Why Afghanistan’s high rates of childhood lead exposure are a cautionary tale for the Middle East

Why Afghanistan’s high rates of childhood lead exposure are a cautionary tale for the Middle East
Afghan children carry coal collected from a brick factory on the outskirts of Kabul on June 1, 2018. (AFP)
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Updated 27 August 2024
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Why Afghanistan’s high rates of childhood lead exposure are a cautionary tale for the Middle East

Why Afghanistan’s high rates of childhood lead exposure are a cautionary tale for the Middle East
  • Lead poisoning is a silent epidemic in Afghanistan, damaging the brains and futures of nearly all Afghan children
  • Contaminated cookware, battery recycling, and conflict remnants are poisoning millions, harming cognitive development

DUBAI: With one of the world’s highest rates of childhood lead exposure, Afghanistan is in the midst of a major public health crisis, perpetuating a cycle of poverty, illness and lost potential, in what could be a cautionary tale for impoverished and war-devastated countries in the Middle East.

It is estimated that almost all Afghan children have some degree of lead poisoning, which can result in brain damage, irreversible loss of intelligence, behavioral difficulties and learning problems.

A 2020 survey found that one in three children has lead in their blood above the threshold for lead poisoning, meaning they could suffer damage to their cardiovascular system and internal organs, and experience behavioral problems in adulthood.




It is estimated that almost all Afghan children have some degree of lead poisoning, which can result in brain damage, irreversible loss of intelligence, behavioral difficulties and learning problems. (AFP)

The “Toxic Truth” report by the UN children’s fund, UNICEF, and the non-profit environmental health organization Pure Earth estimates that about 800 million children worldwide have blood lead levels exceeding 5 micrograms per deciliter.

“The consequences of lead poisoning for global health, for children’s education and for overall development and economic growth are staggering,” Rachel Bonnifield, a senior fellow at the US-based Center for Global Development, told a recent conference on lead and public health.

While some of those affected live in wealthy countries, it is mainly poor countries such as Afghanistan that have the highest rates of lead poisoning, as their populations are more likely to be exposed to lead from multiple sources.

These sources can include inhaling dust and fumes from lead-acid battery recycling operations, being around open-air smelters, as well as eating food contaminated by cookware containing traces of lead and lead-infused spices such as turmeric.




Afghan children play on the remains of an old destroyed Soviet tank in the eastern Afghan city of Jalalabad on September 29, 2012. (AFP)

Children playing or working in lead-contaminated spaces such as electronic waste dumps also face a high risk of exposure.

Lead poisoning is a serious health issue in the Middle East, with significant impacts in countries such as Iraq, Yemen and Egypt.

In Iraq, decades of conflict have left high levels of lead contamination, especially near industrial sites and in urban areas, leading to widespread health problems among children, including cognitive impairments and developmental delays.

In Yemen, lead poisoning has been exacerbated by the use of contaminated water sources and the lack of proper waste management, resulting in elevated blood lead levels in children. 

Similarly, in Egypt, the use of leaded paint and lead-infused pottery has contributed to widespread exposure.

INNUMBERS

  • 815m Children worldwide who have exposure levels considered as lead poisoning.
  • 20% Proportion of learning gap between rich and poor countries attributable to lead poisoning.
  • 5.5m Deaths each year caused by cardio-vascular diseases linked to lead exposure.

(Source: CGD)

Gaza has also seen significant rates of lead poisoning, in part owing to Israel’s 2008 ban on the export of used batteries, which resulted in mountains of discarded units piling up in the overcrowded enclave, where their chemical contents leak and contaminate the soil and water.

According to the World Health Organization, there is no safe level of lead exposure. Even low levels have been shown to damage cognitive development, IQ and attention span in children.

Juvenile delinquent behavior and adult violence have also been associated with lead exposure. Studies have found that pupils with a lower concentration of lead in their blood are less likely to commit crimes or be arrested.

