Pathetic tales of Niger, Zamfara children exposed to brain damage, death.
“I lost three children in succession, the first died a day after birth, I had another and she died four days later, the third stayed for seven months and died, you can imagine my terror, when I gave birth to the fourth and a month later, realised he was headed on the same path as the others”
This is one of many tales from Ngwan Magiro, one of two villages in Shikira community, of Kagara in Raffi Local Government Area of Niger state, where twenty eight children were reported dead in May 2015. Any many of the villagers insist that the seemingly high figure was grossly under- estimated
Thrity-year-old mother of five, Amina Umaru explained that her worst nightmare began repeating itself for the fourth time when she noticed her month old son, Abdulrasheed Umaru foaming in the mouth, convulsing as his eyes turned back into his skull, while vomiting and purging at the same time.
“I knew it was the same illness, because that was how the other three died.” she said.
For 19 years old Aina’u Musa, from Ngwan Kawo, the story is a bit different, one minute, her one year old daughter Zapa’u was playing with other children, the next minute, the children ran back home to tell her that Zapa’u was convulsing and foaming in the mouth.
“I was scared, I had no experience with it because none of my children before her had suffered from it before, I had only heard tales of the sickness.” She said.
Before the outbreak of lead poisoning was officially confirmed in Shikira community, parents like Amina and Aina’u had thought that the illness was spiritual and could be healed by local herbalists who presented the parents of the sick children with herbs. They prepared for the troubled mothers a herb inhalation therapy to be administered on their children orally and as ointments. Unfortunately the children’s condition got worse and they died.
Miles away from Shikira, in Abare, Anka Local Government Area of Zamfara State, Najib Muhammed was born healthy, he was fond of running around with his peers until his second birthday in 2010 when an illness his parents thought was a mere fever developed into something more severe.
Like parents from villages in Dareta, Abare, Tungar Daji, Duza, Yargalma, Tungar Guru, Sumke and Bagega, in Anka and Bukkuyum Local Government Areas of Zamfara State where an outbreak of lead poisoning was reported in 2010, leading to the death of over 400 children (about 40 per cent of the children’s population in the said village), Najib’s parents thought he was possessed by a demons when the fever and convulsion worsened. The herbs and steam inhalation therapy failed to achieve the desired result.
Just like the others, his parents took him to spiritual healers called mallams, who make incisions on such children’s bodies to let out the bad blood in their system, when it did not work, verses from the Quaran was written out for the parents to recite to chase out the evil bedevilling Najib but he condition continued to get worse even after a charm known as laya was tied around him to ward off the evil spirit his parents felt was tormenting him.
The discovery
In Zamfara and Niger states, cases of lead poisoning was reported in 2010 and 2015 respectively, after unusual deaths in the community made the Centre for Disease Control (CDC), in collaboration with the Ministry of Health to take samples and found dangerous levels of lead in the bloodstream of humans and animals, it was realised that the high level of lead in children under five was causing the unusual deaths with symptoms, including fever, abdominal pains, vomiting, convulsion, altered levels of consciousness, where blood lead levels of 100 mcg/dL put children at high risk of brain damage and death.
Exposure to lead poisoning can occur through direct injection and inhalation. Children are at higher risk since they always pick things that might have been contaminated from the ground to put into their mouths. While high level of the lead poisoning in children can be fatal, in adults can cause constipation, memory problems, infertility, risks of miscarriage, kidney failure. Lead is also passed through the placenta and children can be born with lead poisoning. Once present, the effect of lead poisoning can be life long.
In states where the outbreak of lead has been reported in Nigeria, investigations show that the outbreaks were caused by artisanal mining activities due to wide spread gold ore dust suspected to be contaminated with lead. In the last decade, the international price of gold has increased, pushing more people into mining and as a quicker way of making money.
After blood samples were collected in both states and it was confirmed that the children, adults and animals in these communities were found to have high level of lead poisoning. After the outbreak was reported in Zamfara in 2010, Medecins Sans Frontieres (Doctors without Borders or MSF) offered their assistance. In Niger, they where invited in 2015 following their work in Anka, where they had set up a clinic at the General hospital in Anka and other smaller clinics within the other communities.
After testing the environment, people and livestock in these villages, environmental and safer mining practice education was embarked upon in the communities, where after characterisation, miners were educated on centralising the processing of ore in locations at least two kilometres away from villages and ensure working materials are not brought back home with them.
Since it was realised through environmental assessment, which is called characterisation that the soil in these communities where highly contaminated, environmental soil remediation was embarked upon by the Federal Government, where all the soil in the villages and compounds where removed and replaced. Then MSF embarked on treatment of children below the ages of five, who are at higher risks of developing extreme health complications from the exposure than older individuals.
Treatment
The major treatment used in these communities is the Chelation therapy, the drug called Succimer, which is manufactured by only one company globally, has to be booked six months in advance before it is made and it costs €3 (about N1,200) per tablet, which is provided for the children free. This expensive drug is unfortunately just a band-aid which helps decrease mass mortality in children.
Research shows that when lead enters the blood stream, it goes and settles in the bone marrow. So, for the therapy, the affected children are given succimer for up to 19 days, depending on the concentration of lead in the in the body, which extracts the lead from their blood-stream. They rest for a couple of weeks, and in the process, the marrow releases more lead into the blood-stream and chelation is repeated again. This process can last for years before the lead level is reduced in such children.
The Project Coordinator MSF Niger state, Benjamim Mwangombe explained that after environmental assessment was completed in Shikira communities, it was realised that lead contamination was up to 570,000 parts per million (ppm) in some areas, within the villages which exceeds the United States (US) Environmental Protection Agency (EPA) hazard standard for bare soil where children play, which is 400 ppm of lead.
