We meet Mykhailo Shatskyi, 86, in his hospital room in the haematology ward. Initially reluctant to speak, he softens when his favourite doctor asks him to give an interview.
Within minutes, Mykhailo is immersed in memories from 40 years ago, vividly recalling how he evacuated people from the exclusion zone. This chapter of his life began on 26 April 1986, when an explosion occurred at the Chornobyl Nuclear Power Plant in Kyiv Oblast.
The Soviet authorities were slow to disclose the accident, but when elevated radiation levels were detected in Sweden, the world's attention turned to the man-made disaster in Ukraine.
The Chornobyl disaster changed the lives of hundreds of thousands of Ukrainians. The evacuation of Prypiat began the day after the explosion at reactor 4, but people were never told they would not be coming back.
The evacuation gradually spread beyond Prypiat to nearby towns and villages, eventually forming what became known as the 30-km exclusion zone.
Thousands of firefighters, medics, engineers, soldiers, drivers and plant workers took part in dealing with the aftermath of the disaster.
Those not directly involved in the response effort at the plant itself often did not realise the deadly danger: some relied on basic protective gear such as gauze masks that provided almost no protection against radiation.
Some Chornobyl first responders were less severely affected than others. Many, now in old age, are battling numerous illnesses caused by radiation exposure.
Known as "liquidators", the first responders were civil and military personnel called in to deal with the immediate and long-term aftermath of the nuclear disaster, at great personal risk.
Today, Mykhailo is undergoing treatment at the National Research Centre for Radiation Medicine, Haematology and Oncology of the National Academy of Medical Sciences – one of several key institutions providing care to first responders and others affected by the disaster. Over the past 40 years, hundreds of thousands of Chornobyl survivors have been treated there.
Ukrainska Pravda. Zhyttia (Life) spoke with Mykhailo, and some of the doctors who have worked with patients like him for many years, about the long-term repercussions of the disaster.
"We arrived in Prypiat and there were no lights on – it was terrifying"
On 26 April 1986, Mykhailo Shatskyi, an employee of the Ministry of Road Transport, was celebrating his 40th birthday. His nephew was getting married the same day. Sitting in the restaurant after lunch, he heard some of the guests discussing something: "There's been an explosion at Chornobyl."
Mykhailo barely gave it a second thought – accidents at infrastructure facilities were not unusual. He didn't know that within weeks, he and his colleagues would be evacuating people from the contaminated territory that later became the exclusion zone.
"We were at a wedding in a restaurant when people started saying after lunch that there had been an explosion in Chornobyl," he recalls. "I remember saying: 'As if there haven't already been enough accidents.' Then it turned out to be the biggest disaster of all. Rumours were going round despite official attempts to conceal what had happened. Radio Liberty [the Ukrainian service of the American broadcaster Radio Free Europe/Radio Liberty] was already reporting on it, while our authorities kept saying: 'Everything is fine'."
Immediately after the disaster, Mykhailo was appointed head of a working group overseeing road transport operations in the Chornobyl zone. He spent 31 days there without going home, sleeping either in his office in Chornobyl or in Zelenyi Mys. His main responsibility was organising the evacuation and supervising drivers brought in from across Ukraine. Food supplies for the first responders were delivered in 70 refrigerated lorries.
"Every day I made sure no one was drunk, discipline was adhered to, vehicles were refuelled and there were no incidents or accidents," he says. "I also made sure people and deliveries arrived on schedule. Everything ran smoothly."
On one occasion, Mykhailo and a colleague went to Prypiat to see how the police units were getting on. By that point, the city had effectively been frozen in time: all residents had been evacuated, permitted to take only documents and basic essentials with them. Pets had been left behind, as they were not allowed to be taken.
"Prypiat was completely fenced off with barbed wire," he said. "It was a large city, with more than 30,000 residents. It was right next to the power plant. Chornobyl itself was farther away, but Prypiat was right beside the reactors.
