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. 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. 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. 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. 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. 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.” 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. 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.