TAB D-2 DISCLAIMER The following is a staff memorandum or other working document prepared for the members of the Advisory Committee on Human Radiation Experiments. It should not be construed as representing the final conclusions of fact or interpretation of the issues. All staff memoranda are subject to revision based on further information and analysis. For conclusions and recommendations of the Advisory Committee, readers are advised to consult the Final Report to be published in 1995. DRAFT FOR DISCUSSION PURPOSES ONLY MEMORANDUM TO: Members of the Advisory Committee on Human Radiation Experiments FROM: Advisory Committee Staff DATE: May 1, 1995 RE: Documentary Update on Marshall Islands I. Introduction Documents recently located by staff at the Department of Energy's Germantown facility provide a fuller and richer picture of the story of medical research and treatment conducted in the Marshall Islands in the aftermath of the tragic irradiation of the islands during a March, 1954 hydrogen bomb test. The documents, which only cover a period through the early 1960's, indicate that from the onset the Marshallese were puzzled by the continued studies undertaken by U.S. researchers, and viewed themselves as guinea pigs. They asked why, if they were not sick, continued study was necessary. The U.S. and its researchers, the documents show, were engaged in activities that simultaneously had scientific, geo-political, and medical treatment purposes. In a 1961 statement to "The People of Rongelap," the Atomic Energy Commission told the Marshallese that some of the research would be of no direct benefit to them. Faced with questions from the Marshallese, U.S. officials and researchers considered ways to keep the research moving forward--including trinkets, compensation, and the provision of more treatments or even placebos (to convince the Marshallese that they were getting something from the study). II. Attachments Attachment 1: In this July, 1955 memo, to Dr. Charles Dunham of the Division of Biology and Medicine (DBM), AEC health and safety official Merril Eisenbud notes the importance of data being gathered from the people of Utirik: "I realize the Uterik (sic) situation is quite atypical and that the factors governing uptake are complex and are numerous. However, the problem has great importance both to civil defense and industry." 1 Attachment 2: In this December, 1955 memo from the AEC Public Information Service, a question is raised about the characterization of the Marshallese experience in a proposed technical report: The tone of . . . the report bothered us somewhat. Its profuse acknowledgements of the 'unselfish cooperation' and 'sacrifice' of the team in gathering the research data undoubtedly are justified, but we feel that they tend to give the impression that the Marshallese were regarded as 'guinea pigs,' whose irradiation was important primarily because it afforded an excellent opportunity for study. This impression could be softened by including the Marshallese in the kudos. Could a couple of sentences be added, stating that the Marshallese cooperated fully with the medical team, showed understanding of the importance of gathering the data, etc.? As the preface stands now, everyone gets a pat on the head except the people who were irradiated. Attachment 3: In this February, 1958 memo from Gordon Dunning, Chief of the DBM's Radiation Effects of Weapons Branch, there is a discussion of the survey undertaken prior to the resettlement of the Rongelapese. "A resurvey of Rongelap Island should have been made prior to the return of the Rongelapese." The alternative undertaken was "a poor second" and ". . . represented only a small part of the data we should have obtained." Attachment 4: This April, 1958 memo from Division of Biology and Medicine (DBM) Director, Dr. Charles Dunham, to the Director of the AEC Division of Military Application addresses "Redetermination of Whole Body Contamination of Marshallese Natives." As requested in a prior classified memo (the instant memo does not seem to have been classified), DBM reconsidered the need to resurvey the whole body burdens of Marshall Islanders. "It was the consensus of all concerned that the promptest (sic) resurvey possible would be in the best interests of the Commission, and the Departments of State, Interior, and Defense." The memo explains the need for this in terms that are not clear in their implications, as per the final quoted paragraph: In the event of any surface contamination of the atolls, a base line value of the degree and type of internal contamination by radioisotopes originating from the 1954 incident is almost mandatory. It should be possible to evaluate additional body burdens picked up under such circumstances or alternatively to prove that the present series has not added to the amount and composition of their present contamination. 