In Afghanistan, however, few are even aware that they and their children are being poisoned, nor are they aware of the health consequences.




An Afghan labourer makes metal pots at an aluminum factory in Herat on January 22, 2019. (AFP)

Afghans who work in electrical waste dumps or metal work factories have little or no protection. Many wrap scarves around their faces as a makeshift guard against the fumes. Few of them wear gloves as they carry scrap to the furnace, raising the likelihood of contamination.

Some of these factories produce pressure cookers and cooking pots called kazans, which Afghans use to cook their daily meals — unaware of the lead contaminants seeping into their food from the cheaply made alloy.

A kazan, usually made out of low-quality recycled aluminum, is a kitchenware staple in Afghanistan. Their popularity has thereby contributed to widespread lead poisoning.




Some factories produce pressure cookers and cooking pots called kazans, which Afghans use to cook their daily meals — unaware of the lead contaminants seeping into their food from the cheaply made alloy. (Shutterstock)

The Taliban government, which returned to power in 2021, appears to lack the financial means and political will to address the problem, as it wrestles with a succession of humanitarian emergencies and security threats amid its continuing isolation by the international community.

“The government is not taking any measures to stop the exposure,” said Ali, a Kabul-based Afghan who spoke to Arab News on condition of anonymity. “I don’t think the men who work in the dump and metal fields are aware of the dangers of their work.

“The men work to put food on their family’s table. Where do you start to explain that even the cookware is poisoning them?”

Baffled by high levels of lead found in children arriving in America from Afghanistan, US researchers conducted studies on kazans and other aluminum cookware, only to find the products far exceeded the US Food and Drug Administration’s limit for lead content.

As a result, multiple states have put out warnings against the use of Afghan pressure cookers. This year, Washington state banned the manufacture, sale and distribution of lead-contaminated pots altogether.

However, Afghan cookware is not the only source of lead contamination.

Decades of conflict in Afghanistan have left the country littered with the remnants of spent and unexploded munitions and ordnance, and the wreckage of military vehicles, polluting the environment with lead and other harmful elements.

Additionally, the use of kohl — a kind of eyeliner worn to guard against the sun’s glare and as part of traditional dress — is also a culprit of lead poisoning.

Dr. Cyriac Abby Philips, an India-based specialist in hepatology and liver transplant medicine, says that lead poisoning is among the most damaging things to a child’s physical development.




Afghan deminers from the Halo Trust prepare to detonate unexploded ordnance (UXO) at a hill in Deh Sabz district of Kabul on May 21, 2024. (AFP)

In a recent thread on the social media platform X, Philips said that even exposure to small amounts of lead can result in children appearing “inattentive, hyperactive and irritable.”

“Afghanistan has a major public health crisis,” Philips said. “Almost all children have lead poisoning there.”

He added: “Children with greater lead levels may also have problems with learning and reading, delayed growth and hearing loss. Studies show that lead exposure leads to reduced IQ in children, and this reduction in IQ carries on into adulthood.

“It also causes attention deficit disorders and has been linked to both Parkinson’s disease and, more recently, Alzheimer’s disease. Children who survive severe lead poisoning may be left with permanent intellectual disability and behavioral disorders.”




An Afghan internally-displaced woman cooks in front of her tent at Shaidayee refugee camp in Injil district of Herat province on February 20, 2022. (AFP)

Although lead poisoning is a complex challenge that will take time to solve, the Center for Global Development says it remains entirely feasible to end childhood lead poisoning by the year 2040.

The center says the international community must invest $350 million to tackle the three known sources of lead exposure — paint, spices and battery recycling. Money should also be allocated to research and to raising public awareness about the dangers of lead contamination.

UNICEF has outlined a six-pronged approach to tackling the scourge of lead poisoning, including monitoring and reporting systems and building capacity for blood testing and identifying lead-contaminated sites.

