“I can remember the last day very well,” says Americo Maria Lacetti, a former colonel of the military division of the Italian Red Cross.
During the Kosovo War in 1999, he was stationed in Albania, a few hundred meters from the border with Kosovo. He was commander of a field hospital for refugees from the province, which at that time belonged to Serbia.
“We stood on the containers and watched the bombing. It was like a distorted New Year’s Eve fireworks display. Even from a distance, you could feel the air pressure, the shock waves going through your body. But no, we were not told about the specific dangers of the weapons being used.”
In March 1999, NATO’s Operation Allied Force intervened in the conflict between the Serbian state and the Albanian majority population in Kosovo, which had been ongoing for years. Over 78 days, the coalition flew missions against Serbian security forces with 1,000 aircraft. According to official figures, more than 28,000 explosive devices were dropped, including controversial uranium munitions suspected to cause cancer.
This ammunition had a core of depleted uranium (DU), which had high explosive power due to its high density, which was three times denser than lead. Therefore it is mainly used against tanks and armored targets. This impact can produce fine uranium dust, which continues to emit radiation and can cause health problems, for example, if it is inhaled.
NATO rejects cancer allegations
In response to questions about the health risks posed by DU ammunition, NATO provided only a written statement. “We take health and environmental issues very seriously,” it said.
In 2001, a committee on DU, citing independent findings, concluded that the use of DU ammunition in Kosovo posed “no lasting health risk to the population”.
NATO cited 2014 UN reports. “This is scientific evidence; it was credible and we stand by it,” the military coalition said in a statement.
However, this contradicts decisions of Italian courts on approximately 500 lawsuits filed by the Kosovo War Veterans who developed cancer after exposure to depleted uranium ammunition.
Lacetti says he was aware that during the NATO bombing his field hospital in Morina, Albania, was located in a “hot zone”, close to an active conflict – something that would always have been risky.
“However, we were never told that some types of ammunition could pose a long-term threat even if you were not attacked directly – for example, from a nearby unexploded ordnance or from the substances used in ammunition production.”
triggering chronic disease
When Lacetti returned home in July 1999, he experienced difficulty breathing and went to the hospital to be examined. “The medical staff suddenly became very nervous,” he recalled.
Finally, a doctor showed him the image: “There was something in my lung measuring 24 by 12 by 14 centimeters (9.4 by 4.7 by 5.5 inches).” The then 36-year-old man was diagnosed with a very aggressive malignant tumor.
Lacetti was initially treated successfully, but in 2008, he fell ill with cancer again. The tissue test results were worrying. “They found an extraordinary amount of perfectly round ceramic particles – as if I was standing in a blast furnace.”
The conclusion was clear: “These particles had accumulated in my body over many years and could cause new damage through migration or inflammation.”
Successful lawsuits in Italy
Lacetti learned from other soldiers of the same age who were stationed nearby and had received the same diagnosis. He contacted lawyer Angelo Tartaglia, who represented those affected.
About 500 military personnel successfully sued the State of Italy. They included Lacetti, who was certified as a victim by a Rome court in 2009 because he had fulfilled his military duties. The court awarded him compensation.
After the Kosovo War, a commission of the Italian Defense Ministry investigated the possible association between DU exposure and cancer. It found a statistically significant increase in the incidence of non-Hodgkin lymphoma, a group of blood cancers, among the affected soldiers. However, other studies, such as the WHO report from the same year, found no clear evidence of a direct link between individual cases of DU and the disease.
Difficult to prove cancer connection
For Wim Zwijsenberg, a member of the International Coalition to Ban Uranium Weapons (ICBUW), the case is clear.
“The judge considered that the Italian state had a duty of care, which is why compensation was awarded,” said Zwijsenberg, who has been investigating the use and consequences of DU for more than 16 years.
“My conclusion is that it is extremely difficult to make a definitive statement,” he admits, because depleted uranium has an effect only when it enters the body, usually in the form of fine dust particles that are inhaled. “But the exact amount that people actually absorb has never been properly measured. There are very few reliable long-term studies.”
The causes of cancer are often difficult to determine. Unhealthy lifestyle, environmental influences, genetic predisposition and many other factors contribute to the number of cases.
“It’s difficult to prove,” says Zwijsenberg. “Have affected people ever touched a DU grenade or been near a contaminated tank? It can take a year for uranium to penetrate the skin. Doctors cannot make any claims if it is not completely clear. People look for the obvious cause, but the reality is far more complex.”
Did NATO do enough to clean up Kosovo?
In 2002, the United Nations passed a resolution obliging countries to notify affected states after the use of uranium munitions and to assist in the cleanup of contaminated areas. It is unclear to what extent NATO fulfilled this responsibility in Kosovo – the NATO peacekeeping force KFOR, which has been deployed there since the end of the fighting to ensure peace, does not provide any information.
Visits to the sites show that the population in many areas of Kosovo is unaware of the potential risks, and, except for one site in the village of Lugbunari near Gjakova in the west of the country, decontamination measures have not been taken.
Expert Wim Zwijsenberg said, “NATO can be criticized for using these weapons, but even more so for not carrying out a cleanup operation after the war. There are clear safety protocols for soldiers – but for civilians? Nothing. It is unacceptable to use toxic ammunition and then simply walk away.”
Officially, the material the DU ammunition is made of is classified as low to medium level radioactive waste. But, Zwijsenberg said, “in humid climates like the Balkans, the shells can deteriorate and disintegrate, leaving dangerous remains.”
The risk does not diminish over time, as uranium has a nearly infinite half-life. For Zwijsenberg, this is evidence of the states’ double standards.
“If such a grenade is found in a Dutch park, the area will be cordoned off. Special forces in protective suits will place the grenade in a lead container and store it safely.” So when it comes to their own population, the risks are taken extremely seriously – but elsewhere, this is not the case.
Lacetti is frustrated that there has been no fundamental change in his case and that of many other veterans. “Depleted uranium ammunition is still legal. We have tried in every possible way to ban it, like cluster munitions or anti-personnel mines,” he said. “We have failed.”
With additional reporting by Gabriele Cruciata in Rome and Marjolein Koster in Utrecht.
Research for this article was supported by JournalismFund Europe.
This article was originally published in German.