Children are bearing The brunt of environmental degradation.

Item

Title
Children are bearing
The brunt of
environmental
degradation.
extracted text
CH-(fl•

►►ANALYSIS

SDA-RF-CH-1A.5

SOFT TARGET
Children are bearing

PRANAY G LAL and SARITA BAHL

the brunt of

afe inside the warm womb of the
mother, a child kicks and turns. This is
the third time that Sarah Connell is
pregnant,
she has
never reached
her
second but
trimester
of pregnancy.
She
aborted twice earlier. This time she has moved
houses, cleaned up her home, and taken every
precaution to ensure that this baby survives. So
far all is well. The seed to the problem began
when Sarah was a not quite in her teens, but had
reached puberty when she was all of nine years
old. Like every girl in the scenic town of Lake
Charles, Lousiana, also known as the capital of
the vinyl industry of USA. “All the girls are reach­
ing puberty early in this generation,” assured
the local gynaecologist. Sarah remembers this
vividly. She knows that her failure to conceive is
because of the contamination of her womb. She
is not alone ■— at least not the only one from
Lake Charles. Or from any industrial town else­
where in the world, including India.
When Shubha Kulkarni, a nine-year-old
schoolchild from Mumbai, reached home, she
complained of severe uneasiness. Then she
started coughing, often bending with pain, her
eyes watering. Her mother thought she had
caught an allergy, given the city’s high air pollu­
tion levels. Suddenly, Shubha spluttered, her
face contorted and almost choked, her lungs
gasping for air. This was Shubha’s first asthma
attack. She’s had several since then.

S

environmental

degradation. Across
the class divide, they

(3

are eating, drinking

and breathing

poison. And their
special bodies make

them most vulnerable
to a host of diseases
PHOTOGRAPHS: PREET! SINGH / CSE

ANALYSIS

More children are suffering from asthma, cancer and
learning disorders than ever before. Global figures suggest that
since 1990, childhood cancer rates have risen by 12 per cent,
asthma in children by 17 per cent and systemic disorders by 16
per cent. But these are just conservative estimates. Developing
countries like India do not have authoritative registries, and
guesstimates do the rounds. “There are few epidemiological
studies conducted in India,” says India’s leading paediatrician
H N Billimoria. Worse, even physicians are inept in diagnos­
ing diseases. A critical review published in the Journal of the
American Medical Association shows that doctors in India
‘under-diagnose’ asthma by 15 per cent.
Some indicators do throw light on this alarming increase.
Some may argue though that this could be due to increased
awareness. Still sample this. Children’s hospitals in India
increased from 22 in 1990 to 148 in 2001, according to the
Directorate General of Health Services. Contribution of
asthma drugs for children increased from seven per cent in
1987 to 18 per cent in 1999, says the All India Pharmaceutical
Manufacturers Association. Childhood cancer cases grew
from 4,124 in 1988 to 6,187 in 1996, says the recentlypublished Cancer Registry of India. “These figures in many
ways reflect the poor environment we live in,” says Anupam
Sachdev, paediatric oncologist at the Sir Ganga Ram Hospital,
New Delhi.

Brittle bodies
Environmental changes affect children
the most
t is frightening. Children and adults today carry an esti­
mated 300 or more chemical residues that were not pre­
sent in their grandparent’s body. The fact that a com­
pound bio-accumulates tells us that the body cannot
metabolise and eliminate every compound. The human body
simply doesn’t possess enzymes or other chemical mecha­
nisms to counter the assault of novel compounds whose mol­
ecular structures are different from natural compounds. These
chemicals accumulate in the body with time and are passed on
to the next generation through the placenta and breast milk,
often in high concentrations.
From conception to adolescence, rapid growth can be eas­
ily disrupted due to exposures to toxins. Cell growth is partic­
ularly rapid in the embryo, providing more opportunity for
chemicals to cause mutations and congenital anomalies.
During this period, structures are developed and vital connec­
tions are established. The foetus and infant have different vul­
nerabilities to damage. Children’s metabolic pathways, espe­
cially in the first months after birth, are immature. And their
ability to detoxify and excrete chemicals is much lower than
adults.
That’s why any change in the environment will affect
them the most. Children drink more water, eat more food
and breathe more air than adults in relation to their
body weight. For example, the air intake of a resting infant
is twice that of an adult. An infant (six months old) drinks

