MARK NIESSE Associated Press Writer

2:46 p.m. EDT, September 6, 2009
HONOLULU (AP) — Pius Henry fears his adopted government will kill him, that the United States won't live up to a health care obligation to people from Pacific islands where it tested nuclear bombs.

Henry, a diabetic from the Marshall Islands, has received free dialysis treatments three times a week for years, but the cash-strapped state of Hawaii has threatened to cut off him and others to save money.

Like thousands of legal migrants to Hawaii from independent Pacific nations, Henry believes the United States has a responsibility to provide health care to compensate for the radioactive fallout of 67 nuclear weapons tests from 1946 to 1958.

"I don't have any option. I'm asking the government to help us," Henry said. "They say we're like U.S. citizens, but then they don't treat us the same. It's really unfair."

A federal judge's ruling Sept. 1 temporarily prevented Hawaii from halting critical dialysis and chemotherapy treatments to hundreds of migrants from three nations: Micronesia, the Marshall Islands and Palau. His order lasts at least until October.

Those three countries are beneficiaries of the Compact of Free Association, a 1986 pact with the United States granting it the right to use defense sites in exchange for financial assistance and migration rights.

With doctors and medical facilities lacking in their own countries, many with life-threatening conditions have moved to Hawaii seeking better health care, education and quality of life.

The islanders have struggled adjusting to American culture and their new home. They fill public housing projects and a disproportionate share of homeless shelters, according to a 2007 study. Without college degrees or a command of the English language, many work in fast-food or hotel jobs, which still pay far better than they could earn in their home countries.

"We're the last immigrants," said Innocenta Sound-Kikku, a Micronesian whose father, Manuel Sound, suffers from diabetes. "We come here for the same thing everyone else came here for — the chance for the American dream. The U.S. has an obligation after what they've done to us."

The nuclear testing occurred in the Marshall Islands, carrying the explosive power of 7,200 Hiroshima bombs, said Dr. Neal Palafox, chairman of the Department of Family Medicine and Community Health at the University of Hawaii. The blasts contaminated thousands of miles across the Pacific Ocean.

The residual radioactivity led to high rates of leukemia and thyroid, lung, stomach, skin and brain cancers, Palafox said. Fallout exposure could result in about a 9 percent increase in cancer in the Marshall Islands, according to a 2004 National Cancer Institute estimate provided to a U.S. Senate committee.

"It's a monster increase in cancer rates no matter how you look at it," Palafox said.

He said that while the high rate of diabetes isn't directly connected to the nuclear tests, fast foods and processed meats introduced by the U.S. led to worsening diets in a culture that was dependent on fishing.

The migrants also widely believe the United States owes them for their various illnesses because of the destruction to their homelands and the displacement and agony they have suffered.

While living with diabetes and high blood pressure, Manuel Sound takes about 11 pills daily and said he feels wary of death. If he missed any of his 3½-hour, thrice-weekly dialysis treatments, his health would be in danger.

"One day you miss, and the poison begins to circulate in your bloodstream. I could die if I'm not careful," said Sound, who has lived in Hawaii for seven years after migrating from Micronesia. "With these budget cuts, I really thought I was going to go."

The state of Hawaii sought to save $15 million by cutting health services to more than 7,000 migrants, who are treated as legal residents lacking citizenship. Their ambiguous status, as well as their cost to taxpayers, led to the state's proposed health reductions.

Both the Hawaii government and the migrants argue that the U.S. government should take responsibility for their health treatments.

But federal Medicaid funding to the migrant islanders was slashed when welfare reform passed in 1996, resulting in Hawaii picking up the tab. U.S. Rep. Neil Abercrombie, D-Hawaii, said he is trying to reinstate Medicaid benefits for compact migrants as part of the pending health care legislation.

"The United States cannot wash its hands clear of this responsibility because the islands will still have that nuclear testing effect for the next 2,000 years," said William Swain of the Marshallese community organization Pa Emman Kabjere, which means "don't let go of a good hand."

In Swain's family, 15 siblings on his father's side died from cancer, with the men suffering from thyroid cancer and the women from urine and breast cancer, he said. His 12-year-old niece has been diagnosed with thyroid cancer, and his older brother died from thyroid cancer two months ago.

While the government lacks data showing how quickly people are moving from these island nations, there were about 12,215 migrants of the Compact of Free Association states living in Hawaii in 2008, according to the U.S. Census Bureau.

Many of the migrants said it's racially discriminatory for the U.S. government to grant lifesaving health coverage to poor Americans while denying it to them.

"It's wrong for people to be so prejudiced," said Tita Raed of Micronesians United. "Most of the people in Hawaii moved here. This is not their native island, but they're upset when other people move here."