the toxic truth - Greenpeace

54 Amnesty internAtionAl And greenpeAce netherlAnds
Chapter 5
How many people
were affected?
It is difficult to get a complete picture of the
number of people whose health was affected
by exposure to the toxic waste. The publicly
available data is largely compiled from
analyzing the forms that the Ministry of Health
asked all medical facilities to complete. These
forms (or fiches d’enquête) required medical
personnel to record the personal data and
symptoms of people who had been treated at
their facilities for exposure to the toxic waste.
According to the National Institute for Public
Hygiene (INPH), based on an analysis of
survey forms, “103,116 consultations were
registered between 20 August 2006 to 31
January 2007”. The vast majority of these
consultations (97.6 per cent) were conducted
in September and October 2006. It should
also be noted that the provision for free
medical treatment only continued until the
end of October 2006. 211
The INPH, working with clinicians,
epidemiologists, biologists and the
consultants at the WHO and CDC, developed a
classification system of “suspected”, “likely”
and “confirmed” cases of poisoning. 212 These
categories were based on whether the patient
displayed the symptoms identified on a list
of clinical symptoms, along with information
about exposure.
A number of the patients – 7.4 per cent
(7,433 people) – could not be classified
because there was not sufficient information
about their symptoms. The INPH study
therefore focused on the 93,880 patients
for whom survey data existed. Of these, 46
per cent (43,492 people) were classified as
confirmed cases of poisoning by toxic waste,
26 per cent (24,825 people) as likely cases
of poisoning by toxic waste, and 27 per cent
(25,563 people) as suspected of having been
poisoned by toxic waste. 213
According to the INPH study, 82 people were
hospitalized because of poisoning caused
by the toxic waste, 214 of whom 31 were
treated in the paediatrics department. 215
The reasons for hospitalization varied from
gastrointestinal and other digestive problems,
dyspnoea and other respiratory problems,
neurological problems and other more severe
manifestations of the symptoms noted
above. 216 The longest period of hospitalization
recorded was 12 days; the average was 2.5
days. 217
While the medical forms constitute an
important source of data, they have several
limitations. They were only created at the end
of August and, in some medical facilities,
only came into operation in the first week
of September, 218 so there are gaps in the
information about patients who were treated
prior to this date. A doctor involved in the
medical response told Amnesty International:
“[T]he first people seeking consultation
after 21 August – often the most ill, with
nosebleeds and other serious symptoms –
were not recorded on the fiches.” 219
The same doctor also noted that, in some
instances, the survey forms were not filled
in fully or at all when doctors were under
pressure to see many patients or when the
medical centres ran out of forms. 220
An additional problem with the data collection
was that not everyone whose health was
affected sought treatment at a health
facility. The Centre Suisse de Recherches
Scientifiques en Côte d’Ivoire (CSRS),
conducted a survey of 809 households in
areas close to the dumping sites. The survey
was conducted between 9 October and 28
December 2006. Out of a total of 2,013
people surveyed who presented symptoms
of exposure to the waste, only 64 per cent
(1,297 people) sought treatment in a health
care centre. 221