I

| 26 | Down To Earth * June 15, 2002

an average adult. Children between the age of 1-5 eat three
to four times more food per unit body weight than the average
adult. Absorption rates are also higher: infants absorb as
much as 50 per cent of the lead and other heavy metal
contaminants present in food while adults have an uptake of
only 10 per cent.
Recent research shows that the link between a degraded
environment and children’s health is unmistakable. “Even in
the rich countries of Europe, the major environmental impact
on people are borne by children. Policies as well as impacts are
deeply unjust and hurt the poor communities more than the
rich,” says the World Health Organisation’s (who) latest publi­
cation Children’s health and environment: a review ofevidence. In
industrialised countries, many children die due to birth defects
that cannot be explained. In usa, about 6,500 children die due to
birth defects, which is the leading cause of infant morbidity.
While only about 20 per cent of birth defects are due to known
factors, the causes for the remaining 80 per cent remain elusive.
And evidence against environmental factors is mounting.
Consider just three studies, which conclusively prove the

ANALYSIS

in 1979 to 29 per cent in 1999. He attributes the rise in asthma
due increasing urbanisation, industrialisation and more
importantly vehicle exhaust.
A study by S G Kabra, a physician at the Indian Institute of
Health Management Research in Jaipur, found that pesticide
residues in food are responsible for deformed babies. An esti­
mated 8,000 babies are born with neural defects each year in
Rajasthan (sec Down To Earth, Vol 9, No 3; June 30).
A recent study by K Senthil Kumar of University of
Yokohama, Japan, shows that dioxin levels in tissues of
Indians is as high as heavily industrialised countries like Japan,
while other developing and some industrialised countries have
lower levels of dioxin. Dioxin are produced by incineration of
plastics and vinyl. Children are particularly susceptible to
dioxin exposure. It causes structural birth defects, premature
births, mental retardations, and systemic cancers. It is also
considered one of the most potent carcinogens.

What's eating our children?
The threats just don’t end with pesticides and dioxins. Large
amounts of toxic chemicals used in industrial processes are
incorporated into products. For example, over half of the top
20 chemicals in use (over 120 million tonnes), and half of
those incorporated into products in India, are known or sus­
pected carcinogens. An additional 80 million tonnes of
restricted pesticide products are legally released each year in
India. Mercury and other heavy metal contamination of our
waterways is growing.
These toxic chemicals diffuse across the globe — to even
environments that were considered pristine. Inuit mothers in
the Arctic, far from sources of industrial pollution, have some of
the highest levels of pcbs in their breast milk as a result of a diet
rich in marine mammal fat. With “safe” levels for hazardous

and air than adults. That’s why they are more susceptible to any contamination
link between environmental contamination and their impact
on children. A review of global studies published in the Journal
of Epidemiology and Community Health in 2001 showed that
exposure to polychlorinated biphenyls (pcbs) caused child­
hood neurological disorders to the foetus, which can lead to
birth defects, spontaneous abortions, mental retardations and
reduce fertility, pcb are commonly used as industrial reagents
in electrical equipments like transformers and in household
cleaning solutions and sprays. Another study published in The
Lancet in November 1999 showed that pregnant women and
the foetuscan be affected indirectly by pesticides — people can
bring pesticides used in farms and gardens and expose them.
The study showed that children between 0-9 years, whose par­
ents had occupational exposure to pesticides, developed acute
lymphoblastic anaemia (all) during early childhood.
In India, studies linking a changing environment to chil­
dren’s diseases are few. H Parmesh of the Lakeside Medical
Centre, Bangalore, recently conducted a study using 20-year
data for asthma in 20,000 cases in children under 18 years. He
found that Bangalore, a city with comparatively cleaner air,
showed a high rise of asthma prevalence — from nine per cent

