Let Us Prevent Disability (PIDEE - CEDIAL)

Summary: On the 6 October 1997 the
Committee on the Rights of the Child
devoted a Day of General Discussion
to the theme "The Rights of Children
with Disabilities". This is the
submission made by the Fundacion
Para la Proteccion de la Infancia
Danada por los Estados de
Emergencia (PIDEE) and the Child
Documentation Centre for Latin
America (CEDIAL) to the committee.

LET US PREVENT DISABILITY - PIDEE-CEDIAL -------------------------------------------------------------------------------- BACKGROUND: The National Survey for Socio-Economic Characterisation (CASEN 1996) shows 616,434 disabled people in the country out of a population of 14,227,035, that is, a percentage of 4.3. Of these, 15.5 per cent are under the age of 15. The age range with the highest number of individuals with speaking disabilities is between 0 and 14 years of age, with 48.2 per cent. Type of disability in the age range 0 -14 years Hearing 10.6 Speaking 48.2 Sight 13.6 Mental 25.1 Physical 9.9 Psychiatric 16.8 Ten NGOs have as their main task providing assistance to disabled children and teenagers. In addition, 20 lay, community, church and other organisations carry out work in rehabilitation and/or assistance to physically and /or mentally handicapped individuals. We would like to deal mainly with the subject of prevention, firstly as shown in various documents. Paragraph 22 -Prevention-of the United Nations Standard Regulations on Equal Opportunities for Handicapped Individuals, passed by the General Assembly on 20th December 1993, reads as follows: Prevention is understood as the adoption of measures aimed at preventing the occurrence of physical, intellectual, psychiatric or sense impairment (primary prevention) or preventing such an impairment from leading to a permanent functional disability or limitation (secondary prevention). Prevention may include various types of different actions, such as primary health care, pre-natal and post-natal infant care, education in nutrition, campaigns of vaccination against transmissible diseases, measures against endemic diseases, security regulations and programmes for the prevention of accidents in different environments, including the adaptation of places of work to prevent disabilities resulting from environmental pollution or arising from armed conflict. In 1994, the "National Disability Fund" (FONADIS) was created in Chile, where it reads in Article 13, Title III, paragraph 5: "The promotion of physical and mental health principally through the prevention of drug misuse and alcohol and tobacco abuse", and paragraph 4: "The prevention of traffic accidents and work and occupational hazards". In the Report on the 16th period of sessions (22nd September- 10th October 1997) of the Committee on the Rights of the Child CRC/C/69 under title IV "General debate on the rights of handicapped children", of the 14 recommendations made by the president of the Committee, on the basis of the debates, only letter f) refers to "prevention", mentioning the "repercussions of armed conflicts disabling hundreds of thousands of children" and encouraging Governments to sign the Convention banning the use, storage, production and transport of anti-personal mines. This is the only recommendation specifically dealing with prevention. DISABILITY AND ENVIRONMENT: With this background, our institution would like to bring to the awareness of CRIN member agencies and all interested parties the following situations occurring in our country and surely in other "developing" nations. Pesticides: We should inform on the comments and reports madeevery year, crop season after crop season, about the dangers of agro-chemicals used especially in fruit-growing and forestry. Accusations are made regularly about the use of high- risk products, the so-called "dirty dozen", no longer employed in at least twenty-five countries, but among which ours is not included. In relation to Chile, between 1976 and 1986 the import of pesticides increased from 4 million to 38 million dollars, 50 per cent being applied in fruit-growing and vineyards. Today the figures reach over 60 million dollars. The Sixth Region of the country, mainly fruit-growing, accounts for 40 per cent of the 12 thousand tons of pesticides coming yearly into the country. Of the 250 thousand temporary rural workers recorded each year, 52 per cent are women ( (in work related to crop-gathering, packing and farming). For many years temporary women workers would take their children to work, with the older ones working beside their mothers. For this reason, the National Women's Service developed, together with other government agencies, the Educational and Recreational Care Programme for children of temporary workers. In an analysis carried out by the Gynaecology and Obstetrics Service of the Hospital of the city of Rancagua, based on follow- ups of malformed new-borns out of a total of 10 thousand live births between January 1975 and April 1977 and between December 1988 and June 1990, 30 major malformations were observed in the first period, rising to 90 in the second. The above shows that in the Sixth Region, employing 60 per cent of the agro-chemicals applied in fruit-growing, there is a marked prevalence of multiple malformations compared to the national level. According to this study, limb malformation increased