Marshall Islands stagger from ravages of U.S. control Struggle: U.S. nuclear tests and Westernization have crippled the Marshall Islands, which have contracted with the University of Maryland, Baltimore, to recommend reforms.

October 26, 1997|By Frank D. Roylance | Frank D. Roylance,Sun Staff

MAJURO, Republic of the Marshall Islands -- Nature blessed the Marshall Islands with warm Pacific breezes, tropical fruits, schooling fish and turquoise lagoons.

But a half-century of U.S. control and influence here since World War II has cursed them with illness and crumbling medical care.

The Marshallese still live with the contamination, illness, displacement, dependency and fear brought on by U.S. nuclear tests in the 1940s and 1950s - 67 blasts with a total power 7,000 times that unleashed on Hiroshima, Japan, in wartime.

But even more devastating have been the dietary and lifestyle changes, cultural and economic disruptions caused by rapid Westernization of the Marshalls - first as a United Nations trusteeship under U.S. administration, and later as an independent country under America's financial and military wing. These changes have brought the islanders premature old age, soaring cancer death rates and more diabetes than in almost any place in the world.

"The entire situation of the Marshallese is quite unfortunate," said Col. Richard Chapman, a retired former U.S. Army commander at the Kwajalein Atoll missile range, who developed an affection for the islands and their people. "They embraced a good deal of what's wrong with our culture and lost a great deal of what was good in theirs."

Struggling to address its health care crisis, the Marshallese government signed a $40,000 contract last year with the University of Maryland, Baltimore to study the country's medical system. UMAB physicians visited the islands' hospitals and clinics, peformed 48 eye surgeries and recommended reforms.

The islands face enormous problems that affect public health.

Lured by paychecks from the Army or the U.S.-financed Marshallese government, nearly two-thirds of the country's 60,000 people have crowded into urban settlements on just two islands - Majuro and Ebeye. Those who find jobs are joined by relatives who come to share the income.

On overcrowded Ebeye, failing water, electric and sewer systems have led to outbreaks of gastrointestinal illness that killed four children over four months this year and sickened more.

The pursuit of cash and consumer goods, and disruption of traditional family and community life, are also blamed for crime, spousal abuse, drug abuse, truancy, teen pregnancy and suicide.

The traditional diet of fish and tropical fruits and vegetables has been largely supplanted by the worst of the West's culinary exports. Spam and frozen turkey tails are favorites, as are other convenience foods high in fat, salt and sugar, and low in nutrition.

Among the consequences: Twenty percent of preschoolers are malnourished and 38 percent are anemic. Half of the adult women are overweight. Thirty percent of the people over age 15 suffer from non-insulin-dependent diabetes, resulting in high rates of hypertension, cardiovascular disease, kidney and eye disease.

"It really is a disaster," said Dr. Paul Z. Zimmet of the International Diabetes Institute in Caulfield, Australia, who has studied diabetes in the Pacific Islands.

There's more. Forty years of U.S. administration of the former United Nations Trust Territory and nearly a billion dollars in U.S. aid since independence in 1986 have left the Marshallese with a U.S.-style health care system they have not been able to maintain, and that does not keep them healthy.

For example, the U.S.-funded hospital on Majuro is literally dissolving in the salt air and tropical rains. The roof leaks, and the walls are crumbling. Just outside the 11-year-old facility, raw sewage bubbles from a broken septic system.

At the similarly decrepit Ebeye Hospital, medical equipment breaks down and can't be fixed. An X-ray developer was idled when its wiring was gnawed by rats. A new hospital stands empty nearby. The Marshallese can't afford to open it.

Inadequate preventive care has contributed to appalling health statistics. Life expectancy for men is 61 years, third worst among 15 Pacific Island populations. Infants die at rates five times that in American Samoa in the South Pacific. Women die of cervical cancer at 75 times the U.S. rate. Liver cancer kills men at 30 times the U.S. rate.

There is no breast cancer screening because there is no mammography machine. Only after Marshallese women develop suspicious lumps are they flown 2,300 miles to Honolulu for a mammogram. Breast cancer kills at five times the U.S. rate.

The Marshallese believe their suffering and sacrifice for U.S. nuclear weapons testing and America's continuing military presence at the strategic Army missile range at Kwajalein Atoll entitle them to more U.S. help. Talks begin in 1999 on the extension of the Compact of Free Association, which defines the two countries' relationship.

But U.S. officials express no interest in expanding the taxpayers' largess for what is now an independent country with a diminished strategic importance and a history of mismanaging previous aid.

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