Medical textbooks say: timely medical assistance is a fundamental requirement during liquidation of the consequences of a radiation accident. To do this, it’s necessary to quickly rebuild the existing health care system. Moreover, it’s vital to strengthen this with rapid response forces and provide medical support.
Physicians, as well as ordinary citizens, just didn’t have enough information about the liquidation of the consequences of the Chernobyl accident. They needed an assessment of the radiation situation to prepare medical and sanitary measures related to the evacuation of the population. There was a need to determine some areas of resettlement of the evacuated population and the degree of harm caused to their health by radiation. They wanted to know an assess the forecast of radioactive exposure.
Retrospective studies of the Chernobyl accident showed that doctors had to deal with radiation without any idea about it. Medical institutions didn’t receive any official information on the above indicators. The information did not appear a day after the radiation accident. Not in two days, not in a week. So, this concerned both the Ministry of Health of Ukraine and the Ministry of Health of Belarus.
State and party bodies, both union and republican, were silent about the nature of the disaster at the ChNPP. The specially created government commission of the USSR held some information. But even it was hidden from the doctors. As a result, the population, doctors and authorities didn’t know what happened at the ChNPP and the scale of the accident.
The notification about the radiation accident had to spread automatically. This was provided for by the rules of anti-radiation protection. However, there was no automatism in real life. At night, at the time of the accident, people were asleep. Citizens, suspecting nothing, went to work in the morning. Their children went to school or kindergarten.
Only a day and a half later, on April 27, the residents of Pripyat left. Rural population from the nearest farms and villages left 10 days after the accident. The evacuation, which should’ve been carried out within the first few hours after the accident, dragged on for almost two weeks.
Deadly radiation: time was lost
The Republican Commission on Elimination of the Consequences of the Accident, created only after the May Day demonstration, remained silent until May 7. As a result, the population was notified only on the 9-th day after the accident. The Minister of Health of the Ukrainian SSR A.E.Romanenko did it. However, information about the radiation situation and proposals for urgent notification of the population came to the government in a timely manner. But radiation didn’t stand aside in standby mode. Therefore, having got out of the reactor, it instantly spread in search of the first victims. We lost the time to take preventive measures to mitigate human exposure to radiation.
The Ministry of Health of the Byelorussian SSR received the first information about a radiation catastrophe only on April 28, 1986. Moreover, it took place after the Ministry of Health of the Ukrainian SSR delved into the details of what happened at the ChNPP. Having previously understood the situation, it demanded some information about the protection measures taken in Belarus from the Ministry of Health of the BSSR. The release of radioactive products from the emergency unit continued for a long time. Consequently, the radiation situation got a fragmented nature. Extensive areas, not only adjacent to the accident site, got radiation of varying degrees of risk. Radiation occupied territories, distant from the epicenter of the accident for hundreds and thousands of kilometers.
As a result, millions of people around the world took part in the emergency. In world practice, no one has solved such large-scale tasks for the radiation protection of a huge number of the population. This affected the timeliness of medical preventive measures and, above all, the timeliness of emergency preventive measures.
There was a lack of data on radiation doses for the personnel, participants in the liquidation of the accident and the population. External radiation monitoring devices stopped working on the territory of the Chernobyl NPP. The available individual dosimeters hadn’t an appropriate design for large doses of radiation. So, they simply went off scale.
For the population, neither individual nor group dosimetric control was even provided for in the norm. Privately, the population didn’t have dosimetric control devices. There was a huge shortage of automated radiation monitoring systems in the affected areas.
Personnel and radiation and technological shortage
Initially, there was no equipment for gamma-ray imaging from an airplane at the civil defense headquarters or at the hydrometeorology department. In addition, not only modern, but even outdated dosimeters weren’t found suitable for organizing group dosimetry. Wartime dosimeter kits proved unsuitable for this situation. Departmental enterprises didn’t have devices for technological and radiation monitoring in the processing of food and its raw materials.
The shortage of trained personnel such as dosimetrists, radiometrists, chemists specializing in radiation, had a negative impact on the situation. The lack of coordinated actions was especially evident in the implementation of radiometric control of food, water and environmental objects.
A paradoxical situation has developed. There were plenty of structures responsible for the production, processing, storage, transportation, sale of food products and water supply. However, their provision with equipment and trained personnel was critically low. That’s why, initially, the health authorities had to take control of the situation.
