13 Feb 96
Special Federal Program to Render Medical and Social
Assistance to the Population and Normalize the Sanitary and
Hygienic State of Population Centers of the Republic of
Altay Exposed to Radiation as a Result of Nuclear Testing
at the Semipalatinsk Range, for 1996-1997 and for the
Period to the Year 2000
1. State of the Problem
The Special Federal Program to Render Medical and
Social Assistance to the Population and Normalize the
Sanitary and Hygienic State of Population Centers of the
Republic of Altay Exposed to Radiation as a Result of
Nuclear Testing at the Semipalatinsk Range, for 1996-1997
and for the Period to the Year 2000 (henceforth the
Program), was developed in accordance with Edict No 309, 2
March 1993 of the President of the Russian Federation "On
Measures of State Support to the Socioeconomic Development
of the Republic of Gornyy Altay" with regard for provisions
of the Federal Law "On Social Protection of Citizens
Exposed to Radiation as a Result of Nuclear Testing at the
Semipalatinsk Range."
Scientific research established the fact of exposure
of the environment and population of a number of rayons of
the Republic of Altay to radiation from 22 nuclear bursts.
The health of inhabitants of these rayons is characterized
by a high incidence of malignant tumors, an elevated infant
mortality, and a decrease in life span (compared to average
indicators for Russia).
Around 50 locations where an elevated radiation
background was recorded and over 70 local centers of
contamination by the radioactive products of nuclear bursts
were revealed in the Republic of Altay.
According to preliminary estimates the average
exposure doses in certain rayons may have exceeded 5 cSv,
and may have been responsible for remote unfavorable
consequences to the health of people living in these
territories.
Research associated with evaluating and forecasting
the medical and demographic situation and the population's
health showed that under the standard territorial
classification, the Republic of Altay falls in group 1--the
most unfavorable.
Of interest is the high perinatal mortality, which is
20-35 percent higher than in regions with similar landscape
and geography; high levels of infant mortality and
congenital abnormalities (developmental defects) are noted.
Indicators of oncological morbidity exceed the
averages for the Russian Federation.
The sanitary and hygienic state of population centers
exposed to radiation is alarming. Problems concerned with
supplying the population with drinking water meeting the
established quality standards have not been solved, and only
30 percent of the population of the Republic of Altay gets
its water from a water pipeline network. Rural population
centers lack municipal sewage systems. The incidence of
acute intestinal infections, viral hepatitis and
helminthiasis in the population exceeds average indicators
for the Russian Federation by three to four times, which is
a consequence of an unsatisfactory sanitary and hygienic
situation in population centers, in food industry, public
food service and trading enterprises, and in children's
preschool and primary school institutions. The level of
development of sanitary supervision in the Republic of Altay
falls significantly short of modern requirements.
One of the reasons for such a situation is the weak
material and equipment base of public health institutions
and the sanitary and epidemiological service, and their
shortage of qualified specialists.
2. The Program's Goal
The goal of this Program is to solve problems
associated with mitigating the negative medical, social and
psychological consequences of the effects of radiation from
nuclear testing at the Semipalatinsk range on the health of
the population of the Republic of Altay, with rendering
highly qualified medical assistance to it, and with
improving living conditions (Attachment No 1).1
These goals are achieved by creating conditions
permitting systematic observation of the health of exposed
individuals, revealing among them persons with a higher risk
and the sick, treating them and improving their health,
helping people exposed to radiation to surmount
psychological stress, normalize the sanitary and hygienic
situation in the population centers of rayons exposed to
radiation, conducting radiation monitoring in the Republic
of Altay, reducing the level and doses of further exposure
to other radiation sources (medical and radon), and shaping
a healthy way of life. Scientific research having the
purpose of identifying population centers subjected to
significant radiation effects (over 5 cSv) and estimating
the population's exposure doses will be continued.
Measures of social protection of victims (payment of
benefits and compensation) will be determined after the
doses received by the population are determined
retrospectively, and after the list of population centers
exposed to radiation is updated and confirmed.
The Program is to be carried out in 1996-2000 in two
phases:
the first phase--1996-1997;
the second phase--1998-2000.
3. Safeguarding the Health of People Exposed to
Radiation
The Program foresees the following measures:
forming an effective system at the republican and
rayon levels for improving the health of citizens exposed to
radiation;
creating a three-tiered system of early diagnosis of
disease, medical assistance, and rehabilitation of victims
(central rayon hospital--interrayon specialized department-
-republican diagnostic center);
carrying out detailed clinical and epidemiological
research within the population;
improving the medical personnel training and advanced
training system;
establishing a medical dosimetric register providing
an effective system by which to monitor and maintain
records on the health of citizens exposed to radiation and
their progeny, and providing assistance to republican
public health agencies in implementing the necessary
measures of medical rehabilitation;
raising the effectiveness of preventive medicine,
revealing disease early and treating it, and making
specialized health care accessible to citizens in relation
to the most widespread forms of disease.
In order that these measures could be implemented, the
Program includes plans for establishing new medical
institutions, expanding and rebuilding ones currently in
operation, increasing the capacities of local sanatorium and
health resort bases, providing therapeutic and diagnostic
apparatus and pharmaceuticals to rayon and city hospitals
and specialized institutions at the republican level, and
erecting housing for medical workers.
4. Normalization of the Sanitary and Hygienic State of
Population Centers Exposed to Radiation
The radiation situation in the Republic of Altay is
not currently detrimental to the life of the population and
to its economic activity therein.
At the same time the sanitary and hygienic state of
population centers exposed to radiation, the material and
equipment base of sanitary and epidemiological institutions,
and the number of specialists working in them are at a low
level.
