Lessons from on-site medical support activities In 1988, I was requested by NHK Hiroshima to translate a report of the Chernobyl nuclear power plant accident and understood for the first time how serious the accident was. Next year, I acted as an interpreter for Dr. Alexander Yakovlev, chief of the Radiology Laboratory, Kiev Research Institute of Pediatrics, Obstetrics, and Gynecology when he visited Hiroshima. During August and September 1990, I visited the former Soviet Union for the first time in 15 years as a medical interpreter for the “Citizens’ Investigation Team for Chernobyl Accident.” In October that year, I served as an interpreter for a lecture given in Hiroshima by Mr. Igor Kostin, a photographer from Kiev who visited Japan on the invitation of the Asahi Shimbun Co. In January 1991, at the request of the Asahi Welfare and Culture Corporation, I joined as a medical interpreter the “Light to Chernobyl” project jointly supported by the said corporation and the Japan Red Cross. This was the beginning of my involvement with the “Chernobyl nuclear power plant accident.” In April that year, I accompanied a physicians’ team which visited Japan as the first training group supported by the said project to the Prefectural Office and RERF for its courtesy calls. On that occasion, we were told by Governor Takeshita and RERF Chairman Shigematsu about the establishment of HICARE. Until then, while working for support groups in places other than Hiroshima, I had always wondered why Hiroshima, the first A-bombed city in the world, had been so slow in providing medical support to those exposed to radiation in other places. I well remember how I felt encouraged by hearing about HICARE, while interpreting for them. There were differences in various aspects between Japan and Russia, including the organization of the Red Cross (in Russia, the Red Cross headquartered in Moscow had no hospital, hematology center or physician exclusively belonging to it) and the speed of conducting administrative work. In each stage of the project, we could not feel relaxed until we visited the country or until we actually confirmed the arrival of physicians and children in Japan. From about that time on, we received reports from local physicians about an increase of childhood thyroid cancer, but no sufficient data were available. This was the time when various issues were raised. Under the circumstances, I felt it necessary to make various experts interested in the support project. Furthermore, specialists who can bring back to Japan data or tissue specimens that would satisfy interested experts, epidemiologists, pathologists, and clinicians considered, after seeing how thyroid cancer surgery was performed there, that experts in thyroid surgery were necessary for the establishment of a system for early diagnosis and treatment. On August 28, 1991, Dr. Nobuo Takeichi, a lecturer at the Second Department of Surgery at Hiroshima University (currently director of Takeichi Thyroid Clinic) and I stayed at the Ukraine Hotel in front of the Russian Republic’s supreme council where barricades placed at the time of Moscow citizens’ uprising remained. Dr. Takeichi enthusiastically talked about thyroid cancer among A-bomb survivors in Hiroshima and those exposed to radiation in Chernobyl. We earnestly talked about the future support activities, forgetting the passage of time as the night of Moscow wore on. This was one of my good memories of the journey to Russia. Based on the reporting and advice of Dr. Larisa Danilova (Medical Reeducation Academy, Hospital No. 10 in Minsk), who visited Hiroshima for training supported by the Japan Red Cross, the Japan Red Cross Hiroshima Prefectural Branch, and the Red Cross Hospital & Atomic-bomb Survivors Hospital, examinations mainly for thyroid cancer have been conducted since 1997 under the support of a citizens’ group “Chernobyl Support Campaign in Kyushu” (membership: 2,800 or more) at the Stolin District Central Hospital and Brest State Cancer Hospital in Brest State, which had been considered to be a non-contaminated region. Dr. Kenjiro Yokoro, former director and professor emeritus of the Hiroshima University Research Institute for Radiation Biology and Medicine, participated in the sixth examination in Stolin and an international symposium in Minsk in October 1999 and the second examination in Brest in December 2002. At the international symposium, Dr. Yokoro delivered a special lecture entitled “An Atomic Bomb Dropped on Hiroshima” and was appointed the 46th honorary member of the Belarusian Medical Academy. In May 2004, a team dispatched by the Japan Red Cross Hiroshima Prefectural Branch and the Japan Red Cross Hospital headed by Dr. Fumio Sawano, chief of the 5th Department of Internal Medicine, conducted thyroid-cancer examinations at the Brest State Cancer Hospital in cooperation with a mobile examination team from the International Red Cross. Dr. Sawano had been providing training and guidance to dispatched medical teams since 1991. At Hospital No. 10 in Minsk, examinations of diabetes mellitus and related lectures were conducted by Dr. Alexei Ramanovski, an endocrinologist who received HICARE-supported training in Hiroshima. During 2004, a fund-raising campaign by the members of the “Chernobyl Support Campaign in Kyushu” group enabled the purchase of the second examination automobile (Volkswagen, Co.). In October, at the State Endocrinology Hospital in Vicebck, a control area, Dr. Nobuo Takeichi conducted medical examinations based on the exposure dose data provided by Dr. Masaharu Hoshi, a professor at the Hiroshima University Research Institute for Radiation Biology and Medicine, for the first time as a Japanese medical team. I think that medical support should be provided in such a way that physicians in radiation-exposed regions can provide medical care for the local residents. If a necessary medical care system is established, support teams should withdraw right away. Support for those exposed to radiation throughout the world, including the victims of the Chernobyl accident, cannot be provided by a single organization. I believe that support of this kind should be handled at the political, diplomatic and financial levels by the countries involved. I therefore fear that the main medical support project may reach an impasse in the future, unless the ongoing support projects of various organizations in Japan can influence the countries involved. If our support projects are to be of such a high level, it is natural that precise analysis of the current state of the areas requiring support and collection/analysis of information with scientifically objective basis are required even for citizens’ groups. While Japan has been involved in various forms in support activities for nuclear victims throughout the world, the mentality of those who are provided with support has changed over time. However, I feel that those who provide support seem to be still attached to their original sentimental idea about a support project and cannot grow out of their naive comradeship. I keenly feel this whenever I study the details of requests for support from those who are provided with support. There is a subtle discrepancy between what is requested from those who are supported and what is focused by those who provide support. It may be high time for the support organizations, especially citizens’ groups, to spend much time seriously discussing again how Japan’s support projects should be in the future. Those who are provided with support often say, “It seems more effective to have many support groups in Japan unified, so that a medical care facility can be established in our country.” Whenever I hear such a practical request, I have to think about what I have just described above. In the future, it will become more important for various organizations concerned to share relevant information and closely cooperate with each other to deal with the negative legacy of the 20th century. On the way back from various affected areas to Moscow, I always feel at ease. Probably because I lived in Moscow for the greater part of my twenties, I sometimes get a sudden surge of nostalgia for that city. Unlike the time when I lived in Moscow, the Federation is now undergoing radical changes. Recently, however, I feel that each republic is gradually moving towards a good direction. Each of the republics possesses its own splendid history, culture, and tradition. Whenever I visit various places in the Federation, I feel that I want to learn more about the above-mentioned aspects of each place and well understand the people and maintain good relations with them. [References]
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