Four decades after Chornobyl: an 86-year-old first responder on radiation, survival and illness

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 once 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 Nuclear Power Unit No. 4, but people were never told they would not come back.

The evacuation gradually spread beyond Prypiat to nearby settlements, eventually forming what became known as the 30-kilometre exclusion zone.

Thousands of firefighters, medics, engineers, soldiers, drivers and plant workers took part in dealing with the aftermath of the disaster.

People who were not taking direct part 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 affected less severely 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 – a key institution 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) has spoken with Mykhailo and doctors who have worked with such patients for many years about the long-term repercussions of the disaster.

"We arrived in Prypiat and there were no lights on – it was terrifying"

Mykhailo Shatskyi, an employee of the Ministry of Road Transport, was celebrating his 40th birthday on 26 April 1986. On the same day, a nephew of his was getting married. After lunch, while sitting in a restaurant, he heard guests discussing something: "Something's exploded in Chornobyl."

Mykhailo barely gave it a second thought – accidents at infrastructure facilities were not unusual. He did not yet 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 circulating 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 returning 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 by 70 refrigerated lorries.

"Every day I made sure no one was drunk, that discipline was kept, that vehicles were refuelled and that there were no incidents or accidents," he says. "I also made sure people and cargo were delivered on schedule. Everything ran properly."

On one occasion, Mykhailo and a colleague went to Prypiat to see how police units were working. By that point, the city had effectively been frozen in time: all residents had been evacuated, permitted to take only documents and basic essentials. 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 stood right next to the power plant. Chornobyl itself was farther away, but Prypiat was right beside the power units.

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. 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, Kyiv's spring streets were almost deserted within a few weeks.

"I remember going outside in Kyiv and there being nobody around," Mykhailo recalls. "At first, they kept it all under wraps, but then it got out that the windows shouldn't be opened and the vents had to be covered with wet cloths. You'd go out to the shops and not meet a single person."

Mykhailo also helped transport 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 stretched for about a mile, with police vehicles and flashing lights at the front. We brought 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 yet imagine the toll 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. Doctors said I had a bundle branch block. My heart only works at half capacity.

Before that, I used to do sports – I held a first-category volleyball qualification [an advanced club-level athlete under the Soviet sports 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.

In recent years, Mykhailo has often been in hospital. Both 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 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 also now losing his hearing and eyesight – this may be due both to age and to the effects of radiation.

However, Mykhailo's doctor, haematologist Zoia Martina, says he is holding up well: now in the seventh year of treatment for cancer, 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 speaking 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 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 dealing with the aftermath of the Chornobyl disaster, including more than 30,000 motorists alone. Yet the memory of them, like that of other first responders, is preserved mostly by their fellow liquidators – those who are still alive.

Each year, the number of elderly witnesses to those events declines: where once several hundred people gathered at the memorial, now only 50 to 60 come.

Mykhailo says as we speak about memory and remembrance: "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 does not celebrate his birthday very much. Even though his granddaughter and son visit 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 such patients, says the scale of the catastrophe still strikes him even today.

"The total contaminated area amounts to around 145,000 sq km. That is an enormous 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 and 40,000 to almost 90,000 people were resettled. In the first 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 Mykola Tronko, director of the Vasyl Komisarenko Institute of Endocrinology and Metabolism and Doctor of Medical Sciences. 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 managed to disprove this.

"Chronic lymphocytic leukaemia used to be regarded as unrelated to radiation exposure. But we demonstrated internationally that it can, in fact, be caused by it. International radiation safety standards were later revised based on our scientists' work," she says.

The disease manifests itself through, among other things, 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 accompanying illnesses: cardiovascular disease, diabetes and ulcers. Not all of these conditions are caused by radiation, but they further complicate 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 draws particular attention to the disaster's impact 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 specifically into the epigenetic impact of the Chornobyl disaster on future generations.

As regards Chornobyl first responders themselves, their numbers are steadily declining – many of those who were treated for years at the radiation medicine centre have now died.

40 years after the Chornobyl disaster through the eyes of medics

The Centre for Radiation Medicine, Haematology and Oncology still retains records on millions of people who have been examined. Around 2 million people have had internal radiation exposure measurements – evaluations of radionuclide levels in the body.

Forty years after 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 role, but also a strategic one.

"Our primary focus is the medical support of 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 operates 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 to 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 living and what is happening to them," Zhovnir explains.

Ukrainian medics also cooperate with their international colleagues, particularly Japanese researchers studying the aftermath of the atomic bombings of Hiroshima and Nagasaki and the accident at Fukushima Daiichi Nuclear Power Plant.

It was specifically 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, practise triage, decontamination and treatment.

"Ambulances arrive with flashing lights, bringing in patients. We observe how they are dressed, 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 water used to wash radioactive dust off, how to decontaminate clothing and how to organise patient flows.

"We have even worked out where the water from the showers goes afterwards. Because it is contaminated too," he adds.

These exercises are not limited to a single institution – other medical facilities also take part, so 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 power units 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 must keep our heads on a swivel 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 something confined to the past.

"One of the most dangerous myths is that it has all passed and been 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 near the hospital rather than on Shchekavytsia Hill [which was the joke about a nuclear strike by Russia, suggesting that people would hold an orgy before the end of the world – ed.]. At least there, 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