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Chernobyl’s legacy


By John Sparrow

Chernobyl is an accident that is still happening. Ten years after the nuclear disaster, a cloud of fear hangs over the fallout region. Children can die of cancer for want of early diagnosis, chronic stress is endemic and health care is in crisis.

“Ten-year-old Nina Pyshnyak was as playful as ever. As she waited for a Red Cross medical check-up in the north-western Ukrainian village of Staroye Selo, she laughed and jostled her classmates.

A few hours later her worried mother, Galina, was coming to terms with the news that Nina was a child of Chernobyl. An ultra-sound scan had found a nodule on her thyroid gland. It had come as a shock. Nina had not felt unwell. Other than the occasional cold, she complained of nothing, and this was the first medical check-up she had ever had. Galina would now wait for the results of further tests. What she feared was thyroid cancer: it had already claimed children’s lives in the district and Galina prayed that the mobile laboratory of the Ukrainian Red Cross which had come to Staroye Selo had caught Nina’s condition in time.

Time is of the essence in the fallout zone of Chernobyl. Thyroid cancer is curable but the goitres, cysts, thyroiditis and other conditions which can lead to it are only treatable if intervention is timely. Unfortunately, a decade after the disaster, as the world continues to dither and debate its consequences, children can die because they have not had the benefit of an early diagnosis.

 
 

Lurking killer

Much is unclear about the effect of Chernobyl on the health of the surrounding population in Ukraine itself, and in neighbouring Belarus and the Russian Federation. Some aspects have been exaggerated and sen-sationalised. Others have been tragically underestimated. Most experts agree, however, that a sharp increase in thyroid cancer — particularly among children — is directly related to the nuclear accident. Figures revealed at a World Health Organization (WHO) conference last November showed that the incidence had increased 100 times over pre-1986 levels, and radioactive iodine released into the atmosphere is considered to be the main culprit.

In poor rural corners like Staroye Selo, parents live in fear for their children, the more so since thorough medical check-ups and reliable information have been wanting. When a hard-pressed Ukrainian Red Cross mobile diagnostic unit made it to the village in February, it was the community’s first opportunity for mass medical screenings since the disaster. As it happened, Nina wasn’t the only child with a problem. In three days, among 300 village children, seven of them had thyroid problems.

On a fact-finding tour of the region, Professor Pierre Pellerin, a French consultant to the Federation and a leading authority on Chernobyl, and Dr Jean-Pierre Revel, the Federation’s Relief Health Advisor, shared the villagers’ concern. “This country is so enormous and communities are so dispersed, and the resources of the Ministry of Health are diminishing in a time of economic crisis,” Revel says. “There are holes in the health-care net through which many communities are falling, communities which have been screened by no one. That’s of concern to us, for ten years after the accident everyone should have been seen at least once.”

Pellerin, a world-renowned expert on radiation, has called for fast action. “We must detect as many of these thyroid problems as we can,” he said, “and where cancer is discovered it must be treated as quickly as possible if we are to save the lives of these children. Thyroid cancer is not a difficult one. If you detect it early and treat it, you have a 95 per cent chance of success. The enemy is time. If you detect it too late, a child can die. The fault lies with the medical response. We cannot accept such a situation.”

A dismal picture

Thyroid disease isn’t all that ails children in the 10,000 square kilometres of fallout zone that surrounds Chernobyl. As a mobile team from the Ukrainian Red Cross screened the villagers of Staroye Selo, an appalling picture of general child health emerged.

Red Cross therapeutist Dr Svetlana Volyanuk reported that only a quarter of the village children were free of sickness. Blood disorder and liver problems topped the list. “One child was so anaemic,” the doctor says, “you’d have thought our equipment was analysing water.”

It isn’t, Federation consultants emphasize, all due to Chernobyl. The break-up of the Soviet Union brought social and economic decline. Standards of living — and nutrition — have tumbled, health services have broken down, or been restricted for financial reasons. Doctors are deserting rural areas. A Canadian Red Cross survey in mid-1995 concluded that inadequate funds threatened the entire Ukrainian health-care system. Pregnant women and new-born and hospitalized children are among those most at risk.

