This is an account of the Yuri Grigoriev, appointed Deputy Commander by the Ministry of Health of the Soviet Union to plan and carry out the medical evacuation and treatment of radiation victims of the Chernobyl nuclear disaster in 1986. The first three weeks, from April 26th to May 15th he was in Moscow, receiving patients and setting up decontamination and health care for the injured. On May 15th, he relocated to the scene of the Chernobyl accident. Grigoriev spent the next month documenting radiation levels and developing protective measures for those working where the radiation levels were most severe near the reactor disaster zone.
Dr. Grigoriev, is Professor, Doctor of Medical Sciences, General Director of the Center of Bioelectromagnetic Compatibility. He is the author of 18 books and more than 370 research articles on the biological action of ionizing and non-ionizing radiation, radiation protection of astronauts and general population, and assessment of the hazard of physical factors.
Dr. Grigoriev says "Here, I am going to share my memoirs of the first 6 weeks after disaster as a physician-radiobiologist with 40 years of experience, including my medical experience during the World War II. This will be a brief report of what I saw and did during this period.”
The accident happened shortly after 1 a.m. on April 26, 1986. Several hours later, in the early morning of this day, the Director of the Medical Agency at the Ministry of Health of Soviet Union issued an order "Creation of the team for liquidation of the accident at Chernobyl Nuclear Station." I was appointed as the deputy commander, and my duty was to organize and monitor the hospitalization of the victims with severe radiation disease in Moscow and the course of their treatment.
At 9 a.m. of April 27, all members of the disaster team were convened at the office of the Director of the Institute of Biophysics at the Ministry of Health (The Institute of Biophysics at Ministry of Health was created in 1947 to investigate the biological effects of the ionizing radiation and to develop methods of care for the victims with radiation pathology). At that moment, the information was very limited, but for us, experts in radiobiology, it was clear that the accident resulted in the emission of radioactivity in the atmosphere and potential severe injuries for the personnel of the Chernobyl nuclear station.
Further, the events were going very fast. At 10 a.m. of the same day, I was in the hospital #6 that belonged to our institute and, for many years, specialized in the treatment of radiation traumas. All victims with serious damages from the radiation exposure were flown to this hospital only.
The situation was very dramatic: we, as radiobiologists, understood that the airplanes and buses that transported the victims were already contaminated and, for that reason, could not be used further for transportation. In addition, we must minimize the radiation pollution of the hospital rooms and offices. All action must be done as fast as possible.
Examining the status of individuals and the primary reaction of their organisms, we quickly understood that these individuals had the heaviest form of radiation disease. I should note that they were diagnosed by the team of experts from our Institute that had been dispatched at the night of the disaster into Chernobyl area and in Moscow were sent in emergency order only the patients with the heaviest radiation disease.
It quickly became clear why we did not obtain information from the dosimeters around the reactor—they simply went out of order because the radiation was beyond the range the meters would withstand.
I was responsible to secure the acceptance of the victims and for "cleaning" them from any possible radiation contamination. It was a very difficult task because we need to change their clothing and decontaminate their bodies, which for some patients was an impossible task. Further, I needed to ensure that the hos pital facilities are only minimally contaminated and to prevent spreading of radiation across the hospital staff.
One should remember that the world was not exposed to a catastrophe of such dimensions, and in many cases, we needed to improvise.
For example, the hospital #6 did not have enough blood and plasma to handle so many patients delivered at once by buses from the airport; however, with the help of the Ministry of Health, we quickly ensured continuous delivery of blood and all necessary medications. Another example — we did not have enough personnel and devices to conduct dosimetry of people entering and leaving the hospital. This problem was resolved within an hour. We needed more doctors and supporting staff, even receptionists. Problems occurred every hour, even every minute — we needed linens and bandages, antimicrobial underwear, protective suits, gloves and glasses.
