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Sunday, October 11, 2015

Svetlana Alexievich, Chernobyl, and Cuba’s medical assistance program

The award of the 2015 Noble Prize in Literature to Svetlana Alexievich has brought discussions of Belarus, Ukraine, Chernobyl, and the USSR invasion of Afghanistan flooding back.

[Alexievich's status as a stranger in her own country can usefully be understood  with context provided by this article on the region.] 

A Paris Review excerpt of Alexievich's Voices from Chernobyl can be read here.

A Spanish-language epub of the book can be downloaded here.

The documentary "Cuba and Chernobyl" can be viewed here 

This 1996 article from The Militant is also worth reading:

Chernobyl Disaster Still Haunts Region  

BY JON HILLSON

MINNEAPOLIS - Tens of thousands demonstrated in Ukraine and Belarus April 26 to mark the 10th anniversary of the worst nuclear accident in history. In the preceding days, continued problems showed that the danger at the Chernobyl nuclear facility has not ended since the 1986 blast, which released 200 times the radioactivity of Washington's 1945 atomic bombing of Hiroshima and Nagasaki in Japan.

On April 23, fire swept through five abandoned villages near the partially crippled plant, where two nuclear reactors churn out energy. Flames spread through the highly radioactive 18-mile "exclusion zone" around the plant. Officials downplayed the spread of radiation, but local Greenpeace spokesman Antony Frogratt termed the wind-swept blaze "one of the major ways [radiation] travels, clearly a danger to the health of people, and not only in Ukraine."

On April 25, as demonstrators in radiation protection suits neared the zone at the conclusion of a 66-mile march demanding Chernobyl be the shut down, nuclear waste leaked during a disposal operation. A CNN dispatch stated the leak caused 1,000 percent increase in radiation.

The April 26 demonstration of 50,000 in Minsk, Belarus, was attacked by the police. Belarus, which borders Ukraine, received some 70 percent of the fallout from the original disaster.


Continued affects of meltdown

The April 26, 1986 core meltdown occurred during a safety test of the Chernobyl cooling system. The blast and subsequent inferno took the lives of 32 plant workers and firefighters. The final toll is far from complete.

While no accurate figure on Chernobyl-linked deaths exists, both the World Health Organization (WHO) and Ukraine's Health Ministry cite a figure of 125,000, in Ukraine alone, which is expected to rise to 200,000. In the region's contaminated zone - whose 54,000 square miles are equal to the land surface of Denmark, Belgium, the Netherlands, and Switzerland - the thyroid cancer rate for children is 100 times the norm.

Cancers are not expected to peak until 2005. Leukemia, which develops slowly, has yet to emerge. A major increase in leukemia around Hiroshima did not appear until 1955, 10 years after the atomic bombing. Ukrainian biologist Vyacheslav Konovalov reports no slowing of the rise in the rate of multiple birth defects and pathological disorders in human fetuses since the 1986 calamity.

Floods around the Chernobyl plant, as well as seepage from "graves" of buried radioactive waste, have contaminated a lake 156 miles from the blast site, and now threaten drinking water for 9 million people, and irrigation and fishing sources for another 23 million.

Virtually all the meager Soviet-era pensions and programs for 800,000 "liquidators," who carried out the massive clean up of the blast site, and others ill from radioactivity, are long gone. The United Nations estimates 9 million people in the area suffer from the effects of radiation.

In the early March cold, the Ukraine government turned off the heat at Kiev's Center for Radiation medicine, the country's main hospital for Chernobyl victims, for unpaid bills.

The Belarus government, which states it has spent $235 billion in Chernobyl-related programs, was recently denied the remaining $230 million of a $300 million lending package from the International Monetary Fund.


Testimony of Chernobyl survivor

"On every floor of my building, people have died, and are dying," Sasha Sirota told 50 people at the University of Minnesota April 22, as part of a national speaking tour sponsored by Greenpeace. The 19-year-old former resident of Pripyat watched Chernobyl burn from his apartment in 1986. "American corporations have a peculiar form of `aid' for us," he said. "They come to Russia to build `sophisticated' nuclear reactors. We don't need this kind of help."