and toxic chemicals being revised more frequently than before,
it appears that there is no safe limit to many chemicals. In com­
bination, their safe limits decrease manifold.
Over and above, the Indian child suffers from a double
burden — dirty water is still the biggest killer in the country.
AU this exacerbated by the lack of nutrition. Incidences of traditional diseases like diarrhoea and malaria are also increasing.
“Over half of the children under age of five years in India are
moderately or severely malnourished, 30 per cent newborn
children are significantly underweight,” says the National
Human Development Report 2001 of the Planning
Commission.
The burden of disease on children is increasing. The con­
stant onslaught of both traditional diseases and modern dis­
eases (pesticides and fertilisers in dusts, air, water and food,
plastic wastes, agricultural or industrial effluents) make chil­
dren vulnerable to a range of infections. Lifestyle-related dis­
eases such as diabetes and obesity are also on the rise, as urban
children are getting addicted to “junk" food with little or no
nutritive value and lead an increasingly sedentary life. The web
of death and diseases does not seem to end.
June 15, 2002 • Down To Earth | 27 |

ANALYSIS

| BODY OF EVIDENCE
Toxins present in the environment can invade almost every part of the child’s body. Some threats

BLOOD
Benzene and polychlorinated
biphenyls (PCBs)
Plastics, diesel fumes and pesticides
Leukaemia and other cancers,
anaemia

SKIN
Arsenic
Paint and varnish
Cancer

BRAIN
Cadmium, lead, mercury and
Dichlorodiethyl tetrachlorine (DDT)
Fumes, lead batteries, water from leaded
pipes and therometers
Cancer, learning disability

EYES
1
Toluene, phenols
Household solvents
Reduced eyesight

BONES
Proparg ite
Pesticides
Bone abnormalities

LUNGS
Polycylic aromatic
hydrocarbons (PAHs)
and benzene
Diesel fumes and
tobacco smoke
Cancer and asthma

LIVER
DDT and Trichloro ethylene (TCE)
Pesticides and
insecticides
------------Cancer
NERVOUS SYSTEM
Vinyl chloride
Toys, carbonated drinks and plastics
products
Birth defects and miscarriages and
nerve damage

KIDNEYS
Cadmium
Batteries, pigments and metal
coatings
Renal failure

STOMACH
Arsenic
Toys, pencil erasers
industrial emissions
wood varnishes
Cancer

REPRODUCTIVE ORGANS
Benzopyrene
Diesel fumes and tobacco smoke
Birth defects and abnormal sperm

PROSTRATE
Bisphenol-A,
dioxins
Plastics and toys
Cancer

ANALYSIS

Every drop kills
Waterborne diseases are the
biggest threat to children
aterborne diseases, caused by the
intake of chemicals and contaminated
water, affects around 3.4 million peo­
ple globally. In India, around 563,000
people are affected annually, one fourth of which are
children, according to the Union ministry of health
and family welfare.
Water gets contaminated due to sewage from
households, industrial effluents, human excreta and
even groundwater contaminants like arsenic, fluo­
ride and nitrates. Flouride in water is essential to
protect teeth but higher levels can adversely impact
health. Groundwater contamination due to fluorine
affects six million children in India. High fluoride
content is found naturally in the waters of Rajasthan.
So are nitrates.
High levels of nitrates can prove fatal for infants
who drink powdered milk. Nitrates restrict the
amount of oxygen reaching the brain, causing the
'blue baby’ syndrome. Nitrates are also linked to
digestive tract cancers and affect lungs. Cholera,
another waterborne diarrhoeal disease, causes death
of about 700,000 people every year. Needless to say,
children succumb to changes be it in water or any
other source faster than adults.
But diarrhoea still remains the most common
symptom of water contamination. Every year, a bil­
lion children get sick with diarrhoea, and for 3.3 mil­
lion of those infected, the disease is fatal. Rotavirus,
considered to be the main cause of severe diarrhoea,
causes over 800,000 deaths annually in children aged
less than five years in developing countries.
Diarrhoea also causes over one-half of diarrhoeal
deaths of children below the age of five in rural
northern India.
The pathogens originate in manure heaps,
domestic garbage and human faeces where there are no
proper latrines. Malnourished children exposed to contami­
nated water are more susceptible to a diarrhoea attack. An
estimated 60-70 per cent of diarrhoeal diseases are caused by
dehydration.
Polio targets children under the age of three. Nearly 50 per
cent of polio cases are found in this population. Young chil­
dren, pregnant women and people with low immunity are
especially at risk. Lack of hygiene and sanitation worsen their