A litany of rising disease is evident in children. In Belarus, disorders of the nervous system increased 43 per cent between 1990 and 1994, and blood circulation illnesses by the same margin. Disorders of the bone, muscle and connective tissue system were up 62 per cent.

At the time the mobile laboratory was in Staroye Selo, another Red Cross team was screening a school in the southeastern Belarusian town of Gomel. While ten cases of thyroid disease were found among 1,000 pupils, 40 cases of blood disorder had to be referred to a local hospital. A Red Cross doctor was unequivocal. Show her a healthy child, she said,and she would show you a thousand sick ones.

The school’s vice principal saw more than the spectre of Chernobyl. “So many children are sick and weak, sleepy during lessons,” she said. “It’s hard for them to sit and concentrate for 45 minutes. The tough economic situation is certainly having an impact on them and we are greatly concerned about nutrition.”

The free school meal each child receives has assumed a new significance. “It isn’t always of the quality I would wish for,” the vice principal says, “but parents from the countryside have told me that all they can afford to feed the children now is what they formerly fed to the animals.”

Frontier spirit

The Red Cross units — or mobile diagnostic laboratories (MDLs) — belong to the Chernobyl Humanitarian Assistance and Rehabilitation Programme. It was launched by the Federation in 1990 to ease the plight of high-risk groups among the four million people inhabiting the 10,000 square kilometres of Ukraine, Belarus and Russia contaminated by the Chernobyl accident. Two more MDLs are operated by the Belarusian Red Cross, and two by the Russian Red Cross.

Ben Hofman, the Federation’s regional head, speaks of a frontier operation. “We are going to those areas where no one else goes, remote towns and villages where often there is no medical service at all, and the population has no access to the nearest regional health centres. It is astonishing but we are confronted every day with people who have not been screened before.”

So far, the Chernobyl Programme has screened 200,000 people, and 60,000 more are added each year. It isn’t just a question of finding disease and dealing with it. Hofman points out that the MDLs also provide psycho-social support to the population.

“There are,” he says, “a lot of frightened people out there. Fear produces stress and psychological problems. So we inform people of our findings on the spot. We reassure them. We check their homes for contamination, if necessary, as well as the soil, the air and the food they grow in their gardens. By the time we leave a community, it knows where it stands and has been advised on the safest ways to go on living there.”

 

Chernobyl Ten Years After

To mark the 10th anniversary of the Chernobyl events, the Federation and the International Red Cross and Red Crescent Museum organized a temporary exhibition depicting the human and environmental consequences of the world’s worst nuclear disaster, still so evident a decade after it occurred. Between 4 April and 9 May the Geneva-based museum displayed a series of black and white photos that depict the reality of Chernobyl today and the action taken by the Federation in cooperation with the National Societies of the region to assist the victims.

“The exhibition serves as a useful reminder that disasters of this magnitude do not go away overnight,” says Marie-Jeanne Macheret who organised the exhibition. “People are suffering the health and psychological effects to this day and many who lived in the vicinity of the reactor have not been able to return to their homes.”

 

Downward spiral

The distress and disruption Chernobyl has wrought is immense. As many as 400,000 people have been obliged to leave their homes and are unlikely to return to them in the near future. Many were peasants whose lives were the land and who now suffer wretchedly in unhealthy urban conditions. Tens of thousands more live in communities that the authorities would evacuate if they had the means to do so. Stress and fear are common phenomena and, many now believe, their consequences have been grossly underestimated.

Economic ills and poverty compound the problem. Inflation reached 281 per cent in Ukraine last year, and gross national product fell 12.7 per cent. Some researchers say psychological and social problems are contributing to an immense increase in disease among Chernobyl victims which cannot be related biologically to radiation. Some now suggest, indeed, that psycho-social suffering could be an even greater problem than cancer or chromosome damage. Chronic stress disorders could be affecting as many as three million people.

Leaving the frightened inhabitants of Staroye Selo, Dr Jean-Pierre Revel remarked that the Federation’s most serious concern is for the early diagnosis of thyroid cancer among children. “But,” he adds, “more has to be done to alleviate the psycho-social suffering through a programme of information and education. If we can do that, the rehabilitation of these areas can really begin. People have to go on living.”

Nina Pyshnyak’s mother would second that.

John Sparrow
John Sparrow is a freelance journalist who has worked for both the Federation and the ICRC.



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