Claiming he was "immeasurably moved" by a March visit to a Kiev hospital for children suffering from radiation, U.S. secretary of state Warren Christopher announced a $10 million donation to Ukraine for a mobile radiation monitoring laboratory and medical aid.

This is a tiny sum next to the aid given by Havana to the victims of the Chernobyl explosion. Since 1990, Cuba has treated more than 13,000 children, and 2,400 adults in its Children of Chernobyl project at Tarara, a beachfront campsite donated by the Pioneers, a Cuban children's group.

Sirota had a chance to make the trip to Tarara, but gave up a likely spot, "so that someone sicker than I could go," he said.

There is intense pressure on the few spaces that open for the journey, the young anti-nuclear fighter said. "In my building in Kiev, a `Chernobyl' building where 3,000 of us live, when a sign goes up for [the medical trip to] Cuba, everybody wants to go. Sometimes, the children of the bureaucrats get selected, not the sickest. This is a scandal. I don't think Cubans have knowledge of this."

Sirota has friends who have been treated in Cuba. "They loved it. They get fresh fruit, which they never get here. They think the camp is wonderful," he said. "Not like the Soviet camps we used to go to. They were like concentration camps, with military discipline. The children were very glad they went to Cuba. They get care they would never get in Ukraine. That is why so many want to go now."  


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Children from Chernobyl, Ukraine, visit Cuba  in 1989 (left). Since the 1986 nuclear disaster in Chernobyl, some 13,600 children and 2,500 adults affected by the intense radiation have received treatment in Cuba. This major act of
international solidarity with the victims of Chernobyl began at the height of the Special Period in Cuba.


A more substantial political article on Cuba's internationalist role in treating 25 thousand children from the Chernobyl region can be read here. That 2015 story:


‘A program born out of the values of the Cuban Revolution’ 
Interview with Dr. Julio Medina, director of center in Tarará, Cuba, that treated 25,000 
children after Chernobyl nuclear disaster

BY FRANK FORRESTAL, 
RÓGER CALERO 
AND MARY-ALICE WATERS 

The April 26, 1986, nuclear meltdown in Chernobyl, Ukraine, remains the greatest nuclear disaster to have occurred in the post-World War II world. The response of the Cuban government and medical personnel to that disaster, like their response to the Ebola crisis in West Africa today, provides striking confirmation of the proletarian internationalism of Cuba’s socialist revolution.

Dr. Julio Medina, the pediatrician who was in charge of Cuba’s program for treating children who were victims of that disaster, sat down with Militant reporters Róger Calero and Mary-Alice Waters in Havana on Sept. 10 to talk about Cuba’s response and the effort he directed for more than 20 years.

The program came out of the values of the Cuban Revolution, Medina began by explaining. “The values that are part of the revolution in Cuba — humanity, friendship and solidarity.

“We couldn’t sit with arms folded and watch a people with whom we had relations of friendship face by themselves a problem like Chernobyl,” Medina said. “This was a catastrophe whose ecological, social and medical dimensions are still difficult to fully grasp.”

The Chernobyl nuclear disaster unfolded during a test of the control system of one of four units that were being shut down for routine maintenance. Design flaws — including no containment structure — and the fact that the reactor’s emergency safety system had been turned off led to a power surge causing explosions that blew apart the top of the reactor. The reactor core melted down and an intense 10-day fire broke out that released large amounts of radiation.

More than 2,000 square miles of Ukraine, Belarus and Russia were contaminated; clouds of radioactive dust reached other nearby countries, including Sweden, 700 miles away. Chernobyl workers and firemen who tried to cope with the catastrophe were unprepared and largely unprotected.

More than 130 workers at the plant were sickened by high doses of radiation; 28 were dead within a few weeks. And more than 6,000 children and adolescents from Ukraine and Belarus contracted thyroid cancer, probably from iodine 131, which was inhaled or ingested, mostly from contaminated milk and vegetables.

