We also sent out a second press release under the title “Swiss perestroika in a Soviet hospital. How we can save the children of Chernobyl”, which said:
Last year, when the world learnt from the Soviet authorities that the disaster at Chernobyl had been much worse than they had wanted us to believe for the past four years, the Chief Medical Officer at the Oncology Hospital for Children in Minsk, Olga Aleinikova, finally managed to launch her appeal to the West. On the initiative of the Chaine du Bonheur (Happiness Chain) and a group of Swiss oncological paediatricians, a team of doctors and journalists was sent to Belarus to investigate and document the health catastrophe: the radioactivity was destroying the children’s immune systems. The children were dying every day, not only from leukaemia, but from hepatitis and chicken pox, from a lack of syringes, minimal hygienic conditions, essential medicines. Thanks to the money collected from viewers who responded to the appeal, an aid programme was implemented, exemplary in its rational, practical effectiveness and a further documentary, entitled “Survivre à Tchernobyl” (Surviving in Chernobyl), broadcast the following year, on the 26th April, described the problems and the first results.
1. DIE IN JUNE, SURVIVE IN NOVEMBER
In June 1990 the Chief Medical officer, Olga Aleinikova, shows us round her empty and dilapidated hospital.
O. Aleikinova.—As you can see, we have no equipment. Bare walls and beds. All we have is our brains and our hands, that’s it. If the children feel unwell, if they faint, if they have complications, we have practically nothing except this electric mucus suction pump and this oxygen cylinder on the wall; and The Austrian Red Cross gave us 2000 indwelling catheters at no cost, three months ago. This is the last box. When that’s finished, we will have to give the children an injection whenever they feel they need it and that could be up to five times a day.
We don’t have any disposable infusion and transfusion systems either. We only have a few boxes left. As we cannot interrupt their care, we have to sterilise the same equipment several times, which increases the risk of infections. From Hepatitis B, among other things...
Katia is four and a half years old, and has lost all her hair. She is from the Mogilev region which is badly contaminated, and she has been ill for more than a year.
Katia’s mother (in a resigned tone).—We have tried every possible treatment, radiotherapy, chemotherapy, everything… with no positive result. My daughter has a tumour in her back. Her bone marrow is compromised. She hasn’t walked for five months. She had such beautiful hair…
Artiom’s mother cradles him in her arms.
Artiom’s mother.—When he was born, he was a really good baby… But he fell ill on New Year’s Eve, and six weeks after, he was diagnosed with leukaemia.
Q.—Do you sleep with him?
—Yes, in the same bed. That way, I am at least close to him.
NOVEMBER 1990
O. Aleikinova.—Artiom completed a course of treatment and we hoped that he would survive. But he caught chicken pox, which might seem a mild childhood illness. For our children, it’s dreadful, because they have no immune defences. To prevent the virus multiplying inside his body, we had to inject him with Varitect, an immunoglobin against the chicken pox virus. But we didn’t have any and he died of generalised chicken pox. His intestines were covered in vesicles. The vesicles had invaded the lungs. He died of emphysema. But I knew how to save him ...
We talked to the despairing parents of another child called Dima Pranovich.
The mother.—We haven’t got the necessary drugs. He could be treated abroad, but here, we have very little chance. I so much want our child to live! We have already written twenty letters to different countries, without any result, without any reply. I would do anything to save my child. My husband is also ill himself. He was treated for early stage cancer in December, and in January, it was the little one… what a tragedy!
The father.—They tell us here at the hospital that he has a 10% to 15% chance of recovery. I haven’t got the money to pay for his treatment but if someone wanted one of my organs, I would sell it to them…
O. Aleinikova.—Many children are dying but over the last two months we’ve noticed a slight decrease. Last year, 21 children died in our centre and about the same number at home, because the parents sometimes take their children home before they die to avoid an autopsy. At present, the new law says that we cannot proceed with an autopsy without the parents’ permission. This year we have already had 33 deaths at the hospital. That’s an enormous number. I couldn’t take it any more and last year, I approached a journalist from the television programme Vzgliad (Look), Alexandre Poliatkovsky, who was in Minsk, and we decided to make a programme right here in the children’s haematological hospital to show people the conditions in which these ill children were being cared for.
If you had come here with your cameras a year ago, you would probably have wanted to cry. It was frightening: battered old camp beds, torn sheets, no equipment, no sanitary materials… When people saw that on screen, it was a real shock. Children who were so ill, in conditions that gave them no chance of survival. We didn’t even have a private room for the children who were dying; they died in the communal room, in plain view of the others.
You can’t imagine the suffering the doctors and nurses go through and how the mothers who stay here lose hope… Because, straight away, they think: “It could be my child next”. And I think that too: “Who will be the next?” It’s terrible. The feeling of powerlessness, that’s the worst thing for a doctor, when he knows how to help but can’t, through a simple lack of equipment.