All this was at the entrance of the hospital. But the situation also required resolving "technical" problems such as packing and utilization of materials polluted with radioactivity, such as bandage, injection vials, even boxes from medication. It seems easy in normal conditions, but not in a situation like this. I called in the authorities and a detachment of Civil Defense quickly arrived in the hospital and were located under tents in the hospital court yard. The soldiers stayed in the hospital courtyard for one whole month. We needed to continuously deactivate the whole hospital and adjacent territories. All rooms adjacent to the rooms with victims (left and right, up and down floors) were emptied to avoid any additional exposure problems.
For some of the heaviest cases, transplantation of bone marrow was necessary and we called the relatives of the victims. For them we had to secure accommodation within and outside of the hospital, subjecting them to all necessary protection and dosimetry control.
On the South–East (Kiev) railway station in Moscow refugees from Kiev, Pripjat and other locations around Chernobyl began to arrive. Right on the railway station, we organized examination and dosimetry of these people. The Ministry of Health dedicated a hospital in Moscow to hospitalize patients whose dosimetry and clinical data required further monitoring and eventually treatment. The staff of this hospital received a specialized short course on radiation pathology.
It was decided to create photo and video documentation of the entire process of treatment of victims with radiation disease and especially radiation caused burns. It was impossible to organize professional recording with the teams of "Central science film" because of the total radiation pollution of the entire hospital. There was appropriate equipment in my laboratory; therefore, this job was conducted by my associates and as a result we could take some rare photographs.
By May 5 (10 days after the accident) in the hospital #6, 172 individuals were hospitalized with heaviest forms of radiation disease, 47 of them being firefighters. All of them were in very complicated status with visual burns, in severe pain and with little chance to survive. To work with these patients was very difficult both physically and psychologically. After a few days the hospital staff became exhausted and even a small remark led to reactions which cannot be expected in normal time. I saw one doctor on duty after night shift went to nervous crisis.
It should be remembered that all medical staff entering the rooms with irradiated patients became also exposed to intensive radiation from victims who they were supposed to serve. We should express deep gratitude to the entire personnel, from the reception area, to sterile rooms, to specialized offices and laboratories, to dosimeter controllers for their tireless service and sacrifice.
As experienced radiobiologists, we understood that some of our patients would not survive—they received radiation doses of more than 1,000 rad, which resulted in large and deep radiation burns and penetration of significant amount of radioactive material inside their bodies. Therefore, we should plan events connected with their funerals. It included selection of appropriate location(s) for funerals, estimation of the necessary depth of tombs in order to avoid increase in the radiation level above the tomb. In short time, we needed to equip vehicles that will transport the dead bodies with strong protection layers so as not to harm the drivers and to avoid radiation pollution from the hospital to cemetery.
Of course, every day offered a situation that was not predicted or even thought about. On May 13, the first victim passed away. The pathologists refused to accept the dead body for the much needed autopsy: the body was seriously polluted with radioactive material and it might result in contamination of their working space. Soldiers from the Civil Defense detachment moved the body to the bath tube in the reception area. Since everybody refused to wash the body, it was me to resolve this situation. I wore the protection suit, respirator, and gloves, took a brush on long handle and using water and a special solution, washed the body. This is a demonstration that the dynamics of the situation required sacrifice and heroism from everybody involved in the process.
On May 14, I received a call from the Ministry of Health stating that the next morning (now twenty days after the accident) I should be at Domodedovo Airport to fly to the disaster site. We arrived by plane in Kiev, took a helicopter and flight to the real inferno. The copter flew over the damaged reactor and the nearest town of Pripjat. We saw damaged buildings and structures, abandoned houses and agricultural fields.
In the headquarters located in Chernobyl, the teams of the Ministry of Health were situated in a special area. Here I was given detailed information on the radiation situation in the reactor zone, in Chernobyl and Pripjat, as well as within the entire 30-km zone around the reactor.
My job was to travel within the affected radiation zones and document radiation levels. I had access to every point within the 30-km zone. At my disposal was a car with personal driver and it significantly facilitated my work. However, at the territory of nuclear station the movement was possible only with special vehicles that looked like tanks.
I immediately went into the ‘normal’ working cycle: 9 a.m.—morning briefing, then inspection of radiation safety in different locations, working meetings until the evening briefing at 9 p.m. After that—departure out of the 30-km zone, dinner and going to bed not earlier than 1 a.m. Wake- up call was at 7 a.m. In other words, only 5–6 h was available for sleeping.
