Features | Politics | Oceania

Tumours in Paradise

Evidence is increasing that more than 40 years of nuclear testing in the Pacific is having a horrific impact on the people of the region, with Solomon Islanders bearing the brunt, writes Susan Merrell.

There’s trouble in the Solomon Islands. As the government, with the aid of international peacekeepers, focuses on maintaining the rule of law and keeping in check the ethnic tensions that threatened political stability a few years ago, chronic health problems keep getting worse in the troubled Pacific nation.

Diabetes and heart disease are rife, as are cancer-causing viruses such as the human papilloma virus. But besides being hit by this double-whammy of stereotypically Western and developing-nation concerns, the Islanders also face a unique problem in a higher-than-average and increasing incidence of abnormal growths: tumours for which there is no satisfactory explanation.

Stanley‘s a teenager. He misses his school in Honiara, where his favourite subject is maths. He’s a defender in his soccer team. Stanley seems like a happy and healthy young man with a cheeky smile and a mischievous nature. However, intermittently and without warning, Stanley fits or projectile vomits as the unidentified lesion in his brain produces its symptoms.

Tumours worry the Solomon Islands’ Honorary Consul-General, Trevor Garland. A University of Sydney-trained medical doctor; he practised medicine in the Solomons, running a hospital and area health service in the Western Provinces before taking up his diplomatic post. During that time he forged a relationship with St Vincent’s Hospital in Sydney and as a result that hospital has undertaken, as part of its charitable charter, to treat 10 patients a year from the Islands.

‘We see tumours in the Solomon Islands that you see in Pacific Island races [but] don’t see very often in Caucasians,’ Garland explains. ‘We see rare facial tumours – benign, but fatal because they eat away at the mandible or jawbone. An ENT [ear, nose and throat] surgeon might see one in 20 years, where we had a run on them. We gave a surgeon three in one year. There are also weird sarcomas that you might see in very, very small numbers in a larger population. We’re seeing them in significant numbers in the Solomon Islands population.’

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Rex is just 17 months old. He’s an engaging child with big, blue eyes – not an unusual characteristic in his part of the Solomon Islands. His beautiful little face is marred by a growth that extends from his neck to halfway up his head, seriously disfiguring one ear. In his short life, the tumour has grown so large that it’s now bigger than his head, which he struggles to hold up against the weight of the tumour. The tumour is winning for now. Still, his lop-sided smile is infectious.
Garland is not convinced that ethnicity alone is a satisfactory explanation. He suspects an underlying cause of the tumours may be the after effects of nuclear testing in the Pacific finding their way to the Solomon Islands via the main food source: fish.

Studies suggest geography a factor

These suspicions were first prompted by research published in the New Zealand Medical Journal in 1992. A paper titled Incidence of cancer among Pacific Island people in New Zealand tracked the epidemiology of new cancer registrations among Pacific Islanders living in New Zealand compared to the Maori population (who originated in the Pacific Islands). There was a higher incidence amongst Pacific Islanders, which suggests geography is a factor.

Similar findings were published in 2004, and tellingly, the World Health Organization has also noted ‘.there is some evidence that non-communicable diseases like cancer [in the Solomon Islands] . are increasing.’
‘You only need to look at lifestyle,’ says Garland. ‘The Solomon Islanders live, especially in the rural areas, in the most pristine environment, where lifestyle has not changed – not in hundreds of years but in thousands, in terms of building materials and so on. People live a subsistence lifestyle beautifully. They take from the earth in the form of root crops and they take from the sea. They fish.’
Fish tend to be migratory creatures and Garland believes this is the crux of the matter when it comes to establishing a possible causal link to the tumours.

Alfred has a growth that extends from his neck down his chest. It’s the size and shape of half a tennis ball with an adjacent golf ball attached. He was born with it and has now lived with it for more than 20 years. Today his anxiety is palpable as he’s due to have it removed in the morning. Hospitals, especially Australian ones, are alien places to Alfred. In the Solomons, he is more at home diving for fish. Reef fish are his favourite .

