Environmental Threats to the Health of Children: The Asian Perspective

By Carpenter, David O.; Chew, Fook Tim et al. | Environmental Health Perspectives, October 2000 | Go to article overview

Environmental Threats to the Health of Children: The Asian Perspective


Carpenter, David O., Chew, Fook Tim, Damstra, Terri, Lam, Le Hung, Landrigan, Philip J., Makalinao, Irma, Peralta, Genandrialine L., Suk, William A., Environmental Health Perspectives


In Asia, as in the rest of the world, there are serious and significant effects on the health of children arising from environmental contamination. On 9-11 April 2000, the first biannual meeting on Environmental Threats to the Health of Children in the Asian Pacific was held in Manila, Republic of the Philippines, with over 120 attendees representing 15 countries. The goal of the conference was to bring to light the specific environmental conditions existing in the Western Pacific Basin countries that are affecting the health of children living in these countries and to raise awareness of the special vulnerability of children to degradation of the environment. Through open discussion the meeting fostered both an increased visibility of existing programs directed to environmental threats to the health of children within the different governments in the region and promotion of regional cooperation on the issue.

Environmental quality has important direct and indirect determinants of children's health in Asia and elsewhere in the world. Poor children and especially poor children in the poorest countries are most at risk for environmental quality problems. Poor children are the most vulnerable and disenfranchised segment of any society, and environmental hazards in conjunction with social stress and malnutrition often pose almost insurmountable barriers to a child's normal development. It is the health of children under 5 years of age that is most damaged by poor environmental quality. The lack of safe drinking water and uncontaminated food is of particular importance, causing morbidity and mortality through diarrhea and other infections, both because of exposure to infectious organisms and contaminant-induced suppression of the immune system.

It is a truism in all the world that the major predictor of ill health is poverty, and the reason this is true is because poor people are the least able to obtain uncontaminated water and food, receive immunizations and quality health care, and obtain the knowledge necessary to avoid factors that cause sickness. One of the most moving aspects of this conference was a video shown by participants from Cambodia of children at the Phnom Penh city dump scavenging for food and anything that could be sold so that the child could buy food. Figure 1 shows a scene from this video. Children, like the girl illustrated, often spend all day scavenging for items among the foul odors and filth. Some of the homeless children even sleep on the garbage under an old cloth or canvas strip supported by four poles (Figure 2). Not only are these children exposed to contaminated food and water, but they are also particularly vulnerable to being bitten by mosquitos carrying diseases such as malaria and dengue, to say nothing of the diseases transmitted from rats and other pests that inhabit a garbage dump. Because of the mass killings that took place in Cambodia in the recent past, homeless street children are all too common in Cambodia. Similar scenes are common in many of the major city dumps throughout Asia.

[Figures 1-2 ILLUSTRATION OMITTED]

Our Cambodian colleagues also discussed sexual exploitation of children, ranging from child prostitution to the actual selling of children. Both boys and girls are sold for sexual purposes, usually to foreigners. Other children are given drugs that cause gross physical deformities by adults who believe that deformed children will be more effective beggars.

There are a number of problems related to environmental exposure pathways of children in Asia, particularly in the less-developed countries. For example, there is a particular lack of education, enforcement, and understanding regarding exposure risks. Although countries have environmental protection laws, enforcement often is poor. Public officials are frequently paralyzed because of lack of resources, facilities, and direction. Standards for environmental contaminant exposure are often viewed as a Western agenda, and for the most part are simply ignored. …

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