W

condition.
Roundworm, hookworm, tapeworm, threadworm and
whipworm infections couple with malnourishment in tropical

countries. In India, infestation from worms is widespread,
especially in rural areas, where it is estimated that 20 per cent
of outpatient morbidity is due to helminth infestation. There
is no regular monitoring of such diseases, therefore little reli­
able data is available. But it is believed that about 10 per cent
of the population in India carries heavy worm loads with mild
symptoms, while one per cent is severely affected. Worldwide,
about 400 million schoolchildren are affected by wormrelated diseases, often with multiple infections. Of these, the
two most significant in terms of mortality are roundworm and
hookworm, each believed to cause about 60,000 deaths every
year globally.

Groundwater contamination affects around six million children in India
June 15, 2002 • Down To Earth | 29 |

ANALYSIS

Tropic of cancer
Childhood cancer rates in India are
increasing by six per cent every year
aediatricians are worried about rising cancer rates
among children. Like Anupam Sachdeva and A K
Dutta, head of department of paediatrics at Lady
Hardinge Medical College, New Delhi. They have
been witness to a rise in the incidences of brain cancer
and acute lymphocytic leukaemia, commonly found among
children.
In fact, incidence rates of childhood cancer in India have
risen in the past decade by about 14 per cent, according to the
tCMR’s latest cancer registry. The greatest surge has been in
leukaemia, says L S Arya of the All India Institute of Medical
Sciences (aiims), New Delhi, who has worked extensively on
such illnesses. Arya also says that parents are more aware today
and seek early treatment, which may have also led to this
upward trend in cancer registries in hospitals. Recent research
attributes this to environmental causes.

P

Plastic toys and teddy bears can lead
A study in Cancer Research, a us-based journal, in
1991, found that baby rats were seven times more susceptible
than older rats to a potent liver carcinogen. To make matters
worse, infants and children have greater exposure to carcino­
gens than adults. For instance, chemicals like formaldehyde,
exuded by new carpets, insecticides sprayed at home,
herbicides in the lawn, even benches coated with wood
preservatives linger longer at the ground level. Children
crawling on the floor, playing on the lawns or tumbling in
the grass with pets come in close contact with such
chemicals.
High exposure to toxic compounds like pesticides (spe­
cially organophospates) have long been recognised to cause
nerve damage (called the nerve gas syndrome). More recent
animal studies have suggested that even low dose exposures
can cause injury to the developing foetus, and can do so at
exposure levels that do not cause clinical symptoms in the
mother.
For example, on an average, children in the us by the age
of six, would have accumulated about 35 per cent of
their allowable lifetime cancer risk from captan — a fungicide
frequently used on apples, grapes, and peaches. Similarly,
despite the partial ban on ddt, a toxic insecticide, India
still has one of the highest concentration of ddt in breast
milk in the world, ddt is known to cause severe nerve
disorders in children.
Pesticides also cause biological changes in the body that
enable cancer cells to multiply. They can change the body's
genetic code by damaging the deoxyribonucleic acid (dna)
structure. They can also seriously weaken the human immune
system, making the individual more susceptible to the
onslaught from cancer cells.
Exposure at an early age can increase an individual’s risk of
developing cancer over his or her lifetime. Experts believe that
transformation of pre-cancerous cells into a malignancy generally takes years, even decades.

