Twenty-year review of medical findings in a Marshallese population accidentally exposed to radioactive fallout Page: 4 of 164
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The medical examinations of the Marshall
Islanders accidentally exposed to radioactive fall-
out in 1954 have now covered a span of 20 years,
A 5-year period has elapsed since findings have
been presented in full, and this report includes de-
tails of this period as well as a summary of the data
for the entire 20 years. Some background informa-
tion is presented first.
The Marshall Islands were chosen as an atomic
bomb proving ground at the time of Operation
Crossroads at Bikini in 1946 and were subse-
quently used for numerous tests at both Bikini and
Eniwetok until the moratorium was declared in
1958. These islands were chosen because of their
isolated location in the vast, nearly empty ocean
area of Micronesia just north of the equator, east
of the Caroline Islands, and northwest of the Gil-
bert Islands, about halfway between the Hawaiian
Islands and Australia. The Marshall Islands com-
prise 34 islands and atolls spread over some 180,000
square miles of ocean. Each atoll consists of a low-
lying chain of sandy, palm covered islands con-
nected by a reef surrounding and protecting a cen-
tral blue-green lagoon. Habitable land area is sur-
prisingly small - only about 70 square miles in the
ensure Marshall Islands. The climate is tropical, and
the trade winds blow much of the year. The atolls
involved in the 1954 accident are located in the
northern Marshalls: Rongelap and Ailingnae
about 100 nautical miles east of Bikini. Rongerik
about 135 miles east of Bikini, and Utirik 275
miles cast of Bikini.
During the past century the Marshallese people
have been governed by four countries. Germany
purchased the Marshall Islands from Spain in
1886 and governed them until 1917, when Japan
took over under a League of Nations mandate:
Japan declared ownership in 1933 when she broke
from the League of Nations. The United States
liberated the Marshalls in 1944, during World
War II, and was given authority under a United
Nations mandate to administer the scattered islands
of Micronesia as the Trust Territory of the Pacific
Islands; this was done first by the U.S. Navy and
later by the Department of the Interior.
The early explorers and traders found the is-
lands inhabited by friendly, gentle, primitive
people, living in thatched huts, fishing from out-
rigger canoes, and subsisting entirely from the
local environment. The increasing encroachment
of civilization via traders, missionaries, and gov-
erning authorities has changed their way of life.
The missionaries brought religion, clothing, and
changed customs. A dollar economy based on
copra production and employment by local gov-
ernments has tended gradually to supplant the en-
Sanitary conditions and health care in the Mar-
shalls had been primitive, with treatment of the
sick often involving a large element of superstition
and magic, and apparently did not improve under
Japanese rule. During World War II the Mar-
shallese were forced to live on low calorie diets
with inadequate medical care. When the U.S. was
made trustee in 1947, the Navy, under the aus-
pices of its Bureau of Medicine and Surgery, un-
dertook a comprehensive medical survey of island
populations in the Trust Territory including the
Marshall Islands, using one of its vessels, the USS
1i hidber.' The survey showed that unsanitary con-
ditions with regard to flies, garbage disposal, and
excretory habits made for multiple intestinal para-
sitit infestations and diseases. A high percentage of
the people had positive Kahn tests, associated with
yaws, and widespread treatment with penicillin
proved extremely effective. Diseases of the eyes
and skin, acute and chronic respiratory diseases,
and vitamin deficiencies were especially common.
No malaria, filariasis, yellow fever, or cholera
was seen. Subsequent health care in the Trust Ter-
ritory was hampered by lack of trained medical
personnel and poor transportation ty the outer
islands. This was the status when our special med-
ical examinations began.
Some of the events over the years in the Mar-
shall Islands that are relevant to the medical sur-
veys are listed in Appendix 1.
The first examinations in 1954 after the fallout
were conducted by an emergency medical team,
requested by the Atomic Energy Commission,
directed by Dr. E.P. Cronkite and composed
largely of Navy medical personnel whose service
experience proved extremely helpful for this field-
type operation. Resurveys were conducted at 6
months tinder Dr. V.P. Bond and at 12 months
under Dr. Cronkite. In 1956 the surveys were
placed under the direction of the author at Brook-
haven National Laboratory. Since then the surveys
have been conducted in conjunction with the De-
partment of Health Services of the Trust Territory
and with the participation of medical specialists
from the Armed Forces and from medical centers
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Conard, R.A. Twenty-year review of medical findings in a Marshallese population accidentally exposed to radioactive fallout, report, January 1, 1975; Upton, New York. (digital.library.unt.edu/ark:/67531/metadc866112/m1/4/: accessed December 11, 2018), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.