Nuclear Payouts: Knowledge and Compensation in the Chernobyl Aftermath

*This is a special feature from the second, atomic themed print issue of Anthropology Now.*

“Nothing happened”
When the Chernobyl nuclear reactor exploded in the early morning of April 26, 1986, it blasted a radioactive plume as high as eight kilometers into the sky. In a failed attempt to suffocate the flames of the reactor’s burning graphite core, helicopter pilots dropped several thousand tons of boron carbide, dolomite, sand and clay on the raging fire. Winds carried a radioactive cloud over Belarus, Ukraine, Russia, Europe, setting off alarms in a Swedish nuclear facility 1100 km away. Chernobyl is now widely acknowledged as the world’s worst nuclear power plant disaster. At the time, however, it took the Soviet government 18 days to acknowledge that anything out of the ordinary had transpired. And although the amount of radiation released into the atmosphere was four hundred times the amount of dispersed by the bombing of Hiroshima, according to official reports, only 237 people, airlifted from the disaster site to a hospital in Moscow, required medical attention.

Of those, 134 were diagnosed with acute radiation sickness; the death toll was set at thirty-one. This number became a mantra of sorts, invoked by international scientific bodies every year on the anniversary of the disaster. Chernobyl’s public health effects, the official story goes, “are not nearly as substantial as had at first been feared” (United Nations Report 2005); radiation exposures that populations received were insignificant to their health. That nothing of widespread medical significance had happened here echoes what Dr. Robert Gale, an American radiation specialist who traveled to the disaster site in 1986, told me in an interview a decade later. With the exception of the initial acute radiation victims he attempted to treat, from a medical point of view, “Basically nothing happened here. Nothing happened here…and nothing is going to happen here.”

Yet something did happen here. Over two decades, 600,000 soldiers, firemen, and other workers were dispatched to the disaster site to physically contain the radiation. They razed contaminated buildings and forests, disposing of contaminated topsoil and irradiated materials. Some worked in one-minute shifts on the roof of an adjacent unit, shoveling radioactive debris into the mouth of the ruined one. These volunteers referred to themselves as bio-robots, a term that suggests that the one-minute time limit was not well enforced.

In 1992 I met a nuclear worker who was on a two-week break from work in the Chernobyl Zone in Kiev, Ukraine. Filled with despair, he told me: “Now I’m a sufferer.” He used the word “sufferer” in reference to a legal category introduced the previous year by a newly independent Ukrainian state for persons affected by the Chernobyl disaster.
“I get five dollars a month compensation. What can I buy for that?” He said he had no option but to continue working in the Zone, an area 30 kilometers in diameter marking out the infamous disaster site. Because of his work history, no firm would hire him.
He lifted his pant-leg and stuck his cigarette through a ring made of skin that had puckered up above his ankle. “This is from radiation,” he said. It was the result, he told me, of direct contact with a radiation source, and what clinicians would call a “local skin burn.”

“This happened in the Zone … We’re people no one understands, in hospitals, in clinics.” He saw himself as one of the “living dead.” “Our memory is gone. You forget everything—we walk like corpses.” As a member of the living dead, he spoke of the invisibility of the Chernobyl disaster to the outside world, and of the complicated damages that followed.

Twenty three years after this devastating event, many sufferers have died, and new sufferers are emerging, telling a different story about the extent of the fallout and its effect on human life. This calamity is not just a story about a devastating nuclear explosion and subsequent cover-up or denial, but rather, a more complicated story about health and disease and how they become, like bread, milk, or medicine, traded for value in a post-Soviet marketplace. I began studying a world where risks, abuses, and uncertainties escalated, and where economic forces drove people to become solely preoccupied with survival. What, then, became of the value of a human person here?

