Providentia

200 Million Girls Go "Missing" in India and China

So there are no girls born, in China anymore
I feel so forlorn, with nobody to keep me warm
Confucian culture scorns daughters in favor of sons
So there are no girls born and I'm doomed to be just one

My parents chose me in utero to carry on the family name
But if I can't find a bride I'll be carrying nothing but shame
You gotta be tall, educated, and own your own house
miss one out of three, you won't find a spouse.

While the plaintive lyrics of the new video and song No girls born (in China anymore) released by Taiwan's Next Media Animation highlights the grim gender imbalance arising from China's population control policy, the epidemic of female infanticide in parts of India is less well-known.    A shocking BBC documentary, India's Missing Girls, released in 2007 provides stark testimony relating to the thousands of  infants in India who are abandoned, aborted or killed, simply for being female.   In one case, a two-day old baby in India's Andhra Pradesh state was found and rescued after being buried alive by her grandfather.   Following his arrest, the grandfather defended his actions by insisting that his household could not afford another female.    She had been wrapped in a cloth and buried deep in the ground but bystanders found her by the sound of her crying and a tiny hand sticking out of the earth.   

In rural China and India, the same somber arithmetic often comes into play for families with limited incomes:  boys are more valuable since they will traditionally carry on the family name and provide for parents in their old age.  For numerous Chinese families, with the one-child policy in force in many parts of the country, forced abortions (following genetic testing for sex), female infanticides, and underreporting of female births remain common.   Despite growing concern over the growing shortage of females in China, the one-child policy is expected to remain in place for at least another decade.

Although mandatory dowries for brides are no longer required in India, they remain a traditional part of most Indian marriages.   Since impoverished families worry about dowry costs, female children are typically made to feel that they are burdens from an early age and abandoned children are typically female.    Female infanticide has become less common due to advances in medical technology.  Still, ultrasound scans to determine an infant's gender in the early stages of pregnancy often lead to abortions if that infant turns out to be female.   According to Rita Banerji, founder and chief-administrator of an online global campaign to halt female infanticide in India,  "I’m an Indian woman, and my country looks me in the eye and says, “You and your kind mean nothing to us.  You are like little flies. We’ve swatted 50 million females like you!”  You kill a cow, and a riot breaks out in the city.  Here we have young married women and new born girls killed every few minutes in this country.  Why does that not evoke the same response from Indians?".   

A new documentary film titled "It's a Girl!" scheduled for release this year interviews Banerji and other activists and, as well as a  second documentary film, "Born to Die", raise troubling questions surrounding lack of action in China and India concerning the need to protect female infants.  

Along with legislation banning the use of portable ultrasound imaging to determine gender of unborn infants, children's organization in India are mobilizing to protect abandoned girls as well as combatting attitudes encouraging female infanticide.   The Aarti Homes project was first launched in the Andhra Pradesh city of Kadapa with the discovery of an abandoned three-year old girl in 1992.  Over twenty years, the Aarti orphanage expanded from a shelter for abandoned girls to providing shelter and schooling for hundreds of children.  As well, the Aarti Foundation provides community outreach programs to raise awareness about gender equality and the very real power imbalance that exists between Indian men and women.  

Despite slow progress, the plight of female children in India and China continues.   Without real change, the demographic and economic consequences of gender imbalance is likely to haunt both countries for decades to come.

For more information

 

International Stigma Conference Coming Up

The Mental Health Commission of Canada and the World Psychiatric Association Scientific Section on Stigma and Mental Illness will be hosting the fifth annual International Stigma Conference in Ottawa this June.  Titled "Together Against Stigma: Changing how we see mental illness", the international conference will bring together more than five hundred researchers, mental health professionals, activists and policy makers from around the world.   The focus of the conference will be on finding effective ways to combat the stigma and discrimination that people with mental disorders often face.   In many cases, that stigma and discrimination often leads to unemployment, inability to find proper housing, lost educational opportunities, loss of friends and other vital social support, and even the self-stigma resulting from people with mental disorders learning to believe the negative impressions stigma can convey.

Over the course of the three-day conference, attendants will have the opportunity to engage in discussion and debate at Ottawa's Delta Ottawa City Centre.  Keynote speakers include CTV host and chief correspondent Lloyd Robertson,  , Dr. Norman Sartorius, former director of the World Health Organization's (WHO) Division of Mental Health, Dr. Graham Thornicroft of the Institute of Psychiatry, King’s College London, Patrick Corrigan of the Illinois Institute of Technology, Dr. Heather Stuart of the Queen's University Centre for Health Services and Policy, and Professor Tony Jorm of the Unversity of Melbourne. 