On 22nd June a Telethon was organised in Switzerland that collected 1,300,000 Swiss francs for us. That money allowed us to buy equipment, as you have seen…Before we were supplied with the equipment, a group of specialists from Lausanne came here under the direction of Doctor Beck, who organised the medical side of the aid programme. He stayed here for three days and worked out what we needed: the aid that came was exactly what we needed. Not a single franc was spent in vain. As well as equipment, they sent us specialists. Speaking as a doctor, I have to say that it was the first time in fifteen years that I was able to work under normal conditions.
So, it was as a result of this programme, Vzgliad, that public opinion was alerted, first in the USSR and then in the West, and now we are able to administer the same treatment as in Western clinics.
From October 1990 to March 1991 the departments of Pediatric Oncology from Lausanne, Bern, Aarau, Basle, St. Gallen and Zurich sent teams of specialists to Minsk and, over a six month period, they installed technical equipment and trained their Soviet colleagues in a treatment system that raised the percentage of cases cured from 10% initially, to 60%, the average in Switzerland. This targeted approach, under the direction of the Swiss doctors, went far beyond the usual relief operations. The Western technology and protocols were more or less grafted on to the obsolete health care structures of the Soviet Union.
Dr Imbach, who has been researching childhood leukaemia for fifteen years, has his own secret weapon against the disease. It relies on very precise dose calculations of the powerful anti-leukaemia drug called Methotrexat. It needs to be administered using extremely expensive analytical instruments so that the treatment can be adapted according to how each organism reacts. This is why the treatment needs to be extremely rigorous and the doctors and nurses must be disciplined, in order to monitor and record the biochemical reactions of each patient according to a precise protocol.
Dr Imbach.—With the other Swiss specialists, we decided that a team would come first accompanied by a doctor to install everything we had brought and to train the local staff to use it. That was the task of the previous team. My task now is to organise the treatment, so that it is administered in the same way as in Switzerland.
We lacked the most basic equipment for controlling infection. Everyone here, including the children and the
doctors still has a lot to learn. We need receptacles to be available in every room to dispose correctly of paper, hand wipes, and towels. We need disinfectant soap so that people can wash their hands properly. Then there are all the instructions about how to care for a child, in a sufficiently sterile manner. But there are still other problems. We have to ask, diplomatically, for example, that the nurses and doctors keep their nails short, because this is exactly the sort of place where infection can be transmitted.
We think that two out of three children are infected with Hepatitis B through blood products or through inadequate hygiene procedures. We need to take tests, change our blood transfusion procedures and improve hygiene in general.
My impression is that there is still a lot to do. Doctors here receive a different training than in Switzerland. The nurses are not very motivated. There are many improvements still to be made, and I am still not very optimistic.
O. Aleinikova.—The fact that we have introduced this method which has up to a 60% to 80% probability of curing leukaemia, allows me to hope that the children we have treated will live.
Dr Imbach.—We would also like to introduce our system of data collection and processing. First of all we need to train the doctors to use the system. Then we need to find nurses who can familiarise themselves with the procedures. That is what we are doing at the moment.
Then we need to help the chief medical officer to play a bigger role as director. We’ve noticed that she works completely alone. I am going to introduce her to our way of working. To do that she needs to be visiting patients on a regular basis and writing daily reports. We would also like the doctors to begin to visit the patients daily, accompanied by the nurses and improve the dialogue between the latter and the doctors.
We have advised the chief medical officer to train heads of department, who receive specialist training abroad, to ensure their younger colleagues are trained in their turn, so that oncology will spread from here all over the Soviet Union.
2. EIGHT YEARS LATER (JUNE 1998)
Eight years later, I met up with Olga Aleinikova, in her magnificent new hospital for the treatment of children with cancer, at Borovliany, on the outskirts of Minsk.
Q.—How did you manage to get this centre built?
O. Aleinikova.—With God’s help, of course (she laughs), but also the help of a great many charitable people, both here and in the West. The construction of the centre was financed jointly by the Austrian State, an Austrian charity, Germany and the Belarusian government. But the biggest contributor was Switzerland.
1,800,000 Swiss francs had already been invested in equipment and medicines when we were still at the old centre. If we hadn’t already started on the new treatment using this new technology, I don’t think this centre would ever have seen the light of day. We were already prepared by the time we got here. As soon as this appeal had been launched on Swiss television, Doctor Daniel Beck came here. He looked around, he asked questions, then he sat down and drew up a plan: how to help as quickly as possible. And there had been this unforgettable contribution from the Swiss specialists, who worked here in relays for six months, to help us to introduce all this very quickly. That’s how it all started, the source of it all.
