team of doctors led by Dr Alia Haider, the general secretary of the Haqooq-i-Khalq Party (HKP), arrived in Shadipura, a small industrial neighbourhood dotted with steel mills in Lahore, in December last year, to provide medical care to the underserved community. They set up a temporary clinic, with tables and chairs arranged to form a series of makeshift examination counters.

As the patients began to arrive, the doctors quickly realised that many of them, especially children, had similar complaints: chest pain, abdominal pain and fatigue. Some of the patients also had blackened teeth and gum issues, and many were experiencing difficulty with coordination and balance.

At first, the doctors were puzzled. The situation was much worse than they had expected. A doctor at the medical camp noted a high prevalence of stunting among the children. “The child who was five appeared to be three, the one who was 10 and appeared to be five,” she said. Some patients were so anaemic that it was difficult to take samples of their blood.

The doctors weren’t sure what was going on, but as they saw more and more patients, they began to suspect poisoning. Eventually, they deduced that the symptoms reported were consistent with lead poisoning.

At this point, the HKP requested Dr Nausheen Zaidi, a researcher at the University of the Punjab, to assess the situation in Shadipura for potential causes. When Dr Zaidi reached out to local laboratories to arrange blood tests for the patients suspected to be suffering from lead poisoning, she discovered that no laboratory in Pakistan had the capacity to perform the test. In Karachi, Aga Khan University Hospital used to offer the test, but discontinued it owing to a lack of demand.

Dr Zaidi tells TNS that she was shocked by the high cost of testing. She says that it costs the lab a fraction of the amount.

With the available resources, she ordered blood tests for 10 of the patients who had shown the symptoms. When the results came back, it was found that nearly all those tested had high levels of lead in their blood.

There is no safe blood lead concentration — even concentrations as low as 5 micrograms per litre might be associated with decreased intelligence in children, behavioural difficulties and learning problems. The average serum lead level in children from Shadipura was found to be 16 micrograms per litre.

Children are especially vulnerable to the toxic effects of lead. It may cause permanent and irreversible damage to their developing brains and nervous system. Even low levels of lead may contribute to neurological problems, learning disabilities and lowered intelligence and brain function. Lead also causes long-term harm in adults, including an increased risk of high blood pressure and kidney damage. Exposure of pregnant women to lead can cause miscarriage, stillbirth, premature birth and low birth weight.

Eventually, it was determined that the industrial waste from nearby workshops was contaminating the water and soil in the area. There are many iron foundries located within 20 km of Shadipura. These foundries melt scrap metal, ingots and other forms and pour it into moulds to shape it. The process of burning materials containing lead during the smelting and recycling processes can release lead particles in the air which find their way into the water and soil. A survey shows that more than 90 percent of Shadipura residents drink untreated tap water.

Dr Zaidi communicated her findings to the Water and Sanitation Agency (WASA) and urged them to initiate action. Initially, the authorities rejected her team’s findings saying that they hadn’t provided water to the area the scientists carried out the tests in. Dr Zaidi’s team started referring to the area in question specifically as Shadipura, instead of Sharifpura, which is how the area is better known to locals. This is due to an administrative technicality. The WASA provides water to Shadipura and they made it clear that they would only be concerned if Shadipura’s water was contaminated. When they ultimately had to accept the supply of water to the area that was under their jurisdiction, they contested the team’s findings, saying it could not prove that lead poisoning was the result of drinking contaminated water.

According to Dr Zaidi, her team collected water samples from kitchen faucets in Shadipura. These samples were sent to the Soil and Water Testing Laboratory for Research (Agriculture Department, Government of the Punjab, Pakistan) and Qarshi Research International for paid testing that cost around Rs 1,000 per sample.

Dr Zaidi’s team collected water samples from kitchen faucets in Shadipura. The samples were sent to the Soil and Water Testing Laboratory for Research (Agriculture Department, Government of the Punjab, Pakistan) and Qarshi Research International for paid testing.

Despite the tests showing a high concentration of lead in tap water, the authorities said the water was safe at the reservoir and could have met with contaminants at any number of points between the reservoir and Shadipura. To quote Dr Zaidi, “The water regulatory bodies are in complete denial of the crisis. They claim they have inspected their water reservoirs and not detected any contaminants. They doubt our test results.”

Dr Zaidi’s team then decided to test the soil for lead, to show the contamination originated in Shadipura itself, specifically due to the presence of iron foundries. Her team collected 1kg soil samples from areas frequently visited by the residents. The samples were sent to the Central Labs at the Syed Babar Ali School of Engineering Sciences, LUMS, for a scanning electron microscopy with energy dispersive X-ray (SEM-EDX) analysis. The concentration of lead in the samples was found to be up to 2.29 percent, or approximately 22,900 ppm.

Dr Zaidi’s team continued to collect water samples and conduct tests. They presented their findings to several government agencies, but each time the results were dismissed. The authorities cited test results from the Pakistan Council of Scientific and Industrial Research which had consistently shown that there was no lead in the water samples taken from Shadipura.

“Labs in Pakistan claim to have water testing facilities but they are unable to detect anything in most cases,” says Dr Zaidi. “The PCSIR and Qarshi — have a very high detection limit which leads to a high margin of error.”

Dr Zaidi says that when she received the reports from the PCSIR, she went ahead and spiked the samples with lead (500ug/L & 1500ug/L) and sent them back to PCSIR and Qarshi labs for re-evaluation. (The WHO’s permissible limit for lead in water is 10ug/L, while the limit set by the Punjab government is 50ug/L.)

“When we sent the spiked samples to the PCSIR, they reported that there was no lead content in the samples, but when we sent the same [spiked samples] to Qarshi they detected 500 microgram, less than what was in the sample, which remained undetected. 500 microgram is still 10 times higher than the permissible level. I don’t know what kind of testing they are doing,” she says.

To her dismay, the government officials refused to acknowledge the independent test results, let alone take any action in this regard. But Dr Zaidi wasn’t ready to give up. She says, “The people of Shadipura are being poisoned by the water they are drinking, and that’s a fact.”

ead poisoning is a serious public health issue. The discovery in Sharifpura/ Shadipura highlights the need for continued efforts to address the problem and protect communities from exposure to lead. The factories in the area have been operating for several years without proper regulations.

The residents are calling for immediate action to address the contamination and provide assistance to those affected by the poisoning. “We need help, and we need it now,” says Ali, a resident of the area who works in an iron workshop.

Many iron foundry owners were shocked to find their own children stunted, anaemic or disabled by lead poisoning. “The people who are worst affected by lead poisoning in this area are mostly those who own or work in these workshops. In fact, the head of the household we found most deficient in iron, owned one of these workshops. He lives right next to it,” says Dr Zaidi.

The studies seem to have alerted them to the gravity of the issue, and encouraged some residents to campaign for filtration facilities in the locality.

Dr Zaidi says she is determined to take the matter to the court: “Whatever conversations we’ve had with the water authorities, we’ve reached nowhere. We are thinking about litigation now.”

The writer is a staff member