Belarus: A word I had associated with Chernobyl, with statistics on thyroid cancer and leukemia--a word that, for me, symbolized the insanity of nuclear energy. I had wanted to know more about it for quite some time, to form my own impressions of that country, of its people and their problems. In September, I finally had the opportunity to go there for six weeks and experience life in Gomel, in the south east of the republic. I wanted to experience it for myself, and find out what Chernobyl really means to people there. 

The thyroid centre in Oblast, Gomel

While I was doing my clinical training at the thyroid center in Gomel and, at the same time, collecting data on patients at the computer, I became familiar with the effects of the disaster. The thyroid center is the main establishment providing outpatient care for all patients of Oblast, Gomel (which covers an area a little larger than Holland). As papillary thyroid carcinomas grow very aggressively in this region and metastasize at a very early stage, early diagnosis is very important for the patients. 

Diagnosis is performed in a laboratory with modern equipment for hormone analyses, by doctors who are highly trained specialists in making diagnoses and giving therapy for diseases of the thyroid. Every day, long queues of patients form in front of the examination rooms. Their number grows every year, according to Galina Alexandrovna, endrocrinologist and my 'teacher' during my clinical training. During the time I was there, she patiently showed and explained to me all of the steps in making a diagnosis. Diagnosis starts by palpating the thyroid gland, followed by laboratory parameters, sonography and fine needle puncture of suspicious nodules. If all of the results indicate a carcinoma, the patients are transferred to the State Polyclinic for Oncology in Minsk for an operation. After the operation, the pathologist then gives a definitive histological diagnosis on whether the patient has cancer, and of any differentiation identified. The patient then undergoes post-care treatment for the tumor in Gomel. The patients need large doses of thyroxin, both as a substitute and to keep the TSH as low as possible, as it has been identified as the most powerful growth stimulator for the thyroid gland and thus for any recurrence of a tumor.

The prohibited zone is absolutely silent

On one of my last weekends, I paid a visit to members of staff at the Otto Hug Radiation Institute and to a camera team of the Bayerischer Rundfunk broadcasting station in Narovlja on the Ukrainian border. Narovlja was once a town with 12,000 inhabitants. It now has 6,000. Narovlja is situated on the edge of the 30-kilometre prohibited zone around the 'monster,' as the reactor is often referred to here. No life will be possible in the area for many decades to come. 

In the poorly equipped hospital in Norovlja, the district capital, we met three small girls by chance: Nastja, Christina and Anna. Three five-year-old girls: pale and exhausted. Their radiation exposure levels are to be determined in a measuring station especially established for this purpose. We watch... Nastja has twice the threshold value. The nurses tell us that she has probably eaten mushrooms in the forest. People living out in the country get most of their food from the forest or from their own gardens. As it doesn't cost them anything, it is an obvious and almost essential alternative given the daily increases in the prices of basic foodstuffs. 

"Why don't the people leave the area?" I ask Christine Frentzel, board member of OHSI-MHM, who has become an expert from her many stays here over the past few years. "Where are they supposed to go? Their roots are here. They don't have any money to go anywhere else and make a new start. And they will be treated like lepers if they go anywhere else, because they come from the area around Chernobyl. Many of those who have already been evacuated have returned, because they have not been able to settle down anywhere else." I can't get Nastja off my mind. What will happen to her? Will she ever reach adulthood and be able to have children? What effect will this have on her children? 

Nobody has any answers to these questions. But they will come quietly and insidiously, and in a few years time, we shall all see what these technological wonders, built by human beings, are capable of. 

These impressions will burn themselves into my mind. I think of the western European states: our nuclear power stations are located in densely populated urban conurbations. Where are the inhabitants of Würzberg and Schweinfurt supposed to go if Grafenrheinfeld explodes, or those of Mainz, Frankfurt, Wiesbaden, Heidelberg, Mannheim and Speyer, if there is an MCA in Biblis?

The future in the district of Gomel

Nobody can estimate what the future will bring for people in the country during the next few years. There are no precedents, and thyroid cancer, the first belated effect of radiation, has grown faster and more aggressively than experts, who drew comparisons with Hiroshima, had expected. Furthermore, diseases of the immune system also play a critical role, especially among children; they are probably triggered by deposits of strontium in the bones. Other malignant diseases are also on the increase: leukemia, breast cancer and tumors of the gastro-intestinal tract. There is a growing incidence of diabetes mellitus type I among children. According to the Minister for Emergency Situations, Mr. Ivan A. Kenik: "Chernobyl forces not only us, but the entire world, to take a new look at ourselves, at what is happening on our planet at the moment. Conclusions and the bitter lessons of the Chernobyl catastrophe are just as valuable to the entire human race as help is vital to White Russia, in order to secure a healthy future for the present and future generations." 

For many generations to come, Chernobyl will be a grim reminder that a form of technology that is capable of extinguishing so much human life quietly and slowly when humans make mistakes ought not to be allowed, no matter how sophisticated that technology may be.

My clinical training and the time I spent with the people in Belarus showed me, above all else, that the country will be dependent on medical aid for years to come: that these people - and especially the children - are the victims of a highly dangerous form of technology, and that they deserve support in their country, for they are having to pay for the fact that nuclear energy is still an acknowledged form of energy production throughout the world. And my stay there also showed me that we, as medical students and doctors, have a duty to tell the truth to the people here, and not to allow politicians, scientists and industry to pull the wool over people's eyes about the safety, and "clean energy", of nuclear power stations. 

We must learn about the consequences of Chernobyl, which are still being played down, and even denied, by countless scientists. We must make sure that we finally stop using this technology before we witness yet another example of its effects in Western Europe. Anyone who has seen Chernobyl and its terrible effect on the people in Belarus with their own eyes, anyone who has shared their fears with them for a few weeks, can no longer sit back and do nothing all the while these time-bombs are ticking away somewhere on our planet.