The order that has been given to the regional public health authorities to break their contracts with Belrad is illegal.
On 19th July, Nesterenko sends a document to the organisations in the West that support him. It is partly an appeal to the international community and partly an accusation: “The Ministry of Health in Belarus is covering up the truth about the consequences of the Chernobyl disaster on children’s health”.
On 31st July, the ambassador Hans Georg Wieck, director of the Organisation for Security and Co-operation in Europe in the Republic of Belarus, intervenes. He writes to the Prime Minister of Belarus:
In accordance with the mandate of 18th September 1997, the Consultative Observation Group (COG) of OSCE monitors human rights in the Republic of Belarus, to ensure that it fulfils its obligations towards the OSCE.
We have received a letter from Professor Nesterenko saying that the activities of the Belrad institute, of which he is the director, have been terminated by the Minister of Health on the grounds that they do not have a licence.
His letter has been studied by our group.
In our opinion […] the injunction to stop work at the institute has no basis in law. Nor does the Minister of Health have the right to outlaw work undertaken through contracts with this institute, as this represents an illegal interference in its activities: an abuse of power.
I would ask that the Minister of Health be advised not to put obstacles in the way of the work of the Belrad institute.
On 7th August, the Council of Ministers of Belarus requests the Presidency of the Academy of Sciences to set up a commission composed of scientists and experts from the Academy, the Ministry of Health, the Ministry of Emergency Situations, the government homologation committee, the Belrad institute and other “interested parties” to study the question and to report back to the Council of Ministers before the 1st September, in order to inform the Security Council of Belarus. Deputy Prime Minister Demchuk is in charge of the commission.
There are several Deputy Prime Ministers of government. This peculiarity would be pivotal in the subsequent manoeuvring that took place later at the Ministry of Health, which used Deputy Prime Minister B. Batura to get round Demchuk.
On 14th August the presidency of the Academy invited participants to a meeting on 22nd August 2000.
On 16th August, the Ministry of Health, knowing that general opinion is not in its favour, writes directly to another “friendly” Deputy Prime Minister, Batura, a long letter in which he reaffirms his position. The same letter is sent separately to Nesterenko, but he is unaware that other people had received the letter.
On 21st August, i.e. the evening before the commission meeting, Deputy Prime Minister Batura gives the Ministry of Health’s letter, of the 16th August the force of a decree, by writing in the margin of the letter, in his own hand, the resolution: “For information and guidance”. This resolution that reiterates the obligation for Belrad to obtain a licence for its medical activities, would be transmitted on 7th September 2000 by Deputy Prime Minister Demchuk himself (wolves don’t eat each other ) to the members of the commission who, not knowing about the manoeuvre, would be meeting on 22nd August for absolutely no purpose.
Thus the presidency of the Council of Ministers dispensed with a procedure that it had set up itself, before it had even taken place, showing utter contempt for those involved.
On 22nd August, the meeting was to take place, as always, at 2 pm in the presidency room at the Academy of Sciences. The “interested parties”, in other words, scientists, specialists and journalists that Nesterenko had invited are all excluded, whereas several representatives of the Ministry of Health are present. As he leaves for the meeting, Nesterenko discovers that one of the tyres on his car had been slashed twice with a knife. He changes the wheel as quickly as he can and arrives at the Academy, out of breath, two minutes before the meeting started. He was supposed to speak for about 7 minutes. That did not happen. Instead there was a heated and chaotic exchange of views during which a lot of pressure is put on him by representatives from the Ministry of Health, to submit: he must not publish any more data from his HRS measurements, outside the Ministry. However, the majority, that is to say everyone except the Ministry of Health, agrees that Belrad’s activities does not constitute a medical intervention and that a second licence makes no sense. He already has a licence from the Ministry of Emergency Situations.
At the end of the meeting a member of the Academy, a lawyer by profession is asked to summarise the findings which would then be approved by those who had taken part in the meeting and sent, before the 1st September to the Council of Ministers. This text was agreed by most participants but the Ministry of Health has refused to sign it (no-one knew yet about the letter to Batura, sent on 16th August). The president of the commission, is embarrassed, and asks one of the vice presidents to rewrite another “compromise” text.
On 1st September, the compromise text, signed by the president of the Academy of Sciences, A. Voitovich, is sent to Deputy Prime Minister Demchuk, who has been given responsibility for the task by the Council of Ministers. The central message, exonerating Nesterenko, is contained in the following sentence:
The legislation on public health of the Republic of Belarus does not define the concept “medical activity”. One can therefore conclude that the Institute of Radiological Protection, Belrad, is acting in accordance with the licence from the Ministry of Emergency Situations, which it already possesses.
On 13th September, Nesterenko receives the “directive” from Batura, in other words from the government.
In the meantime, unaware of what had been going on behind the scenes, he responded to the letter sent on 16th August. The controversy with the Ministry, whose central arguments are presented below through extracts from Nesterenko’s reply to the letter that Orekhovsky sent to him and to Batura, clearly shows the fundamental incompatibility in their positions. On the one hand, we have a bureaucracy that distorts reality by trying to make it fit a predetermined scheme, and on the other, the objective approach of a scientific dealing with concrete reality.
