I am kind of struck by your statement about the necessity for the university to participate. Your suggestion is participation in the selection of staff or the rendering of the services itself? Which is it that you are heading toward?

Dr. DUBANOSKI. I think that in particular, if you take a look at a lot of the States that offer good mental health services, what you do is you see a much greater collaboration between the State services and the services that are provided by the university.

Our university does not interact as much as we could. We are, again, just starting that, at least from the social sciences and mental health. But a month ago Hank Foley and I got together-he is the head of mental health-to try to see how we can in fact get much greater collaboration between the university, and it might be in fact of having joint appointments between the State and the university, also providing a number of different kinds of projects with respect to research with respect to both the etiology and also the intervention of mental illness programs.

Ms. MINK. That is a very encouraging word, because I have been quite alarmed at our inability, seemingly, to overcome the criticisms and other points that have been made with regard to the continuing deficits in our mental health structure. And I think that that has a very devastating outreach throughout the community among all of the various segments of our community.

So I encourage you in that regard.

I would like to just take this opportunity, Senator Inouye, to commend Dr. Izutsu and Dr. Michael for their very strong participation in the welfare of the people in Micronesia. It is an area that I have been long associated with.

I am somewhat disturbed by your reports about the continuing inadequacies of the health care system, which is something that I noted many, many years ago. And I quite agree that it is in the prevention of illness that we have a particular responsibility, and that is in providing clean water, clean sanitation, and other healthful environmental conditions which go beyond the responsibility of a school of public health or a school of medicine or whatever.

So I think that the Congress and this committee, taking your words and expanding upon them, can perhaps devise a stronger support for these entities, so that in the long run it is not an emphasis on health care, but an emphasis on community infrastructure that perhaps might lead to more wholesome, healthy communities out there.

But I join the Senator in applauding your efforts and hoping that the Congress will continue to support these programs, so that the university can really fulfill what has long been described as its major responsibility in the Pacific area.

So thank you very much.

Senator INOUYE. Congressman Abercrombie.

Mr. ABERCROMBIE. Ďr. Izutsu, can you tell me whether the School of Medicine has been associated with the activity at Rongelap, with the refugees from Rongelap as a result of the atomic testing?

Dr. IZUTSU. No; we have not. But we have

Mr. ABERCROMBIE. Is it possible under your approach-and perhaps Dr. Michael can comment on it as well-if we are able to get

funding for the radiological studies as well as the other program associated with that-I guess here is where the social services, where the social sciences could come in as well.

I am sure you are familiar with the conditions and circumstances under which those people must live. And as Senator Inouye has said, there is a moral obligation operating here. These people are utterly and totally the victims of the atomic age and, because they are not powerful people, because they do not have oil, because they do not have some economic commodity, because they are not in some strategically based situation crucial to the so-called national interests of the United States, they find themselves, despite their best efforts to help themselves, constantly in a position in which they must depend upon others, particularly us, for their very sustenance and of course for their future.

So if you could comment as to how you might integrate their problems with the possibilities that you put forward here today, I would be very grateful.

Dr. IZUTSU. I think one of the areas that we would want to really elaborate more deeply would be the U.S. Public Health Service, and the U.S. Public Health Service has a program whereby they assign health teams and health personnel to Micronesia as part of that program. And I think that Dean Michael might be able to expand a little bit more on that particular program.

Dr. MICHAEL. Thank you, Congressman. I know that we have a group of faculty and students at the School of Public Health that would be delighted to be called upon to be of assistance. We are providing that kind of support in a wide variety of areas, including training. And in collaboration with the Public Health Service, if the committee language would so indicate, that would give us the opportunity for that kind of participation. I think that we could serve a very valuable role there.

The people there would have a great deal of trust for the work that we would do.

Dr. DUBANOSKI. If I could just add one thing, I think it is interesting, the point that you are making. We often have environmental impact statements about the impact that a particular plant will have on the environment. Very rarely do we have kind of a social environment impact statement.

I think the example that you talk about, the displacement of people, is exactly that, and also the problem that we see in Micronesia has been exactly that. We have never gone in there again to take a look at the impact that our so-called intervention models will have on a lot of people, and therefore I think a lot of suffering could have been prevented if we took a look at this kind of social impact statement.

Mr. ABERCROMBIE. The reason I bring it up, aside from the obvious responsibility and obligation we have toward the people of Rongelap, is that there is some discussion even in the Congress today about the possible renewal of testing. Memories I am afraid are short. It is probably one of the reasons, Senator, why we need an institutional memory in the Congress, if I can make a commercial for not limiting terms.

Ms. MINK. And allow people to come back.

Mr. ABERCROMBIE. And allow people to come back as well, I might add, who have been on hiatus.

But this is crucial. We have forgotten what the consequences of this. I should not say we have forgotten necessarily, but it is so easy to forget the consequences of actions such as atmospheric testing.

And of course, the Pacific has been the chosen ground-my analogy obviously is pretty bad there-the chosen area. But the ground there, that is to say the precious land, which has been so well articulated by Alu Like, those representing Alu Like and the heritage in Hawaii, that is something very precious to the people of Micronesia and all of the areas cited, obviously, to them.

They recognize better than any other people perhaps on the face of the Earth the fragility of humankind's existence between the sea and the land.

So if you could do something in that area, it would be useful. I know that the Interior Committee in the House is considering this at the present time, and if I could convey to its new chairman, Mr. Miller from California, that there is an interest here as he expressed to me just the other day, he said: The people of Rongelap and the Pacific need a champion. And I think that he will be open to whatever we can provide in that area, so I make that suggestion. Just one other thing, Dean. I would add and would solicit your view, on the integration of the social sciences, I believe that the Department of Political Science at the University of Hawaii has some very valuable additions or contributions that they might make.