Gender bender
Chemicals cause birth defects and
premature births
hemicals in the environment can alter sex ratio
dramatically. A study in Seveso, northern Italy —
the scene of a devastating explosion at a chemical
factory in 1976 that released large quantities of
dioxin into the atmosphere — found that more girls than
boys were born into families living in 12-kilometre radius.
Says Shikha Reddy, researcher at UK-based Batkins Institute:
“The real challenge is for infants. Breast fed infants are
exposed to levels to dioxins that exceed adult exposure by as
much as a factor of 50.”

C

Pesticides cause biological changes in the body that enable
cancer cells to multiply

| 30 | Down To Earth • lune 15, 2002

ANALYSIS

to impaired mental development and growth retardation in the child
Toxic toys
Even innocuous consumer items like plastic toys and teddy
bears can lead to impaired mental development and growth
retardation in the child. Gone are the traditional red sandal­
wood dolls or medicinal teethers made of Vasambu wood.
Many soft and chewable toys, chemical pacifiers, teethers and
even baby bottles are made of recycled polyvinyl chloride
(pvc). This material contains a group chemical called phtha­
lates, which are confirmed growth retardants.
Manufacturers of toys in Mumbai, New Delhi and
Chennai confirm that most toys are today made from virgin
and recycled plastics. Toys made of pvc contain dangerous
additives, which leak out and are ingested by children. In fact,
the softest and most chewable toys could be the most poiso­
nous and toxic.
Investigations carried out by the international pressure
group, Greenpeace, found that 71 soft pvc toys, including five
from India, contained high levels of phthalates.
Even adults are known to be susceptible to the effects of
phthalates, especially pregnant women. It can result in imma­
ture babies, underweight neonates and depressed immune
responses. The adverse effects of these chemicals on children
takes many years to become apparent.

FOETAL ATTRITION________________
Womb may not be quite the safest place on earth

Early maturity
Today consumer products too are reported to contain
toxic chemical compounds. Recently, New Scientist reported
that shampoos containing traces of female hormones
could lead to girls attaining early puberty. Certain shampoos,
especially those marketed to blacks, were found to contain
small amounts of hormones that could cause premature
sexual development in girls. In every developed country,
girls are reaching puberty earlier, a phenomenon that has
been blamed variously on hormone pollutants in the
environment. Chandra Tiwary, former head of paediatric
endocrinology at Brooke Army Medical Centre in Texas,
says that these hormones are probably absorbed into
the bloodstream through the scalp and lead to premature
puberty.
The report cites that “at least five us companies” made
hormone-laced products, which appeared to fall into a regula­
tory “grey area”. The products are on sale without the specific
approvals required from the us Food and Drug
Administration. Even in a less chemical-intensive country like
Puerto Rico, researchers have found that eight in 1,000 chil­
dren attained early puberty. Before they have outgrown doll­
houses, many young girls are faced with confusing mood
swings, hormonal changes and sexual attention that accompa­
nies physical maturity.

A mother’s womb could well be a tomb for the foetus.
Studies show that exposure to toxic chemicals during
pregnancy interfere with normal growth and development
of the foetus resulting in intrauterine growth retardation
(IUGR). Some chemicals affect foetus’ growth. There is
also a high probability of abortion or peri-natal morbidity.
If they survive the ordeal of birth, these babies are more
likely to experience poor cognitive development and
mental deficiency during childhood.
Even as adults, IUGR babies have increased risk of car­
diovascular disorders, high blood pressure, diabetes, and
related diseases. Certain chemicals, such as methyl ethyl
ketone (MEK), have the capacity to produce abnormally
small head circumference (microcephaly) because they
target the developing foetal brain and Interfere with proper,
timely, and adequate proliferation and migration of the
neural cells and impact the foetal liver, preventing it from
detoxifying toxins and cause irreparable brain damage.
Ethanol inhalation and ingestion as in glue or paint
sniffin, certain drugs, maternal infection like rubella and
radiation are common environmental factors associated
with microcephaly.
A study by S Srivastava and his colleagues from the
University of Faizabad showed that lead and zinc levels in
the blood of pregnant women and their offspring can
cause IUGR.