We arrived in Prypiat and there were no lights on – it was terrifying. The buildings were standing there with no lights, nothing at all," he recalls. "We drove through Prypiat and headed back. As we were leaving, there were about five or six policemen on duty at the checkpoint. And there were dogs everywhere. The people had been evacuated, but the dogs were left behind. They were hungry and kept coming up to people."
After the disaster, thousands of people were evacuated from the Chornobyl zone. No matter how hard the Soviet leadership tried to downplay the scale of the catastrophe, the streets of Kyiv were almost deserted within a few weeks that spring.
"I remember going outside in Kyiv and there being nobody around," Mykhailo recalls. "At first they covered it up, but then it got out that windows shouldn't be opened and vents had to be covered with wet cloths. You'd go out to the shops and not meet a single person."
Mykhailo also helped to take children aged between three and five from Kyiv and the oblast to Yevpatoriia in Crimea.
"I suggested that we seal off the bus station entirely and keep outsiders out until the children had boarded the buses," he says. "That's what we did. We needed 30 buses, and I insisted on three reserve buses as well. They only provided two, and I said: 'No, we need three.' In the end, they brought another one in, so that if one broke down, the children could be transferred.
The convoy was about a mile long, with police vehicles and flashing lights at the front. We got the children there safely, everything went well," he says.
Mykhailo recalls that he did not even use a radiation dosimeter, saying that at the time, most people did not realise the deadly danger they were facing.
"They gave us these little pen-like devices [self-reading pocket dosimeters], supposedly to accumulate radiation exposure. But nobody used them, nobody checked them. I might as well have put that dosimeter right next to the reactor and recorded whatever reading I wanted. Disability status was not determined by those devices, but by a person's state of health," he says.
After the operation ended, Mykhailo underwent a series of medical examinations for first responders. At the time, he could not have imagined the toll that radiation would later take on his health.
Since 1986, Mykhailo has suffered four heart attacks, and in 2019, he began treatment for leukaemia.
"A few years after Chornobyl, the heart attacks began one after another – four in total. The doctors said I had a bundle branch block. My heart only works at half capacity.
Before that, I used to do sport – I held a first-category volleyball qualification [he was an advanced club-level athlete in the Soviet sport system – ed.]. In my army unit, I could lift kettlebells better than anyone else, and I could do about 30 one-legged squats. I was strong. But once my heart started to fail, that was it. Now I can't even carry a five-litre bottle of water without stopping," he laments.
Mykhailo has been in and out of hospital in recent years. Age and the effects of Chornobyl have taken their toll. He says that a few years ago, he suddenly became seriously ill – he could hardly walk, and was sent to Feofaniia Hospital in Kyiv.
There he saw wounded soldiers lying in the corridors due to a shortage of beds.
"It was hot, and they were still in uniform, in that heat… I felt so sorry for those soldiers… I looked at them and thought: it would be better for me to die than for some soldier to be moved out of there because of me," he says.
Mykhailo is losing his hearing and eyesight now too – this may be due to both his age and the effects of radiation.
But Mykhailo's doctor, haematologist Zoia Martina, says he is holding up well: now in the seventh year of cancer treatment, doctors are trying to maintain his quality of life and minimise pain.
The only thing Mykhailo does not always manage to maintain is his mood. At times he becomes pessimistic, but as soon as he starts talking about the other first responders, he smiles. He says they were extremely disciplined.
He still keeps in touch with them. Every year, he visits the memorial to the motorists and road workers who worked in the Chornobyl zone in 1986. The installation of the memorial was partly his own initiative.
Tens of thousands of people took part in the clean-up after the Chornobyl disaster, including more than 30,000 motorists alone. Yet their memory, like that of other first responders, is preserved mostly by their fellow liquidators – those who are still alive.
Every year the number of elderly witnesses to those events declines: where once several hundred people would gather at the memorial, now only 50 to 60 come.
As we speak about memory and remembrance, Mykhailo says: "I read that there was a cooling water tank beneath the reactor when it exploded. And if all that molten mass had broken through into the water, there could have been another blast. The water had to be drained, so they found three welders who knew where the hatch was because they'd welded it themselves.