For more information on registration and travel arrangements.

 

 

February Is Psychology Month In Canada

Since 2005, the Canadian Psychological Association has named the month of February as Psychology Month.  The goal of Psychology Month is to promote grassroot campaigning to raise awareness of the role of psychology in fostering mental health among Canadians.  Psychologists are urged to reach out to their respective communities and encourage the public and lawmakers to support psychological research, education and training. 

To recognize Psychology Month, a coalition of mental health groups including the Canadian Mental Health Association, the Mood Disorder Society of Canada, and the Canadian Psychological Association has recently issued a statement calling for additional funding for mental health services.  Canadian Mental Health Association CEO, Peter Coleridge,  pointed out that provincial health insurance plans do not cover psychological counseling services despite the fact that one in five Canadians will experience a mental disorder in a given year.  For that reason, psychological treatment and assessment are out of reach for Canadians who are unable to afford to pay for those services themselves.   The Canadian Alliance on Mental Illness and Mental Health (CAMIMH) has determined that two out of three people with a diagnosable mental disorder does not seek treatment.  While reasons for not seeking treatment can be difficult to determine at times, affordability and stigma associated with mental illness often prevent Canadians from getting help.  Recent initiatives in the United Kingdom and Australia have improved access to psychological services in those countries but similar access to services are often not available to many Canadians. 

The statement also adds that mental health problems cost the Canadian economy $51 billion dollars a year in lost productivity.  According to the World Health Organization,  depression will be the second leading cause of disability by 2020 (second only to heart disease). 

Click  these links for more information.

Psychology Month for the public.

Psychology Month news and events.

Psychology Month facts.

 

 

 

 

 

 

 

 

 

Suicide and the New DSM

The revision process for the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) has generated fierce controversy in many circles.  One of the main complaints  raised is the lack of transparency in the process by which new diagnostic concepts are generated.  In a recent editorial in  Crisis: the Journal of Crisis Intervention and Suicide Prevention, Editor-in-Chief Diego De Leo discussed his own  concerns relating to proposed DSM-V changes relating to suicidal behaviour.  While self-harm is already included in the DSM-IV-TR as a symptom of various mood and personality disorders, the proposed changes involve creating several new diagnoses including "suicidal ideation and behavior" and "non-suicidal self-injury".  A related diagnosis which had been considered for inclusion, "prolonged grief disorder", has been shelved although "bereavement-related disorder" has been proposed in its place. 

While the way in which suicide is perceived by mental health professionals has changed extensively over time and across cultures, the current trend towards medicalization of suicide seems virtually complete with the new DSM.   In his editorial, Professor De Leo argued that directly assigning a psychiatric diagnosis to suicidal behaviour represents a step backwards from current multi-disciplinary approaches to dealing with suicide. Making suicidal behaviour a DSM-V diagnosis also means shutting out non-mental health professionals who are considered unqualified to make DSM diagnoses which could complicate prevention and treatment.  He also points out that slogans such as "Suicide is Everybody's Business"  which have been embraced by international suicide prevention organizations would argue against making suicide exclusively a mental health issue.   

In countries such as China and India, suicide is far less likely to be linked to psychiatric conditions than in Western countries.   In cases of suicide among the elderly, psychological autopsy studies have shown relatively low incidence of psychiatric illness.   Although suicidologists Ron Maris and Mort Silverman successfully argued fifteen years ago that "...suicide is, by definition, not a disease, but a death that is caused by a self-inflicted intentional action or behavior", the new DSM-V diagnosis process would automatically make suicide a mental disorder regardless of the actual motivation involved.  While any countries have decriminalized suicide, redefining it as a mental disorder would have far-reaching implications into laws regarding the mandatory reporting of suicide attempts and how they are treated by health professionals. 

A more profound change being considered in the new DSM is the proposed classification of "non-suicidal self-injury" (NSSI) which would distinguish between deliberate suicide attempts and engaging in self-harm behaviour without intending to commit suicide.   Previous versions of the DSM already include non-suicidal self-harm as a sign of Borderline Personality Disorder, which DeLeo's editorial criticises for being too broad a diagnostic label.  De Leo also argues that the proposed NSSI category might well be a cure worse than the disease. 

