the toxic truth - Greenpeace

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the toxic truth Challenges faced by doctors in the medical response Despite major national and international efforts, even where treatment was provided, demand frequently outstripped the availability of medical personnel and supplies. Medical teams report being “overwhelmed” by the numbers of patients. “ during the peak period, throughout September, we were seeing up to 600 patients on certain days. … when we arrived at work in the mornings, there were already long queues of people awaiting us. Some people waited all day, only to have to return the following morning, which made them very frustrated. It was a very difficult time. … Sometimes we ran out of particular medicines and had to send people elsewhere… ” dR. Bleu GP in the Abidjan military hospital during the crisis 251 While the scale of the medical emergency put unprecedented demands on Abidjan’s health system, the impact of the waste reduced overall capacity, as medical and support staff themselves fell sick or stayed away because of the unbearable stench and its associated health impacts. 252 A WHO assessment in mid-September 2006 noted that there were only three doctors to deal with an average of 300 patients a day at the Akouédo health centre, despite the fact that there were many people living on and around the Akouédo dump: “ A great flow of affected people has been registered; most of them are children and infants. this health centre is located not far from the biggest toxic waste disposal. the ambient air is very prickly [for] breathing. three medical doctors [have been] dealing with patient management since September 12th 2006, but currently, this is not enough … the population complains about the low quality of 253 patient management (long waiting). ” There was also lack of essential medicines and medical supplies. 254 In its evaluation of the crisis, the Red Cross later also reported shortages in its own supplies of medicines during the emergency. 255 Doctors were additionally hampered by a lack of information on the composition of the waste. A doctor told Amnesty International, “As we are not aware of the composition of the waste – although we know it was hydrocarbon and non-radioactive waste – we had to do a symptomatic treatment for all the symptoms. As a result we mostly used generic medicine to treat symptoms related to the toxic waste.” 256 The UN Special Rapporteur on Toxic Waste and Human Rights, who visited Côte d’Ivoire in 2008, also noted that, while treatment was free, it was – in the majority of cases – quite basic. 257 For example many patients received paracetamol for pain relief or antiseptic drops for eye problems. Gaps in the medical response To the government’s credit, tens of thousands of people were given free medical treatment at access points all around the city. 258 However, in some cases, the government failed to respond to requests for help for several weeks. For example, it was only in mid-September that mobile health units were dispatched to Djibi village, even though the head of the village had alerted the authorities soon after the dumping that the village had been badly affected. When the authorities failed to respond to their requests for help, the residents of Djibi organized a sit-in on the Route d’Alepe, one of Abidjan’s major transport routes, to demand medical treatment and a clean-up of the waste next to their village. “ eventually we decided that the only way to get help was to make ourselves heard. I believe this was at least two or three weeks after the 61 Chapter 5
62 Amnesty internAtionAl And greenpeAce netherlAnds Chapter 5 Angèle N’tamon, February 2009. A nurse at Djibi who treated victims of the toxic waste dumping. © amnesty InternatIonal odours had first begun. we decided to have a sit-in and block off the Route d’Alepe, which is one of Abidjan’s major transport routes. the whole village turned out to sit on the road for at least half a day… Soon after that tV footage was shown on tV... the Red Cross came to investigate what was happening in djibi. they came with the government doctors from SAMu and set up a tent in my courtyard to treat people and began to distribute free medications. ” CHef Motto of dJIBI VIllAGe 259 “ After three or four days I had a headache, unusual fatigue, spots, bloating, bearable abdominal pain but permanent, very dry throat […] and a burn on the body and swollen eyes ANGÈle N’tAMoN ” 223 When the medical team arrived in Djibi, the magnitude of the need was clear. One of the doctors later described the situation: “ from the time that my team and I spent in djibi … I think it likely that the entire population of that village were victims of the waste. … All the people treated there were claiming some combination of symptoms consistent with the chemical exposure that were easily externally verifiable on consultation. I had little cause to doubt the existence of other subjective symptoms, such as headaches, as my staff and I had suffered similar symptoms on exposure. unfortunately, only symptomatic treatment was available, as there was nothing that we could do to address the apparent cause of the illnesses, the waste. As a result, many patients had to consult more than once in order to receive further medication. ” MANASSe Goule Director of Operations, Emergency Medical Services (SAMU) 260 Those who could afford it went to private clinics to seek treatment or follow-up care. However, very few had enough money for this. Most people had to queue for days to receive basic treatment. The medical response officially concluded at the end of October 2006. 261
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