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The reports of bleeding, abdominal pain and, more recently, death of people who had been exposed to waste washed ashore by the tsunami waves are alarming. To explain why, let me provide a brief description of the effects of radiation.
Low levels of radiation can induce cancer and lead to gene alteration in cells. These are delayed effects that can take decades to develop. The hallmark of high levels of radiation, on the other hand, is cell killing. A small part of an organ can (unless it is a serial structure like the spinal cord) take a lethal dose of radiation. (This is what radiotherapy is all about: killing the tumor and, with it, some surrounding healthy tissue, with radiation). Irradiating the total body, however, is a different matter. Hiroshima , Nagasaki , and the Chernobyl nuclear accident, along with experiments on animals, have supplied us with abundant data on clinical response when the whole body is subjected to high levels of radiation. Acute radiation syndrome, as this condition is called, manifests itself (in order of increasing severity) as hematopoietic (mainly affecting bone marrow), gastrointestinal, and neurovascular syndromes. Mostly, healthy adults with proper medical care can survive low levels of radiation damage to the bone marrow, an appreciably increased risk of leukemia not withstanding. But severe damage to the bone marrow is almost always fatal. Platelet loss leads to bleeding, while the depletion of white cells causes infection. It is the combined effect of the bleeding and the infection that leads to death. The next level of ARS (acute radiation syndrome) is gastrointestinal syndrome. The intestines suffer ulceration and hemorrhage, and the damage to the bone marrow is even more severe than with hematopoietic syndrome. Death occurs within 3 to 10 days after exposure. Neurovascular syndrome, the most severe form of ARS, gives little chance for the lower levels of ARS to take hold as the victim goes into severe neurological disorder and cardiovascular shock. Death occurs within 2 to 3 days. Now, I hope, you can forgive me if in the beginning of the article I came across as too much of an alarmist. The reported symptoms are consistent with exposure to lethal levels of radiation. What is more, this is surely only the tip of an iceberg, and maybe a whiff from hell. Just how much nuclear waste is out there and exactly where are only two of the many unknowns. How many victims will die from radiation overexposure today, tomorrow, next month, next year, twenty years from now, fifty years from now, or centuries from now? How many will suffer and die slow deaths from radiation-induced cancer, ten years from now…fifty years from now…a hundred…? How many children will grow up, if you can call it growing up, mentally retarded? The daunting list of questions can continue, but at the risk of turning it into an overkill. What Should We Do Now? • Dispatch a team to survey the suspected areas. DO NOT WAIT FOR THE UN. For now, it is not necessary to have an accurate and detailed study. We just need to confirm the presence of significant levels of radiation. The instruments needed are inexpensive hand-held Geiger-Mueller survey meters and ionization chambers. We will also need to secure personnel monitoring film badges; • If the presence of high levels of radiation is confirmed, there is only one of two choices: a) do nothing and leave tens of thousands of poor, unsuspecting Somalis at the mercy of an enemy they cannot see, touch or smell; or b) mount a rescue operation by mass-evacuation of the local populations to nearby towns and regions. How? I do not know. At the very least, children and pregnant women must be rescued. Then What? • Fence off areas with significant quantities of radioactive material; • Bring together a team of Somali scientists, engineers, doctors, environmentalists, lawyers and official representatives from the affected areas. The mission of committee would be to study and work on the issue for decades; • Responsible companies should be held accountable. We should seek the help of European environmentalists to bring them to court. The offending companies should divulge crucial information (exactly what has been disposed of and where) and make monetary compensation for damages caused to local populations and to the environment. Payments should be used for the benefit of affected populations alone; • Ask the UN and the European Union to shoulder cleanup work, both offshore and onshore. This will most likely be a long-term, massive project, which may never be complete; • Devise ways to educate the local populations on the dangers of radiation. If they have to go into an area suspected of contamination, time (seconds) and distance are of the essence. Children under the age of 18 and women of childbearing age should never venture into a suspected area. NO ONE SHOULD GO INTO AN AREA KNOWN TO BE CONTAMINATED. This is an attempt on my part to draw the collective attention of all Somalis to the grave danger this matter presents. WE HAVE A MORAL DUTY OT ACT NOW. Mohamoud A. Gaildon Medical Physicist Atlanta , Georgia 
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