There can be many reasons for attempting suicide and differing degrees of suicide intent.  Placing "suicidal ideation behaviour" and NSSI into the DSM would limit treatment and diagnosis for suicide attempters by making suicide intention into a "yes/no" dichotomy which often fails to reflect the true extent of the underlying motivation involved.  Could the question of whether a self-harm action was intentionally suicidal or non-suicidal even be answered properly?  In many cases, the suicide attempter may not even be certain whether the attempt was deliberate or not (as I've observed myself in many cases).   In one study described by DeLeo, an Australian community study showed that almost 50 per cent of self-harmers reporting having suicidal ideation, far more than same-age counterparts who did not self-injure, even when the self-harm attempts were not driven by a desire to die.  Other studies of self-harmers showed that only a small percentage actually sought medical help for self-harm attempts (self-cutters were even less likely to seek help) despite being at a signficantly higher risk of death than other suicide attempters.  

Previous versions of the DSM have shown a tendency to inflate the number of people diagnosed as new diagnostic labels are introduced.  The inclusion of suicide attempts as a diagnostic criterion of borderline personality disorder despite limited evidence to support the link led to an increased stigmatization of suicide attempters.  Will assigning a diagnosis of NSSI lead to further stigmatization that might prevent suicide attempts and self-harmers from seeking help until it is too late?  This is an especially troubling question given the alarming rise in suicide attempts among adolescents (lifetime incidence of self-injury among adolescents can be as high as 14% according to some estimates).  

In concluding his editorial, Professor De Leo points out that there is still too much that isn't known about suicide to justify the potential risks involved with the two proposed suicide diagnoses.  Since suicide is often a complex process that can be shaped by a range of internal and external factors, including cultural, legal, and economic aspects, directly placing "suicidal ideation and behavior" and "non-suicidal self-injury" in the new DSM may well do more harm than good.  In his own concluding words, "As a researcher, a clinician, and a caring human being, I believe we are not ready. Not yet."

For the abstract.

Fighting Child Witchcraft Persecution in Nigeria

"I am not raped anymore because people know that we have people who protect us in case of any trouble. I feel more safe and protected than before and I have people to call my own no matter what happens."

When Elizabeth was found wandering the streets in Nigeria's Akwa Iborn state,  she had already faced enormous suffering including repeated rapes and being threatened with physical violence on a regular basis.  Abandoned by her family after one relative accused her of being a witch,  learning to live in one of the specialized accommodation facilities for abandoned children like her has been a challenge although she is slowly making the transition.  Her story is hardly unique and there are far too many children like her there. 

The belief in child witchcraft is prevalent in many parts of Africa and children like Elizabeth routinely face abuse and persecution as a result.   The accusations are fuelled by widespread belief in child witchcraft as well as religious evangelism and the media influence of the Nollywood film industry with its lurid portrayals of child witches.  Despite Nigeria passing the Child Rights Act in 1993 designed to outlaw child abuse, witchcraft accusations are not prohibited under the act and there are few real protections for accused children.    As well, it is up to each individual Nigerian state to ratify all parts of the act and not all states have done so to date. 

One of the primary agencies fighting on the behalf of accused children is Stepping Stones Nigeria.  First conceived in 2003, Stepping Stones is now the most effective international child rights agencies working in the Niger Delta.  Along with the thousands of abandoned children to be found in Nigeria's streets,  Stepping Stones has specifically focused on the countless Nigerian children suffering due to witchcraft accusations and trafficking.  

As part of their mission, they have marked December 14 as an international blogging day to publicize their Prevent Abuse of Children Today (PACT).  PACT aims to bring long-term positive social change to vulnerable children in the Niger Delta region of Nigeria, particularly those at risk of witchcraft accusations, abuse and trafficking.   Their theme is:   "Every child has the right to happiness" and they are asking bloggers to help spread the word. 

This post is part of a series inspired by the Prevent Abuse of Children Today (PACT) campaign, hosted by Stepping Stones Nigeria. Please add your name to the PACT petition to prevent abuse of innocent children in the Niger Delta and visit the site to find out more: www.makeapact.org

How Common is Suicide in the U.S. Military?

 How common is suicide in the U.S. military?  While previous research has actually shown that suicides occurred less frequently in the different branches of the U.S. military as compared to the general population, suicide prevention programs developed in the 1990s have helped lower suicide rates among active-duty members over the past twenty years.   In recent years, however, high-profile cases of suicides in  veterans returning from tours of duty in Iraq, Afghanistan, and other high-risk deployments have shown a disturbing reversal of this long-term trend.  According to a 2007 report by the Department of Defense Task Force on Mental Health, possible reasons for higher incidence of suicide in returning veterans include lack of proper treatment resources, greater stress resulting from prolonged deployments overseas with a high risk of death and/or disability, and failure to acknowledge the potentially crippling effects of post-traumatic stress disorder.   Considering the stigma often associated with mental illness, especially in a military culture that tends to regard emotional problems as a sign of weakness, service members are often reluctant to seek help for suicidal thoughts until it is too late.   While military training is designed to toughen soldiers to the harsh realities of overseas deployment, it can also make treatment for suicidal thinking more difficult.  Overseas deployments also serve to isolate service members from their natural support networks, i.e., family, friends, and the extended community to which they belong which may make them increasingly vulnerable to suicidal thoughts.