The long-term health effects of Chernobyl have been the subject of ongoing dispute. International scientific organizations insist that contamination from the Chernobyl reactor has been contained. The UN Scientific Committee on the Effects of Atomic Radiation, which relies on data from the International Atomic Energy Agency (IAEA), has acknowledged the increase in thyroid cancers among children living in affected areas. Most other disorders continue to be characterized as products of “informational stress,” “somatization of fear,” or lack of proper “risk perception.” Fear alone can create organic disease. Yet the nuclear worker’s puckered up skin suggests otherwise. In fact, the fallout unleashed in this medical disaster exceeded the ability of any single agency to bring it under control, let alone account for its public health consequences.

For instance, high doses absorbed by at least 200,000 Chernobyl clean-up workers between 1986 and 1987 were insufficiently documented due, in part, to a lack of available functioning monitoring equipment and lax radiological scrutiny. One biochemist told me in 1996 that many of the workers received 6 to 8 times the lethal dose of radiation. “They are alive,” he said. “The workers know that they didn’t die. But they don’t know how they survived.” Over two decades out from the disaster, Ukrainian and Belarussian scientists acknowledge rampant stress among affected populations but continue to criticize international health assessments for ignoring the contribution radiation makes—even in low doses—to adverse biological change.

By the time I had arrived in Ukraine in 1992, the political situation had dramatically changed, and with it, understandings of Chernobyl’s effects. The Soviet Union had collapsed, but memories of the Soviet mishandling of the disaster as in, for example, the state’s famous battle against “radiophobia” were still raw. A post-Soviet (Ukrainian) parliament denounced the preceding Soviet management of Chernobyl as “an act of genocide.” Lawmakers were lowering the Soviet “threshold dose” from 35 rem to 7 rem, comparable to what an average American would be exposed to in his or her lifetime. Maps of the radioactive fall-out that justified limited or ad hoc human evacuations in the Soviet era were being revised and expanded. More people were claiming themselves as part of a state-protected post-Soviet citizenry. The state's social welfare system swelled to accommodate the large influx of newly designated Chernobyl sufferers.

One biophysicist responsible for conducting retrospective dose analyses on affected groups told me that when the new laws appeared: “Long lines of resettlers extended from our laboratory doors. It wasn’t enough that the resettlers were evacuated to ‘clean’ areas. People got tangled up in the category of victim, by law. They had unpredictable futures and each of them wanted to know their dose.” Compensation (kompensatsiia) became the order of the day, and post-Soviet politics became enmeshed with the ten-year old calamity to produce new concepts of self, health, citizenship, and belonging.

Desperate Appeals
For five years (1992-1997), I worked in this convoluted world of science, statistics, and bureaucracy, and in which international scientists were adjudicating the validity of citizens’ claims to Chernobyl suffering and seeking to close the matter. I had a little less wishful agenda and asked open-ended questions like: how did a catastrophe of unimaginable scope become manageable? How did some kinds of suffering become acknowledged and visible, and why, while others remained invisible?

These questions about the everyday lived aspects of the Chernobyl aftermath led me to extended conversations with resettled families and radiation-exposed workers and their families. I interviewed key scientific and political actors in Kiev and Moscow, comparing scientific standards informing concepts of biological risk and safety in the Soviet and post-Soviet administrations of the aftermath. How was scientific knowledge about radiation risk being promulgated? How was the disaster being recognized or “made visible” as Ukraine developed a new national identity after the collapse of the Soviet Union?

Meanwhile, across the region, the Soviet industrial framework fell apart. Household financial savings were wiped out by hyperinflation. Social protection systems were overburdened and inadequate to address fast-paced changes in which a core group of long-term poor emerged. What I also discovered was that the very framing of injury was now intimately linked with the region’s economic restructuring: “If a person needs medicines, a person needs money. The diagnosis we write is money,” one administrator told me. Chernobyl workers realized they faced fewer job prospects outside the Zone and continued working there, hiding their illnesses until they could no more. For evacuees and those still living on contaminated territories, illness became a “form of work.” Both groups (not to mention the citizenry) wanted the state to defend them not only against the risks of contamination, but also against the worst effects of a brutal market transition. Kompensatsiia was no longer just payment for past damages, but a body politic’s attempt to balance or neutralize forces that gave or took life.