2. TRENCH WARFARE
Minzdrav, 16th August.—Regarding Nesterenko’s statement that the register of dose, produced in 1998–1999, was inaccurate, we would like to point out that one of the errors made by the corresponding Member of the Belarus Academy of Science, Doctor of Technical Science, Professor V. Nesterenko, is that he does not recognise the essential point: radiological protection measures should be based on the values of projected average effective annual dose (EAD), and not on the dose of the critical group. This procedure conforms fully with the internationally recognised principles of radioprotection82 according to which it is standard practice to estimate the need for radioprotective measures and their optimisation on the basis of the significance of the damage to health, as determined by collective dose.
82 IAEA, Vienna, 1997. Safety Standards Series No 115, “Radiation Protection and Safety of Radiation Sources: International Basic Safety Standards”.
Nesterenko, 28th August.—International safety standards for protection against ionising radiation and safety in the management of sources of radiation (IAEA, Vienna, 1997) state that the averted dose and the number of projected case of illness should be calculated according to the collective dose and the values of the projected average effective annual dose, but radioprotection measures should be based on the values of the dose for the critical group in the population.
In this distorted interpretation of the regulations, Minzdrav refuses to differentiate between calculated epidemiological predictions (based on what can be deduced from average dose) and the absolute criterion for obligatory radioprotection in the villages (based on the highest levels of contamination). In so doing, the Ministry is not only sacrificing the villages that are most at risk (by omitting the critical group) by excluding them from radioprotection, but going against the “basic saf
ety standards” established by the IAEA, to which it refers. The IAEA itself, recommends83 that radioprotection should be based on the dose to the critical group within a population. The error made by Orekhovsky explains the sentence at the beginning of Nesterenko’s response where he says: “Could I suggest that you find someone more qualified to respond to my letters”. There is a joke in Belarus (people in the ex-Soviet Union maintain their ironic and slightly black sense of humour) about how the average temperature in hospital would prove that the patients are doing very well.
83 Idem
V. Nesterenko.- I need to underline the main omission on the part of the Ministry of Health specialists, when they underestimate the significance of direct measurement using a human radiation spectrometer (HRS) of all patients undergoing medical examination at the clinics. It is only by combining medical examination of the population and HRS measurement of incorporated caesium-137 in the body that the causal relationship can be determined between the incorporation of radionuclides within the human organism and the increase in illness.
Information about this phenomenon can only be obtained in the areas of Belarus, Ukraine and Russia affected by the accident at Chernobyl. It is an important argument for the organisation of radioprotection and in medical treatment, in convincing the international community of the need for aid for Belarus and for a reduction in the radiation exposure of the inhabitants, as well as for an understanding of the consequences of the accident at the Chernobyl nuclear power station (at the moment the only causal link that is recognised is between the Chernobyl disaster and thyroid cancer).
Minzdrav.- Nesterenko’s comments and his conclusions that “Methodological errors of calculation and errors in the 1998 dose register led to a substantial underestimation of radioactive load following exposure to radiation, both external and internal” reveal his lack of understanding of the procedure used to calculate annual effective dose, an erroneous interpretation of the parameters used and an ignorance of the empirical data available. It is a question of estimates of coefficients used to calculate radiation dose, both external and internal, of insufficient information about the people’s diet in Belarus and his elementary ignorance of the application of statistical methods to estimate the indeterminacy of the data obtained.
V. Nesterenko—As a member of the Academy of Sciences of Belarus, in conformity with its statutes, I am responsible for assessing the radiological situation and organising radiological protection for the population of the Republic. My professional career in radioprotection started in 1958, when I was still working at the Academy of Sciences in the USSR (Obninsk). I am, therefore, surprised at your assessment of my “elementary ignorance”.
The Ministry of Health’s grievances against the 1999 expert commission for the 1998 dose register are incomprehensible. The Ministry of Health’s institutes established a register of dose in 1992, according to which of the 3,324 villages affected (more than 2 million people) 1,120 villages, had levels of radioactivity that exceeded 1mSv/year. In the 1998 register, following calculations based on indirect and archaic methods, there were only 169 villages with levels measuring more than 1mSv/year, with 55,181 inhabitants.
The director of the Institute of Radiological Medicine of the Ministry of Health, Professor V.A. Ostapenko, accepted the claims made by the commission of the State Committee for Science and New Technologies concerning the underestimation of internal radiation dose to the population by a factor of 3–8, and the errors made in calculating the external dose. As far as I know, the 1998 register of dose was withdrawn in order to be reviewed.
In January 2000, you invited me to a meeting to examine the new 1999 register where new versions of the register, in which coefficients said to be “in reserve” with a quantile of 0.95%, were proposed. But this approach excluded precisely the critical group within the population (5–7%), who would not then receive the necessary radioprotection.
When we measured incorporated caesium-137 in the bodies of inhabitants (mainly children) in 45 villages in the Gomel region, with a human radiation spectrometer (HRS), and calculated the dose for the critical group, we found that the real dose had been minimised by a factor of 3–8, as with the 1999 register, that was based on selected samples of milk and potatoes.