I visited the damaged reactor number 4 several times to assess the working condition for miners who prepared the concrete stretch under reactor. Special, protected corridors where the radiation was reduced were created; nevertheless the safest way to pass there was running—to minimize the time of exposure. I explained again and again how to follow the methods and use the tools for individual protection and insisted everybody to use them even if these precautions created discomfort during the work. The main issue was to minimize the negative effects of radiation on each and everyone of the people under our supervision.
Cigarette smoking in the zones with high level of radiation turned out to be a serious concern—it was a quick way for radioactive particles to enter the internal organs.
Smoking in closed rooms was forbidden, so the smokers used to go outside, sit at the bench and smoke—often. One may not believe, we took a very simple decision—we removed the benches around the buildings. At least, the smokers would finish the cigarettes more quickly and will go out to smoke less frequently.
A lot of time was consumed for telephone conversations. I received calls from our Institute, from Ministry of Health, from news media, from colleagues. Many calls were from scientists and physicians, even from ordinary citizens who suggested popular remedies. I suggested the creation of "pharmacological commission" in our institute to collect and analyze all proposals, even those that look inappropriate. We learned to work under pressure of time and conditions.
One of the most serious problems I needed to resolve was ensuring the protection of firefighters. Some of their locations were just around the reactor #4 where the radiation levels were the highest. As radiobiologist, I calculated that for just 1 week, working in shifts, a firefighter could receive radiations of 20 rad, which was the highest permitted radiation level.
I requested that the Governmental Commission introduce completely new order of work: a firefighter should work around reactor #4 a maximum 2 h per week, using respirator, having continuous monitoring of leukocytes level and his health being examined every 10 days.
We knew that for recovery of the organism after exposure to ionizing radiation was very important to maintain sufficient pool of bone marrow. A significant amount of bone marrow is concentrated in the pelvic area. Having this in mind, I proposed to surround the firefighter posts with lead blocs to the level of firefighter chest in order to protect the body parts containing most bone marrow. The proposal was accepted and quickly turned into reality.
Earlier we created an office for psycho-emotional relaxation because it was clear to me that many of the people working in the headquarters had been already under stress arising from the situation: nuclear explosion, radiation everywhere, special regimen of work, increased responsibility for any action and decision, long hours of work. I felt that as if I were back to the War years I experienced in 1943–1944.
It might be interesting to note that within 30-km zone everything was free of charge: transportation, food in any restaurant, housing, and any living service. Money did not matter at this area.
Summarizing, I should say that the experience during the first month or two after Chernobyl accident is a significant confirmation that the years of research in nuclear physics, radiobiology and public health provided scientists, clinicians and public authorities with knowledge that allowed making quick decisions in situations when time was limited.
Nearly 25 years after the Chernobyl disaster, the world was shocked with the tragedy in Fukushima. Immediately after the first news was broadcasted, I began to receive telephone calls and e-mail requests from my Japanese colleagues and colleagues from other countries of North America and Europe in regard of prophylactics against ionizing radiation. I shared my experience, especially in regard of evacuation, and doses of iodide to be prescribed to different population groups, especially children.
It is always sad that home-made disasters happen. Under situations like Chernobyl and Fukushima, the scientific knowledge accumulated during the decade of laboratory experiments and clinical trials, even when some errors were made, became of crucial importance.
Especially, after the Chernobyl disaster the scientific world obtained enormous information, at the cost of many lives and suffering.
After the first weeks of secrecy (obviously needed to avoid spreading of inaccurate information), and months of politically motivated finger pointing, a lot of conferences and publications summarize the heavy work done to minimize the damages from the explosion.
I would like to believe that our Japanese colleagues took some of our experience in their work after Fukushima disaster. Such accidents are sad, but the mankind has to learn valuable lessons from them.
The full article is published in Environmentalist, Volume 32 · Number 2 · June 2012. Copies can be obtained from Dr. Grigoriev or Cindy Sage.