June 15, 2002 ♦ Down To Earth | 31 |

ANALYSIS

Diseases linked to lifestyle are more prevalent in upper-middle

Junk life
Fast food and slow death
ndians are at great risk of lifestyle diseases. Inactivity
alone claims two million lives globally every year, warns a
recently-published who report. Indians, particularly the
younger generation, are increasingly facing problems due
to overweight, blood pressure, stress, high cholesterol and dia­
betes, all of which are a fallout of physical inactivity. Studies
show that up to 80 per cent of coronary heart disease, 90 per
cent of diabetes and about one-third of all cancers can be
avoided through a change in lifestyle.
In the industrialised world, junk food like burgers, fries
and pizza are extremely inexpensive, compared to green veg­
etables. The inherent subsidies to the meat industry means
that poor people (especially the blacks and Hispanics in the
us) predominately consume such foods. As a result, they
develop obesity and many children suffer from attention

I

deficit disorders. A survey by a restaurant association found
that fast food companies prefer to open shop in poorer areas,
rather than in an up-market area. The trend in India is, how­
ever, opposite. The prime targets for fast food joints are the
rich and the middle class.
Studies conducted by the National Foundation of India
(nfi), a non-governmental organisation, in Delhi have
revealed that it is not the well off, but the poor and the under­
privileged that are increasingly falling victim to sedentary
lifestyles. One reason for this is the migration from villages to
| 32 | Down To Earth • June 15, 2002

urban centres. Among non-communicable diseases, cardio­
vascular diseases caused by obesity account for the highest
number of deaths. Of the 15 million deaths due to cardiovas­
cular disease worldwide in 1990, 2.5 million occurred in India
alone. Several studies in India have shown that changes in
dietary patterns, physical activity levels, lifestyles associated
with affluence, and migration to urban areas are related to
increasing frequencies of obesity and the risk of diseases, such
as coronary heart disease and diabetes.
The incidence of diabetes is the highest in India with 20
million contracting the disease that in 50 percent of cases can
be avoided through a healthy lifestyle and diet. By 2020, the
number of diabetics in India is expected to touch 58 million
and around seven million will die of heart-related diseases, if|
they do not change their sedentary lifestyle, warns K Srinath
Reddy, a leading Delhi-based cardiologist.
Another risk factor for heart disease striking early is low
birth weight, a problem that is not uncommon in the country.
Experts say that children with birth weight of 2.5 kg and less
are prone to getting heart disease in early adulthood. Recent
studies have, in fact, indicated that a mother’s
poor diet may place the foetus at a higher risk of
getting heart disease later in life. Such infants
would not only be underweight but could also
have a disproportionately large head or a narrow
waist. These features, experts point out, indicate
damage to the baby's organ systems and affect the
way the body regulates cholesterol and blood
clotting in adult life.
Another nfi study shows that malnourished
populations in developing societies, particularly in
Asia, have an increased predisposition to obesity
and, more specifically, to abdominal obesity,
largely during the foetus’ development period.
These changes, as a result of prenatal and post­
natal malnutrition, increase susceptibility to obe­
sity under the right environmental influences such
as an increased intake of fat in the diet and
reduced levels of physical activity. These environ­
mental changes are now characteristic of econom­
ic development and urbanisation in these coun­
tries and will hence fuel the epidemic of obesity
currently seen in these societies, says the study
Another study conducted by nfi in Delhi
found that the problem of obesity was found to be
more prevalent in the upper-middle class than among slum
dwellers. Thus, as against the prevalence rate of obesity of one
per cent for males and four per cent for females in the slums,
the corresponding figures for the high-income group among
the middle class were 32.2 per cent and 50 per cent, respec­
tively. More females than males have been found to be
overweight in all age groups. Apart from dietary errors and
excesses, the lack of regular physical exercise among urban
middle class with sedentary occupations is a major contribu­
tor to overweight and obesity.