It is quite staggering to read in your letter the following sentences: “We cannot exclude the possibility that in particular villages the internal radiation dose, measured with a human radiation spectrometer (HRS), could exceed the calculated values. Such cases may arise following the consumption of fruits and agricultural products, mainly milk, which is contaminated above the admissible levels of contamination in Belarus (ALC) But this does not mean it is a “bad” method, because it was never intended to register cases where food contaminated above the admissible levels (ALC) had been consumed” Is it possible, Professor, that you have only just found out that in 550 villages in Belarus, according to data from the Ministry of Health itself, people are drinking milk that contains inadmissible levels of caesium-137?
Finally, it has to be said: we need to abandon these useless attempts to improve an indirect method of calculating internal radiation dose. We need to allocate all our scientific resources to creating a register of real dose, based on direct HRS measurements of the incorporation of radionuclides in the organisms of inhabitants of the regions contaminated by Chernobyl.
Minzdrav.—Analysis of the changes that have occurred over the last five years show an increase in both general and primary illness among victims of all ages. However, the rhythm of this increase in illness in adults and especially in children has diminished in 1999 in comparison with 1994, and is no higher than 1.4% in adults.
V. Nesterenko.—On 21st April 1999, we all listened to the Minister of Health, I.B. Zelenkevich, at the parliamentary hearings at the National Assembly of Belarus. He stated that “1,940,000 people, including 414,000 children, are at risk. In the period following the accident, 1,100 children were operated on for thyroid cancer. Illness among victims of the disaster was higher than in the population that was not affected, and there were indications that this was increasing each year”.
On 25th April 2000, during parliamentary hearings at the National Assembly of Belarus, the deputy Anatoli Volkov stated that among 85,900 children examined by doctors in the Stolin, Luninets and Pinsk districts, 27,000 had diseases of the thyroid gland, 23% had heart problems and 22% digestive tract problems. Only 13.7% of the children could be described as “healthy”.
Given this information, I cannot accept your statement about the decrease in rates of illness in children between 1998 and 1999.
Minzdrav.—There is no convincing scientific data concerning the pathological effects of various levels of radioactive caesium incorporated into the vital organs and systems of the body, as cited by V.B. Nesterenko, referring to the work undertaken by Y.I. Bandazhevsky.
V. Nesterenko.—This statement does not reflect the real picture either. The work undertaken by Bandazhevsky was accepted previously by the Ministry of Health in Belarus. As for the author himself, he received the Albert-Schweitzer Gold Medal in 1998 and an international prize in 2000 in Paris (IPPNW). His work shows that “pathological states are recorded in the vital organ systems of children when levels of incorporated caesium-137 exceed 50 Bq/kg”. It is extremely regrettable that his work at the Gomel Institute has been interrupted.
Minzdrav.—In accordance with the Ministry of Health directive No. 282 of 13th September 1999, radiological diagnosis is subject to a licence from the Minister of Health, and therefore measurements using a human radiation spectrometer (HRS) constitute a medical activity and, according to the regulations, require a licence from the Minister of Health.
There is no doubt that measuring gamma rays in the environment is a physical procedure. However, if the equipment is used for diagnosis of a patient, either for treatment or prevention, as is the case under review, the use of this technology constitutes a med
ical intervention and according to the regulations, needs to be registered with the Minister of Health.
V. Nesterenko.—It is clear that you are substituting one concept for another here. The introduction of radionuclides—iodine 131, technetium—into a patient’s body, for the purposes of treatment or radiodiagnosis is clearly a medical intervention, but the measurement of gamma radiation emanating from a human body, using a human radiation spectrometer, is a normal physical procedure, similar to measuring someone’s height or weight.
Minzdrav.—Using the food additive Vitapect to aid the elimination of radioactive caesium from the human body has been discussed a number of times in a series of meetings, with specialists from the Ministry of Health, the Ministry for Emergency Situations, the consortium Belbiofarm, the Ministry of Agriculture, etc. The Ministry of Health believes that apple pectin products and polyvitamins have a part to play in the prevention of negative effects from internal radiation. However, they need to be prescribed under medical supervision. […] It is unacceptable that they should be produced by random individuals with no medical or pharmaceutical qualification. Moreover, pectin-based products do not specifically eliminate radioactive caesium from the body. The statement made by Nesterenko, who is a doctor in technical sciences, that “there is a 60–80% purification effect in the children’s bodies” is a simplistic approach to a very complex process.
V. Nesterenko.—According to eminent doctors in Ukraine (Professor, Doctor of Medicine, M.I. Rudnev), and in Belarus (Professor, Doctor of Medicine, N.D. Kolomietz), “pectin promotes the elimination of radionuclides, heavy metals and other toxic substances in the body”.
In April 2000, the Belrad Institute received a licence to produce and use the pectin-based food additive Vitapect. Given that pectin is a natural substance, there is no real necessity for a dose limit. It is a dry concentrate of apples enriched with vitamins, whose content in the final product is ten times less than the admissible dose. Therefore the Vitapect recommended by Belrad constitutes a dietary food product and not a medicine.
The Crime of Chernobyl- The Nuclear Gulag Page 31