It also calls for control measures to prevent children and pregnant women from being exposed to lead, including guarantees of adequate nutrition and the elimination or replacement of lead in cookware.




Workers make traditional tin stoves at a tin workshop in Kabul on September 19, 2023. (AFP)

Furthermore, UNICEF calls for the provision of training for health care providers on how to identify and manage lead exposure in children and pregnant women, as well as providing enhanced educational interventions and services alongside cognitive behavioral therapy.

Additionally, governments should launch public awareness campaigns on the dangers and sources of lead poisoning.

Legislation, including the development of health and safety precautions and standards, especially in substances that contain lead such as paint, lead-acid batteries and other e-waste, is also necessary.

This also extends to eliminating lead compounds in gasoline, children’s toys, cosmetics, spices and medicines.

Finally, global and regional action is required to create a global standard unit of measures to track and verify pollution and public health, as well as establishing partnerships and creating international standards for the recycling of lead-infused products.

 


Germany has stopped approving war weapons exports to Israel, source says

Updated 27 sec ago
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Germany has stopped approving war weapons exports to Israel, source says

Germany has stopped approving war weapons exports to Israel, source says
  • Germany’s arms exports to Israel slow sharply in 2024
  • Legal challenges argue German arms exports breach humanitarian law
BERLIN: Germany has put a hold on new exports of weapons of war to Israel while it deals with legal challenges, according to a Reuters analysis of data and a source close to the Economy Ministry.
A source close to the ministry cited a senior government official as saying it had stopped work on approving export licenses for arms to Israel due to legal and political pressure from legal cases arguing that such exports from Germany breached humanitarian law.
The Economy Ministry said on Thursday there was no ban on arms exports to Israel and there would not be one, with decisions made case-by-case after careful review, adding that international law, foreign and security policy were key factors in their assessments.
“There is no German arms export boycott against Israel,” a spokesperson for government said on Wednesday, commenting on the report.
Last year, Germany approved arms exports to Israel worth 326.5 million euros ($363.5 million), including military equipment and war weapons, a 10-fold increase from 2022, according to data from the Economy Ministry, which approves export licenses.
However approvals have dropped this year, with only 14.5 million euros’ worth granted from January to Aug. 21, according to data provided by the Economy Ministry in response to a parliamentary question.
Of this, the weapons of war category accounted for only 32,449 euros.
In its defense of two cases, one before the International Court of Justice and one in Berlin brought by the European Center for Constitutional and Human Rights, the government has said no weapons of war have been exported under any license issued since the Oct. 7 Hamas attacks on Israel, apart from spares for long-term contracts, the source added.
Israel’s assault on Gaza has killed more than 41,000 Palestinians since Oct. 7, according to the local Hamas-controlled health ministry. It has also displaced most of the population of 2.3 million, caused a hunger crisis and led to genocide allegations at the World Court, which Israel denies. No case challenging German arms exports to Israel has yet succeeded, including a case brought by Nicaragua at the ICJ.

Disagreement on arms exports in German goverment
But the issue has created friction within the government as the Chancellery maintains its support for Israel while the Greens-led economy and foreign ministries, sensitive to criticism from party members, have increasingly criticized the Netanyahu administration.
Legal challenges across Europe have also led other allies of Israel to pause or suspend arms exports.
Britain this month suspended 30 out of 350 licenses for arms exports to Israel due to concerns that Israel could be violating international humanitarian law.
In February, a Dutch court ordered the Netherlands to halt all exports of F-35 fighter jet parts to Israel over concerns about their use in attacks on civilian targets in Gaza. President Joe Biden’s administration this year paused — but then resumed — shipments of some bombs to Israel after US concerns about their use in densely populated Gaza.
Approvals and shipments of other types of weapons, in more precise systems, continued as US officials maintained that Israel needed the capacity to defend itself.
Alexander Schwarz, a lawyer at the European Center for Constitutional and Human Rights, which has filed five lawsuits against Berlin, suggested that the significant decline in approvals for 2024 indicated a genuine, though possibly temporary, reluctance to supply weapons to Israel.
“However, I would not interpret this as a conscious change in policy,” Schwarz added.

