The Office of Environment, Health, Safety and Security (EHSS) recently transmitted its annual report to Congress on the Republic of the Marshall Islands Special Medical Care and Logistics Program (Special Medical Care Program).
Office of Environment, Health, Safety & Security
July 9, 2024
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By Hart Rapaport
The Office of Environment, Health, Safety and Security (EHSS) recently transmitted its annual report to Congress on the Republic of the Marshall Islands Special Medical Care and Logistics Program (Special Medical Care Program). The Special Medical Care Program was created by a 1986 act of Congress, Public Law 99-239 Section 103(h)(1) [48 U.S.C. 1903(h)(1)], which requires the President, through an appropriate agency, to "provide special medical care and logistical support thereto for the remaining 174 members of the population of Rongelap and Utrik who were exposed to radiation resulting from the 1954 United States thermonuclear ‘Bravo’ test."
Over the course of the year, the EHSS Office of Domestic and International Health Studies (EHSS-13) and its cooperative partner, International Outreach Services, offered medical screening examinations to each person eligible for the Special Medical Care Program. The annual report outlines the activities of the Special Medical Care Program for fiscal year (FY) 2023. Forty-four complete or partial examinations were performed, each of which included a physical examination, laboratory tests, and, when available, imaging services.
The Special Medical Care Program is a voluntary program available to eligible individuals no matter where they reside. In FY 2023, Special Medical Care Program medical staff provided screening and treatment services across a number of atolls in the Republic of the Marshall Islands (RMI), Hawaii, and in the Continental United States, including 151 home visits to ensure access to care for patients unable to travel to a medical facility. In many of these cases, medical staff also provided deliveries of personal care supplies and needed prescriptions.
To ensure appropriate treatment is administered to each patient, program staff work in close collaboration with the RMI Ministry of Health and Human Services (MOHHS). When screening results reveal conditions outside of cancer that require care, referrals are made to the RMI National Healthcare Program or the Section 177 Healthcare Program, both of which are available resources to participants in the Special Medical Care Program. EHSS also provided approximately 300 hundred hours of additional clinical support hours at no cost this year to support MOHHS patients.
If screening indicates a potential cancer, participants are referred to specialists to establish a diagnosis and determine a treatment plan. If appropriate specialists are not available in the RMI, the Special Medical Care Program provides travel and logistical support to enable patients and an escort to travel to Hawaii or the Continental United States to acquire needed care. This support extends to any follow-up examinations and treatment as well as actions needed to resolve any co-morbidities that may prevent travel and treatment. In FY 2023, no referrals for treatment or follow-up were made.
Over the past 8 years, the Special Medical Care Program has completed 567 medical examinations and provided logistical and travel support for 26 referral and follow-up visits to specialists within the United States. An overview of key elements of the Special Medical Care Program’s activities and work in the recent past can be found in the below infographic.
ABOUT THE AUTHOR:
Hart Rapaport is a Research Specialist at International Outreach Services. He graduated from Columbia University with a B.A. in Political Science and Statistics and is an incoming J.D. Candidate at Yale Law School.