They went in knowing it was nearly certain death. Afterwards they were taken to Moscow, where they died horrible deaths in agony. And who remembers them now? People don't even know who they were."
Mykhailo doesn't particularly celebrate his birthday. Even though his granddaughter and son come to see him every year to mark the occasion, the date carries little sense of celebration for him.
"Radiation affects practically everything." How Chornobyl has affected Ukrainians' health
Mykhailo is just one of many Chornobyl first responders who have spent years receiving treatment at the National Scientific Centre for Radiation Medicine, Haematology and Oncology of the National Academy of Medical Sciences of Ukraine.
Volodymyr Zhovnir, the acting head of the institution and a doctor who treats patients like Mykhailo, says the scale of the catastrophe still strikes him even today.
"The total contaminated area is around 145,000 sq km. That is a vast territory – the size of some countries," he says.
More than 1.4 million people can be considered affected. The figure covers a range of exposure levels, from direct radiation exposure to living in contaminated areas.
Up to 600,000 people took part in dealing with the aftermath of the disaster, from those who worked in the Chornobyl zone in the very first days after the explosion to those who later helped build the New Safe Confinement (colloquially known as "the sarcophagus"), organised evacuations and carried out technical work.
"Some of the people who were there on the very first day – around 300 – developed acute radiation sickness. Other first responders were affected to varying degrees," Zhovnir explains.
Tens of thousands more were forced to leave their hometowns: according to various estimates, between 35,000-40,000 and almost 90,000 people were resettled. In the first few years after the disaster, hospitals saw a large influx of patients from contaminated areas, largely linked to the consumption of food products (especially mushrooms and milk) contaminated with radionuclides.
Thyroid cancer is the most common health effect of the Chornobyl disaster, particularly among those who were children in 1986, according to Dr Mykola Tronko, director of the Vasyl Komisarenko Institute of Endocrinology and Metabolism. Those most affected were people with iodine-deficient diets.
In addition to thyroid cancer, doctors have spent nearly 40 years treating many other Chornobyl-related diseases.
Haematologist Zoia Martina, who has been working with such patients since 1992, explains that many radiation-related blood disorders are classified as stochastic effects. This means there is no threshold dose below which they do not occur; for instance, blood cancer may develop even after minimal exposure to radiation.
It was once believed that certain forms of blood cancer were not linked to radiation, but Ukrainian researchers have been able to disprove this.
"Chronic lymphocytic leukaemia used to be regarded as unrelated to radiation exposure. But we've demonstrated internationally that it can, in fact, be caused by it. The international radiation safety standards were later revised based on our scientists' work," Martina says.
Symptoms of the disease include a weakened immune system, enlarged lymph nodes and changes in blood test results. Patients often develop secondary immunodeficiency and are at increased risk of infections, including shingles.
In recent years, doctors have also observed new trends. There has been a significant rise in cases of multiple myeloma – a form of blood cancer that affects the bones and leads rapidly to disability. Martina links this to the build-up of radionuclides, especially strontium, in bone tissue.
Since Chornobyl, Ukraine has seen an overall increase in cancer cases, including colorectal cancer.
Martina says that once cancer has developed, its progression in Chornobyl first responders is no different from that seen in other patients, and treatment follows standard principles.
Today, however, most patients are over 60 and suffer from a range of co-morbidities: cardiovascular disease, diabetes and ulcers. Not all of these conditions are caused by radiation, but they cause further complications for patients' health.
"Radiation affects practically everything: the cardiovascular system, the hormonal system, the nervous system. These people develop heart attacks and atherosclerosis much more quickly," adds hospital director Volodymyr Zhovnir.
He also notes the impact the disaster has had on children and future generations, since radiation causes mutations in DNA.
"There is a build-up in the placenta, and this affects foetal development. Birth defects are more common among children in contaminated areas," Zhovnir says.
The hospital hopes to conduct more research into the epigenetic impact of the Chornobyl disaster on future generations.
As for the Chornobyl first responders themselves, their numbers are steadily declining – many of those who were treated at the radiation medicine centre for years have now died.
