Chernobyl Liquidators' Health
as a Psycho-Social Trauma

5.1. Highly stressful psycho-social situation in the post-USSR countries

       The impact of general economic, social and psychological situation in the post-USSR countries and societies “in transition” often seems to be under-estimated even by those who do understand its importance. I want to emphasise that highly stressful conditions of the post-USSR societies should have more grave impact upon the liquidators as compared to those non-affected: the liquidators have definitely exhausted part of their systems' and psyche's adaptive abilities to cope with the stresses in the Chernobyl zone and with the post-zone stresses, associated with this experience.
       To support the idea about the extreme importance of the present psycho-social situation in the post-Soviet countries, I will refer to several different sources:
       1) the data of psychological study of a Chernobyl-intact sample,
       2) my personal experience,
       3) the research of post-zone life and problems of the Chernobyl liquidators (Mozgovaya 1997), and
       4) conclusions of studies of the possible reasons of the health state of the Chernobyl-affected groups (including the liquidators).

       1. The psychological tests of a Chernobyl-intact sample, consisting of male students of graduation year of study at a respectable technical university, have shown in the objects:
— lack of adaptation reserves (signs of expressed lack of adaptability),
— failures of braking systems: a control of the systems is insufficient and not effective for adaptation (overstrain of protective mechanisms),
— seeing no hope for the future;
— and, as a result of all this — elevated level of aggressiveness.
       “The life is such that even young healthy guys cannot fit to it”, commented the researcher, who conducted the tests.

       2. My personal experience: During several periods of my post-Chernobyl-zone life, there were periods, when, in order to make a living, I had to run a small business in addition to my professional activities as a scientist. It involved such intensity of work and such an excruciating psychological pressure, which I could compare only with my Chernobyl experience. It was not surprising when eventually I found myself in a psycho-physical state that reminded me the one I had had in the end of my Chernobyl service term. With only one difference (besides the one in the levels of radiation) — unlike the Chernobyl zone, the environment was not a local and “unusual” one, it was a normal life of “the country in transition”, the one impossible to escape from. At least twice the psychic and physical exhaustion resulted in continuous health disorders with features reminding some of those I had had in the end of my service in the Chernobyl zone and in the first period after returning from the zone.

       3. The results of the study of post-zone life and problems of the Chernobyl liquidators who were not professional rescue workers (Mozgovaya 1997) essentially expands the testimony above. The study is based upon surveys by the Institute of Sociology of Russian Academy of Sciences that have been conducted since 1989, and, in particular, upon 2 surveys of 1993 and 1996. The sample in both surveys in question consisted of 200 same liquidators — residents of Moscow and Moscow region and of the town of Vladimir and Vladimir region. The concept of life quality, claimed to be the most suitable for the task of social protection and recovery of the liquidators, was employed in the study. The notion of life quality includes both indicators of everyday objective situation of the group, and their perceptions, expectations etc. In particular, the paper does confirm that in addition to psychological problems the liquidators suffer specific social problems as a result of their participation in the Chernobyl mitigation.
       The methodological framework of the study treats social recovery of the liquidators as a long-term process of their re-adaptation to their original social environment, in the situation when both the liquidator and the environment may have changed significantly. It defines at least 2 actors of the process — the liquidator and the society, this latter being represented by its civil institutions, attitudes, legislation.
       According to the study, the overall situation in the country has become an important factor defining the respondents' perceptions, plans and life concepts. In 1993 main values were health, family and material welfare, in 1996 — family, health and “normal situation in the country”.
       As for the professional sphere, about 25% of the respondents were unemployed. The number of the liquidators, who worked at the same place as before the Disaster, decreased two-fold. I consider very prominent the fact that while in 1993 the main reason for the change of the work place was aggravation of the health, in 1996 it was absence of salary and the closure of the enterprise. Thus, the main reason of unemployment has shifted from medical to economico-social one
       In terms of budget: in 1996, 61% (almost 2/3!) of the respondents lived below the level of poverty (!!), 78% — below average level.
       Comparative analysis of family indicators revealed the tendency of decrease in the degree of satisfaction with family relations. The number of divorces increased. “The absence of social programs for psychological therapy makes the family … the first and direct point for psychological and social anger accumulation”.
       Medical treatment: the number of those, who believe they need permanent medical care, increased. It is reflected in the process of receiving an official acknowledgement of invalidity. In 1996 the correlation between the self-estimation of health and doses of irradiation received (most probably, I think, (1) “official doses” and (2) known to the liquidator) became statistically significant.
       The findings related to social security revealed that the liquidators felt most unsafe with regard to the following issues:
— guarantees of security of life and property in the situation of crime rate raise;
— guarantees of protection of life and health in the situation of deterioration of government control;
— employment;
— medical service;
— social stability.
       The degree of trust in the authorities, closest to the respondents — municipal and regional — decreased considerably. Reliance upon one's own effort increased significantly.
       With regard to the attitudes and concerns about Chernobyl, it should be remarked that the interest to the information about radioactivity and its effects, about the Chernobyl Disaster and its consequences as well as fear of radiation — decreased.
       Mozgovaya (1997) concludes that the liquidators problems are:
— a direct result of work under stressful circumstances,
— an indirect result of inadequate work of social institutions, and
— (interesting!) a consequence of flaws of the very concept of social protection and support in Russia, based upon material compensations and privileges (I will deal with this important issue later).
       However, as the researcher remarks, “even this limited concept” of welfare for Chernobyl liquidators encounters many problems in its implementation because of the inadequacy of the social welfare system to the present social situation. She emphasises that the shortage of the state budget and necessity to rank priorities (i.e., interests of different groups of population) turns the issue of the social welfare into a political one.
       4. The importance of the post-Chernobyl, present situation in the country upon of the health of the Chernobyl-affected populations, including the liquidators, has been especially emphasised by:
       a. Nyagu and Loganovsky (1997), who speculate that the tendencies observed in the populations in question reflect pre-accident spread of the health adversities which “redoubled in the last years”. They state that, in condition of severe economic crisis, the basic health adversities of the survivors can lead to unexpectedly negative consequences both for stochastic and non-stochastic effects of the Chernobyl accident.
       b. Barjahtar et al. (1998), who state that it is impossible to extract the Chernobyl contribution from the general aggravation of the people's health caused by a complex of reasons connected with the crisis of the country's economy, and emphasise that the health of a nation is 80—85%-defined by the state of the country's economy.
       At least 3 important conclusions can be made based on the information presented in this subchapter:
       1. The circumstances of the present, post-zone life of the liquidators, as citizens of the post-USSR “countries in transition”, constitutes a highly sttessful (distressful, in terms of Selye), extreme (though, unfortunately, usual and common) environment.
       2. Hence, the expected impact of this post-zone environment upon their health can be predicted by the same frameworks I used for interpretation of the effects of the “in-zone” period of their life.
       3. The economic, social and psychological circumstances of the countries in transition actually constitute both a separate harmful factor and an exhausting, stressful background modifying both (1) the action of the other post-zone harmful factors affecting the liquidators (which can further aggravate their impact), and (2) the mitigation measures (which may lead to distortion or even reversion of their expected effect).

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Studio ARWIS  Kharkov, 2001