Hiroshima Peace Memorial Park. (Inset) ABDI Department of Global Health, Medicine and Welfare head Noboru Takamura.

MANY of us are familiar with pictures of the atomic bombing in Hiroshima, Japan on Aug 6, 1945.

The striking image of the city’s destruction seven decades ago is typically identified as a mushroom cloud. In photos, the effect of the cloud is one of a dusty, barren landscape that looks like abandoned cities on the moon. Three days later, another bombing took place in Nagasaki.

Alarmingly, in Japan, 30 per cent of people have died from cancer. But are these deaths directly connected to radiation exposure?

As cancer becomes a leading cause of death in the world, large-scale population studies of survivors of the nuclear attacks on Hiroshima and Nagasaki have confirmed that radiation exposure can lead to multiple cancers that manifest separately over the course of years or decades.

Professor Noboru Takamura from the Atomic Bomb Disease Institute (ABDI), Nagasaki University, said that, for now, the limitation of science does not allow us to ascertain the actual number of cancer deaths directly caused by radiation exposure.

Takamura was recently in University of Malaya to give a public lecture titled Lessons from Nagasaki, Chernobyl and Fukushima. As ABDI Department of Global Health, Medicine and Welfare head, he has also been studying the accident in 1986 at the Chernobyl Nuclear Power Plant in Russia for more than 20 years as part of his work in nuclear emergencies.

ABDI was established in 1962 to research into treatment and prevention of diseases after exposure to an atomic bomb as well as to study the effects of radiation on the human body.

After the 1986 Chernobyl and 2011 Fukushima Daiichi accidents, ABDI has continued to provide medical assistance for local residents and study contamination levels from radioactive materials.

From 1990 to 2001, Takamura and his team worked to help the people affected by the Chernobyl accident via the Chernobyl Sasakawa Health and Medical Cooperation Project.

“After over 20 years, Chernobyl is still struggling to recover. It has large areas of radiation hotspots compared to the Fukushima Daiichi accident,” Takamura said.

Following a major earthquake in 2011, a 15m tsunami disabled the power supply and cooling of three Fukushima Daiichi reactors, causing the most serious nuclear accident since Chernobyl.

More than 200,000 people were forced to leave their homes because of nuclear contamination concerns when the three reactors failed at the plant after it was flooded.

However, a comparison of data pertaining to the accidents at Chernobyl and Fukushima Daiichi revealed a marked difference in the amount of radionuclides released and number of affected areas. Chernobyl has suffered far more.

“The people in Chernobyl have experienced extensive internal radiation due to the continued consumption of contaminated food. And although the residents within a 30km radius of the affected area have been told to evacuate — no local authority has been placed there to make arrangements and initiate such a move.”

Medical screening buses equipped with ultrasound and various other medical equipment were deployed to areas in Ukraine and Belarus. In addition to cancer support, psychiatric rehabilitation was offered as well.

The radiation exposure suffered by the people covered their entire body and affected the food chain supply. Many people including medical personnel died due to the exposure. There was a dramatic increase in leukaemia and other cancer cases.

In his lecture, Takamura also said that in the event of a nuclear emergency situation, we can best protect ourselves by staying sheltered. It is best to prepare for various scenarios and have a proper line of action for each.

“There should be a proper line of communication from the government to the people. The scientists and the government should take responsibility for advising the people of the real situation and what they should do next.”

He said it is vital to minimise consumption of contaminated food too.

“A chain reaction begins the moment of external radiation exposure. Not only the residents will be affected, but also the environment which includes livestock and the soil will be exposed to radiation.

“To protect the children, contaminated milk must be removed because it contains a high concentration of radioiodine. This affects the thyroid gland as beta and gamma rays cause internal exposure radiation in children.”

Takamura added that Ukraine and Belarus have many cases of thyroid cancer especially among children. The younger the child is when exposed to radiation, the higher the cancer risk.

Takamura also shared his experience in handling the emergency situation in Fukushima through community support.

Nagasaki University has established a base in Kawauchi, Fukushima and cooperates with the municipal government to measure radioactive material, and provides assistance with health consultations.

Undergraduates of the university have been visiting the elementary school to educate the children. Public health nurses trained in risk communication are present to see to the needs of the residents.

“With regard to external radiation exposure, the director general of the Nuclear Emergency Response headquarters gave instructions on whether to evacuate or remain at home. This was done in stages and within a certain radius of Kawauchi Village.

“The Japanese government initiated ‘food control’ measures to minimise internal radiation exposure, and all contaminated cow milk was disposed. The people were given extensive health screenings and follow-ups,” he added.

The situation remained under control. However, unexpected and indirect effects were noted by Takamura and his team. It was clear, for instance, that a form of “social panic” was taking place among the residents of Kawauchi Village at the Fukushima Prefecture.

During a crisis communication talk, an effort by Takamura to meet the residents and explain the situation was met with heated arguments and worried questions as to the future of the village, its residents, the well-being of the children and those who will be born there.

So there was a gap between the reality of the situation (that all measures were in place to protect the residents) and the perception of the residents (who had been affected by what they had read on social media i.e. Twitter, Facebook etc).

Another interesting indirect effect, Takamura said, is an increase in obesity levels. This unusual data came from a Body Mass Index count taken before and after the disaster.

The government has also advised the residents to move from Koriyama City, where they had been evacuated, back to Kamauchi Village which was deemed safe. As part of the process, public schools and houses were decontaminated, trees cut down and there was a removal of surface soil to allow the restart of agriculture.

However, the rate of return has been slow, less than 50 per cent of the population have returned to the area; people aged 40 and below are especially reluctant to return.

Recently, a marathon was organised at the village with runners including people from the university. The idea is to reassure the residents that the area is safe.

During Fukushima’s compound disaster (earthquake, tsunami and nuclear power plant accident), it became clear that there was a shortage of medical science professionals knowledgeable about disasters and radiation exposure.

At the lecture, Takamura took the opportunity to encourage people to sign up for the Master’s in Disaster and Radiation Exposure programme, a medical science joint degree offered by Nagasaki University and Fukushima Medical University.

“There is a critical lack of personnel with specialised knowledge, aside from the doctor who first meets the disaster victim.”

In the future, he said, preparation and provision against nuclear disasters in radiation accidents will be urgent issues, not only in Japan but also in other countries.

“Since the number of nuclear power plants is expected to increase throughout Asia, so will the need for these skills.”

Students in the postgraduate course will learn to prepare for emergencies and complex disasters in the area of healthcare as well as rescue, led by academicians who are experts in their field. Currently, course students come from the world over including Cambodia and Congo but none yet from Malaysia. A full scholarship covering tuition and accommodation is possible, he added. For details of the programme, visit www.fmu.nagasaki-u.ac.jp/en/?

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