Understanding Power Relationships: Commentary on Wurr C and Cooney L (2014) ‘Ethical Dilemmas in Population-Level Treatment of Lead Poisoning in Zamfara State, Nigeria’
Philippe Calain, Médecins Sans Frontières — Unite de Recherche sur les Enjeux et Pratiques Humanitaires (UREPH), Operational Center Geneva (MSF-OCG)
After 4 years of relief activities, it is difficult to keep managing the lead poisoning epidemic in northern Nigeria as an emergency situation, while it appears clearly to be a more complex, widespread and chronic public health issue than anticipated.
Making the continuing treatment of children conditional upon commitments from impacted families to adhere to safe mining practices is unlikely to bring about any long-term benefit. This is because such commitment is ultimately not in the hands of the victims or their families. Demands for better collaboration from the affected communities should take into account local power imbalances and broader networks of human exploitation, which are the ultimate causes of the outbreak.