from three to seventeen while multiple malformations rose from ten to thirty six. Children born without a cranium increased from nine to sixteen; hydrocephalus from one to eight; unperforated anus from one to four; hare-lip plus cleft palate from four to ten and scrasic atraesia (?) from one to five The National Disability Fund allerted on an increase in malformations in the region. One in 350 children presented with harelip and cleft palate, born to mothers employed in temporary work who were in contact with pesticides during pregnancy. The rate of poisoning greatly increases in December and January, period when application of pesticides in agriculture is at its height. Links have been established between exposure to toxic materials and the reproductive function i.e., harmful effects on foetal evolution, abortions and miscarriages, malformations and congenital deformities. The increase in Siamese twin pregnancies, as also some types of cancer. The research sponsored by FONADIS is aimed at analysing the effects of pesticide application on the health of farm workers and the possible protection afforded by vitamins to individuals directly exposed to pesticides. A fact that has received proof from all over the world is that these agro-chemical products are genotoxic, that is, they may produce genetic mutations. HONDURAS: The indiscriminate use of the pesticide DDT since the 1970's has contaminated thousands of mothers who have passed on poisonous residues to their babies through breast- feeding. Research based on 292 milk samples from mothers aged between 15 and 44 years showed a high level of contamination, and ,particularly, in those areas where banana and cotton are cultivated between 106 and 186 milligrams was found in the milk of multiparous mothers. In February of this year under the title of "Hundreds of Hondurans with malformations from pesticides" a news report refers to both physical and psychical damages resulting from the use of chemical sprays on bananas. The director of the hospital in the locality of Olanchito states this is due from pesticides "bombarded day and night" by the multinational Standard Fruit Company on their banana farms. Effects reported are sight impairment, serious congenital malformations and cases of sterility. PERU: The national coordinator of the Alternative Action Network on the use of Agro-Chemicals in Peru, denounced that chemicals used as pesticides affect enzimes that promote motor responses and neuron link-ups, presenting as headaches and drowsiness, a kind of slow death during which victims are unaware of what is happening to them. A study carried out by the Institute for the Defence of the Environment (IDEMA) among 150 women from the coastal and Southern Sierras, in charge of applying agro-chemicals, showed alarming results in saliva, urine and milk tests. 72 per cent of cases showed various degrees of poisoning while 2.7 per cent have given birth to children with somatic and sensorial malformations. The report adds: Particularly, contact with chemicals during the first six to twelve weeks of pregnancy doubles the risk of giving birth to children who are mentally retarded, present with congenital malformations or with sense impairment such as deafness or blindness. LEAD CONTAMINATION: During the thirties lead was introduced in petrol in order to increase engine power. It was estimated in 1980 that in the world there were approximately 320 million cars, 75 million lorries and 20 million buses, and these figures today must be horrendously higher. A report by the United Nations Programme for the Environment states that pollution from engine exhaust fumes, and specifically from tetraethilic lead, forms a severe neurotoxin in children leading to neuro-physiological impairment. Lead particles are highly mutagenic causing chromosomal abnormalities in human cells. The risk to the population is difficult to assess and since the effects on cells are cumulative actual damage can only be evaluated in the long term. These diverse effects on human beings, of a physical and psychological nature, caused by prolonged exposure to lead, especially between the ages of one to five years, provoke damage in brain cells and inneurological development. Children absorb 50 per cent of the metal, while among adults this figure is between five and ten per cent. Lead from exhaust pipes comes into contact with oxygen in the atmosphere, becomes oxidised and falls to the ground, contaminating the soil. Children play with the soil, then put their fingers in their mouths, the lead goes into their digestive system and they are subject to poisoning. Respiratory absorption is second in importance, after digestive absorption. Lead is absorbed into the body through breathing, usually some 35 per cent is absorbed and between 15 and 18 per cent retained. In children inhalation is greater than in adults because they breath at a lower height, where lead concentration is higher and also because their respiratory rate is higher in relation to body weight. If the mother is exposed to lead, the mineral passes from the mother to the foetus via the placenta and breast-feeding, the baby showing a slightly lower level at birth than the mother, this level rising with exposure. The infant will not show symptoms of acute poisoning nor striking neurological signs or symptoms, but there is impairment in cognitive and sensory development. In 1993 a study was carried out by the Centre for Information on Drug Toxicology of the Catholic University with the aim of detecting blood lead levels in a group of 132 children from areas in the southwest of Santiago. 