attention by the United States. At that mee :ing, the Government of the Marshall Islands presented the results of its own rough, preliminary survey of the people o F one of these northern atolls, Likiep, which identified out >f a --i population of approximately 600 people, 22 reported :hyroi- I dectomies, 18 other chronic throat disorders, 2 case ; of / severe birth malformations, one case of intestinal c ~ncer and 2 cases of chronic nervousness. In light of the ;e of the Marshall Islands asked the Department of Ener Jy and the Department of the Intel-ior to undertake the nece ;sary medical examinations, building on the expertise they had gained in their studies of Bikini, Enewet-ak, Rongela J and Utirik, to determine the scope of the problems which ma.y have been caused by long term exposure to the levels of radiation left on Likiep, 10otje, Mejit, Ailuk, Jemo ~nd possibly other northern atolls by the nuclear weapon ; testTen months later, when a delegation from t Government of the Marshall Islands was invited to re Washington, the members of this delegation were extr disheartened to learn that the Department of Energy even begun the necessary study of the medical proble the people of the northern atolls to determine the e of their low level radiation exposure. Instead, the ment had concluded a contract with Tabershaw Occupat Medicine Associates of Rockville, Maryland, in the a $58,999, excluding travel expenses, for a six month to send statisticians to the Marshall Islands to det ~;nether the preliminary questionnaire used by the GO of the Marshall Islands was a valid method of ascert certain historical medical information. Faced with apparent unwillingness of the Department of Energy t take the necessary medical survey, the Government of
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Marshall Islands sought the assistance of Dr. Rober Loeffler to attempt to identify the medical informs which must be obtained in order o dete~ine the ex potentially radiation related z . ormalities in the Since no definitive radiation measurement available either for the fallout experienced by the in question as a consequence of the weapons testing body dose exposure on these atolls, the only meanin, assessment of the risk factor created by the exposu: people of the northern atolls is the current and re( determination of somatic effects in the potentially population. Furthermore, Dr. Loeffler advised us t] radiation induced Carcinogenicity requires long Iat( periods (10-20 years for some solid tumors) retrospl analysis of incomplete, nondirected- medical records terious effects. Recognizing that the proposed sur’ health effects will of necessity be incomplete, Dr. is of the view that ~~e must attempt to provide answ~ least to the following specific questions. I. Iihat evidence exists of developmental effects This may be established by individual and tion data of histories and physical examinations to studies including cytogenetic chromosoural analyses s II. \Vhat evidence exists of late somatic effects This determination would require: a) Thyroid cancer and malfunction screening to - History and physical examinations - Technetium radioisotope gamma camera imag - Biochemical analyses including Thyroglobu determination by radioimiiune assay
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.3 VI NGTON & BURLING 82 for general screening purposes (Calciu Phosphorus, Alkaline Phosphatase and Chol - Thyroxine Binding Globulin determination - If indicated, in selected cases, needle a biopsy for cytological examination and po b) Leukemia screening to include: - History and physical examination - Complete peripheral bloodcount - If indicated, in selected cases, bone mar~ aspiration or biopsy c) Bone and Cartlige sarcoma screening to inclu e: - Radiographic chest examination and skeleta survey where indicated - If indicated, in selected cases, open or d) Lenticular opacification screening to includ - Opthamological examination to include slit e) Skin cancer screening to include: – History and physical examination - If indicated, in selected cases, inciziona All of the above studies must also be done on an appro control group to provide meaningful statistical analys The information which we are seeking is cruc the Government of the Marshall Islands and to the Gove ‘of the United States in carrying out our shared detern tion that the necessary medical treatment be provided people of the Marshall Islands affected by the United nuclear weapons testing program. Public Law 96–205 re enacted by the Congress commits the Government of the
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States to provide to the people of each such atoll “a program of medical care and treatment d environmental monitoring for any injury, l lness or condition which may be the result dire ly or indirectly of such nuclear weapons testin program.” The statute mandated the development of a the Secretary of Interior in consultation with the G vernment of the Marshall Islands and others that specifies a integrated, comprehensive health care program including primary, secondary and tertiary care tailored to the “condition and nee s of the individual atoll peoples.” The Government of th Marshall Islands cannot assist the Secretary in formulating s ch a plan until it first determines the current medical c ndition of the people living on the various affected atolls. Quite obviously the intention of Conqress cannot begin to e carried out without first obtaining the answers tot e questions we pose. As Congress understood and intended, this must precede ;-mmediately. In Senate Report No. 96–4 7 the Committee on Energy and Natural Resources clearly ex ressed the view that it “expects the Secretary to immediately begi development of the comprehensive health ca e and environmental monitoring plan as provided n this section using existing authorities.” During the House floor consideration of fi ally approved statutory language, Congressman Burton in r ferring to the deadline of January 1, 1981 for submission of this comprehensive health care and monitoring plan to Con ress, emphasized the point that “the committee encourages the Secretary t commence development of the plan as soon a possible and to complete it earlier than t e Chairman Burton went on to note that “All costs of planning, including travel a d other expenses, are to be chargeable to the budg t of
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the radiological program, but in the interes expediting the program, the Secretary is enc to use other departmental funds for later re bursement out of appropriation.” In constrast to the niggardly approach taken the Department of Energy even to ascertaining the true of the medical problems that have possibly resulted frl nuclear weapons testing, Congressman Burton emphasized during the floor consideration of the finally approved statutory language the intent and rationale of Congres! the United States err on the side of over inclusion ra than risk failing to treat any medical problems that W( the legacy of the weapons testing program: “Special emphasis is to be placed upon the biological effects of ionizing radiation, but since health effects associated with radiati{ exposure, such as thyroid anomalies, maligna] tumors, and genetic defects are indistinguisl from ~he spontaneous occurance of the same d: orders , the only way to assure that the radii related problems are dealt with is to deal w: all of the health problems of the affected pf Later in his remarks Congressman Burton explained: “We believe we have a special moral obligatic these people and it is our intent that this ~ vision be interpreted to provide the most po: Finally, of pertinence to our request that t-l most sophisticated scientific approach and most advanc~ technology be employed in identifying the health probl~ in the northern Marshall Islands that received radioact fallout, it is worth noting Congressman Burton’s explan? that Congress specified the involvement of a scientific advisory committee “to insure the maintenance of -the hi professional standards for both basic research and appl Furthermore, the information we seek is cruci the successful conclusion of the political status negot
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between the Government of the United States and the Go Tern- , ment of the Marshall Islands. A key part of these neg ~>tiations ‘- is the conclusion of a separate agreement between the I;overnment of the United States and the Government of the Ma ::shall Islands regarding the provision by the United States o :: radiation related medical surveillance and treatment p :-ograms ~ and radiological monitoring activities. Information r :garding the effects of low level radiation in all of the nt rthern atolls must be accumulated before this agreement can b (! — We 3.ook forward to working with you on these important and urgent matters. ‘The Honorable Amata Kabua