According to him, In Ngwan Kawo and Ngwan Magiro, 210 children where screened, in August 2016, out of them 96 had high level of lead in their blood-stream. It meant they where above 45 mcg/dL, which is above the level required and means that children can develop worst health complications like brain damage, so they are eligible for Chelation therapy. He stated that all 210 children where exposed to lead but only 96 where at high risk of developing acute medical complications and have been put on treatment while the others are made to constantly return for follow-ups.
Mwangombe adds, ” It is likely that many people have been exposed. We can only treat children with high risk. In Ngwan Kawo for instance, a child was having convulsion, after screening, we realised the child had 300 mcg/dL.”
In Anka, Zamfara state Project Coordinator MSF, Zakaria Mwatia clarified that since the start of the project in June 2010, 6,177 patients have been screened, out of that 2,978 patients started chelation therapy. In 2016 alone, 325 new cases have been screen and of them, 95 will be undergoing the chelation.
He also stated that since the inception of the program in Anka six years ago 4,536 patients have been treated successfully. This number has been discharged from the programme. And of the number, 341 patients where discharged from the program within 2016.
Mwatia, who insist that mortality rate from lead in children under five in the communities in Zamfara has been wiped out to zero level, stated that 754 patients were currently in the program for treatment or follow-up. Of this number, he said, 18.0 per cent representing 133 children were undergoing chelation, 68.0 per cent which represents about 512 children, had completed treatment but were still in the programme for follow-up in case their blood levels spikes again and 14 per cent, which is about 109 children are on follow-up, they have never received treatment because the lead level in their blood-stream seemed not to ever get to the scary level.
Mwatia lamented that some children are being re-exposed to lead in Abare and Dareta communities after they were remidiated. The children, he said, were re-contaminated by people who still smuggle in gold dust and equipment into the villages. This he said, makes some children stay longer in treatment than others or cause children that have been treated and discharged, fall ill again. He also said, “325 new screening have been performed this year alone, 90 per cent of the number are new-born children.”
Ignorant miners
“We did not know that we where harming our children by returning home with gold dust.” said Leader of the Madaka Miners, Shuaibu Usman. “We where only trying to safeguard our hard work from prying eyes and thieves, not kill our children.”
Usman explained that after MSF had educated them on the reason for the outbreak that befell their communities last year and ways to prevent it, they had been listening and willing to change some of the things they did that led to the outbreak in the first place. He added that they are willing to learn from the new things being taught them, to ensure safer mining activities in their villages and they support MSF per cent.
The Sarkin Baura and Chairman Health Committee in Anka Local Government Area of Zamfara state, Zubairu Muhammed said the outbreak of lead Poisoning in the communities began during the period of polio immunisation which caused some villagers at the time to believe that their children where being killed off with the vaccine, not until the CDC and Ministry of health confirmed that the deaths was being caused by lead.
Muhammed who praised the Federal Government for the money it had released for remidiation, therapy and safer mining measures in the community, did not forget to applaud the efforts of MSF, “MSF assisted us a lot, we are honestly grateful to them.” he said.
He added that the emirate council forces the miners to take their uniforms with them to the site, as they have been provided with mining gears by the ministry of mines in Gusau, which provided them with rain boots and protective devices. The council also enforced a law that makes them bathe miles away from their communities before returning home after mining.
Road so far
Six years after his exposure to lead, Najib’s brain is damaged. The eight year old can no longer walk, talk, sit or do anything on his own. “They told us that the lead had gotten to his brain and that he might never get better but worse. I’m glad they told me the truth because we where able to prepare our minds for the worst.” said Najib’s father, 45 years old Labaran Muhammed and father of 12.
Apart from Najib, 39 other children in the Anka program are suffering from various degrees of brain damage due to lead poisoning. Doctors say that all the nerves in his body have been damaged to the extent that he can no longer do anything, even swallow on his own. MSF, a few months ago sponsored an operation that enabled doctors pass a tube directly into his stomach so that his parents feed him.
Aisha, Najib’s slight mother who carter’s for him and does all the heavy lifting, believes that God has a reason for everything in his life. “God takes care of us, I feed him pap through the tube and his father takes him to the hospital for the tube to be dressed often.”
Eight months old Abdulrasheed and one and half year old Zapa’u are among the children presently undergoing chelation therapy at the program in Madaka, Zapa’u’s excited mother said that she has improved greatly, Aina’u who explained that Zapa’u was initially admitted for three weeks at the General Hospital in Kagara, said that she is improving. “Apart from constantly jerking in her sleep, she is much better, the doctors have asked us to return in two months for the next round of treatment.” she said.
“Apart from his body temperature still being high, he has improved greatly.” says Amina who also revealed that her husbands second wife had equally lost two children to lead poisoning. “I probably would have lost him if not for them and their medicine.”
On the issue of re-contamination of two communities in Zamfara which had earlier on undergone remidiation, the Special Adviser to the Governor of Zamfara state on Public enlightenment and media communications, Ibrahim Dozara promised the government will look into the issue. He said the government, after remidiation, had instructed community leaders to report miners who still break the rules set aside to prevent re-contamination of such communities.
“It will be looked into and necessary actions taken.” he said.
Head of Mission MSF, Philip Aruna clarified that the situation on lead was not yet over because the activities carried out by small scale and artisinal miners, looking for money in other parts of the country might further expose them to lead.
“The way forward is for the government to embrace a workable safer mining program that will incorporate the artisinal and small scale miners.” he said.