Pripyat, a town of 50,000 built one mile from Chernobyl’s reactors to house the facilities’ workers and their families, was not evacuated until 36 hours after the explosion. Residents were told they only needed clothing for three days and then they could return. They never went back and the town remains off limits.

About 115,000 were evacuated from the surrounding area. Another 220,000 were eventually forced to leave their homes in Ukraine, Belarus, and Russia. An official exclusion zone around the explosion site extends 18 miles in all directions to this day.

At the time of the disaster, Ukraine was a republic of the Soviet Union, only gaining independence in 1991, as the USSR blew apart.

Following the Chernobyl explosion “the authorities didn’t tell anyone the extent of what was taking place,” Liliya Piltyay, a leader of the Komsomol (Communist Youth) in Ukraine who helped organize children and others in need of medical attention to travel to Cuba for care, said in a June 2014 interview with Militant reporters in Kiev. And until 1989 “spreading information about the true extent of the radiation and number of those affected was prohibited.”

Those most affected by radiation poisoning were young children, pregnant women, and the hundreds of thousands of workers known as liquidators, who came to help in the evacuation and clean up the contaminated debris.

As knowledge of the scope of the medical crisis spread, the leadership of Komsomol asked newly arrived Cuban Consul Sergio López Briel for help publicizing the situation and mobilizing an international response. “I said that the job of informing the world was their responsibility, but Cuba would certainly help,” López told reporters for a 2006 Cuban television documentary, “Cuba and Chernobyl.”

“This was a Thursday, and on Saturday we already had the response from our country’s top leadership,” López said. “The three best specialists in common childhood diseases were ready and would be traveling immediately to Ukraine.”

During their first trip the Cuban specialists visited more than 15 towns, small and large. “The inhabitants were under tremendous stress, worried about the nuclear disaster,” Manuel Ballester, director of the Institute of Hematology and Immunology and one of those who went to Ukraine, told the program.

Cuban doctors visited the affected regions of Ukraine, Belarus and Russia five or six times. “We were very well received by the population, though not as well by some of the functionaries back then,” Ballester said. “In the places closest to the disaster area, there were no doctors. They had left the area to avoid the possible radiation that was being released.”

Getting sick children and some of their parents to Cuba proved to be a challenge because the Soviet Union would not provide planes. In response, the Cuban government scrambled to get them. “One Cuban plane had just come off repairs at a factory in Tashkent [capital of Uzbekistan] and wasn’t finished being painted,” Olexander Bozhko, president of the Ukrainian Chernobyl Youth Fund, told reporters for the Cuban TV program.“The other one had its usual Rome-Havana route changed so it could be sent to Kiev.”

The two planes with nearly 140 children arrived in Cuba on March 29, 1990, marking the beginning of the Chernobyl children’s medical treatment program. Several leaders of the Cuban Revolution, including Fidel Castro and Vilma Espín, president of the Federation of Cuban Women, met the first group at the Havana airport. Castro asked one of the women who accompanied them how many people had been affected. She said there were as many as 100,000.

“He went into a huddle with other government representatives right there,” Piltyay said, “and by the time the second plane arrived three hours later, he announced that Cuba would take 10,000 children from Ukraine, Belarus and Russia.

“I couldn’t believe it,” she said. “I asked the translator whether he had made a mistake. But he hadn’t. The Cubans did that, and more.”

The policy of the Cuban government was to minimize publicity surrounding the program. In the TV documentary Cuban Ambassador López comments that Castro told him, “I do not want you going to the press, or the press going to the consulate. We are carrying out a basic duty to the Soviet people, to a sister nation. We are not doing it to get publicity.”

Castro asked López, who had just arrived from Ukraine, to go back immediately rather than take a few days with family in Cuba. Castro was “already thinking about the concern of the parents, the relatives of the children who were in Cuba,” López said. “‘Go and speak to those parents about their children and whose hands they are in, what we are doing for them, the conditions they have here in Cuba. And that we will make every effort in the world to save them, for them to live with a safe and dignified future.’”

