Acute Care MedicineEmergency MedicineSMACCLead Poisoning In developing countries

Lead Poisoning in developing countries

Natalie Thrutle educates on the critical issue of lead poisoning in developing countries.

Critical care means different things to different people. In the context of lead poisoning, you may or may not think of developing countries such as Nigeria.

The response to the Zamfara state, lead poisoning outbreak, in Northern Nigeria, is unprecedented and requires a nuanced interpretation of ‘critical care’.

In 2010, 400 children died from lead encephalopathy in the largest lead poisoning outbreak ever recorded, affecting more than 5000 children in Zamfara.

The outbreak is ongoing. Children were presenting with intractable seizure and coma, not responsive to treatment for malaria and meningitis. 50% of these children were dying.

Notably, environmental poisoning was considered due to the high levels of artisanal gold mining in the area. This increase in mining was a major economic boom to a remote and rural population much in need.

MSF had never dealt with a lead poisoning outbreak before… neither had the Nigerian government. In fact, no one had ever dealt with a lead poisoning outbreak in the world before. It had never been seen.

Initially, there were three main aims. Chelation, remediation, and safer mining practices.

Ultimately, whilst chelation worked, it would have been futile without an effort to clean the environment (remediation). This in turn was futile without considering safer mining practices. The solution to the problem required by in and input from all parties. Herein lay the challenge.

We can draw parallels with the Ebola outbreak in Guinea. In this instance there were attacks on both healthcare workers and quarantine facilities. Evidently, Zamfara did not see such extreme reactions although there was certainly a feeling of animosity and resistance coming from the mining community.

In this talk, Natalie highlights the successes and the ongoing challenges of facing this issue head on.

Finally, for more like this, head to our podcast page. #CodaPodcast

Natalie Thurtle

Medical Coordinator @Médecins Sans Frontières

Emergency Physician with Toxicology