Opinion

Concern about the future of medical care for radiation victims

June 27, 2009

by Junichiro Hayashi, Staff Writer

Based on their many years of experience treating the survivors of the atomic bombings, Hiroshima and Nagasaki have provided medical and research support to victims of nuclear tests and radiation exposure accidents. There is concern, however, with regard to the training of personnel to take over this international contribution effort, which Hiroshima is uniquely qualified to lead.

One reason is that radiology is not popular with medical students. Also, the shortage of doctors throughout Japan has led to a focus on the ability to start work immediately, and the incorporation of national universities has resulted in a tendency to place less emphasis on research in basic fields.

Doctors and researchers who have made frequent trips to Chernobyl, site of the nuclear reactor disaster, feel frustrated and wonder how they can carry on the mission of Hiroshima and Nagasaki. Hiroshima University has accelerated its efforts to train doctors who aspire to contribute on the global level, but the university has yet to find a specific remedy for the problem.

Young people uninterested, university accelerates efforts to train new doctors

In late May Dr. Helena Sleznik, 39, came to Hiroshima from Belarus, which was contaminated by the Chernobyl nuclear reactor disaster in Ukraine. At a briefing in Hiroshima she offered a plea to the citizens of Hiroshima. “We do not have enough doctors or technicians who can examine the victims,” she said. “I hope you will continue to work with us.” Twenty-three years after the disaster, the people of Chernobyl still look to Hiroshima for ultrasound examinations for cancer, research to determine the extent of the harm caused by the radiation, and other forms of support.

Dr. Sleznik was invited to Japan by the Hiroshima International Council for Health Care of the Radiation-exposed (HICARE), an organization formed by Hiroshima University, Hiroshima Prefecture, the City of Hiroshima, and other entities. During her two-week visit she underwent training at the Hiroshima University Research Institute for Radiation Biology and Medicine and the Hiroshima Red Cross and Atomic Bomb Survivors Hospital.

Many people involved in these efforts, however, have expressed concern about how much longer Hiroshima can continue to offer support.

Nobuo Takeichi, 65, a physician at the Hiroshima Thyroid Clinic, said, “These efforts must not come to an end when we retire.” He emphasized that there is a pressing need to train personnel who can play a central role in international assistance.

He has taken time off from his work at the clinic to make nearly 100 visits to Belarus and other areas. He usually stays for two or three weeks examining patients suspected of having cancer and offering advice to local doctors. “Training people in both Hiroshima and areas where radiation victims live to serve as the nucleus of this effort will allow it to continue and will save patients’ lives,” he said.

Hiroshima University, which plays a role in training the next generation of medical personnel, has not stood idly by. Since the 2003 school year, with aid from the Ministry of Education, Culture, Sports, Science and Technology, the school has trained doctors in the treatment of radiation victims. Young people, however, tend to be more interested in the latest genetic research and other fields. Kenji Kamiya, 58, head of the Hiroshima University Research Institute, expressed frustration about the situation. “Young people are very interested in research, but not to the point they can have a real impact abroad.”

Since its founding in 1991, HICARE has sent a total of 182 medical personnel to sites in Japan and in 16 other countries. But the same people always tend to go, and they often merely attend international conferences.

Professor Masaharu Hoshi, 61, of the university research institute, said, “In order to train people to carry on these efforts under these difficult circumstances, proper arrangements must be made at the university level.” Since 1996 he has investigated radiation levels in Belarus and provided support for the medical treatment offered there by Dr. Takeichi and others. Professor Hoshi will retire in two years. “I would like young people to open new frontiers based on our efforts thus far,” he said.

Meanwhile, as a result of developments in genetic research, the effects of radiation on the human body are becoming much better understood. “This is a good opportunity to train doctors with a sense of mission as doctors from Hiroshima,” Dr. Kamiya said. “We must get young people interested in this field.” We never know when people will be exposed to radiation. A system must be created to address unforeseeable circumstances and to ensure that the hopes of the world will not be betrayed.


Number of Medical Personnel Dispatched by HICARE (As of March 31, 2009)

Region...................................Country.............No. of Personnel
Asia........................................India.....................4
...............................................Philippines............2
...............................................South Korea........27
...............................................Mongolia...............2
North America.........................U.S......................10
Central/South America............Brazil...................17
...............................................Mexico...................1
Europe.....................................Austria.................1
................................................Belarus...............26
................................................France..................3
................................................Italy......................1
................................................Kazakhstan........28
................................................Russia................23
................................................Switzerland..........8
................................................Ukraine...............18
................................................U.K.......................2
Tokaimura, Ibaraki Pref........................................9

Total..................................................................182


Nagasaki's efforts: An interview with Professor Shunichi Yamashita, Head of the International Hibakusha Medical Center at the Nagasaki University Hospital of Medicine and Dentistry

Like Hiroshima, Nagasaki has provided medical assistance to victims of nuclear accidents around the world over the years. We asked Shunichi Yamashita, 56, head of the International Hibakusha Medical Center at the Nagasaki University Hospital of Medicine and Dentistry, who has been active at Chernobyl and other areas, about the training of medical personnel in Nagasaki to carry on these efforts.

Could you explain the “international unit” added to Nagasaki University’s medical school last year, along with its admission policy?
Both last year and this year five students were admitted under a new admission system that includes an interview and submission of a report. We don’t believe all of them will embark on careers in international contribution, but even if a few of them take an interest in the treatment of radiation victims it will be of great value in training medical personnel to carry on these efforts.

In March the five students who were admitted last year were sent to Kazakhstan, which was the site of nuclear testing by the former Soviet Union, for a medical seminar. The program focused on visits to local laboratories and other facilities, but being in Kazakhstan, in and of itself, was a very valuable experience for them.

How do you regard medical assistance to radiation victims around the world?
Of course, medical care to atomic bomb survivors is our main focus, but sending medical personnel overseas is also the role of Nagasaki because there are victims of nuclear accidents in other countries. As part of its strategy, the university must establish a system to train personnel who will be involved in international support. Since the 2007 school year, with a subsidy from the Ministry of Education, Culture, Sports, Science and Technology, the university has made the training of radiologists one of its main goals.

What is the role of the International Hibakusha Medical Center?
The center opened in 2003 to clearly represent our effort in promoting international contribution. Including me, the center has a staff of four. Three of them are doctors, and they are training young doctors who will be able to work overseas.

Doctors can spend two or three months of their government-mandated two-year clinical training at the center. Last year only one doctor participated, but the expansion of the center is part of the university’s medium-term plan.

Isn’t fostering a spirit of international contribution also important?
Despite being the child of atomic bomb survivors, I never thought I would be involved in providing medical assistance to Chernobyl. I became a professor in 1990 and was invited to attend a conference of experts from Japan and the former Soviet Union. I first went to Chernobyl in 1991 and began treating children with thyroid cancer. They were the same age as my own children. I talked with their mothers as well and began to feel as if the disaster area was right next door to Nagasaki. I suppose I’ve been there more than 100 times.

What’s most important to me is whether or not we can feel that our work has a direct connection to the people in these areas. If distance seems to be an insurmountable obstacle, you can’t make an international contribution. That’s what I want to convey to young people.

How do you feel about cooperating with Hiroshima?
Like HICARE in Hiroshima, Nagasaki has the Nagasaki Association for Hibakushas’ Medical Care (NASHIM), and we offer short-term training for doctors from overseas. Working together and taking advantage of our own unique characteristics, how much can Nagasaki and Hiroshima enhance the medical care in the areas we visit? Precisely because the two cities were the victims of atomic bombings, this is an international contribution program that we have to sustain.

(Originally published June 22, 2009)

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