If I am not mistaken, Professor Neubauer has established quite a reputation internationally for connecting health issues and political and social sciences issues in a very synergistic way. And I might, just by way of suggestion, indicate that they are a resource to be tapped.

Dr. DUBANOSKI. I am very well aware of it. He and I, we are colleagues and friends, and over the past year he has been developing a program of social sciences and health which we hope to be part of the curriculum at the university, along with medicine and the public health.

Mr. ABERCROMBIE. Senator Inouye, I would like to just conclude by saying that, while the headlines many times occupy themselves with sports activities or whether stadiums should be built or not built and so on, I want to indicate that the University of Hawaii has been in the forefront of building a very, very strong social science component that is complementary on the graduate level and I think is achieving some of the things that we sought many years ago.

Dean Michael and I have talked with one another over a long period of time about integrating everything from the law schools to the school of public health to the school of medicine with the other graduate sciences, social sciences, the hard and soft sciences, if you will.

That was the goal when we established the graduate school at the university, and I think that this hearing helps to exemplify why not only it is a good idea, but that the graduate schools in medicine and law are fulfilling their historic obligation as originally

envisioned when Governor Burns and others helped to put this whole program initially together.

Senator INOUYE. I would like to thank Representative Mink and Representative Abercrombie for joining the committee in this special hearing this morning, and to thank all of you who have traveled long distances from Hawaii to be with us today.

I can assure you that your words and your testimony will be respectfully and carefully considered, and I am certain that we will act on them favorably.

So with those words, I thank you, all of you from Hawaii. Thank you for your manao.

STATEMENT OF HON. ARLEN SPECTER, U.S. SENATOR FROM PENN

SYLVANIA

Senator SPECTER. Mr. Chairman, if I might say just a word of appreciation for being joined by Congresswoman Mink and Congressman Abercrombie and the witnesses who came such a long distance for these very important issues.

I commend you, Mr. Chairman, for your work in these areas, considering all your responsibilities, especially on the Defense Appropriations Subcommittee, which is a full-time job in and of itself.

While I have the floor, Mr. Chairman, I would like to welcome Irene and Abe Pollin to our hearing today. I know them both professionally and personally, and I am aware of the outstanding work which they have done through the foundation, and they have had a certain family involvement which has given them special insights. Through experiencing problems in this area come special insights and special understanding.

So I wanted to be here specially as the ranking member of this subcommittee when they were here to testify. I know you will accord their words great weight, Mr. Chairman, but an extra word is not wasted.

Mr. POLLIN. Thank you, Senator.

STATEMENT OF IRENE S. POLLIN, MSW, PRESIDENT, LINDA POLLIN FOUNDATION, CHEVY CHASE, MD

ACCOMPANIED BY ABE POLLIN

Senator INOUYE. Before I proceed in welcoming Mr. and Mrs. Pollin, may I assure all the witnesses that I will be here chairing this hearing until we are all finished. So it may be until 2 o'clock this afternoon.

Before I call upon Mrs. Pollin, Mr. Pollin, may I tell you that your basketballs are being very appropriately used on the Island of Manua in American Samoa.

Now may I call upon Mrs. Irene S. Pollin, representing the Linda Pollin Foundation. She will be accompanied by her husband Abe Pollin.

Mr. POLLIN. Thank you, Senator.

Senator INOUYE. About 12 years ago I visited Samoa and I found that they had a basketball court with a ring, but no basketball. And Manua was an isolated island where a generation of children have never left the island, and they wanted to learn how to play basketball.

So I called Mr. Pollin and asked if he had any spare basketballs. He had 50 spare basketballs. So now they have a team on the Island of Manua, and some day you may see one of them playing on your team.

Mr. POLLIN. I certainly hope so, Senator.

Senator INOUYE. So Mrs. Pollin, I welcome you, ma'am.

Senator SPECTER. After you fill your team, Abe, maybe there will be a few left for the '76ers.

Mrs. POLLIN. Thank you. Thank you for the greetings.

Chairman Inouye and Senator Specter, it is good to be here this morning. My name is Irene Pollin and this is my very supportive husband sitting next to me, Abe. I appreciate his being here because this is something we do believe in very strongly and have been for many years.

I appear before you this morning as president of the Linda Pollin Foundation, which is dedicated to improving the availability and accessibility of medical crisis counseling services to chronically ill patients and their families. Medical crisis counseling is a shortterm therapy that addresses many of the issues that patients and their families must face when coping with long-term illness.

These issues not only are the emotional and adjustment issues of coping with long-term illness, they are also the medical issues, such as the need to comply with very difficult medical treatment protocols.

I am also speaking to you as a member of the presidentially appointed National Cancer Advisory Board. I have been on that board for 4 years. So my comments today are in response to the report on psychosocial counseling services that are currently being rendered at the National Cancer Institute through their various cancer centers.

This report does reflect actually NCI's recognition of and need for these services. They are saying without question the value of these services.

But unfortunately, the report only represents the ideal, something which is not being currently provided by a majority of these cancer centers. I have some suggestions on how we can achieve the state of the art that we do need to enhance the quality of life of patients with chronic illnesses and to increase their opportunity for survival.

PREPARED STATEMENT

Therefore, I urge the subcommittee to increase the appropriation of the National Cancer Program by $200 million above the President's budget request; two, to take $1 million of this appropriation toward a demonstration study to identify payment mechanisms for psychosocial services in cancer centers; three, to provide multidisciplinary training programs-this includes social workers, psychiatrists, nursing-which will then incorporate the psychosocial intervention.

I want to thank you very much for giving me this opportunity this morning to present these recommendations, and I would be pleased to answer any questions.

[The statement follows:]