Late Harrods owner Al-Fayed accused of rape: BBC

Late Harrods owner Al-Fayed accused of rape: BBC
Updated 42 min 46 sec ago
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Late Harrods owner Al-Fayed accused of rape: BBC

Late Harrods owner Al-Fayed accused of rape: BBC
  • More than 20 women have spoken to the BBC as part of a special investigation alleging assault and physical violence at properties in London and Paris

London: Multiple women have accused Egyptian billionaire Mohamed Al-Fayed, the former owner of upmarket London department store Harrods where they worked, of rape and sexual assault, the BBC said on Thursday.
The allegations, made in a BBC documentary and podcast, are the latest to be levelled at powerful figures following the start of the #MeToo movement in 2017.
Fayed, who died last year at the age of 94, was a prominent figure in British life for decades due to his ownership of Harrods.
A confidant of the late Princess Diana, his son Dodi died alongside her in a car crash in Paris in 1997.
More than 20 women have spoken to the BBC as part of a special investigation alleging assault and physical violence at properties in London and Paris.
Five women said they had been raped by him, according to the documentary “Al Fayed: Predator at Harrods” due to be broadcast later Thursday and the “World of Secrets” podcast.
Fayed had previously been accused of sexually assaulting and groping multiple women but a 2015 police investigation into a rape allegation did not lead to any charges.
Harrods’ current owners said they were “utterly appalled” by the allegations of abuse, adding: “As a business we failed our employees who were his victims and for this we sincerely apologize.”
In July 2023, Harrods began settling claims with women who came forward with claims of sexual abuse by Fayed from the late 1980s to late 2000s.
Fayed sold the famous store in Knightsbridge in 2010 to the investment arm of Qatar’s sovereign wealth fund for a reported £1.5 billion ($2.2 billion).


At least 1000 people evacuated as flooding hits northern Italy

At least 1000 people evacuated as flooding hits northern Italy
Updated 19 September 2024
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At least 1000 people evacuated as flooding hits northern Italy

At least 1000 people evacuated as flooding hits northern Italy
  • Rivers flooded in three of the region’s provinces — Ravenna, Bologna and Faenza — as local mayors asked people to stay on upper floors

ROME: About a thousand residents were evacuated in the northern Italian region of Emilia-Romagna after it was hit by torrential rains and severe flooding overnight, local media reported Thursday.
Rivers flooded in three of the region’s provinces — Ravenna, Bologna and Faenza — as local mayors asked people to stay on upper floors or leave their houses.
At least 800 residents in the Ravenna area and almost 200 in Bologna province spent the night in shelters, schools and sports centers as local rivers overflowed.
Trains were suspended and schools closed across the affected areas, and residents have been advised to avoid travel and work from home where possible.
The Faenza area was just recovering from the devastating floods that hit Emilia-Romagna in May 2023, claiming 17 lives and causing billions of euros in damages.
“The night was dramatic, we waited for the river flood to cross the city,” Faenza mayor Massimo Isola told state TV Rainews. “It rose really close to the limit, but thanks to the works done over the past year we managed to avoid an overflow in the center of the city.”
Several Central and Eastern European nations have been plagued by severe flooding in recent days, including Austria, the Czech Republic, Poland and Romania, with the death toll rising over 20 people across the region.


