Chernobil, Programa humanitario cubano

6 mayo 2010

Cuba a hope for Chernobyl children

Filed under: artículos,chernobil ingles — Dra. Yamila Ojeda Dennis @ 9:56

Various authors, Juventud Rebelde, 27 March 2010

Dr. Xenia Laurenti, Deputy Director for Medical Assistance at the Cuban Program of Medical Care to Chernobyl Children, on aspects of the treatment provided to those affected by the nuclear disaster.

With a smile on her face, little Sophia shows her notebook to Dr. Xenia.
Picture: Juan Luis Aguilera

When, on 26 April 1986, the nuclear reactor in Chernobyl, north of Kiev, the capital of Ukraine, exploded, Lt. Col. Konstantin Kostiuk and other colleagues arrived almost immediately on the scene to evacuate the personnel. As protection, they only wore a mask, and the order that, upon return, they burn the clothes they had worn.

The situation created around the catastrophe prevented people from leaving the area while the radioactive cloud expanded. Konstantin’s daughter Irina, then a child, remembers that on May 1st many attended the Workers Day parade, unaware of the danger they were exposed to.

Irina is in Havana these days, with her two young daughters, who are receiving medical treatment in Tarará, a beach town east of the Cuban capital. The elder, Anastasia, has cerebellar ataxia, and was in physical therapy when we visited their home. The younger, Sophia, who is undergoing allergy treatment, cheerfully showed us her coloring book, and then hugged Dr. Xenia Laurenti, Deputy Director for Medical Assistance at the Cuban Program of Medical Care to Chernobyl Children.

Dr. Xenia’s daily life revolves around a true sea of affection, one that also reaches health professionals, translators and parents here. It is to her that Juventud Rebelde has come, for insights into the Cuban program.
 
What are the main conditions of these children?

The first children that arrived had cancer-related blood diseases. They were transferred to Juan Manuel Marquez and William Soler pediatric hospitals in Havana, and after treatments were decided for them they came back here for follow-up.

They were seriously ill, and were placed under Group I, that is, complex life-threatening pathologies. Under Group II were those with chronic diseases, who needed initial hospitalization but could later continue treatment on an outpatient basis. Group III was basically similar, and Group IV was for those seemingly healthy, but who after testing came up with some kind of condition, such as a high dental caries rate.

Were these all related to the nuclear accident?

Scientifically, it is hard to tell, because these leukemias behave in the same manner as anywhere else. We have conducted DNA studies of patients, we have measured the radiation, and there have been very few cases of high levels of it. The others have remained at non-lethal levels.

The most common diseases are of an endocrine nature (such as thyroid cancer), skin conditions (vitiligo, psoriasis, alopecia), and gastrointestinal and orthopedic disorders (malformations and spinal deviations). These were the main ones.

In the case of these children, who were born long after the accident, are their diseases hereditary or have they been acquired from the environment?

There are radioisotopes that were dispersed by the explosion, especially cesium-137, which has a long life, approximately 50 years, and may remain in nature.

On the other hand, the psychological impact on an affected family is itself a disease. If you ask a Ukrainian child what he or she would like the most, the answer will not be “toys”, but “being healthy”. It has been psychologically incorporated. And part of the program is specifically aimed at psychological rehabilitation, to the non-rejection of any type of pathology. Our goal is to heal.

There is one fundamental condition to come to Cuba: belong to a family affected by the disaster. Ukrainians have clearly marked the areas that were reached by the radioactive cloud, which expanded 30 miles from the nuclear plant, and they have created a welfare program for those families. Given the prevalence of cesium-137 in the atmosphere, Chernobyl remains latent.

What have been the challenges for Cuban doctors in view of the diseases affecting these children?

First degree pediatricians have had to face diseases not from their field of specialization. That’s where science comes in: inquiring, researching, so that the child’s condition may be properly addressed. Find out whether a given syndrome is indicative of this or that disease and should be treated by this or that specialist. We carry out a full screening of the patient, from beginning to end.

So it has meant a leap forward in research…
Indeed. Patients come with multiple diagnoses, and families are disoriented. In Cuba we provide them with an accurate diagnosis. Mothers show real appreciation, and that makes us very happy.

We had, for instance, a young man with a multiple diagnosis who was taking some 70 tablets a day. We discovered here that he had muscle dystonia: totally involuntary movements. He was put under a research protocol, underwent a first intervention at CIREN (Neurological Research Center), then a second intervention, and he came out walking, speaking Spanish, and incorporated into society after ten years in Cuba.

Have there been distinctly Cuban solutions?

Yes. There is the use of Dr. Carlos Miyares Cao’s medications for rehabilitation. We do not alternate other treatments applied in the world, but only use melagenina for vitiligo, pilotrofina for alopecia and coriodermina for psoriasis. The results have been very good.

There is another example: a child born with a malformation of the ear. They use prostheses elsewhere, but there are risks, like their breaking. Our plastic surgeons used cartilage from the patient himself for the correction.

What is the job of the Cuban medical team posted in Ukraine?

There is a medical brigade in the south. From the start there was a Cuban doctor in Kiev, working in the selection of affected children. Then in 1998 the Ukrainian Public Health Ministry became involved in the process. The brigade is in the south, in a zone free from contamination, and it is formed by a hematologist, an endocrinologist, a psychologist, a dermatologist, a general practitioner, and a translator. They provide follow-up to children returning from Cuba.

Not all of those coming to Cuba are related to the Chernobyl disaster. There are also orphaned and deprived children. For example, we treated a child who had suffered burns, with many after-effects. He was put under intensive rehabilitation, for he was also on a wheelchair. He got prostheses, and he is now back in school in Ukraine.

Is the program leaving an emotional imprint on the personnel involved?

There is a word to describe these 20 years: hope. We experience it constantly. There is hope in the children and their parents. Cuba is hope for them. And for us that is a challenge. There are conditions that cannot be reversed. But when a child joins normal life, when a mother sees her child walking again, that is a major achievement. In the first years, when equipment was insufficient, the rehabilitation of many children came out of the hands of our physical therapists. Getting things done, introducing change when change is needed. That is our medicine; that explains its prestige. And we are proud of it all.

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Autor: Dra. Yamila Ojeda Dennis | Contáctenos
Programa cubano de atención médica integral a niños relacionados con el accidente de Chernobil