“There are a lot of people out of work,” an administrator who ruled on claims, told me. “People don’t have enough money to eat. The state doesn’t give medicines for free anymore. Drugs stores are commercialized.” He likened his work to that of a bank. “The diagnosis we write is money.”

Dr. Demeshko allowed me to take notes and to ask questions of claimants entering his office over a week in 1996. Around this time, the Ukrainian laws on procuring Chernobyl compensation were getting tighter. The World Bank, promoting drastic reductions of the state’s social welfare coffers, called the Chernobyl compensation system a “dead weight” on Ukraine’s less than ideal market transition. The following interactions capture the sense and flow of desperate appeals.

A rural woman walks in. She was evacuated from her village in the Zone. When she says how her daughter was pregnant at the time of the disaster, she starts to cry. “The little girl,” she says, “now ten years old, has a dry mouth, she’s weak, her thinking is slow, her thyroid is swollen, her legs hurt, her blood is poor.” She works hard to elicit sympathy from Demeshko, who will eventually decide whether the girl will become state-protected. Demeshko interrupts the grandmother and tells her that she is in the wrong place and should go to the Chernobyl children’s hospital for the evaluation of the child’s status.

A man in his mid-50s enters. He says that he has worked at the reactor site since 1978, and that he regularly checks-in at the local clinic of the Chernobyl plant for monitoring and treatment. The man makes a reasonably good salary working in the Zone but he also keeps careful records of his illnesses. He shows evidence of his dose, a high 73 rem. When I asked him why he was seeing Demeshko now he says, “I’m sick.” Demeshko then asks him, “And before?” The man answered that he was sick, but that he “hid it.” When I ask him why, he answers, “So I could work in the Zone, I’m used to working.”

A middle-aged urban woman enters the office. She says that her husband died 3 days ago and that she is seeking additional state protections. Her husband, a driver by profession, worked in the Zone in 2-week shifts, transporting contaminated building materials from the reactor to “burial pits” scattered throughout the Zone. She lives on a pension of $26.00. He collected a pension of $75.00 before his cancer-related death. “Was there a Chernobyl pension already calculated in his regular pension?” Demeshko asks her.
“Yes, an added $16.00 a month for work in the Zone,” she answers.
“Did you get compensation for his death?" he asks.
“Just for his funeral," she says.
“What do you want here?" Demeshko asks.
The woman answers, “My husband said to me, ‘When I die, get the Chernobyl privileges.’”

In this case, the deceased calculated in advance the benefits to his family of his Chernobyl-related death. His wife “inherited” his medical documents, using them to advocate for more social protections from the state. She claims his disability is linked to his death.

Another man enters the room. He shows Demeshko documents from a specialized examination. The man worked at the Chernobyl plant for 8 months. He alleges that he has acute radiation dermatitis, “diagnosed in Moscow.” Demeshko tells him that there are no disability privileges associated with acute radiation dermatitis. The diagnosis he needs is skin cancer. After the man leaves, Demeshko explains that “in general, disability is no longer given for acute radiation sickness. However, if a person shows complications from the effects of acute radiation sickness, he would be entitled to consideration. Skin cancer would count.”

An exhausted and sallow looking man steps into the room. He throws a document on the table indicating his dose. The estimate was made on the basis of the roads that he traveled to get to the Zone and their levels of contamination. “I worked in the garbage pits [of irradiated materials].” He says that he has had two heart attacks. Demeshko asks him to show documentation of his hospital stays starting in 1990. The man answers that he failed to have his diagnoses registered annually. “You will get no tie,” Demeshko tells him. “But people are busy harvesting their potatoes now,” he added, “so maybe there’s a bed for you in the neurology ward. You can get a diagnosis there.” The man leaves, and Demeshko comments, “He’s on the border with death, we have many like that.”

