The Nuclear Accident at Fukushima

Anand Grover, UN Special Rapporteur on the right to health

The Right to Health— Article 12, ICESCR - Right of individuals to enjoy the highest

attainable standard of physical and mental health— General Comment 14, CESCR- lays down the framework ofthe right to health and principles contained therein— It is not the right to be healthy— It is built on rights and freedoms, and entitlements

necessary to realize the right to health

The Right to Health— Rights and freedoms include the right to information, informed

consent and right to participation in decision makingprocesses— Entitlements include healthy environment, adequate andnutritious food, education and information— Non-discrimination in all aspects of and decisions taken

towards the realization of the right to health

The Right to Health— Independence, transparency, and accountability must

be ensured, including private non-state actors— Quality health facilities, goods and services must be available

in adequate and sufficient quantity; accessible without
discrimination and; acceptable— Laws impacting the right to health must be evidence-based

State Obligation— States have an obligation to— Respect – States must refrain from interfering directly or

indirectly with the right to health of people, such as bywithholding information— Protect – States must prevent third parties (non-state actors)

from interfering with the right to health of people— Fulfill – States must adopt a national health policy andplan of action and put in place appropriate measures towards
the realization of the right to healthState Obligation— Right to health is progressively realizable— Obligations are of three kinds – continuing, immediate, andcore obligations— Continuing obligations mean that the right to health isprogressively realizable— They are subject to maximum available resources— State are obliged to continuously take steps and have a timebound plan towards the full realization of the right to healthState Obligation— There must be non-retrogression in policies— Immediate obligations are not resource dependent— They include non-discrimination and participation— Taking targeted, deliberate and time bound steps towards

the full realization of the right to health— Putting in place benchmarks and indicators to measureprogress— Core obligations are non-derogable obligations of the State

State Obligation— There is no justification for non-compliance with them
— Minimum essential levels of the right, such as provision ofessential medicines, must be satisfied— Ensuring participation of affected communities is a core andimmediate obligation— Affected community and not just their elected

representatives must be at the decision making table, forinstance when formulating and implementing evacuation plans
and shelters, resettlement and decontamination policy

Content and Meaning ofRecommendations in the ReportDisaster Management andDissemination of Information— The government lacked efficient disaster management

system to contain an accident of this scale and magnitude— There was a significant time lag in disseminating

information after the accident and designating certain
areas as evacuation zones— Evacuation orders were not coordinated— No distribution of Iodine prophylaxis, which is astandard step in nuclear disaster management was notundertaken and undermines people’s right to access essential
medicines

Post accident policies and decisions— State has based it’s policy on the ICRP recommendation, there

is no significant increase in cancer incidence in doses below
100mSv.
— Policies are based on information on Chernobyl which may not

be reliable as it was released after 4 years— WHO and UNSCEAR dismissed evidence of healthanomalies, other than those related to thyroid— Long-term exposure to low doses of radiation is linked toincreased incidence of cancer

Resettlement Policy— The policy is based on the ICRP recommendation of increasingradiation dose to a reference level of 1mSv-20mSv/y during
emergencies, based on a risk-benefit analysis— This is contrary to domestic law of the country which

requires areas with radiation doses of 1.3mSv/quarterly to be
designated as controlled areas— Post the Chernobyl accident countries such as Ukraine instituted

laws under which acceptable radiation dose for living and working
without limitations is 1mSv/yearMonitoring health risks of radiation
exposure— The government instituted four health monitoring survey(excluding basic health survey) based on reports after
Chernobyl, which acknowledged only the effect of radiation on
the thyroid gland in individual exposed during childhood— Surveys are restricted in scope, as other health anomalies

have been ignored and they do not capture all potential healtheffects— Surveys were not conducted in all affected areas

Monitoring health risks of radiation
exposure— Results of thyroid examination of children are not easily

accessible to parents— Nuclear power plant workers employed through layers ofsub-contractors are the most vulnerable. They were exposed
to high levels of radiation during the accident and clean-up havebeen given no health survey or medical examination— Monitoring stations set up by the government to measureradiation dose in the atmosphere do not capture radiation
doses of areas, including hot spots, further away from thestations

Decontamination Policy— There is no concrete and time bound plan for

reducing levels of radiation dose to maximum acceptablelevel of 1mSv/year beyond 2013
— Play grounds and residential areas are used to bury

contaminated soil, putting people, especially children, at
risk of getting exposed to radiation. There are no
warning signs indicating the presence of such
radioactive debris

Decontamination Policy— Affected communities are undertaking decontamination

activities. Though participation is good, the government should
provide residents with necessary information and appropriate
equipment before decontamination is undertaken— There is no plan for temporary or permanent storage ofthe contaminated debris. In furtherance of its right to healthobligation, the government should, at the earliest, announce thesite for temporary and permanent shelters with the participationof communities.

Transparency and Accountability— TEPCO was not held accountable due to collusion between theprevious regulatory regime and the industry— Recognising the need for transparency and independence ingovernance, the government created the Nuclear Regulation
Authority— TEPCO is liable under domestic law but the government’s takeover of TEPCO may help it avoid accountability and liability fordamages— Taxpayers may have to continue bearing the liability of thenuclear damage, for which TEPCO alone should be liableParticipation— Direct and effective participation of affected community is crucial tofulfilment of the right to health— It is necessary to take into account needs of vulnerable groups such as

persons with disability, older persons, pregnant women and young
mothers— Affected communities should be involved in decision-making processes

including, planning disaster management and evacuation zones,
decontamination policy, designing temporary shelters, implementing
and monitoring these decisions— Lack of participation led to ill-equipped evacuation shelters. Groups, likepersons with disabilities returned to their homes in contaminatedareas