A gold mining town in Congo has become an mpox hot spot as a new strain spreads

A gold mining town in Congo has become an mpox hot spot as a new strain spreads
Updated 19 September 2024
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A gold mining town in Congo has become an mpox hot spot as a new strain spreads

A gold mining town in Congo has become an mpox hot spot as a new strain spreads
  • Mpox causes mostly mild symptoms like fever and body aches, but can trigger serious cases
  • Lack of funds, vaccines and information is making it difficult to stem the spread

KAMITUGA: Slumped on the ground over a mound of dirt, Divine Wisoba pulled weeds from her daughter’s grave. The 1-month-old died from mpox in eastern Congo in August, but Wisoba, 21, was too traumatized to attend the funeral.
In her first visit to the cemetery, she wept into her shirt for the child she lost and worried about the rest of her family. “When she was born, it was as if God had answered our prayers — we wanted a girl,” Wisoba said of little Maombi Katengey. “But our biggest joy was transformed into devastation.”
Her daughter is one of more than 6,000 people officials suspect have contracted the disease in South Kivu province, the epicenter of the world’s latest mpox outbreak, in what the World Health Organization has labeled a global health emergency. A new strain of the virus is spreading, largely through skin-to-skin contact, including but not limited to sex. A lack of funds, vaccines and information is making it difficult to stem the spread, according to alarmed disease experts.
Mpox — which causes mostly mild symptoms like fever and body aches, but can trigger serious cases with prominent blisters on the face, hands, chest and genitals — had been spreading mostly undetected for years in Africa, until a 2022 outbreak reached more than 70 countries. Globally, gay and bisexual men made up the vast majority of cases in that outbreak. But officials note mpox has long disproportionately affected children in Africa, and they say cases are now rising sharply among kids, pregnant women and other vulnerable groups, with many types of close contact responsible for the spread.
Health officials have zeroed in on Kamituga, a remote yet bustling gold mining town of some 300,000 people that attracts miners, sex workers and traders who are constantly on the move. Cases from other parts of eastern Congo can be traced back here, officials say, with the first originating in the nightclub scene.
Since this outbreak began, one year ago, nearly 1,000 people in Kamituga have been infected. Eight have died, half of them children.
Challenges on the ground
Last month, the World Health Organization said mpox outbreaks might be stopped in the next six months, with governments’ leadership and cooperation.
But in Kamituga, people say they face a starkly different reality.
There’s a daily average of five new cases at the general hospital, which is regularly near capacity. Overall in South Kivu, weekly new suspected cases have skyrocketed from about 12 in January to 600 in August, according to province health officials.
Even that’s likely an underestimate, they say, because of a lack of access to rural areas, the inability of many residents to seek care, and Kamituga’s transient nature.
Locals say they simply don’t have enough information about mpox.
Before her daughter got sick, Wisoba said, she was infected herself but didn’t know it.
Painful lesions emerged around her genitals, making walking difficult. She thought she had a common sexually transmitted infection and sought medicine at a pharmacy. Days later, she went to the hospital with her newborn and was diagnosed with mpox. She recovered, but her daughter developed lesions on her foot.
Nearly a week later, Maombi died at the same hospital that treated her mother.
Wisoba said she didn’t know about mpox until she got it. She wants the government to invest more in teaching people protective measures.
Local officials can’t reach areas more than a few miles outside Kamituga to track suspected cases or inform residents. They broadcast radio messages but say that doesn’t reach far enough.
Kasindi Mwenyelwata goes door to door describing how to detect mpox — looking for fevers, aches or lesions. But the 42-year-old community leader said a lack of money means he doesn’t have the right materials, such as posters showing images of patients, which he finds more powerful than words.
ALIMA, one of the few aid groups working on mpox in Kamituga, lacks funds to set up programs or clinics that would reach some 150,000 people, with its budget set to run out at year’s end, according to program coordinator Dr. Dally Muamba.
If support keeps waning and mpox spreads, he said, “there will be an impact on the economy, people will stop coming to the area as the epidemic takes its toll. ... And as the disease grows, will resources follow?”
The vaccine vacuum
Health experts agree: What’s needed most are vaccines — even if they go only to adults, under emergency approval in Congo.
None has arrived in Kamituga, though it’s a priority city in South Kivu, officials said. It’s unclear when or how they will. The main road into town is unpaved — barely passable by car during the ongoing rainy season.
Once they make it here, it’s unclear whether supply will meet demand for those who are at greatest risk and first in line: health staff, sex workers, miners and motorcycle taxi drivers.
Congo’s government has budgeted more than $190 million for its initial mpox response, which includes the purchase of 3 million vaccine doses, according to a draft national mpox plan, widely circulating among health experts and aid groups this month and seen by The Associated Press. But so far, just 250,000 doses have arrived in Congo and the government’s given only $10 million, according to the finance ministry.
Most people with mild cases recover in less than two weeks. But lesions can get infected, and children or immunocompromised people are more prone to severe cases.
Doctors can ensure lesions are clean and give pain medication or antibiotics for secondary infections such as sepsis.
But those who recover can get the virus again.
A new variant, a lack of understanding
Experts say a lack of resources and knowledge about the new strain makes it difficult to advise people on protecting themselves. An internal report circulated among aid groups and agencies and seen by AP labeled confidence in the available information about mpox in eastern Congo and neighboring countries low.
While the variant is known to be more easily transmissible through sex, it’s unclear how long the virus remains in the system. Doctors tell recovered patients to abstain from sex for three months, but acknowledge the number’s largely arbitrary.
“Studies haven’t clarified if you’re still contagious or not ... if you can or can’t have sex with your wife,” said Dr. Steven Bilembo, of Kamituga’s general hospital.
Doctors say they’re seeing cases they simply don’t understand, such as pregnant women losing babies. Of 32 pregnant women infected since January, nearly half lost the baby through miscarriage or stillbirth, hospital statistics show.
Alice Neema was among them. From the hospital’s isolation ward, she told AP she’d noticed lesions around her genitals and a fever — but didn’t have enough money to travel the 30 miles (50 kilometers) on motorbike for help in time. She miscarried after her diagnosis.
As information trickles in, locals say fear spreads alongside the new strain.
Diego Nyago said he’d brought his 2-year-old son, Emile, to the hospital for circumcision when he developed a fever and lepasions.
It was mpox — and today, Nyago is grateful he was already at the hospital.
“I didn’t believe that children could catch this disease,” he said as doctors gently poured water over the boy to bring his temperature down. “Some children die quickly, because their families aren’t informed.
“Those who die are the ones who stay at home.”


