By SOLA OGUNDIPE
THE tide of deaths of infants and young children from an outbreak of lead poisoning in Zamfara State, in North West Nigeria did not come like a thief in the night. The stage had been set for the tragic incident several years earlier.
Increasing activities of illegal miners and improper processing of lead-contaminated gold ore within households in the community, were largely responsible for the high death toll.
Inhabitants of at least 10 villages in Anka and Bukkuyum Local Government Areas of the State had, in the not too distant past,”stumbled” on deposits of gold, silver, copper and other precious metals in the soil and rocks in their community. It was a transforming discovery.
A report by the Centers for Diseases Control, CDC, confirmed that the environmental contamination and timing of the outbreak were related to recent increase in illegal mining activities and the greater involvement of women and children in processing lead contaminated gold ore in their homes.
They sprang into action as the news spread like a forest fire in the harmattan. More people in nearby villages joined in the gold hunt. Farming, their erstwhile vocation, took a backseat, while illegal mining of precious stones became the mainstay. It was a crude but lucrative trade.
The harvest was in, it appeared. It was a harvest of cash. Each miner was making an average of N100, 000 every week. On a good day, a hard working miner made more than N30,000. But the joy of striking gold soon proved short-lived.
No one knew it, but the precious gold ore was laced with lethal doses of poisonous lead. While harvesting cash, the people were also harvesting death. Infants and young children, strapped to their mothers’ backs or clinging to their sides, had been inhaling the ore dust. It was a recipe for disaster.
Soon enough, before their very eyes, the communities watched in horror as their children developed seizures and were dropping dead one after the other without any explanation. The seizures became widespread and in time, the death toll rose alarmingly. It was an unnerving and dreadful experience.
The children perished in droves even up to the remotest villages of Anka and Bukkuyum LGAs.
The gale of death swept through no fewer than 30 villages and an estimated 500 children below five years old lay stone dead. Several hundreds more were living with grievous scars of the unsolicited lead attack.
Today, more than a year after the onset of the outbreak, doctors are still struggling to save children stricken by lead poisoning. Many are dead, but many more are blind, deaf or crippled.
Scores of infants and children affected by the severe and acute lead contamination have suffered permanent brain damage as a result of prolonged exposure to the toxic effects of lead. The outbreak has been described as one of the worst cases of environmental poisoning in recent times.
Long term health consequences
Communities affected by the lead poisoning are coping as best they can, but the loss of so many children has obviously been devastating for families in these villages. Long-term health consequences for survivors of lead toxicity are also significant.
People are still trying to understand the causes of the poisoning, and are trying to adapt their activities so as to avoid causing further harm to themselves and their families.
People who mine and process the lead-laden ore have been receptive to the health education messages and are willing to change their behaviour, they need more support. Without the proper facilities and programmes in place on the risk of mining and processing lead-contaminated ore, much may not be attained.
Although the main vocation of the people remains mining and subsistence farming, the presence of enormous sources of precious minerals can never be lost on them. Like a swarm of bees, they keep returning to the mines to extract what they believe is their God-given largesse.
A joint study by the World Health Organisation, WHO and the Zamfara State Health Ministry also identified more than 200 villages where children may have been poisoned by lead.
Up to 30,000 people could have been affected, a good percentage of who are children. Will the children continue to die? Time will tell.
Medicines Sans Francias (MSF) is Nigeria’s long-term response to the lead poisoning saga. In this chat with Sola Ogundipe, Darri Stellmach, Head of Mission for MSF in Sokoto State describes the need to put in place preventative mechanisms to ensure that the event doesn’t recurr, ever.
He argues that such as facilities for safe mining and ore processing, health education, and medical follow-up for survivors are priorities that require urgent attention. Excerpts:
Heavy metal poisoning, MSF response
The Zamfara State lead poisoning crisis is an unprecedented response in the history of MSF and reported as one of the biggest incidences of heavy metal poisoning or environmental lead poisoning ever recorded.
As MSF we have nothing to compare it to. It is a completely new kind of intervention for us.
Immediate and long term issues
Over many months MSF has worked with stakeholders, including the Nigerian government, the US Centers for Disease Control and Prevention, the World Health Organization, UNICEF and TerraGraphics/Blacksmith Foundation.
We have made considerable progress over the past year in bringing the Zamfara lead poisoning under control. But there is much more to be done.
MSF has responded to the acute medical needs of poisoned children. But there are limits to what MSF can accomplish; we are only an emergency medical organisation. The effects of the lead poisoning are not over.
Specialists in environment and public health need to take responsibility for the long-term follow-up. There needs to be a coordinated effort by the Nigerian authorities and international organisations to properly respond to this crisis.
The affected areas need ongoing environmental management. Measures need to be put in place to ensure that such an event can never happen again. These should include regular environmental monitoring for lead contamination.
Facilities and programmes need to be put in place to ensure that people who engage in small-scale gold mining can safely mine and process the ore.
People in the affected areas need health education, so that they understand the consequences of unsafe mining and ore processing for their health and the health of their children, and can take steps to protect themselves and their families.
Also, some lead poisoning survivors require significant life-long medical care and follow-up due to permanent disability.
1000 children saved, more with permanent disabilities
In the first days and weeks of the poisoning, priority was patient care, and we focused only on that. MSF has not done a systematic mortality survey to determine how many children have died from lead poisoning. Such a study was undertaken by the state Ministry of Health.
Of the more than 1000 children that MSF has treated for lead poisoning so far, 14 have died. Not all of these children died directly from complications due to lead poisoning. The common childhood killers, like malaria and diarrhea, of course affect these children as well.
We are aware of a number of children in the villages who have suffered serious brain damage, resulting in intellectual disability, blindness, deafness, paralysis, epilepsy or other disorders.
Unfortunately, we are a rapid-response medical organization the expertise to assist these children, so we must appeal to the government and other stakeholders to take up their care.
Challenges and immediate concern.