2 The possible changes induced in the environment by a few shots may well not have influenced the natives appreciably by the time the resurvey can be made. Alternatively, if beginning changes are observed (based on memory of the original lost data), it may turn out to be the most important data that can be detected and evaluated. The desirability of securing an extra year's scientific data for the purposes of completing the cumulative radiation doses to these natives is obviously desirable from a purely scientific point of view, but the above considerations are believed to be the overriding ones. Attachment 5: This April, 1958 classified telegram from the AEC's Division of Military Application to the Joint Task Force Seven in Eniwetok confirms the need for a resurvey ". . . in the best interests of AEC, State, Interior, and DOD." All concerned believe that the promptest (sic) resurvey possible is in best interests of AEC, State, Interior, and DOD. The possible changes induced in the environment by a few shots may well not have influenced the natives appreciably by the time the resurvey can be made. On the other hand, if the beginning changes are observed (based on memory of the original lost data), it may turn out to be most important that they can be detected and evaluated. Attachment 6: This June 5, 1958 letter from Dr. Conard of Brookhaven (who directed the Brookhaven medical surveys) to Dr. Charles Dunham of the DBM appears to record the body counting that took place, notes the questioning attitude of the Rongelapese, and suggests that on the" . . . next trip we should consider giving them more treatment or even placebos." Conard notes: . . .things began popping with our arrival at Eniwetok and was followed by a slight fallout . . . . We counted about 100 people. We hope to be able to compare the ones that lived on Eniaetok (sic) from those on Rongelap and a few that had more recently moved there from Ebeye. It is unfortunate that the Eniaetok (sic) people had been living on Rongelap for the month prior to our arrival since it is the radioactive body burdens of people living on this more contaminated island that is of most interest. Fortunately there apparently had been only slight additional fallout on Rongelap atoll from the present tests to date. 3 I found that there was a certain feeling among the Rongelap people that we were doing too many examinations, blood tests, etc. which they did not feel necessary, particularly since we did not treat [underlining in original] many of them. Dr. Hicking and I got the people together and explained that we had to carry out all the examinations to be certain they were healthy and only treated those we found something wrong with. I told them they should be happy so little treatment was necessary since so few needed it and most of them were healthy, etc. Perhaps next trip we should consider giving them more treatment or even placebos. Attachment 7: In this July 10, 1958 letter from Dr. Dunham to the Surgeon General of the Navy, Dunham explains that it is essential to continue the research effort for those returned to their native islands and that the continued health of the "natives" was essential: In addition, it is extremely desirable that the health of these natives on the North Islands be maintained in the best possible state. A corollary of such care is that the records would also be invaluable in the event of claims of personal damage in the future. Our problem then is to make it as attractive as possible for the natives to seek adequate medical care regardless of the etiology of the condition. Dunham therefore asked Navy to waive the standard $5.00/day charge for visits to the Navy hospital in Kwajalein. Attachment 8: This September 1958 letter from Edward E. Held, a University of Washington research assistant professor, to Dr. Conard recorded a meeting with " . . .the son of the King of the Marshalls . . . .": [T]he Rongelapese are dubious about the necessity for continued medical examinations. Most particularly, they are apprehensive about being 'stuck with needles.' Amta asked our opinion as to the objectives and necessity for continued medical examinations. We explained that we were not competent to evaluate medical problems. . . . Amta and John were assured that you are sincere in your efforts and that you are the logical person to go to for a true evaluation of the medical aspects. It was also pointed out that there have been medical benefits not connected with radiation 4 which have resulted from the medical surveys. Both Amta and John agreed that this was true. Amta said he would write to you on behalf of the Rongelapese explaining their doubts and requesting a clarification of necessity from you. Attachment 9: This undated document entitled "Plans for 1959 Marshall Island Medical Survey" indicates continued contemplation of the use of therapy and trinkets to maintain needed rapport: Therapy One of the best ways of maintaining rapport with the Marshallese is by medical and surgical therapy. In the past . . . medical and surgical procedures carried out by our team were greatly appreciated by the people. . . . [E]very effort must be made to expand this aspect of our operation. Therefore, careful consideration must be given to therapeutic procedures that