The medical program took shape in the opening years of the Special Period in Cuba. This was the name given to the economic and political consequences of the abrupt loss of 85 percent of Cuba’s foreign trade following the breakup of the Soviet Union. Imports evaporated and agricultural and industrial production collapsed in Cuba. At the time, Castro said it was “as if one day the sun didn’t rise.”

And during this time, the health care system in the countries of the former Soviet Union began to disintegrate. Life expectancy, including in Ukraine, plummeted over the next 10 years. In Cuba, by contrast, despite the economic hardships, life expectancy increased from 74 years to 77 in the same period.

“It has already been some time since the USSR and the socialist bloc disappeared, yet we continue providing care for the Chernobyl children, despite the embargo and despite the Special Period that we are experiencing,” Castro told a group from Pastors for Peace in 1992. “We are doing this for ethical reasons, for moral reasons.”

Cuba’s medical assistance program 

Julio Medina, today the director of the Pediatric Hospital in Tarará, Cuba, picked up the story from there. Medina, a young doctor in his 20s at the time, became the director of the Cuban medical program that between 1990 and 2011 treated more than 25,000 people affected by the Chernobyl nuclear meltdown.

“In 1990, when the scope of the health crisis began to emerge, the Soviet Union was disintegrating,” Medina said. “Cuba and Ukraine didn’t yet have embassies in each other’s country.”

The Cuban people and their government responded in a way that was different from all other countries, he said. Only Cuba offered a medical assistance program completely free of charge. At its high point, the Cubans were treating up to 3,000 patients a year, overwhelmingly children.

The Cuban program only began four years after the nuclear disaster took place, Medina explained, in part because some effects of radiation poisoning develop slowly. But “there had been no real plan to minimize the consequences of an accident,” he said.

“I think they never believed an accident would occur. Evacuation programs weren’t in place. People had to leave by their own means,” he said. “In some cases they were sent to areas contaminated by the radioactive cloud that had passed.”

“The press didn’t adequately inform people about what could happen and what was going on,” Medina said. “Another problem was the delay before the Ukrainian government requested international assistance.”

Cuba’s solidarity began before 1990. “The first act of solidarity,” Medina said, came from Cuban students studying in Ukraine who donated blood. One donated bone marrow.

What was decisive in getting the program started, was “the political will in our country to carry it out. I am speaking here especially of Fidel, our commander-in-chief,” Medina told the Militant.

The team of specialists sent to Ukraine “had a huge impact. People were clamoring to see the Cuban doctors,” who selected the sickest children for treatment in Cuba, he said. “The first flights to Cuba brought nearly 140 children with serious cancer and/or blood diseases.”

The Tarará medical center wasn’t yet up and running, so the first two planeloads of children went to two Havana hospitals — the Juan Manuel Márquez and the William Soler.

“The need for help continued to grow,” said Medina, “and Cuba responded. The collaboration was extended and that’s where Tarará came in.”

In 1976, Tarará, renowned for its healthful and beautiful seaside location not far from Havana, had been turned into a camp for Cuban elementary school children who belonged to the Pioneers youth group. In the 1980s, when the country was hit by a dengue fever epidemic, the polyclinic there grew into a pediatric hospital. Part of the internationalist response of the leadership of the Cuban youth organization was the decision to turn over the Tarará Pioneer City to the Ukrainian children.

Transformation of Tarará 

“We converted the Tarará facilities into a 350-bed hospital and created housing with a capacity for 4,000 people,” Medina said. “As you can imagine, in the midst of the Special Period this was no easy thing.”

The transformation of Tarará was carried out primarily by volunteer work brigades. These brigades were created throughout the country in the late 1980s as part of what was called the rectification process.

