Dispensary No. 4, set on the vast plains of Central Asia, was a medical clinic unlike any other in the Soviet Union.
Its secret task was to collect radiation data on people living near Semipalatinsk, the huge nuclear testing site in northern Kazakstan.
"I knew what was going on, but I didn't tell anyone because I didn't want to get 15 years (in a labor camp) or, worse, shot," said Boris Gusev, who was the clinic's chief doctor until 1991.
Gusev, 60, says he has done everything he can to help people with his knowledge since Kazakstan gained independence in 1991 and the sprawling test site was closed.
"I feel very good because with what I knew and saw, I could do something to help the people," said Gusev, now deputy director of the state-run Scientific Research Institute for Radiation, Medicine and Ecology.
But Gusev's change of heart comes too late for some of the estimated 1.6 million people exposed to high radiation levels during the 470 nuclear tests the Soviet military conducted here between 1949 and 1989. More than 100 of the tests took place above ground.
Before some explosions, local residents were told to leave their houses and stay outside. The ground would shake, glass would shatter and plates would fall from the cupboards. Sometimes buildings would collapse, residents said.
No one told them that looking at the nuclear mushroom cloud could damage their eyes or worse. No one warned them their children and grandchildren would lose their teeth, turn gray in their teens, suffer birth defects or die of cancer.
"The nature of the deformities that resulted they're just gruesome beyond belief," said Dr. James Warf, a chemistry professor at the University of Southern California who has worked on nuclear projects and studied the effects of radiation in Semipalatinsk.
Warf described one instance where a stillborn baby had abnormally large ears and a single eye in the middle of its forehead.
"This all comes from illnesses caused by radioactive exposure," he said in a telephone interview.
The people were meant to be part of the experiment, and the results are only now coming in. Kazakstan's cash-strapped government has done little to address the problem in recent years, and Russia simply ignores the issue.
Still, some Western experts have begun researching the effects of radiation on the region. The Baylor College of Medicine in Texas has undertaken a project to wade through old data that is now becoming available.
"Unfortunately, the types and duration of exposure, controversy regarding historical data, the extended period of secrecy, and current economic and health problems make it quite challenging," said Dr. Armin Weinberger, the head of the Center for Cancer Control Research at Baylor.
At the Home for Psychiatric and Neurological Patients in Semipalatinsk, the vast majority of the 350 patients are believed to be victims of radiation, suffering from mental retardation, schizophrenia and physical malformations, said director Shaiza Rysbekova.
Kazakstan's government pays only a fraction of the $800,000 needed to run the home annually and medical staff have not been paid for two months, Rysbekova said.
The state's lack of money also has prevented the payment of compensation to many radiation victims. Residents who lived in the Semipalatinsk area during the nuclear tests are entitled to a one-time compensation.
The state made payments in 1996, but only 56,445 pensioners received any money, getting the equivalent of $215 each.
It's still unclear how many people actually suffered health problems as a result of the nuclear tests. All data collected during the Soviet era was sent to Moscow and has not been made public.
Kazak officials say that for every 100,000 people in Semipalatinsk, 245 will contract cancer, compared with 174 in Kazakstan as a whole. The pre-natal center in Semipalatinsk said that of every 1,000 births in 1997, 400 babies had some health problems or deformities and 47 died.
But statistics available in Kazakstan are flawed, and probably understate the problem.
"I was a doctor and was not allowed to diagnose cancer," said Aliya Begalina, now head of disease prevention at the Semipalatinsk Department of Health.
Begalina said she was not trained to recognize or treat the symptoms of radiation sickness, such as swollen thyroid glands.
"If someone died of cancer, we had to diagnose a heart problem or another disease," she said.
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