In the northeast of Kazakhstan more than 110 above ground nuclear explosions were carried out between 1949 and 1963. After the moratorium on atmospheric nuclear tests, underground nuclear testing was continued until 1989. This chapter follows the routes chosen by scientists and those responsible for public compensation programmes to navigate uncertainties of radiation-exposure in local communities around Semipalatinsk. It describes how, since the 1990s, research and compensation programmes have been negotiated and implemented in post-Soviet Kazakhstan, following decades of biomedical research during Soviet time. It shows how in the context of international collaborative projects, efforts to document long-term health effects stimulated innovations in epidemiological studies, exposure reconstruction, risk estimation, and radiation ecology. However, while negotiating compensation for local communities, most benefits of the innovative studies travelled to scientific practices in western countries, leaving global health disparities as they were. 'Vzryvaiut' ('They are blasting again'). It was often just one word by which people in the city of Semipalatinsk casually noticed that kitchen cupboards were trembling. As my interlocutors further recall, they had been accustomed to the occasional earthquake-like grumbling from the 'polygon', the Semipalatinsk test site,