“Truckloads of workers, young people, men and women, came straight to Tarará from different towns. It was a massive job,” said Medina. “Ordinary people joined the brigades to paint and make repairs. There were several thousand people whose work had to be coordinated and organized every day — plumbers, carpenters, masons, landscapers.”

When the job was completed in July 1990, Fidel spoke to the brigades there to thank them.

While the Tarará center was transformed, Medina and the rest of the staff of doctors, nurses and technicians were in Havana preparing for the medical challenge ahead of them.

“I was working in a hospital in another part of Havana, as were many who became part of the project,” Medina said. “The doctors and nurses were the last to arrive. We had to study first. We had no specialists in nuclear medicine. We had no experience treating people who had been exposed to radiation in a nuclear accident. We had to prepare ourselves — and we had to keep studying practically on a permanent basis in order to provide the best care for the patients.”

Personal, human care 

The Cubans took special measures for children who came alone, many from orphanages or boarding schools. “Nurses and doctors kept them company. We took on an incredible responsibility from the social and human point of view,” Medina told the Militant. “We understood that a child who comes alone isn’t in the same situation as a child who is accompanied by his or her mother. At that time, in those conditions, our program was quite bold. And that’s what made it so valuable.”

“The families of workers there and the workers themselves made sweets for the children when they were sick and made cakes for their birthdays,” he said. “These were little things they loved to do.”

Many of the children were very sick. They underwent surgery and received extensive chemotherapy. “Some died but others recovered — a process that was sometimes very long. And during all these procedures, if they were alone a Cuban stayed with them at the hospital.

“This kind of social support came from the people, from individuals,” Medina said. “Nobody can be ordered to do what they did. No government or policy can guide it. They are values. Of course those values are the product of the revolution and its policies, our way of life. But the way people expressed those values was spontaneous.”

“In Ukraine the children would hide their skin lesions or a missing ear. They would comb their hair a certain way or wear long sleeves to cover up signs of their sickness,” Medina said. “But in Cuba, within days after they arrived, that self-consciousness began to disappear. They were all equal and the Cubans surrounding them paid no attention to these things.”

“In addition to the difficult moments of surgery and chemotherapy, they needed psychological support in order to go out and get on with their lives, which was not so easy,” he said. “Someone from almost every medical specialty was involved in setting up the program.

“There were professional psychologists in white coats,” said Medina. “But there were also ordinary people who through their affection and love gave these children support they needed to help minimize the impact of the accident.”

“We asked the Ministry of Health in Ukraine to send Ukrainian doctors with each group of children — doctors who could work together with us and tell us their opinions, their views. This played an important role,” he said. “Having Ukrainian and Russian speaking doctors — including psychologists who could help address the trauma from the nuclear accident — made it easier to communicate with the children.

“We organized many excursions for the children because the psychological rehabilitation program also included cultural activities,” he said.

“Can you imagine what it takes to get 10 buses full of children from Havana to Trinidad? Part of the highway is fine, but another section is dangerously twisting and narrow,” Medina said. “Ten buses full of children, with ambulances, doctors, nurses and food, because we had to take our own food. And on these trips every child would go, whether he could walk or was in a wheelchair.”

Target of political attacks 

The medical program was the target of political attack mainly from opponents of the revolution outside Cuba. “Those who had done nothing like our program, who hadn’t created the conditions necessary to care for the children and give them medical treatment, criticized those who did,” Medina said.

Most of the criticism came from the United States. “There were articles in the press there saying that scarcity and hunger in Cuba were so widespread that there was no way to feed these children,” said Medina. “They said we were using them as guinea pigs for medical experiments and so forth. They even said the sun in Cuba was harmful for them!”

Despite the enormous economic pressures of the Special Period, the Cuban government maintained the Chernobyl program. “Fidel didn’t think twice about offering our assistance even in difficult moments,” Medina said. “Because in Cuba — I’m talking about the years from 1990 on — those were the most difficult years Cubans can remember.”

