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