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In Dependent Solutions



Debating Policy to Improve Population Health

This lesson plan uses the health crisis in the Marshall Islands to teach students about the creation of health promotion policy.

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U.S. serviceman guides relocated Marshallese onto boats
The lives and health of Marshall Islanders were disrupted dramatically after the United States invaded during WWII and drove out the occupying Japanese, then began using the outer islands as a nuclear test range after the war. Hundreds of Marshallese were moved off their home islands to make way for the testing. Between 1946 and 1958, the U.S. military detonated 67 nuclear weapons. Their combined power has been estimated as the equivalent of 1.7 Hiroshima blasts a day, every day, for 12 years.

In 1954, after a miscalculation on one of the largest H-bomb tests ever, code-named Bravo, extensive nuclear fallout landed on three inhabited Marshallese islands downwind of the test site. Not knowing what it was, children played in the white radioactive ash falling from the sky. Residents were treated, relocated, and finally tracked and studied by the U.S. military to learn about the effects of radiation exposure on humans.

Also in the 1950s, Marshallese citizens living on the territory’s second largest island, Kwajalein, were relocated to make way for the U.S. military to build what is now the Ronald Reagan Missile Base, a center of the U.S. anti-missile defense test system commonly known as Star Wars.

Today, the missile base is managed by Raytheon Corp. About 2000 private American military contractors and their families live in a quaint suburban environment on Kwajalein with a modern hospital, social clubs, swimming pools, a golf course, and a tiny department store, dubbed Macy’s. The Navy provides electricity and running water. Health outcomes here are not the world’s best, but are comparable to those of middle-class American mainlanders.

Kwajalein from the air
About 1100 Marshallese also work on Kwajalein tending grounds, cleaning houses, fixing vehicles, unloading freight, preparing food, and performing other low-wage service jobs for the Americans. But they’re not allowed to live there. Marshallese employees must leave Kwajalein within two hours after their shifts end. They commute by ferry across the channel about three miles to and from Ebeye, a small island about a quarter-mile wide and half-mile long.

Only a few decades ago, Ebeye was home to about 500 Marshallese. Today, about 12,000 squeeze onto the island. Its population density is greater than Manhattan, but everyone on Ebeye lives on the ground floor. Migration to Ebeye is driven by a “push / pull effect” similar to that which drives many people in the Third World from the countryside to the cities. Globalization and U.S. military occupation have disrupted their traditional economy, diet, and culture, pushing them off their lands, while the lure of a job at the base on Kwajalein pulls them to Ebeye.

Today, the RMI has a 30 percent unemployment rate and its economy is dependent on U.S. government assistance. The gulf between Kwajalein and the other Marshallese islands mirrors the uneven development that characterizes much of the so-called Third World.