April 26, 1986 started like any other day for Alla Shapiro. The pediatrician, then 32 years old, worked in the pediatric hematology unit of the children’s hospital in Kiev, Ukraine. But everything changed when she learned that an explosion had taken place 130 kilometers north of the Chernobyl nuclear power plant, just outside the city of Pripyat. In the hours that followed, hundreds of children came to the hospital by bus for treatment.
As a frontline worker, it was the first time Shapiro and her colleagues had been confronted with treating patients during a disaster the size of Chernobyl. Unfortunately, the Soviet government had no nuclear disaster protocols, and basic supplies were severely limited, forcing medical professionals to improvise and adapt. In the days and weeks that followed, Shapiro found that the government was misleading the public about handling the explosion, which was caused by flawed reactor design, according to the World Nuclear Association.
The explosion occurred at 1:23 a.m. during a routine maintenance check of the plant’s electrical system, when operators violated safety protocols and shut down parts of the control system needed to keep the plant operating safely. The result was an unexpected sudden power surge due to excessive steam build-up in one of the reactors. The accident immediately killed two factory workers, but soon dozens more would die from acute radiation sickness, including emergency workers and firefighters who were sent to the scene. Over the years, thousands of people would succumb to radiation pollution from the explosion, and the total number of deaths is unknown as many people died years and decades later. Cancer, particularly thyroid cancer, would become a common link among survivors, including Shapiro, who, now in his late 60s, is a cancer patient herself. According to a report by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR), approximately 20,000 cases of thyroid cancer were recorded between 1991 and 2015 in regions affected by the Chernobyl accident. The high figures are due to precipitation from the explosion, with the winds carrying poisonous particles all the way to Switzerland.
Doctor on call: Chernobyl responder, Jewish refugee, radiation expert
On the 35th anniversary of the tragedy, Shapiro shares her story from the front lines of Chernobyl in a new book called Doctor on Call: Chernobyl Responder, Jewish Refugee, Radiation Expert. In her memoirs, Shapiro discusses not only the disaster, but also her experience emigrating to the United States with her extended family and her work as a leading expert with the U.S. Food and Drug Administration in developing medical countermeasures to radiation exposure. Her work is a testament to the importance of preparedness, especially in times of adversity. Even now that he is retired, Shapiro continues to work tirelessly to strengthen the United States’ preparedness for nuclear disaster. She is currently a consultant and member of the advisory board for Meabco A / S, an international pharmaceutical company developing a new drug that has the potential to protect people from harmful doses of radiation. She also conducts webinars for scientists and healthcare professionals interested in the health effects of radiation on humans.
Shapiro spoke to Smithsonian about her personal experience during one of the worst nuclear disasters in history, the inability of the Soviet government to act quickly and transparently during the disaster, and her thoughts on how to deal with the Covid-19 pandemic today.
Alla Shapiro, today (thanks to Alla Shapiro)
What went through your mind when hundreds of children arrived at your hospital for treatment after the Chernobyl explosion?
I really didn’t have time to get scared or prepare. We saw the children arrive in panic and in tears. It was a stressful event, but you have to act and do what you have to do. The negative was that we had no instruction, knowledge, or training in radiation, so we practiced ours [medical] background and did what we could. We also didn’t have enough supplies and proper protective clothing to wear during exams.
Since a similar disaster was never recorded in medical history books and there were no guidelines for dealing with the situation, you had to innovate. Can you give an example of how you improvised?
We tried to comfort the children. It wasn’t until much later that we learned the psychological impact [of the disaster]. We told them funny stories and hugged them, which worked out pretty well. And then we looked at what we stood for – when kids cough, we didn’t know why at first. In pediatrics, if a patient coughs, a fever will most likely follow, but not in this case. We soon realized that the cough was not related to a virus or infection. It was because the children were deprived of oxygen and their lungs were clogged with dust that might contain radiation particles. Many of the children waited outside for hours for the buses to take them to the hospital. Many mistakes have been made [in the aftermath of the disaster], but one of the greatest was the lack of knowledge and understanding, [which resulted in] children are left outside to breathe this radioactive air. So we started to give them oxygen. Because we didn’t have enough [individual oxygen tanks] for everyone we made tents from sheets and pumped oxygen and let the kids sit in the tents.
A view of the Chernobyl nuclear power plant three days after the explosion (Shone / Gamma / Gamma-Rapho via Getty Images)
The Soviet government withheld information regarding the explosion and its aftermath and even spread rumors about the situation. How has this affected you?
It was very difficult psychologically, especially knowing that some of the information being disseminated came from government officials or through rumors. Many people, especially doctors, have colleagues in different locations [that were sharing information with one another]. A good friend of mine was called to work on a Saturday, which was unusual for him. He was handed a dosimeter, the device used to measure [ionizing] radiation, and used it to measure levels in tap water. He called me and told me not to use tap water, not even to brush my teeth. It was nothing official, since he was not allowed to tell anyone about his findings. I immediately shared this information with friends and colleagues. This is how information spreads despite all the warnings given [by the government] if you tell the truth. It was a huge risk for him to do what he was doing; he could have lost his job.
As a Jewish physician, you often encountered anti-Semitism, which eventually led to your family emigrating to the United States. How was that transition to get here?
It wasn’t difficult for me as I loved it so much by default [the United States]; I really wanted to come here. In addition, our family received an exceptionally warm welcome from the Jewish community when we arrived in Washington, DC. We made friends in a few weeks, and quite a few of them are still some of our best friends. The welcome we received allayed some fears even though I didn’t have a job and didn’t have the qualifications to allow me [to practice medicine here], plus caring for a little girl and my elderly grandmother, all added to my fear and insecurity. Not every family was so welcome. Some [refugee] families ended up in the far west where the locals weren’t that familiar with immigrants and how to accept them and even whether they should accept them. There was a fear that they would take their job. However, we were blessed and we never wanted to leave Washington DC; I thought it was my home from day one.
A photo of Alla Shapiro MD when she lived in Ukraine. (Alla Shapiro)
How has your experience in Chernobyl prepared you as a medical professional for your work with the FDA to develop disaster response protocols?
This experience taught me a lot. The most important point is that people – not just doctors, but the general public – need to know what is happening. Unfortunately, in [the United States], doctors do not have proper and proper training in radiation. Without knowledge in this field, people cannot do anything, but fortunately we have experts in the field of radiation. While working with the FDA, I had meetings with the Departments of Defense and Health and Human Services on how to prepare our country for a nuclear disaster. There are guidelines and [mock explosion] exercises that take place every two years and pretend a nuclear explosion is happening in a big city. What I’ve seen [at Chernobyl] helped me realize that strong communication between the government and the public and doctors is necessary otherwise it can produce poor results.
You compare the US government’s lack of preparedness during the Covid-19 pandemic to the Soviet Union’s mishandling of the Chernobyl explosion. What can be learned from these two global tragedies?
We have to analyze very critically what happened and why. Any disaster, be it a nuclear or viral pandemic, has many things in common, and we need to be aware of that. There must be strong communication not only within the country, but also between international communities. So much depends on our preparedness, and so many deaths could have been avoided in Chernobyl. And the same with Covid-19. The former Soviet Union did not know how to prepare for such a disaster. The United States knew how to prepare, but failed.