Chernobyl Liquidators' Health
as a Psycho-Social Trauma

5.5. Comparison of Chernobyl liquidators' case with other cases

5.5.1. Semipalatinsk area population

       The findings of this research about the dominating impact of the non-radiation and post-zone (“post-event”, more broadly) factors upon the health of the involved appears to be in a close agreement with recent data for the Semipalatinsk area inhabitants.
       The main conclusion of the Joint UN Assessment and Programming Mission for the former Semipalatinsk Nuclear Test Site (Cherp 1998) is that the situation in the Semipalatinsk area does not constitute an environmental problem and cannot be resolved by a clean-up and medical measures. This complex phenomenon is called “a “creeping” problem”, a “slow-onset disaster”, and suggests that successful and sustainable recovery should be based upon flexible, locally appropriate, participatory interventions, and a long-term programme of capacity-building.
       Semipalatinsk is a name of the town in Kazakhstan that gave its name to a former Soviet nuclear testing site. The 120 atmospheric and 350 underground nuclear explosions at the site in 1949—1989 have had a major immediate impact upon the health of the population of the adjacent area (denoted here as “the Semipalatinsk area”), and observable long-lasting consequences. About 1.6 million people fall under the definition of the “victims of nuclear tests”, according to Kazakhstan Law of 1992.
       The Semipalatinsk area population still demonstrates poor (as compared to the average) indices of general and mental health. In particular, it is notorious for its high suicide rate. For the last 20 years, the country's average suicide rate is equal to 20,5 cases per 100,000 of population per annum. However, within the 60-km zone around the site the suicide rate is equal to 87.7 — more than 4 times (!) higher than the average. For residents of the area located at 60 to 120 km distance from the site, the index is equal to 29.1, for those living further than 120 km — 17.3 (i.e., below the average). The suicide rate at the Semipalatinsk area clearly correlates with the distance from the site (Alimkhanov 1995).
       What factors are responsible for this phenomenon? Most obvious explanation seems to be its attribution to the radioactive contamination as an apparently major ecological problem of the area. However, the report (Cherp 1998) states only a rather small group of those presently occupied in agriculture at (or next to) the site are likely to be under the risk of significant exposure to radiation. This opinion corresponds to the conclusions of IAEA assessment of 1993—1994 (that current risk from the radiation does not justify any interventions), and the WHO Expert Meeting in Rome in 1997 (which confirmed the IAEA assessment's conclusion, and further stated that radiation-induced mortality and morbidity in the area are likely to be insignificant as compared to that induced by non-radiation factors). The levels of contamination are incomparably lower than those in Belarus', except for a very limited area (about one square kilometre) at the ground Zero. Here a melted ex-soil has gamma-radiation levels of about 10 mR/h, but this area can be easily isolated from intrusion and rendered harmless for the area's population (Cherp, pers. comm.).
       Cherp suggests as one of the most probable reasons of the bad mental health in general, and the high suicide rate in particular, an expectation of negative health consequences both by the affected population and the insiders. He illustrates this statement with one eloquent example: “Imagine that a young guy dates a girl. And everything goes smoothly to the wedding — until she learns that a candidate for being a father of her kids is from the Semipalatinsk area. And rejects him. And if this happens to him once, twice..?” — This example is only one (though, may be, the most eloquent) of many real-life situations the inhabitants of Semilatinsk area encounter.
       The report considers psycho-social impacts of the Semipalatinsk nuclear tests upon the local inhabitants profound. Most of the population feel victimised, powerless, and cheated; it impedes people from active solution of their health, ecological and economic problems. The impacts also affect outsiders, repelling them from the area.
       The expert denotes a definite pride of the local population for “living in the Semipalatinsk”, the world-known dangerous place, the attitude actually leading to “no investment, no tourists” situation at the site, and aggravating the existing economical (and ecological: desertification because of overgrazing) situation. These latter problems of the affected area seem to be rather important, for, according to Cherp, they constitute a characteristic triangle, resulting in the poor health of the population:

        Ecological problems
Social problems              Poverty

       In the light of this fact, UNICEF up-to-date approach to the mitigation of community health problems, namely — demedicalization of health mitigation measures (Cherp, pers. comm.) — seems to be of extreme relevance — both for the Semipalatinsk and for the Chernobyl cases. The strategy considers it more efficient (in terms of overall impact upon the population) to spend limited budgets of the mitigation programs by investing them into life-style oriented goals (e.g., better water, clean food, better quality of housing, education) than in direct medical measures. The report (Cherp 1998) outlines UNICEF strategy for Semipalatinsk case in more detail, the description definitely useful for mitigation of the Chernobyl consequences.

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Design by: M.Opalev
Studio ARWIS  Kharkov, 2001