In March 2010, MSF received an alert about a high number of child fatalities in Nigeria’s Zamfara state. Across several villages, more than 400 children had died within just six months.
“When MSF arrived, we were suffering a lot,” Alhaji Muhammadu Bello, the chief of Dareta village told me. “In my village, 120 children died. Six or seven were dying every day.”
Small scale, massive impact
Laboratory tests later confirmed high levels of lead in the blood of survivors. It became clear that the gold deposits in this area contain an unusually high concentration of lead, and that unsafe artisinal mining practices were contaminating the environment, causing the poisoning.
"Artisinal" means that the mining and processing was done on a small scale, often by hand. This kind of work had been going on for a decade in this area, with people transforming their villages into mineral processing sites. Lead can cause severe brain damage and death in children, and these residential areas were being contaminated by the processing, with lead getting into the soil and dust.
Before my colleagues could start treating patients, the contaminated areas needed to be 'remediated': worked on so that children would not be continually re-exposed to toxins.
Between June 2010 and August 2013, TerraGraphics International Foundation provided environmental management training to Zamfara state’s Environmental Sanitation Agency (ZESA).
Our medical team saw children who were re-exposed to lead more than three times...
In partnership with the community, contaminated soils and mineral processing waste was removed from residential areas, wells and ponds in eight villages in Anka and Bukkuyum local government areas.
Between May 2010 and December 2021, our MSF team screened 8,480 children who were under the age of five for lead poisoning.
More than 80 per cent of them were enrolled in a medical lead program, including 3,549 children who received lengthy chelation therapy to remove lead from their blood.
A new crisis
Five years after the outbreak in Zamfara, another lead poisoning outbreak was discovered in two villages in Nigeria’s Niger state in April 2015.
It was also caused by artisanal gold mining and resulted in the death of at least 30 children.
Again, we provided chelation treatment to 139 children shortly after the land had been remediated, and then handed over the project to Niger state authorities and traditional leaders in October 2018.
Remediation and chelation therapy are not only very expensive, but also insufficient to eliminate the lead poisoning risk faced by the communities.
Due to the rampant poverty and lack of other employment opportunities in the area, artisinal gold mining remains the only option for many people. Many we spoke to were unaware of the health hazards caused by their mining practices. Some previously remediated areas were re-contaminated.
Our medical team had children who were re-exposed more than three times. Even if their compound was clean, all it would take was for the children to go to play on their uncle’s compound, where the soil is contaminated, and they would be at risk.
A different approach
The only sustainable, long-term solution is the prevention of lead poisoning. So we decided to engage OK International, a specialist industrial health organisation.
Working in partnership with Nigeria’s Federal Ministry of Mines and Steel Development and the responsible state agencies, OK International developed and implemented safer mining pilot projects in Niger and Zamfara states.
Safer mining is a set of practices to reduce occupational exposures and minimize environmental contamination. The safer mining program involved:
- Working cooperatively with mining communities and we trained over 5,000 miners to increase awareness of lead hazards and low-cost methods to reduce exposures to lead poisoning.
- Implementing safer work practices which reduced airborne lead exposures by 95% and off-site contamination and establishing safety committees in every targeted lead poisoning outbreak village to train new miners and ensure the sustainability of these efforts.
“We will continue to ensure that the environment remains clean, so that children will not get poisoned again”, Alhaji Shehu Anka, the general director of the Zamfara State Environmental Sanitation Agency (ZESA) told us.
Almost 12 years after we first started intervening in the area, children are no longer dying of lead poisoning in Zamfara. And as a result, at the start of this month we handed over the programme to key ministries of the Zamfara state government, the Anka Emirate Council and to the local community.
The fact that fewer young children are dying or getting sick because of lead poisoning is a major achievement, but it's not the only one.
We're also really proud that the work we did was rooted in the communities affected. They have been involved throughout, taking ownership of the project and building resources and expertise which mean that if there is another outbreak in future, they will be ready.
Looking to the future
One of the key factors for the successful reduction of exposure to lead poisoning was the involvement of international organizations with expertise in environmental health, safer mining and occupational health that complemented our medical response.
However, challenges remain. Artisanal mining is a poverty-driven activity that will persist as long as gold mining is profitable. Recently, another area with a high level of lead contamination was discovered in Abare village in Zamfara. At the end of January 2022, the Zamfara state government approved the financing of the environmental remediation of the contaminated area.
For the long-term sustainability of the decontaminated land, and to prevent children from dying from lead poisoning again, all partners need to remain committed to promoting and maintaining safe mining practices.
Going forward, prevention requires involvement from everyone – from village chiefs and traditional leaders to state authorities and legislators, so that everyone’s efforts will help maintain the remedy that we have handed over and prevent any future outbreak of lead poisoning in Zamfara state.