Biological Citizenship
Citizens poured into offices such as this one. The social course of radiation illness was unstoppable. In the daily deciphering of what counts and does not count as a disaster-related ailment, of who is and is not on the border with death, a new relationship was being forged between a sickened citizenry and the state. Acutely aware of themselves as having lesser prospects for work and health in the marketplace, they inventoried those elements in their lives (measures, numbers, symptoms) that could connect to a broader history of the disaster’s mismanagement and risk.

I called the complex bureaucratic process by which a population attempts to secure a status as harmfully exposed and deserving of compensation a “biological citizenship” (2002). It entailed massive demands for, but narrowing access to, a form of social welfare based on medical, scientific, and legal criteria that acknowledge and compensate biological injury. Where an emergent democracy was yoked to a harsh market transition, the damaged biology of a population became grounds for social membership and a basis for staking citizenship claims. In this labyrinthine world of protection-seeking, health was selectively promoted for some while downward health spirals accelerated for others. People fell into or out of categories haphazardly or were subjected to ones that they did not choose or could not escape.

There is nothing laudable about being a biological citizen. It is not an achieved status, and it is something I personally would not like to become. Biological citizenship speaks to health as a political project on the one hand. But more centrally, it speaks to a profound failure of politics to account for human welfare, compounding vulnerability for those who not make the cut.

In the former Soviet Union and elsewhere, citizens are looking beyond the state to safeguard their health. Their particular characteristics make them resources visible not only to the state, but to capital as well. My book, When Experiments Travel (2009), tracks the global offshoring of clinical trials and the drug industry’s quest for human subjects. What I found was that these experiments offer short-term and previously unattainable medical goods in Eastern Europe and Brazil, compensating for state deficits or dysfunctional public health care systems. But as clinical trials become surrogates to health care, do they let local health authorities off the hook and limit other sorts of interventions? International ethical and regulatory bodies have opened the floodgates to ethical recruitment. But after the trial, patent and drug pricing regimes foreclose patient access to high-cost drugs. The world is becoming a series of interlocking laboratories and data-producing sites, yet citizens still go to local pharmacies only to find that essential medicines are out of stock. This new for-profit medical cartography brings together players separated by vast economic differences, but is global recruitment legitimating a new sort of biological citizenship? One Moscow-based physician running trials for a major drug firm recounted to me as one of her trial subjects ran to her one day. Exhilarated and relieved, he declared: “‘Professor, I have a 38 degree Celsius fever, which means that I am definitely not on the placebo arm of the trial!’ I had to laugh,” she told me. “He didn’t know that he needed a 40 degree fever!’” Medicinal shortages and opaque drug pricing structures unfortunately do not enter into the joke.

I was fortunate to have had the kind of access to the machinations of the state and nuclear state science that I had in the former Soviet Union. I guess that a post-Soviet requesting similar access to U.S. down winder clinics would be denied access in the name of national security. Today anthropologists lament the closing down of fieldwork frontiers. The tribunals where justice is supposedly meted out are closed to scrutiny (Greenhouse 2005). Corporate meetings where the value of drugs is determined are off-limits. Restricting access to knowledge and power is nothing new. But the cover up of the devastating consequences of power, the “invisibilizing” of crisis, makes accountability a central challenge of our time. Too often responsibility for nuclear disasters like Chernobyl is eluded, or arrives decades too late. Obligation is reduced to a mere occasional payout. Our challenge is to move beyond the mantras and to reestablish relations with the imperceptible disasters. We need to train our eyes on the practices, ethics, and politics that promise protection, for they can just as easily devastate lives. Our burden is to unearth the convoluted field of “what happens.”

Adriana Petryna is an Associate Professor of Anthropology at the University of Pennsylvania. Interested readers can visit her webpage here and/or contact her at petryna@sas.upenn.edu