86 per cent of children studied who presented with high levels of lead lived in areas with a high presence of traffic jams, the statistical differential with control groups being significant. It was found that 17 per cent had lead levels nnaowadays considered high, that is, over 10 micrograms per decilitre of blood, a high enough level to provoke neurological damage. Although no sample showed levels higher than 20 micrograms per decilitre of blood, damages are quite serious: these children can show a lower score in development scales and therefore a lower I.Q.; hearing impairment; attention span problems; learning problems. They can also present with behavioural changes such as irritability, anorexia, decrease in physical activity, presence of sporadic vomiting and abdominal pain. If absorption is higher it may lead to renal failure, arterial hypertension, permanent neurological damage. With the proper oral drugs rates can be lowered, while anaemia, renal failure and behavioural problems can be reverted. According to the degree of damage, neurological problems can also be treated. Unfortunately, certain levels of brain impairment cannot be reverted. MEXICO: The intellectual development of future generations of Mexicans will be affected by the lead poisoning to which pregnant women in the capital are exposed. Children affected by pollution can present with a lower pregnancy age, birth weight, an abnormal increase in neurological reflexes and signs as well as a deficit in intellectual and psychomotor performance during their first two years of life or more. This is shown by an increase in the incidence of hyperactivity, learning problems and a lower I.Q. These children will not be able to lead a normal life and will have to attend special schools. VENEZUELA: According to charges made by environmental non- governmental organisations, the amount of lead in the atmosphere over the main cities in Venezuela is above the limits considered healthy by international agencies. Around 70 per cent of the population of Venezuela, 19.5 million inhabitants, live in urban areas, where the highest levels of air pollution is concentrated. Some 85 per cent of this pollution comes from petrol used by motor vehicles which discharge around 250 thousand tons a year. A high percentage of new-borns show high levels of lead in the blood. According to a study carried out by the University of Carabobo, 82 per cent shows lead levels higher than 10 micrograms per decilitre in the blood, considered the maximum acceptable level by the World Health Organisation (WHO). This is linked with congenital malformations, low weight at birth and an increase in miscarriages. "When lead is inhaled, it passes directly from the respiratory system to the blood, a portion going to the red cells, another to hard tissues like bones and teeth, where it is non-toxic, and another to soft tissues such as the central nervous system where it may lead to harmful effects such as alterations in language development and hearing problems, causing severe obstacles in the learning process. CONTAMINATION FROM LEAD DEPOTS: In the city of Antofagasta air and soil contamination, especially from lead, , has been denounced for many years, and the blame has been placed on the depots for heavy metals coming from Bolivia which, due to the growth of the city, are today located in its centre. The depots receive daily over 300 tons of lead, belonging to Bolivian companies which, in accordance with the 1904 Treaty between Chile and Bolivia, are entitled to a corridor for the export of this product through Chilean ports. The metal depots contain some 4 thousand tons, and it is estimated that the total amount of lead having passed through the city from the mines of Potosi, Bolivia may be in the region of 14 thousand tons. This franchise would not be harmful to anybody if the minerals were taken directly to the port and put on board immediately. But this is not the case. Bolivian companies send these products with no fixed embarkation dates, since the treaty allows them to store their exports in our country for a long period of time. Therefore, the Antofagasta-La Paz Railway (FCAB) has to store the minerals where it can -in the railway yards -till the Bolivian contractors come to transfer them to the port in open lorries. In a study carried out in 1991, monitoring showed that children attending schools near to the depot showed a higher concentration of lead in their urine and blood than school-children from more distant areas. Today, some 2 thousand children under the age of 15 live right next to the depots inside the city. Blood tests have shown an increase in the number of contaminated children. According to medical investigations, damage occasioned by the mineral is permanent, since it is not bio-degradable. There is proof that lead is slowly deposited in the bones preventing growth. The absorption of this heavy metal may even affect the brain and therefore the intellectual capacity of children. Other areas affected are the nervous system, stomach and intestinal muscles and blood. According to results