We had a 12% probability of a cure. Today, this has increased to 70%. We have 70% survival rates for acute lymphoblastic leukaemia. For acute myeloblastic leukaemia the figure is 50%. For Hodgkin disease, the survival rate is 92%. For non-Hodgkin lymphoma, around 75%. For Wilm’s tumour, or nephroblastoma, the figure is 65%. Of course, there are certain forms of cancer that are hard to cure even in the West, and we have problems with these too. But today we are able to treat most tumours and most melanoma.
The nucleus of the team that started with me in 1990 is still here. At that time, they were between 25 and 28 years old. Now they are 35. They have had a lot of experience, they have had the opportunity to train in the West and to put their skills into practice. They are very highly qualified professionals.
Q.—I remember that Dr Imbach predicted a great deal of work to introduce this very precise regime, and to allow the treatment technology to be used effectively. How easy was it to achieve?
O.A.—It was an enormous amount of work, but I think the secret lies in our enormous desire to succeed. We worked sixteen or eighteen hour days, with no days off, and maybe also, I was able to transmit my obsession to young people, because the young are still capable of being trained in something…On the other hand our task was made easier by the fact that we were benefiting from this same Dr Imbach’s experience, and the experience of paediatric childhood oncology and haematology in the European community. Their experience had been built up over several years. In substance, the experience we had received and that had already been verified, had been being researched by others for twenty five to thirty years. We were simply adopting procedures that were already in place and so it was much easier for us. All we had to do was introduce them a disciplined manner.
Q.—As a citizen of your country, how do you view the role of the public authorities, both in your own country and also the global community, as regards this tragedy at Chernobyl?
O.A.—The tragedy had a direct impact on my own family. My children had to take part with their school in the May Day procession, as everyone did in the old Soviet Union. Every day, from 26th April to 1st May, the children rehearsed for the parade, taking part in the street marches… With no iodine…
But I myself had already started giving them iodine from the 28th April. It was a real stroke of luck. There had been a few lines in Pravda on 28th saying simply that there had been an incident at Chernobyl, and that four firemen had perished. That was all. But one of the nurses who worked with me had parents living in Bragin. They told her over the telephone that the power station was on fire. That was enough to alert me to the danger. I remember diluting iodine drops in milk. But even so, I wasn’t sure. Was it really necessary? The lack of serious information, the silence from central government and the local authorities about the risks, and about the protection measures that should have been put in place immediately, constitutes a crime against humanity! As for the International Atomic Energy Agency—the IAEA or in Russian, MAGATE, the very name is used as an insult today. At any rate, among the people I know, among my friends.
Q.—Do you share that opinion?
O.A.—I share the opinion of our scientists, the academicians, Konoplia and Nesterenko, who have researched the matter, and have reached very different conclusions from those of the IAEA. Chernobyl has affected all of us, big and small, wherever we live. Children as well as adults. Including those children who weren’t even born. It continues to have an effect through the mothers who grew up at that time with these high levels of radioactivity, and who, contaminated themselves, give birth today after a pregnancy in a radioactive environment. That’s why I think that all our children are at high risk from radiation, the risk of radioactive effects on the organism.
A human being is a grain of sand in today’s world and no-one cares about them. Governments of every country claim they are working exclusively for the people. But “the people” is an abstract concept. You and me, we are also “the people”, aren’t we? At the hospital, we care about each of our cases; every patient is a human being that is suffering. And if we manage to save someone’s life ... What a shame you didn’t meet him! Yesterday, one of my patients, from 1990, came to see me. He was one of the first patients to be treated with the new method. He is 27 now. He is a professional soldier in the Belarus army, and he has a five-year old daughter. He brought me a photo of her. He came to see me just to say hello because he was passing by. It made me so happy!
3. DOCTORS WHO TELL THE TRUTH. THE MOTHER OF DIMA TUROVETZ—NOVEMBER 1990 AND JUNE 1998
We had filmed Dima eight years before, when his mother was carrying him up the stairs of the dilapidated hospital, at the old centre, for a painful lumbar puncture, undertaken without
anaesthetic because none was available.52 We had exchanged a few words with her before her child, who was not yet 3 years old, underwent his ordeal. The young woman was going out of her mind: she was personally going to help the nurse during the puncture operation. She was going to relieve his suffering, by whispering encouraging words and tenderness.
52 Documentary Nous de Tchernobyl, Swiss Italian Television (TSI), 1991.
NOVEMBER 1990
Q.—Has he already had a lumbar puncture?
The mother.—Yes
Q.—Does he know what it is?
The mother.—Yes
Q.—Does he know he’s going to have one now?
The mother.—No, I haven’t told him.
Q.—Is it very painful?
The mother.—Of course.
Q.—How long has he been ill?
The mother.—We’ve been here for six months. We’re still hoping. They are using the new treatment from abroad. We’ll see. Very few of the children who were hospitalised with him are still with us.
Q.—Where are they?
The Crime of Chernobyl- The Nuclear Gulag Page 19
