'We want a fair deal'

From The Marshall Islands Journal
July 22, 2005

He listed what the Marshall Islands wants from the US Congress:

• $15.7 million so the Nuclear Claims Tribunal can pay existing personal injury awards. As of December 31, 2004, 45 percent of personal injury awardees with radiological illnesses have died without receiving full compensation for their injuries because the Tribunal does not have sufficient funding to pay the full amount of its awards. $15.7 million represents the shortfall in funds to pay current awards. In the case of the program for US Downwinders, the (US) Attorney General requires that 100 percent of compensation be paid within six weeks of the time an award is made. The RMI agreed to the 177 Agreement of the Compact of Free Association because it provides compensation for the people of the Marshall Islands who contract radiological illnesses.
The Nuclear Claims Tribunal created a compensation program based on US programs for Downwinders and Veterans exposed to radiation, but the Tribunal’s program is unique because the people of the Marshall Islands were exposed to more radiation than any other population in the world. As the U.S. National Cancer Institute recently noted in its report to Congress, “[m]ost of our understanding of the biological response to radiation exposure pertains to doses that are much lower than those of the more highly exposed Marshallese.”

• Replenish the Nuclear Claims Trust Fund so the Nuclear Claims Tribunal can continue to make personal injury awards in the future.

The preceding shortfall from request number one represents the current balance on personal injury awards as of June 24, 2005, and does not take into consideration the US National Cancer Institute’s prediction of several hundred more radiation-related cancers in the future. The RMI government believes that the Nuclear Claims Trust Fund needs to be replenished to provide compensation for future radiation-related injuries — such as the cancers the NCI has told us to expect — as the intent of the 177 Agreement is for the Tribunal to create and maintain, in perpetuity, a means to address past, present and future consequences of the nuclear weapons testing program. The intent of the 177 Agreement is for the Tribunal to have the future means to pay awards for personal injury but the Tribunal does not have funding to make the future awards agreed to in the 177 Agreement.

• $1.1 billion so the Nuclear Claims Tribunal can pay for the Enewetak and Bikini private property awards.

Like the personal injury awards, the 177 Agreement provides for claimants to receive compensation for private property damages. Since the Tribunal funding is manifestly inadequate and the Tribunal does not have the ability to pay for awards it has made, the intent of the 177 Agreement has not come to fruition. Recognizing that the dollar amounts needed for the private property claims are quite high, the RMI would welcome consideration by Congress to moving the land claims to the US federal courts to review the decisions and the right of claimants to receive awards.

• Establishment of similar consideration for future private property claims.
The RMI also requests that a similar mechanism to request number three be adopted for pending private property claims. The Tribunal is expected to rule on several private property claims in the near future for atolls such as Rongelap, Utrik, Ailuk, Likiep, and others. Private property claims will become meaningless if the Tribunal is unable to pay out its rewards.

• $50 million to build adequate infrastructure for the delivery of radiation-related healthcare.

The RMI currently lacks the infrastructure to respond to radiation-related illnesses. We believe that infrastructure is a critical component of building the RMI’s capacity to address its radiation-related healthcare needs. We envision a scenario where we establish facilities and services that are reasonable to provide in the RMI, including the ability to monitor exposed populations, diagnose radiological illnesses, and provide treatment for most conditions. When it is not cost effective or practical to provide treatment in the RMI we would like to send our patients to Hawaii to purchase the care we cannot reasonably provide.

• $45 million each year for 50 years to provide health care delivery.
Once infrastructure is in place, the RMI needs funding to hire doctors, purchase medication and some services in Hawaii, and to deliver health care for patients exposed to radiation. Building the health care capacity of the RMI will benefit Marshallese citizens exposed to radiation and provide the capacity to deliver more timely care for radiation-related illnesses, with the hope of identifying medical problems when they are still treatable and extending the lives of the patients.

• Assignment for the monitoring of the Runit Dome to a US agency.
The portion of the Enewetak population that has resettled one of its home islands needs assurances that its health is not adversely affected by living adjacent to a nuclear waste storage facility. Currently, no US agency has responsibility to monitor the integrity of the Runit Dome. The Defense Nuclear Agency used to have responsibility for this work, but the agency was abolished and responsibility for the Runit Dome was not transferred to another agency.

Palafox puts strong case for health care funding

Dr. Neal Palafox made a strong pitch for US funding for health care in the RMI in a statement to the US Senate Energy Committee hearing on Wednesday this week.

He called for the US government to fund a high-quality medical care program that would address both the direct health problems caused by nuclear testing, and build capacity of the Marshall Islands to address these needs.
Palafox worked at Majuro Hospital as a US Public Health Service doctor in the 1980s and early 1990s, and until the contract was ended last month, ran for the past seven years the medical program for Rongelap and Utrik islanders affected by nuclear testing.

“Building a comprehensive cancer health system, providing a high standard of health care for the 177 health care recipients, and managing the Department of Energy medical program can be done for an operations cost of $45-50 million annually,” he said. “The system and facilities that would be constructed would have the absorptive capacity to provide a high level of health care for the RMI, in general. The Commonwealth of the Northern Marianas, which supports a similar population to the RMI (55,000 people), has an annual operations budget of $45 million annually.”

Building such a system could provide comprehensive cancer care to all Marshallese while meeting their comprehensive health care needs, Palafox said. “The National Cancer Institute report suggests that the ionizing radiation which caused cancers reached beyond the four atolls and even beyond the northern atolls of the Marshall Islands,” he said. “The lack of a defined boundary of who was affected and who was not affected by nuclear fallout makes a nationwide system ideal.”

Such a system could also address the health care needs of over 300 Marshallese and other indigenous Pacific islanders who participated in the clean-up of Bikini and Enewetak atolls who live in the RMI. This subgroup has little access to extra health care services, he said.