may be carried out such as medical, minor surgery, dental, etc. Discuss list of drugs and equipment and suggest additions or deletions. Discuss inducement gifts. The 1959 protocol for the survey is also included. Attachment 10: This January 1, 1959 "To Whom it May Concern" memo attests that the bearer of this memo, Dr. Conard, is the team leader of a group of scientists, and the AEC considers the re-examinations ". . . to be of utmost importance, not only to the health and welfare of the residents of the Marshall Islands but also to the continued availability and use of the Marshall Islands for the weapons development program of the United States." Attachment 11: This January 16, 1959 letter from Dr. Conard to Dr. Dunham requests approval for tracer studies; "[c]areful consideration of such studies using trace materials is necessary since a policy decision forbidding their use at all in these people would seriously curtail future studies that may be quite important both from the point of view of the health of the people and for scientific reasons." The letter proposes three studies, which ". . . would be carried out only in volunteers who may perhaps be given some compensation." The January 27, 1959 response from Charles Dunham to Dr. Conard is also included. 5 Attachment 12: This April 14, 1959 letter from Dr. Bruner, a DBM official, to Conard again raises the possibility of providing trinkets to assure cooperation: As I read your report I began to be worried for fear that the discontent of the natives with continued examinations would become a real problem but you seem to have managed the situation very well. It occurred to me to ask whether it might be possible to send each of these people some sort of a little trinket to indicate to them that you appreciated their cooperation and to say that you are looking forward to the same thing again next year. . . . It would be a good investment, I believe, if it is possible to manage administratively. Attachment 13: This June 3, 1959 letter from Dr. Conard to Dr. Bruner had as an enclosure a memo from Dr. Conard to Dr. Farr, both of Brookhaven, which notes regarding Rongelap: Low levels of radioactive contamination persist on Rongelap Atoll. The levels are considered safe for habitation. However, the extent of the contamination is greater than found elsewhere in the world and, since there has been no previous experience with populations exposed to such levels, continued careful checks on the body burdens . . . is indicated to insure no unexpected increase. The memo also notes that the privileged position of Rongelapese vis a vis medical care promoted dissatisfaction with those on other islands and increased concerns about the Rongelapese. Attachment 14: This June 1959 Dunham memo to his files records a meeting with the U.N. High Commissioner Nucker, an Interior Department official, and an anthropologist. Mr. Nucker declared: . . . that the arrival of . . . 20 odd scientists plus supporting personnel was not only a disrupting influence but fostered the following feelings: 1. If we aren't sick why do you come back each year? 2. The U.S. Gov't. is very wealthy and easily could support us in toto so why should we 6 not let the copra rot, and why should we fish? Mr. Nucker urged that we work through their Medical Service as much as possible and forego all but absolutely necessary examinations. He believes that if given 2-3 years freedom from large medical surveys the people will accept a normal life and have no further interest in perpetrating (sic) the 'dole.' Whether he is right or not I cannot say, but I think the situation is serious enough to warrant our grossly simplifying our studies: The physical surveys are less of a problem but there seems to be a tendency by the natives egged on by a few to interpret these visits as well in a dim light--to pump Dr. Held on radioactivity and to misinterpret his comments re contamination. Attachment 15: This July 1959 letter from Dr. Conard to Dr. Dunham records Conard's meeting with Mr. Nucker at the U.N. The memo notes that Nucker did not grasp the importance of the medical surveys: . . . I was surprised that Mr. Nucker did not appreciate the fact that the body burdens of the Rongelap people had increased since their return to Rongelap. They seem to take the attitude that we are merely carrying out a scientific experiment using the Rongelap people as 'guinea pigs.' I tried to make our position in this matter clear and to emphasize the importance of continuity in our observations of the people for the early detection of significant changes that may be related to radiation so that they could be treated as soon as possible and that the scientific value of these studies was extremely important, but that this was secondary to the former objective." Attachment 16: This February, 1961 statement from Dr. Dunham "To the People of Rongelap" explains that the health studies will benefit them, but have a second purpose which ". . . is of no direct value to you. They help us to understand better the kinds of sickness caused by radiation." 7