Atomic Islands: Health Disparities In the Shadow of the Manhattan Project

I used to live on an island called Tinian, and I had atomic bombs behind my childhood home. Not the literal bombs, of course, but life-sized replicas of the Earth-shattering fission bombs “Little Boy” and “Fat Man” whose fundamental designs came to be in our very own Lawrence Berkeley National Laboratory. These were the ones that were dropped on Hiroshima and Nagasaki in August 1945, effectively ending World War II and permanently shifting the global political landscape. The bombs I saw didn’t seem so impressive. The replicas stood alone in a crumbling concrete lot behind Tinian’s one luxury hotel, their blue and yellow paint stripped by the elements. There was no signage explaining what they were, but everyone knew. World War II had left its marks on the island. Beyond the tourists’ old bunkers and tanks was a local health crisis. In the shadow of the Manhattan Project, the island was slowly battling cancer and disease.

Tinian is one of the three main inhabited islands of the Commonwealth of the Northern Mariana Islands (CNMI). These islands were a critical location during WWII due to their proximity to Japan, making them an optimal attack position. Following the Battle of Saipan that wrested control of the Marianas away from Japan, the United States built what was, at the time, the largest air base in the world on the little island of Tinian. The physicist Philip Morrison, who had studied at UC Berkeley under J. Robert Oppenheimer,  travelled to Tinian to assist the assembly of Fat Man. Witnessing the scale of construction there, he said: “ Tinian is a miracle. Here, 6,000 miles from San Francisco, the United States armed forces have built the largest airport in the world. A great coral ridge was half-leveled to fill a rough plain, and to build six runways, each an excellent 10-lane highway, each almost two miles long. Beside these runways stood in long rows the great silvery airplanes. They were not by the dozen, but by the hundred. From the air this island, smaller than Manhattan, looked like a giant aircraft carrier, its deck loaded with bomber.”

It was from Tinian and its giant airfield that the atomic bombs were launched. The miraculously large airfield that was a short drive from my home hardly remained. Most buildings were abandoned, crumbling and graffitied. The pavement slowly made way for the rainforest encroaching. Only the atomic bomb loading pit was carefully preserved. Easels that propped up photos of the bombs sat in a boxy cement cavity, shielded from the elements by a glass roof.

I used to think it was cool that I got to live in such a historic place, like I rested on a hinge of the world. At the same time, I held some aching suspicions about the nature of my home, its urban abandonment, and the health problems that plagued my community. The CNMI deals with a health crisis; circulatory diseases and cancer that make up a little over half (33% and 18%, respectively) of deaths on the islands. These issues may seem reminiscent of many countries in the Global North. For the US-Affiliated Pacific Islands (USAPI), these issues come with the association of WWII and post-war era nuclear testing. 

To explain what this means, we need to briefly touch upon the history of the USAPI. The CNMI is one of six island-based jurisdictions classified as USAPI—the others being American Samoa, Guam, the Federated States of Micronesia (FSM, inclusive of the four states of Chuuk, Kosrae, Pohnpei, and Yap), the Republic of the Marshall Islands (RMI), and the Republic of Belau (Palau). These islands (excluding American Samoa) were previously occupied by Japan and were put under U.S. control following World War II. All six of the USAPI are outposts for the US military, fulfilling a variety of roles, once including nuclear weapons testing. Most notable of these nuclear weapons tests were the ones conducted in the Marshall Islands. 

Post war, the power of the atomic bombs spurred the US government to double down on the Manhattan Project and pursue atomic weapons research further, branching out from fission to hydrogen and thermonuclear bombs, and testing these bombs in their newly acquired territory, the Marshall Islands. The Marshall Islands were deemed a suitable location for testing due to their remote location, relative proximity to the US’s other Pacific military bases, and their sparse population. In February 1946, the 167 residents of Bikini Atoll were asked to temporarily relocate to the Rongerik Atoll by the military governor for “the good of mankind and to end all world wars." In the twelve years from 1946 and 1958, the United States had carried out 67 nuclear tests in these islands, 23 of which were at Bikini Atoll and 44 near Enewetak Atoll. The impacts of these tests, however, were widespread.

Most notable among these is the Castle Bravo test. Conducted in the Bikini Atoll in 1954, Bravo was the first ever test of a deliverable hydrogen bomb as well as the largest nuclear detonation ever conducted by the US. The bomb was over 1,000 times more powerful than “Little Boy”, the atomic bomb that was dropped on Hiroshima in WWII. The test was more powerful than scientists had anticipated, and wind and tide patterns contributed to the spread of nuclear fallout and debris. The Marshallese were not warned of the environmental consequences of Bravo and the potential dangerous health risks posed by the radioactive ash debris that fell from the air. A 1997 summary of the impacts of Bravo on the health of the Marshallese, identified long-term effects were an excess development of leukemia and thyroid cancer. Proximity to the test site was also correlated with extreme birth defects, an issue still plaguing the Marshall Islands today. A 2016 study by Columbia has noted that radiation levels in certain areas of the Marshall islands are almost double what is deemed fit for habitation.

Concerns regarding the health impacts of the tests aren’t limited to the Marshall Islands either. Considering weather conditions at the time of the Bravo test, parts of Micronesia west of the Marshall Islands —now the FSM, Guam, and the CNMI—likely sustained considerable fallout. Cancer is one of the top three causes of death in every USAPI region. Additionally, informant reports strongly suggest that cancer mortality is underreported due to limited access to healthcare in the islands. 

It is in this context of thermonuclear testing in the USAPI that islanders are hyper aware of cancer as a community epidemic. Nuclear radiation, however, is not the only cause of the islands’ soaring cancer rates. Cancer has also been attributed to the prevalence of tobacco smoking on the island. Tobacco was first introduced to the islands by US soldiers during World War II. Up until 1997, US tobacco companies were not subject to the same display regulations and warning label mandates in the USAPI as they were in the mainland. This led to aggressive marketing campaigns by these companies towards islander youth that would not have been allowed in the States.

In many islands, the leading cause of death is not cancer, but circulatory diseases—high blood pressure, heart attacks, heart failure, and the like. These are associated with high rates of obesity and diabetes that stem from poor diets and sedentary lifestyles on the island. Attributing the epidemic to diet and lifestyle, however, is not meant to imply that the epidemic is a matter of personal choice for USAPI residents. For many of these islands, the role of wartime battlefield and US colonialism has overhauled local communities and destroyed traditional methods of food gathering and production. Islands would come to depend on imported rice and low-nutrition processed foods for the bulk of their diet. (Spam, anyone?) Food, tobacco, and alcohol are products marketed by multinational corporations that target the Pacific Islands as  a dependent source of income, at the cost of the people’s health. Similar to the rural mainland US, auto-oriented planning can also be attributed to the lack of opportunities for physical exercise that contributes to the obesity epidemic. Low-density, sprawling development patterns and car dependent infrastructure necessitates that residents travel relatively distances using cars in their day-to-day life. These issues are also exacerbated by the limitations of healthcare infrastructure in these islands. Complex cases like cancer may often mean referrals for off-island care. 

What’s happening in the USAPI is known as a health disparity. A 2004 report stated that nearly all health indicators for Pacific Islanders living in the USAPI are worse than those in the United States. This is an issue that goes beyond the stereotypes of laziness or incompetence that may be associated with areas dealing with health disparities, Pacific Islands especially. Far from it, the root of the health disparity in the Pacific cannot be understood from the ground level. To understand is to unravel a complex web of international history, war, colonialism, and integration into the globalized, cosmopolitan economy.