By Unni Karunakara
Following alarming child mortality
reports from Zamfara State (Northwest Nigeria) in June 2010, Médecins Sans
Frontières / Doctors Without Borders along with the Nigerian government, the
United States Center for Disease Control, United Nations agencies, and other
groups responded to what is now considered the largest environmental lead
poisoning crisis in history. At the outset, over 400 children died and
thousands more were discovered to have excessive and unprecedented levels of
lead in their blood as a result of artisanal mining activities.
Through the last 2.5 years, MSF has
successfully treated over 2000 children. A necessary precondition for
treatment has been environmental remediation which consists of removing lead
from the home environment. Since chelation therapy, the main component of
treatment for lead poisoning, is ineffective if children continue to be exposed, it
is the initial remediation of seven of the eight most contaminated villages
identified in the last two years that paved the way for MSF to provide medical
treatment to lead poisoned children.
As a result, hundreds of lives have
been saved and mortality rates among children under-5 have fallen drastically
in remediated areas (prior to MSF’s intervention, some villages suffered over
40 per cent of their children perish from the poisoning, while the cumulative
mortality since has been less than three per cent). Nearly one thousand
children have since been discharged, many with an excellent chance of leading
normal lives despite the astonishing levels of toxicity they have suffered.
However, one highly contaminated
village has yet to be remediated. To this day, hundreds of children in
Bagega continue to suffer the devastating symptoms and life-threatening risk
associated with lead poisoning. The remediation efforts that had been
previously so successful in seven other villages of Zamfara State foundered in
Bagega due to lack of funds, despite ongoing promises of assistance from
Nigerian authorities for the affected population.
MSF is standing by, ready to begin
treatment in Bagega as soon as remediation is completed. Until that happens,
the children of Bagega continue to be at high risk of death and the
debilitating effects of lead toxicity including brain damage. An
internationally recognised expert in environmental remediation, Terra Graphics
International Foundation, which played a key part in the remediation of the
first seven villages, is also standing by ready to assist and ensure that
remediation is done effectively and thoroughly. What remains is for the funds,
earmarked by the Federal Government at the Abuja International Lead Poisoning
Conference of May 2012, to be released and the clean up to begin.
Indeed, time has run out. The
situation in Bagega has reached a crisis point. After a delay of more than two
years, remediation was scheduled to start in October 2012. At this
moment, it is unclear where the funds are, and no action has occurred. If
remediation is not started within a few weeks, it will not be finished before
the beginning of the next rainy season, and until remediation is complete MSF
will not be able to begin treatment for the children of Bagega. In the
meantime, more children are born into a toxic environment, more lives are lost,
and the effects become increasingly irreversible.
As a medical doctor, I know that young
children living in Bagega village are at risk of seizures, organ failure and
death due to lead exposure. When parents from Bagega bring their severely ill
children to us for treatment of lead poisoning, we experience first-hand the
anguish they feel living in a community that puts the lives of their children
at risk. Without remediation our hands are tied. With every delay, more
children will die and a generation is at risk of long-term brain damage from
lead poisoning.
That remediation has not yet started in
Bagega is both inexplicable and unacceptable. The funds have long since been
promised and all parties are apparently prepared and committed to the clean up.
What then prevents this activity from happening?
Of course, remediation alone is not
enough. MSF looks forward to working with the Ministry of Health to continue
to treat the victims of lead poisoning, and I urge the Ministry of Mines and
Steel Development in Nigeria to support a safer mining programme to mitigate
the danger of more contamination. Only through a three-pillar approach,
with medicine, remediation, and safer mining practices will the crisis in
Zamfara be truly resolved.
On my recent visit to Nigeria, I
conveyed these concerns to the Inter-ministerial Committee on Lead Poisoning,
and to the Ministers of Health and Mines and Steel Development. I am
grateful that the Nigerian government is taking this issue so seriously,
and I would like to thank the ministers, their employees, and the Committee for
their warm reception and taking the time to discuss this issue. I was
encouraged to hear of the renewed commitment by the ministers and Committee to
address the contamination in Bagega, and look forward to seeing the work begin
very soon.
•Dr. Karunakara is the International
President of Médecins Sans Frontières / Doctors Without Borders (MSF), a medical
humanitarian organisation that has been providing medical services throughout
Nigeria since 1971.
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