of a study carried out by the Regional College of Physicians (January 1998), 7 per cent of the 85 children examined show lead concentrations in the blood between 40 and 49 micrograms; 14 per cent between 30 and 39; while 34 per cent show between 20 and 29 and only 10 per cent showed under 10 micrograms per 100 ml. of blood. All these levels are considered extremely toxic. This is why one hundred per cent of the children with over 40 micrograms have some kind of manifestation of alterations in the central nervous system. The study ascertained that the whole population examined shows some kind of neurological symptom such as lower I.Q., learning difficulties, hyperactivity, behavioural alterations (greater violence and irritability) and, possibly, loss of hearing. It has been found that each person only employs the best 20 per cent of the total number of neurones at his or her disposal. On reaching the brain, lead can be deposited on the neurotransmitters of nervous impulses between neurones and can prevent synapsis. The brain reacts by making use of other cells, and because these are of lower quality, this results in the long term in learning difficulties and mental deficiency. These effects are irreversible. Various actions have been started in the past nine years, including restriction proceedings presented before the Court of Appeals. In September 1992 the Health Service of Antofagasta set a deadline for the Railways to remove depots from urban areas. Nothing happened. At meetings between the Ministries of Foreign Affairs of Chile and Bolivia in 1994 it was agreed to put to tender the building and running of the depots. In 12th December last year proceedings were started at the Court of Appeals against FCAB for endangering health and polluting the environment. The ruling of 4th March this year was favourable, banning the transport and manipulation of lead and ordering the installation of new depots. The FCAB appealed against this decision stating that the responsibility for building the depots lies with the Government of Chile and not with the Railway. In brief, the legal wrangling continues. In the wake of discussions and proposals to arrive at a solution, several high- level agreements have been reached. A key question is why nothing has ever been done before. Finally, at a meeting held in February in Santa Cruz, Bolivia, an agreement was reached to remove the lead depots from the urban area of Antofagasta to a distance of 30 kilometres in the space of 60 days. We are still waiting. Can the children wait? AND ARICA: Between 1984 and 1985, the Swedish company Boliden Metal AB sent 19 thousand tons of industrial waste to the city of Arica, paying its counterpart PROMEL to receive the waste. The export of this material towards our country is trafficking with mineral residue. This illegal international trade has served to confirm the suspicion that the Atacama Dessert, in the extreme North of Chile, is one of the locations in the world used by the companies in developed countries to dump toxic waste. There is evidence of other imports constituting a similar trafficking carried out by various companies since 1982, all of them coming through the port of Arica. It is necessary to locate where these dumps are situated. It is important to find out whether Boliden violated the Treaty of Basle -which was signed by both Sweden and Chile - banning the transfer of dangerous industrial waste from industrialised countries to developing countries. Executives of the Swedish concern affirm that their company sent the waste in the belief that it would be properly processed and made the accusation that the Chilean health authorities showed incompetence in not controlling this toxic material properly. People living in two housing developments built around the 19,000 thousand tons dumped by PROMEL may have been contaminated by arsenic and lead. Samples taken from 191 children showed dangerous arsenic levels over 45 micrograms (ug) -in 50 per cent. Around 20 per cent show over 10 ug per decilitre of blood. The removal of this waste containing lead, iron, manganese and cadmium, was only initiated at the beginning of February, fourteen years after the material was deposited. Tests for lead contamination are not representative, because so far the local Health Service has taken blood samples from only 20 children which are being analysed by the Institute of Public Health. It has been decided to take more widespread samples in order to find out the exact levels of poisoning among children. Arsenic contamination does not cause neurological damage leading to physical disability. But we should mention that samples show levels considered highly dangerous which may cause cancer in rapidly reproducing tissues such as in the skin, kidneys, liver, lungs and bladder. The above information provides only a brief view of what is happening. The question we ask is whether it would be possible to obtain additional information on the subject of primary prevention in the field of disability from non-governmental agencies working with children in Latin America. Such a paper would provide valuable background information and be more representative of our reality. Footnote: All the material used in the present paper has been taken from the Library of the Child Documentation Centre for Latin America. CEDIAL. (1991 onwards). 1998