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For five years, Frederick Chukwuemeze had the grim task of treating children poisoned by lead in Anka, a mining town in north-west Nigeria.
Since 2010, more than 600 children have died from lead poisoning in Zamfara state and hundreds more have been left with brain damage and physical disabilities as a result of hazardous artisanal gold mining.
“I’ve seen patients with continuous seizures that couldn’t be controlled with any medication. Children that can’t talk, can’t walk. Always in bed, not knowing where they are. And then, of course, children dying. It’s actually heartbreaking when we see such cases,” said Chukwuemeze.
But no child has died on his watch since October last year, thanks to a joint effort between local and international agencies that has virtually wiped out lead poisoning cases in the state.
“It’s a wonderful accomplishment – for the patients and for me,” said Chukwuemeze, who works with Médecins Sans Frontières (MSF), which was involved in the clean-up operation.
The huge effort followed an outbreak of lead poisoning in at least seven villages in Zamfara in 2010. Over six months, 400 children died in a crisis that sent shockwaves throughout the country and brought into sharp focus the dangers of mineral processing in a largely impoverished and rural area.
The intervening years have seen more deaths and hundreds of poisoning cases, including children who have been left with brain damage and physical disabilities.
Alhaji Muhammadu Bello, the head of Dareta village, said that at the height of the crisis: “In my village, 120 children died. Six or seven were dying every day.”
The cause of the poisoning was found to be contamination of soil, water and food from the processing of gold deposits in village homes and residential areas.
Artisanal – small-scale – mining is a source of income for many in Zamfara, a mineral-rich state, and many children who are out of school in the region are involved.
In response, MSF joined forces with OK International, an organisation specialising in occupational and industrial health, and TerraGraphics International Foundation, an environmental engineering group, to work with Zamfara state health, environmental and other government officials to devise a long-term programme to reduce lead poisoning. Their task was not made any easier in villages regularly overrun by militants and inaccessible to aid.
After an intensive monitoring programme, more than 8,000 children in affected mining communities have been screened by MSF and state health officials, and more than 3,500 have been through lengthy chelation therapy to remove lead deposits from their blood.
A “safer mining” programme has seen more than 5,000 miners and community workers trained on improved standards to prevent exposure to lead, and designated processing sites – with showers – have been set up 2 to 3 miles away from residential areas to prevent miners bringing mineral deposits home.
As a result, no child has died of lead poisoning this year, and cases are now rare.
“Each of the village heads and council leaders have the responsibility to ensure that people aren’t bringing mining processing home but processing in designated areas for every village,” said Benjamin Mwangombe, MSF’s project coordinator in Zamfara.
Alhaji Shehu Anka, the head of Zamfara state’s environmental sanitation agency, said excavation work removed waste from soil and mineral processing left in wells and ponds.
“The mining activities had really damaged the local environment so we had to undertake a major effort to restore the environment and make it safe,” he said.
“Because of the security challenges we were doing some of this environmental work and environmental training remotely. We used to invite miners that come from those villages. Then collect soil samples from the homes of children that are not responding to treatment, then they would remediate the environment themselves,” he added.
Mwangombe said the success of the project, which was now being handed over to the Zamfara state government to lead, was due to the engagement of the communities and local and state officials.
“We realised the reason the outbreak happened was because people brought mineral processing to the villages. People didn’t have any knowledge on how to mine safely. Now we believe there is a good level of behavioural change,” he said.