The medical effects of the Chernobyl disaster are many and far-reaching.
As with other problems highlighted elsewhere, they are two-fold. First, the radiation and secondly the poverty caused as a result of the radiation.
The specific isotopes released during the explosion have a propensity to the thyroid. This has resulted in over 90% of the adults in the southern regions of Belarus have thyroid abnormalities with a high proportion of cancers developing. However, since people in the villages may not have access to health care (due to distance needed to travel, no transport to get there, caring or work responsibilities), most of these cancers or abnormalities are not diagnosed. With the numbers of people needing treatment being so high, there are not enough funds available to treat all of them as they would be treated, for example, in the UK.
It is extremely unusual to see thyroid disorders, particularly thyroid cancers, in children. In southern Belarus, thyroid cancer is commonplace in children. As these cancers are not seen anywhere else in the world, there is no treatment. In fact, these problems are so common that they are even consider 'normal'.
Leukaemias are also very common, in adults but especially in children. One interesting aspect that I recently became aware of was the change in what is considered 'normal' values now. For any blood test (anywhere in the world), there are a range of values for which 95 % of the 'healthy' population will fall into. These limits are set by statistical analysis of the population being considered. In Belarus, these values have now been altered because so many of the population have readings that would be considered abnormal elsewhere. Basically, this means that if people from the area had their blood tested elsewhere, they would be diagnosed with leukaemia or one another of the 'lymphoproliferative' disorders (abnormal cell counts in the blood). However, because the population is so totally affected, these previously abnormal results are now considered 'normal' and so the people are not diagnosed as unwell or even terminally ill –although many of them actually are.
This is an attitude that I see a great deal of in Belarus. The people do not see themselves as victims or ill or under-privileged. In many ways, this way of coping with their problems gives them a drive and resilience that is certainly beneficial to them and enables them to carry on living.
Brain tumours are common with a high number of them causing hydrocephalus (a build up in the pressure of the fluid surrounding the brain). Without surgical treatment for this, the person will die. The operation is relatively simple. A stent is placed that will allow the fluid to drain freely but in a child, this has to be replaced as the child grows. With few resources, these operations are limited to people with little or no brain damage. Assessing this accurately in developing children is difficult especially since they have the potential to recover to a degree. We are funding one such operation for a little boy called Dima, so that he can have the chance to recover as much as possible and go on to lead a happy, comfortable life.
Tumours of the stomach and bowel are very common, both in adults and children. Bowel cancers are seen in adults in most areas of the world but are very rare in children. As adults and children are consuming radioactive food, the incidence of tumours induced is high. Again, these are not often diagnosed and rarely treated.
Breast, lung, kidney, bladder and gynaecological cancers are all common as well, in higher incidences and different forms to those found elsewhere. Other unusual problems are seen, such as a type of lung fibrosis, thought to be caused by the radioactive dust. This can affect children and is often fatal before the age of twenty.
Birth defects are plentiful and distressing to all involved. Babies with severe defects often die before birth but some survive. The defects can also affect the pregnant mother, causing a high level of problems, including a high mortality rate. A proportion the affected children die in soon after birth but some manage to survive longer. The birth of a severely deformed baby is distressing for the parents and family. Some feel that they are able to care for the child, although this obviously puts a huge strain on the family emotionally, limits their capacity to work and earn money and can have a detrimental effect on the other children in the family. Others cannot manage the task and so there are many disabled children's homes that take these children in. The care is basic at the best of times with staffing, finance and experience all being limited. We try to support these institutions where possible but it is often hard to know where to start.
With the limited supplies available to them, the local healthcare professionals work wonders. They are dealing with disorders not seen anywhere else in the world, for which there is no treatment and that they can do little to alleviate. However, they are dedicated and inspirational. I can offer my knowledge and experience but need to work with them to get the best care for the person in their own environment. I know that together we have helped many families and hope to support many more. I have certainly learnt a great deal from the children, families and professionals that I have had the opportunity to work with.