Blinken subpoenaed to appear next week before House committee over Afghanistan

Blinken subpoenaed to appear next week before House committee over Afghanistan
Updated 19 September 2024
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Blinken subpoenaed to appear next week before House committee over Afghanistan

Blinken subpoenaed to appear next week before House committee over Afghanistan
  • The committee had previously wanted Blinken to appear today but was told he was not available on September 19
  • If Secretary Blinken fails to appear now, he can be held in contempt of Congress for violating a duly issued subpoena

WASHINGTON: The US House of Representatives Foreign Affairs Committee subpoenaed Secretary of State Antony Blinken on Wednesday to appear before it on Sept. 24 over the chaotic US withdrawal from Afghanistan in 2021.
“If Secretary Blinken fails to appear, the chairman will proceed instead with a full committee markup of a report recommending the US House of Representatives find Secretary Blinken in contempt of Congress for violating a duly issued subpoena,” according to a statement from the committee.
The committee had previously wanted Blinken to appear on Sept. 19. The State Department said earlier this month that Blinken was not available to testify on the dates proposed by the committee, but has proposed “reasonable alternatives.”
The State Department did not immediately respond to a request for comment from Reuters on Wednesday.
The Republican-led committee has been investigating the deadly and chaotic withdrawal from Afghanistan for years and an appearance next week before lawmakers by Blinken over a heavily politicized issue would come just weeks before the Nov. 5 election.
Blinken has testified before Congress on Afghanistan more than 14 times, including four times before the committee, and the State Department has provided the committee with nearly 20,000 pages of records, multiple high-level briefings and transcribed interviews, a department spokesperson said earlier in September.