ANALYSIS

Brain dead
When pencils and paints lead
to lower IQ
ome chemicals can affect brain devel­
opment and function. They also have
serious effect on children's learning
and behavioural abilities. Compared to
other organs, the human brain develops over a #
long period of time — beginning with the first £
pveek after conception. Brain weight at birth is J
about one-third of adult weight. There is a £
brain growth spurt from the third trimester of
The developing human brain is vulnerable to toxic assault
pregnancy, which continues until the age of
two. Brain development continues during the
early years, some systems maturing at puberty
but persist by accumulating in fat tissues. It was found in fish
and beyond. Most of the basic brain structure is laid down
in the Great Lakes region in usa. A study of the offspring of
before birth, with great postnatal activity, for example, in the
women who ate Lake Michigan fish during their pregnancies
development of connections, enzymes and nerves. The blood­
showed extremely high prevalence of mental retardation in
brain barrier is not complete until about six months after
birth. The developing human brain is much more vulnerable
their children.
"But distinguishing among the various syndromes, and the
to toxic assault than the mature brain in most cases. And this
not only affects those processes undergoing development, but
"normal" from the "abnormal" is a subject of considerable dis­
some processes programmed to come later.
cussion and uncertainty. These disorders may be best charac­
Lead and other heavy metals like cadmium, arsenic and
terised as works in progress, rather than rigid diagnostic test.
mercury are the most-studied neurotoxicants. Their effect on
Often it is confounding as many syndromes are overlapping,
and decisions to identify the real cause eats into crucial time. If
children has led to revisions in their levels within the us —
from about 60 microgrammes per decilitre of blood (pg/dl) in
the (environmental) source is not identified, then it gets too
late to reverse the damage," says Ganesh Murthy, psychomet­
the late 1960s to 10 pg/dl today. It is possible that many chil­
dren were, in fact, lead-poisoned during the decades when
ric specialist at the Institute for Children with Learning
high lead-levels were acceptable and not recognised.
Disability, Dehradun.
Other heavy metals, such as cadmium and aluminium, are
Unleading of fuel has been one of the most significant pub­
known to be neurotoxic, but there is very little research on
lic health and educational advances of the 20th century.
their potential to affect the developing brain. Polychlorinated
Research now equates a 10-point drop in blood lead levels with
biphenyls (pcbs) are organic chemicals that have been banned,
an average 2.8-point gain in IQ. Since the elimination of lead
from gasoline in the us, there has been a 15-point drop in mean
blood lead levels. This gives every baby born today a gift of an
average of four to five additional 1Q points. What is that worth
economically? In the us, conservative calculations suggest that
each iq point is worth about us $8,300 in additional lifetime
income, which would mean that the 15-point drop in blood
lead levels is worth an average of US $30,000 in income to each
baby born. With approximately four million babies born every
year, the elimination of lead has an economic value of over us
$100 billion per year for the lifetime income of those children.
The us Census Bureau estimates that nearly 12 million
children in the us under 18 (or about 17 per cent) suffer from
one or more developmental, learning, or behavioural disabili­
ties. According to the National Academy of Sciences, toxic
exposures are directly implicated in about three per cent of
these disabilities — about 360,000 us children in 1998 or one
In Harm's Way, Global Boston Physicians for Social Responsibility
in every 200 children.