40 years on from the Chornobyl disaster through the eyes of medics
The Centre for Radiation Medicine, Haematology and Oncology still retains records on the millions of people who have been examined. Around 2 million people have had internal radiation exposure assessments – evaluations of radionuclide levels in the body.
Forty years on from the disaster, Ukraine is trying to use the experience of Chornobyl to prepare for new threats. According to Volodymyr Zhovnir, the institution serves not only a medical purpose, but also a strategic one.
"Our primary focus is medical support for Chornobyl survivors. The second is a strategic task: preparing medical professionals and the institution itself to respond to radiation-related emergencies," he says.
The hospital has specialised laboratories capable of determining a person's level of internal radiation exposure. Specialists also examine food, water and soil in order to assess whether they are safe. People can even bring mushrooms to the laboratory, and they will measure how much radiation they contain.
Another area of work is long-term monitoring of those affected.
"We study the link between contamination and disease: how much tumour and non-tumour illnesses have increased, how people are doing and what is happening to them," Zhovnir explains.
Ukrainian medics also cooperate with their colleagues internationally, particularly Japanese researchers studying the aftermath of the atomic bombings of Hiroshima and Nagasaki and the accident at the Fukushima Daiichi Nuclear Power Plant.
It was Ukraine's experience dealing with the aftermath of the Chornobyl disaster that helped the Japanese respond more quickly after the Fukushima disaster.
"The Japanese came to us asking for our experience. And the measures we implemented after Chornobyl – evacuation, decontamination and food monitoring – they introduced those as well," Zhovnir says.
Why radiation is not just a horror story from the past
Ukrainian medical professionals are constantly preparing for possible new incidents. The hospital regularly conducts simulation exercises, working with the State Emergency Service, the police and the Red Cross.
The scenarios are designed to be as realistic as possible: medics recreate responses to a nuclear power plant accident, rehearse procedures for receiving casualties, and practise triage, decontamination and treatment.
"Ambulances arrive with flashing lights, bringing in patients. We look at what they are wearing, how they are transported, how the dosimetrists work and how they are decontaminated," Zhovnir explains.
Even the smallest details are meticulously considered – where to dispose of the water used to wash off radioactive dust, how to decontaminate clothing, how to organise patient flows.
"We've even worked out where the water from the showers goes afterwards – because that's contaminated too," he adds.
These exercises are not limited to a single institution – other medical facilities also take part so that the experience can be shared more widely.
Particular attention is paid to readiness for situations that could arise today, especially because of the war.
This includes both the risks surrounding the Zaporizhzhia Nuclear Power Plant and the threat of Russia using a "dirty bomb".
Zoia Martina adds: "If you think about Enerhodar as well, with six reactors under occupation, then any provocation would not just mean another Chornobyl – it would affect the entire Dnipro basin, as well as the Black Sea and the Mediterranean.
We haematologists need to stay alert and always be prepared for whatever may happen."
In the event of another radiation accident, medical professionals would find themselves at the centre of events at least as much as they were during the Covid-19 pandemic. They must be prepared.
That is why specialists at the radiation medicine centre believe the experience of Chornobyl cannot be considered a thing of the past.
"One of the most dangerous myths is that it's all over and forgotten. That is not the case," Zhovnir stresses.
He says the issue of Chornobyl will remain relevant for at least decades to come.
"Sadly, we will be feeling the effects of this tragedy for a very long time. But it has also given us invaluable experience," Zhovnir concludes.
He jokes that in the event of a nuclear strike, people in Kyiv would be better off gathering outside a hospital rather than on Shchekavytsia Hill [the venue, according to a meme that went viral in 2022, for an orgy to be held just before the world ended if Russia launched a nuclear strike – ed.]. At least there, the medical professionals would definitely know what to do.
Olena Barsukova, Ukrainska Pravda.Zhyttia (Life)
Photo: Oleksandr Chekmenov, Ukrainska Pravda
Translated by Myroslava Zavadska
Edited by Artem Yakymyshyn