It’s hardly surprising that there could be human consequences from the nuclear tests in the Pacific. There were 41 atmospheric nuclear tests alone on Mururoa and Fangataufa atolls in French Polynesia between 1966 and 1974, followed by 142 underground tests between 1975 and 1996. Closer to the Solomon Islands, 67 nuclear tests were conducted in the Marshall Islands between 1946 and 1958. The ‘Bravo’ test in 1954 was 1000 times bigger than the Hiroshima bomb. After 50 years, evidence is still being uncovered that broadens the range of adverse effects.

In Britain recently, in a landmark court case that was the culmination of years of campaigning, affected military veterans were given leave to sue the Ministry of Defence based on new evidence presented in 2007 by Al Rowland of New Zealand. Professor Rowland found that radiation caused abnormal changes in the DNA of veterans present at the nuclear tests, which explained why their children were 10 times more likely than the national average to suffer birth defects. The 13-year-old daughter of Doug Hern, Secretary of the British Nuclear Test Veterans’ Association, was among those affected, dying from a rare cancer.

In a similar vein, the French Minister for Defence, Hervé Morin, earlier this year recognised 18 cases of sickness, including many cancers, caused by radiation from the Pacific nuclear tests. The French government has promised compensation.

Less clear are the long-term effects of the tests. Scientists agree that cracks in the basalt layer at Mururoa may allow radioactive gases to escape into the ocean. In 1983, it was estimated that such leaks would not occur for 500 to 1000 years. However, given that further underground tests have taken place at the atoll since then, some scientists fear the atoll could crack open completely, with disastrous environmental and social consequences.

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However, for the Solomon Islands’ government, it is the Coral Sea rather than the Pacific that is the major current concern. Speaking ahead of the Coral Triangle Initiative meeting held in Indonesia in May and attended by the leaders of Indonesia, Malaysia, the Philippines, Papua New Guinea, Timor Leste and the Solomon Islands, Solomons’ prime minister, Dr Derek Sikua, said, ‘This. is the main spawning ground for tuna, and because of the threat of climate change and pollution we need to act together.’
Yet if Trevor Garland’s theory is correct, those long-lived, deep-sea tuna could be at the heart of the tumour problem.

More research required

Alexandra Martiniuk is an epidemiologist and Senior Research Fellow at the George Institute in Sydney. The Institute conducts research into chronic disease in vulnerable populations such as those in developing countries. Dr Martiniuk is familiar with the epidemiological issues in the Solomon Islands and has also conducted research into cancer ‘clusters’. However, she says she would need far more data before a causal link to the tumours could be established.
‘With any anecdotal evidence, it must first be ascertained whether an increase is actual or perceived,’ she explained. ‘It could just be that more people with tumours are presenting for treatment as the health service in the country improves.’ Without accurate historical data, of which there is a dearth, there’s no way of knowing.
There are also many different types of tumour. ‘You’ve mentioned three diagnoses to me,’ Dr Martiniuk points out. ‘The three are quite different and would have different causes.’ However, she concedes that in the aftermath of nuclear testing ‘many cancers increase in incidence’.

It’s hard to believe that Stanley, Rex and Alfred are lucky, but they are. Many Solomon Islanders with life-threatening illnesses never get onto treatment programmes like those offered at St Vincent’s. Back home, even if the medical expertise exists, there is a lack of sophisticated diagnostic and treatment tools, meaning treatable conditions are too often fatal.
Whether the incidence of tumours in the Solomon Islands is increasing or whether they’re merely being noticed and recorded for the first time, the anecdotal evidence suggests that the occurrence is high, while scientific studies indicate that cancer rates in general are also high. This should be of concern.
Rex has only just started his treatment. It could be a long road. His medical team firstly needs to arrest the growth of the tumour before it can operate to remove it. It’s a dangerous time for Rex, as the tumour-retarding injections will cause inflammation. His doctors need to ensure that the inflammation doesn’t push on and block his airways. It’s going to be quite an ordeal. He’s so small. It hardly seems fair. But then for sick Solomon Islanders, it rarely is.
I ask Trevor Garland how he thinks Rex will fare. ‘I don’t know,’ he replies. ‘I’ve never seen one of these before.’ There remain so many questions – so few answers.