S

June 15, 2002 • Down To Earth | 33 |

ANALYSIS

Pinch of salt
How poor research claimed 14,000 lives every year

Children of a lesser god
Children don’t have a voice. They can’t
lobby or fight governments. The initiative
lies with India’s medical establishment
and the civil society
pen the recent National Human Development
Report (nhdr), or any glossy document of the
World Bank and its ilk, and it will reveal how
the world
is a people
much live
better
place.
Death
rates
have
declined,
longer,
fewer
children
are dying and incomes are increasing. Of course, forget the
places that are in the grip of wars and disasters. Barring them,
all’s well. So how does one explain the increase in the cases of
asthma, cancer, learning disabilities, obesity and diabetes.
They persist because governments have preferred to remain
oblivious. The Indian government does not collect or
publish data concerning the health of children. It just simply
does not care.
And if you think the scourge extends only to the poor, the
marginalised and the already suffering — you couldn’t be
more wrong. Asthma affects the rich more than the poor. So
does obesity and diabetes in India. Even childhood anaemia is
more prevalent in the better-off states, according to the nhdr.
The Planning Commission has no explanations for this.
Cancer registries that are sporadically produced once in a
decade do not track areas and communities where these cases
originate. “Cancers are not tracked because the focus is to pro­
vide curative and surgical solutions to the patients,” says
Delhi-based cancer surgeon Anish Goyal. "In the West, track­
ing birth defects, cancers and mapping their origins, linking
them to possible causes are done so that trends can be estab­
lished, based on which investments are made. This foresight is
absent in India,” says H N Billimoria.
“Research on children will happen only there is strong evi­
dence of a causal link. In the absence of research little is done
to invest in establishing such links. This is true of the West,”
says Sue Brenner of the International Network for Promoting

O

| 34 | Down To Earth • June 15, 2002

Apathy towards neglected diseases that affect children
most can be seen with the research done on oral rehydra­
tion salts (ORS). In 1975, the WHO and UNICEF agreed to
promote a single, orally administered solution of ORS to
prevent dehydration caused by diarrhoea. However, the
ideal composition of this solution has been a bone of
controversy for many years. Standard ORS has caused
several deaths mainly in children because of its high salt
concentration. The new ORS has reduced osmolarity or
concentration of salts and has proved to be more
effective in children and adults with cholera.
Overall a total of 14,000 deaths per million episode of
diarrhoea could have been avoided had the reduced
osmolarity ORS solution been produced earlier. This
would have also resulted in cost savings of US $500 per
death, or US S7.1 million per million episodes. Though
many donors and organisations like WHO claim to have
been working towards a more effective ORS solution, in
reality, most of the research was intermittent and lacked
political will.

Children’s Health based in Toronto, Canada. She points out
that drug development and health research focuses only on
drugs that are largely lifestyle-related diseases because rich
countries can pay for them. It is not profitable to invest in
research and manufacture vaccines for malaria and cholera.
There are drugs for cancer, asthma and diabetes since only
the rich can afford them. “Tropical diseases will remain
neglected if the current trends in drug development continue.
Investments will increase specially for lifestyle-related diseases
like obesity, asthma and diabetes,” says Francois Salle of the
Medecins Sans Frontidres, who has been championing the
cause for neglected diseases at international forums.
Investments too in programmes on children’s health is
decreasing. According to a report by the United Nations
Foundation, international programme assistance has shrunk
by 20 per cent since the last decade and south Asia has the least
share — about us $110 million.
The Indian Council of Medical Research (icmr), India’s
apex medical research body, has no clear strategy for health,
let alone children’s health. Ranbir Singh, spokesperson
of icmr, says that there is no research allocation earmarked for
children’s health.” Still, it published an advertisement
in national dailies claiming it had made “giant strides in
medical research”. It is another matter that most of its
programmes have been going on for several years, without
any substantive results. It’s performance has been criticised
by the governments’ own watchdog, the Comptroller
and Auditor General of India (cag). It is frightening how
public health is governed in this country. With no vision and
strategy.
Children lack a voice. They can’t lobby or fight against
governments, corrupt corporate and powerful bureaucrats.
The initiative lies with parents and civil society to give children
the chance to live in a safer world. It is also time to push gov­
ernments to secure a cleaner environment. ■
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