Written By: Cheryl A. Cohen
On 26 April 1986, the Chernobyl Nuclear Power Plant, located near Kiev, released 192 tons of highly radioactive material into the atmosphere. What was a routine test of electrical equipment became a fiery explosion estimated at 100 times the combined force of the Hiroshima and Nagasaki bombs. The material spread across a vast area of the Soviet Union and contaminated areas now within the borders of the countries Belarus, Ukraine, and Russia. Official reports tell us that 31 people died in the blast and 600,000 people involved in fire fighting and clean-up operations were exposed to high doses of radiation. The United Nations Commission on Chernobyl reports the following statistics:
"8,400,000 people in Belarus, Ukraine and Russia were exposed to the radiation, which is more than the population of Austria. About 155,000 sq. km of territories in the three countries were contaminated, which is almost half of the total territory of Italy. Agricultural areas covering nearly 52,000 sq. km, which is more than the size of Denmark, were contaminated with cesium-137 and strontium-90, with 30-year and 28-year half-lives respectively. Nearly 404,000 people were resettled but millions continued to live in an environment where continued residual exposure created a range of adverse effects."
Yet, the world has largely forgotten its worst technological disaster and little is known about the continuing economic, psychosocial, and health consequences of this tragedy. However, the Academy Award winning documentary "Chernobyl Heart," brings this ongoing humanitarian and ecological calamity back into sharp focus.
Attendees of the Second Annual International Cardiac Outreach Conference in Washington, DC were fortunate to view this film and to gain insight from William Novick, M.D., a pediatric cardiac surgeon featured in the film. Dr. Novick is founder and medical director of the International Children's Heart Foundation (ICHF), which has been sending volunteer medical teams to Minsk, Belarus for eight years.
Maryann DeLeo's "Chernobyl Heart" takes us on a tour through hell and hope starting at the damaged reactor housed in its crumbling concrete 'sarcophagus' where we watch the readings on a Geiger counter soar. Adi Roche, founder and International Executive Director of the Chernobyl Children's Project International and Chernobyl Children's Project Ireland, leads our tour.
The film then takes us to the Vesnova Orphanage where displaced children with severe disabilities spend their days. There we see children with microcephaly, untreated hydrocephaly, cerebral palsy, and various tumors. We don't know if these deformities were caused by exposure to the radiation, but the Belarus government estimates a 250% increase in birth defects after the accident. What we can see clearly is that the children are living in abysmal conditions and they are not getting the health care that they need.
We also visit children with thyroid cancer and learn of its high incidence and the inadequacy of the local health system to the task. According to the World Health Organization (WHO), since the accident there has been a hundred-fold increase in the incidence of thyroid cancer in children living in the Gomel region. We visit a school and watch children undergo testing (routine to them) to ascertain levels of radioactivity in their systems and watch as a child with an extremely high level is scolded by a health worker for eating the local wild berries and forest mushrooms. We begin to feel that we are witnessing something with consequences beyond imagination that we need to revisit until its consequences are mitigated.
 William Novick, M.D.
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Finally, we learn about Chernobyl Heart--an expression coined locally that refers to the heart condition known as a ventricular septal defect (VSD). VSDs, both single and multiple, seem to occur with greater frequency in children born after the meltdown. A VSD is a hole in the wall (septum) between the two lower chambers of the heart (the ventricles). It allows oxygenated blood from the left ventricle to mix with oxygen-poor blood in the right ventricle. Cardiac surgeons often use a synthetic patch to repair VSDs. Other congenital heart anomalies that appear to occur at a greater than normal frequency include pulmonary stenosis, Ebstein's anomaly, tetralogy of Fallot, and atrial septal defect. In the film, we see Dr. Novick operating on a girl in her early teens with a VSD and see her grateful parents thanking him profusely after a successful operation. In the United States, VSDs are closed early in life, usually prior to two years of age and earlier if the defect is large. VSD (all types) closure is the most common open cardiac procedure performed in the US (as indicated by the Society of Thoracic Surgeons' recent Database), but multiple VSDs are rather rare. If untreated, large or multiple VSDs cause pulmonary hypertensive vascular disease and eventual death in a person's teens or twenties, so early treatment is essential. The Chernobyl Children's Project reports that there are 7000 children in Belarus alone on the waiting list for heart surgery. |
According to Dr. Novick, there has not been enough epidemiological research tracking the continued health effects on the populations exposed to the radiation and very little on congenital defects. With the cooperation of the Belarus government, he hopes to participate in an epidemiological study of the area.
Dr. Novick and his ICHF surgical teams have been traveling to Belarus since 1996 and have operated on 89 children there. In May 2004, ICHF is sending another team to Minsk. This twelve-member team will consist of one surgeon, two operating room nurses, two intensivists, four PICU nurses, one anesthesiologist, one cardiologist, and one respiratory therapist. In addition to his work in Belarus, Dr. Novick and other ICHF volunteers perform surgery and train local health care providers in Croatia, Yugoslavia, Uzbekistan, Nicaragua, Peru, Columbia, China, Sudan, and elsewhere.
"Chernobyl Heart" tells its story in a straightforward way and shows us the horrors of human folly along with the efforts to set things right when they fall apart. Though not screening at any theater, "Chernobyl Heart" will be shown on HBO's Cinemax in August. I hope the world gets a chance to glimpse at this forgotten horror and perhaps, like the Dr. Novick and the volunteers and staff of the International Children's Heart Foundation and the Chernobyl Children's Project, to use their skills and resources to help the victims in Belarus, Ukraine, and Russia. To learn more about this ongoing humanitarian crisis, please visit the United Nations and Chernobyl and Chernobyl.info. For more information about the film and how you can help, contact the International Children's Heart Foundation.