There was inconsistency on other issues. For example, the Radiation Safety Standards were ignored in some civil defense headquarters. Moreover, wartime standards guided assessing the radioactive contamination of people, vehicles, etc. And they are two levels higher on average. Therefore, dosimetric stations dissolved in a number of places. As a result, radioactive contamination got into cities and towns by transport. Decision-making on the decontamination of vehicles took place too late. This happened due to uncoordinated actions of business leaders and existing departmental barriers.
Of course, there was an attempt to unite efforts and streamline the monitoring of radioactive contamination and exposure of people. The Ministry of Health of the Ukrainian SSR dealt with it first. Ironically, the Ministry of Health of the republic wasn’t even informed about the evacuation of Pripyat and the Ukrainian villages of the 10-km zone. Meanwhile, the health authorities, including mass medical events, also performed duties not inherent to them. For example, providing the population with an exchange fund of clothes.
There weren’t enough radiation medicine specialists in the country. But the branch of radiology has been studied better than any other. Most physicians didn’t realize the problems of radiation medicine, without taking into account the primitive training in civil defense systems. The personnel and material base of the radiation safety service, created in the 60s, gradually fell into decay.
Problems have to be solved in a “fire” manner
The world experience in eliminating major radiation accidents hasn’t become the property of either science or public. Therefore, no one, including healthcare, was really prepared for a radiation accident in Chernobyl. Most medical workers and scientists knew nothing about radiation. In addition, there were ugly notions, overly exaggerated by journalism in the context of emotional anti-nuclear propaganda.
An accident of this scale hadn’t happen in the USSR. It couldn’t occur in a socialist society. Therefore, all medical measures automatically fell on the shoulders of the NPP medical unit in case of its occurrence. The involvement of local health authorities wasn’t even considered. A system for providing medical assistance to the population, which corresponded to the huge scale of evacuation measures, didn’t develop in advance.
A system of the civil defense medical service, its capabilities and the medical unit of the Chernobyl NPP turned out to be inappropriate to the real situation. Therefore, the main burden of medical support fell on the health authorities and institutions of the Ukrainian and Byelorussian SSR. The acute shortage of manpower and means of health care took place in a “fire” manner. It had to strengthen local health authorities. These circumstances significantly complicated a medical and tactical situation. They hampered the activities of public health services and reduced the effectiveness of large-scale labor-intensive measures.
Due to the complex picture of radioactive fallout in a number of areas, preventive measures took place partially or not at all. Iodine prevention didn’t affect the majority of children. There were no areas where its use was urgently needed.
At the time of the accident, the civil defense services couldn’t provide the population with the necessary amount of iodine preparations. They were simply absent. The pharmacists of the Ministry of Health of the Ukrainian SSR had to work for days to produce them in huge quantities. In addition, there was no consensus even among doctors regarding the dosage of iodine preparations. Only the release of the “Instructions for the Prevention of Injury by Radioactive Iodine” established a stable dose of iodine intake.
Radiation and psychological shock syndrome
The lack of data on the radiation situation disrupted the sequence of registration of radioactive exposure and complicated the provision of medical care. A number of diagnostic and treatment measures took place blindly, without necessary information about the radiation doses.
The involvement of a large number of medical workers on a rotational basis created a favorable platform for psychological tension. Frequent change of shift teams, different professional and moral level of doctors, led to controversial assessments of the state of health of patients. This picture was often aggravated by the feeling of irresponsibility among doctors for the final results of their activities.
The shift method has become a source of concern among the population living in the contaminated area. There was also a fairly high psychological and emotional stress among the health workers, who arrived to work in the “contaminated areas”. As a result, it affected the nature of contacts with patients.
The key mechanism for the growth of psychosocial tension was a low level of public awareness. People lacked the official information about the situation. In addition, the low level of competence of the medical staff in the field of radiation medicine, psychoneurology, medical and social psychology affected. This became the main source of inappropriate and too contradictory information about the health status of the surveyed population. This has created a lack of trust not only in the authorities, but also in the health authorities and medical science in general.
Untimely and biased informing of the population about the Chernobyl accident created the preconditions for the formation of social and psychological tension. A retrospective assessment of the psychosocial aspects of the Chernobyl disaster showed the results of the psychological unpreparedness of society for radiation accidents of this scale. A situation arose when psycho-emotional stress in society became a source of much greater harm to health than radiation. The negative socio-psychological consequences associated with stress were larger than the impact of radiation.
The circle of people exposed to radiation stress consisted not only of people evacuated from the exclusion zone. It also didn’t end with the direct participants in the liquidation of the consequences of the Chernobyl accident. The number of victims who underwent a radiation and psychological shock includes not only the population of the zone of radioactive contamination. Almost the entire population of Ukraine has had this syndrome.