The Program calls for planning and erecting centers
for sanitary and epidemiological supervision in seven rayons
exposed to the effects of nuclear testing, a block of
radiological laboratories at the Republican Center for
Sanitary and Epidemiological Supervision in the city of
Gorno-Altaysk, and housing for specialists of the sanitary
and epidemiological supervision service.
There are plans for building and developing water
supply systems providing the population with drinking water
meeting existing quality standards and public utility
systems in stricken rayons, and erecting shops processing
agricultural raw materials and herbs to be used in
producing pharmaceuticals, baby food and dietetic foods out
of local ecologically clean raw materials.
5. Scientific Support to the Program, and Further
Development of Research on the Effect of Nuclear Testing on
the Population of Altay
The Program foresees scientific research in the
following basic directions:
retrospective assessment of the radiation situation in
the Republic of Altay in the period of nuclear testing at
the Semipalatinsk range and of the exposure doses of the
population, on the basis of an approved procedure
accounting for the peculiarities of the local mountainous
topography;
retrospective determination of exposure doses during
the period of nuclear testing, and study of the correlation
between the morbidity of the population of the Republic of
Altay and radiation exposure during the period of nuclear
testing;
study of the ecological, radiation, sanitary, and
hygienic situations in rayons subjected to the effects of
nuclear testing;
continuation of research on radiational, hygienic,
toxicological, sanitary, biomedical, and psychophysiological
factors with the purpose of evaluating their joint effects
on the population of radioactively contaminated
territories;
study and prediction of the medical and demographic
situation and the health of people exposed to radiation, and
their progeny, and evaluation of the effectiveness of
implementing the Program in these directions;
development and substantiation of the methods of
rehabilitating persons exposed to radiation and their
progeny;
scientific support to maintenance of the republic's
medical and dosimetric register of persons exposed to
radiation;
preparation of proposals on producing pharmaceuticals
out of local natural resources that would raise the
resistance of persons exposed to radiation and of their
progeny;
development of procedures for obtaining therapeutic,
preventive, and dietetic foodstuffs out of local resources.
The Program foresees information and analytical
support to scientific research at the federal and
international levels, organization and conduct of
scientific conferences and seminars, publication of
collections of scientific works and monographs, and
international cooperation in studying the effects of
nuclear testing on people and in developing measures to
rehabilitate victims.
6. The Program's Funding
Appropriations funding the Program total 534,710
million rubles, including R512,354 million from the federal
budget and R22,356 million from the budget of the Republic
of Altay and extrabudgetary sources. In addition foreign
exchange appropriations amounting to US$17.2 million are
foreseen for acquisition of imported equipment and
instruments.
Appropriations for 1996 will be R85,274 million,
including R70,118 million from the federal budget.
The volume of funding of the Program's measures is
broken down in Attachment No 2.1
7. Mechanism of the Program's Implementation, and
Organization of Its Management and Supervision of Its
Implementation
The Program is to be implemented in accordance with a
procedure approved by Decree No 594, 26 July 1995 of the
Government of the Russian Federation "On Implementing the
Federal Law 'On Deliveries of Products for Federal State
Needs'."
The Russian Federation Ministry for Civil Defense,
Emergencies and Natural Disasters, and the Government of the
Republic of Altay are to be the clients of the Program for
the state.
The forms and methods of organizing management of the
Program's implementation are to be determined by the clients
of the state. Each year the Government of the Republic of
Altay is to draw up measures by which to reach the
Program's targets. These measures are to be coordinated
with the Russian Federation Ministry for Civil Defense,
Emergencies and Natural Disasters and with the appropriate
ministries and departments of the Russian Federation.
Scientific support to the Program is to be supervised
by a regional scientific council contained within the
Scientific and Technical Council of the Russian Federation
Ministry for Civil Defense, Emergencies and Natural
Disasters (with the rights of a section). The plan of
scientific research subjects is to be approved by the
Russian Federation Ministry for Civil Defense, Emergencies
and Natural Disasters and the Government of the Republic of
Altay according to the established procedure.
Scientific work is to be financed on the basis of an
agreement between the Russian Federation for Civil Defense,
Emergencies and Natural Disasters and the Government of the
Republic of Altay. Reports on scientific research conducted
in the basic directions are to be submitted in phases to
the Russian Federation for Civil Defense, Emergencies and
Natural Disasters, together with proposals for introducing
their results.
The procedure for funding the Program and accounting
for its expenses, and the procedure for reporting on use of
resources allocated for its implementation are to be
determined by normative documents of the Russian Federation
Ministry of Economics, the Russian Federation Ministry of
Finance, the Central Bank of the Russian Federation, the
Russian Federation Ministry for Civil Defense, Emergencies
and Natural Disasters and the Russian Federation State
Committee for Statistics.
The procedure and mechanism for managing the Program's
implementation may be updated on the basis of joint
decisions of the Russian Federation Ministry for Civil
Defense, Emergencies and Natural Disasters and the
Government of the Republic of Altay. The clients of the
state are to maintain supervision over the Program's
fulfillment.
Each year prior to 1 February the clients of the state
are to submit reports on progress under the Program and on
the effectiveness with which budget and other resources are
used to the Russian Federation Ministry of Economics and
the Russian Federation Ministry of Finance.
8. Evaluation of the Anticipated Effectiveness and
Socioeconomic Consequences of the Program's Implementation
Improvement of the health of people living in rayons
exposed to radiation as a result of nuclear testing, a
decrease in possible negative consequences of radiation
exposure to the health of citizens, enhancement of the
quality of health care to the population, and improvement
of the living conditions of the citizens of stricken
territories are anticipated to be the results of the
Program's implementation.
FOOTNOTE
1. Not published.
RUSSIAN NUCLEAR DOCTRINE AND POLICY