Abstract

This article is in response to Wurr and Cooney’s Case Discussion entitled ‘Ethical dilemmas in population-level treatment of lead poisoning in Zamfara State, Nigeria’. The Case Discussion draws attention to Médecins Sans Frontières’ (MSF’s) remarkable achievement of providing the world’s first population-level treatment for severe lead poisoning. Wurr and Cooney raise two key ethical issues: treatment in the face of ongoing exposure, and withdrawal from program. Having participated in the emergency response to the lead-poisoning outbreak, I reflect on the Case Discussion and how the ethical issues fall within a troubling broader context. I offer a deeper analysis of the ethical issues by raising further substantive and philosophical considerations. I draw attention to social injustice and inequity at the root of the disaster, and link the disaster to neoliberal economic policies that impose public health austerity and then look to private non-governmental organizations for disaster response. A larger ethical concern is how the humanitarian response, in addressing immediate medical needs, can leave unjust political structures intact. Around the world, abject poverty, high gold prices and unviable traditional farming continue to drive families into dangerous artisanal mining. Meanwhile, the longer-term prospects for the severely lead-affected children of northern Nigeria remain grim