At every turn, the government “tried to assure the program’s success,” he said. “Under the direction of the Ministry of Health, several hospitals and clinics in Havana worked together to make sure that the children got everything they needed. No request was ever denied because it cost too much. That was a political decision. We did it without tallying the expense.”

The children also benefited from Cuba’s advances in research. “With the development of the Cuban biotechnology industry we were able to provide Ukrainian children with the same vaccines and medicine Cuban children received. That, too, was a political decision, with social costs,” he said.

When it became clear that many of the children would be getting treatment for long periods, the government decided to establish a school for the children, staffed by Ukrainian teachers. “We couldn’t let children who’d be here eight months or a year fall behind in their education,” said Medina.

There were long lines of people in Ukraine who wanted to see Cuban doctors, Medina said, and close collaboration with the Ukrainian Ministry of Health and medical personnel was important. “We kept a medical brigade in Kiev to continue treating children there. In 1998 we sent another medical brigade to open a sanitarium in Crimea that had been used as a rehabilitation center for workers from a missile factory in Dnepropetrovsk, an industrial city in southern Ukraine.

“The new facility was called Druzhba, which means ‘friendship.’ We organized a program there similar to the one at Tarará so that children could be treated in Ukraine,” he said. “Until the program was closed in 2011, Druzhba treated liquidators as well as children — more than 10,000 in all.”

Even though there is still a need for its services and Cuba remains willing to continue, the program at Tarará was suspended in 2011 when the Ukrainian government stopped paying transportation costs for the children. “There is no lack of people, including many doctors with a will to help. But today those with capital, those with money, don’t want to spend it for such purposes,” Medina said. “It’s a political question — a matter of social policy.

“People are still suffering from illnesses related to Chernobyl,” Medina said. “Some because of the impact of a radioactive substance on their immune system and gene structure, making them ill and producing genetic effects that can be passed on to descendants. And some because they are exposed to an area that may still be contaminated.”

“In the current situation of war and instability, life is more expensive. Everything is more difficult, including keeping track of an individual’s health” in Ukraine today, he said. “People today have to depend on their own resources rather than state institutions for health care.”

It changed us, too 

The Chernobyl children’s medical program transformed Cubans who were part of it too. “When I arrived at Tarará in 1990 I was 20-something,” said Medina. “I was a child, a boy. I’m 52 now. I grew up with the program.

“It became a part of our lives. We could say that living more than 20 years with Ukrainians almost made us feel Ukrainian, think like Ukrainians. It’s part of our lifestyle, our foods, our likes, and customs,” he said. “Likewise, they took our food and customs home with them. They loved to dance to Cuban music.

“The program lasted for nearly 23 years. Just think, 23 years of your life without sleeping peacefully, because when you are dealing with kids, you never know what they are going to be up to,” Medina said.

“We had a great responsibility to the Ukrainian families, the Ukrainian government and our own government,” he said. “The parents had trusted us with their children. And the country trusted us.

“We can discuss these things calmly now because time has passed and I feel I can exhale. Now I can go to the beach on a Sunday and not worry about it. I can even have a drink,” he said. “But back then I was saying to myself, ‘What if I have to respond quickly to something?’ Those were very difficult times. Our staff — Cubans and others — had to be dedicated.”

“And the leaders of our country were dedicated as well,” Medina added. “Fidel visited Tarará many times. Every time a hurricane swept through Cuba, a special advance team would come to make sure the facilities were in good shape to protect the children. When you see things like that happening, you feel you should redouble your own efforts, you recognize the depth of the responsibility you are carrying.”

Medina remains hopeful a way will be found for Cuba to continue to provide care for those in Ukraine who need treatment.

In Kiev a few months earlier Militant reporters talked with a number of young women who had been treated at Tarará. Inna Molodchenko is first on the waiting list to go back to Cuba if money for transportation can be raised. “It’s better for her to be in Cuba,” her mother Tatiana said, speaking for Inna, who has had six surgeries on her throat. “Cuban doctors have saved her life and the people of Cuba are very kind, full of warmth. Cuba’s our second homeland.”  

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