In a comprehensive research study recently published in the Journal of Consulting and Clinical Psychology,  a team of researchers examined suicidal behaviour in active-duty members of the United States Air Force.  Led by Dr. Jennifer Langhinrichsen-Rohling of the University of South Alabama and a group of clinicians from Stony Brook University, the study took information from the 2006 Air Force Community Assessment.    Administered every two years, the Air Force Community Assessment is an anonymous survey administered to Air Force serving members at 82 Air Force bases worldwide.  Designed to provide support agencies with information on individual, family, workplace, and community problems as well as sensitive information on mental health issues, including suicidal thinking.    The survey is given online on a purely voluntary basis.   A total of 52,780 active-duty Air Force members completed the survey (79.3% male, 20.7% female) with an average age of 31.78 years.  According to the study results, the one-year rate for suicidal ideation (i.e., recurrent thoughts about/or seriously considering suicide) was four per cent for the total group.   Factors potentially contributing to suicidal ideation included problems on the individual level such as alcohol problems and depression.  Relationship issues including intimate partner violence and marital dissatisfaction, workplace problems, i.e., job dissatisfaction and hours worked, and lack of socal support were also found to be possible factors in suicide.  The authors conclude that military suicide prevention efforts need to focus on multiple levels including individual, family, workplace, and community problems that might contribute to increased suicide risk.  They also acknowledge that their findings were based on self-report information alone and that suicide completers in the military are often less likely to seek help than suicide attempters.  For that reason, military suicide programs also need to focus on the role that stigma can play in preventing actively-service military members from seeking help until it's too late.

For the abstract

 

 

It's World Mental Health Day

Since 1992, the World Federation for Mental Health (WFMH) and the World Health Organization (WHO) have marked October 10 as the annual date for World Mental Health Day.    Observed in more than 100 countries around the world through local, regional, and national events, World Mental Health Day and this year's theme: "The Great Push: Investing in Mental Health" is intended to call attention to the need for greater investment in mental health services.   This is especially true low and middle-income countries that spend less than 2 % of their total health budget on mental health.  WFMH and WHO are dedicated to increasing public awareness of the extent to which mental illness remains underreported and undertreated compared to other diseases which receive greater attention. 

The sheer range of need for treatment services is unquestionable.  According to WHO statistics from 2002, more than 150 million people globally suffer from  depression alone with other forms of mental disorder accounting for an additional 300 million (almost 25% of the world's current population).   Despite this overwhelming need for services, many countries have less than one mental health professional per one million population.  Even when health dollars are allocated, the focus is typically on large hospital settings rather than the community-based services that are likely to be most effective.

An initiative led by Dr. John Copeland and WFMH (titled The Great Push For Mental Health) is attempting to correct years of neglect, especially in developing nations where mental health services are often non-existent.   With its themes of Unity, Human Rights, and Recovery, the WFMH initiative, partnered with the Movement for Global Mental Health, has already launched pilot projects in India, Australia, and Europe to provide appropriate and culturally appropriate treatment for various mental disorders. 

Through grass-roots campaigns, fundraising initiatives, and public awareness programming, work with international aid organizations, and consultation with local community groups,  the WFMH seeks to combat stigma and provide better mental health care worldwide.  Following the  Declaration of Human Rights and Mental Health, adopted in 1989 as the Declaration of Luxor, the WFMH stresses the need for governments to recognize their most vulnerable populations and to provide a safe environment where they can receive the necessary treatment as well as employing the full range of social support initiatives to prevent mental illness wherever possible.   

The various possible initiatives, as recommended by the WHO include:

• early childhood interventions (e.g. home visits for pregnant women, pre-school psycho-social activities, combined nutritional and psycho-social help for disadvantaged populations);
• support to children (e.g. skills building programmes, child and youth development programmes);
• socio-economic empowerment of women (e.g. improving access to education and microcredit schemes);
• social support for elderly populations (e.g. befriending initiatives, community and day centres for the aged);
• programmes targeted at vulnerable groups, including minorities, indigenous people, migrants and people affected by conflicts and disasters (e.g. psycho-social interventions after disasters);
• mental health promotional activities in schools (e.g. programmes supporting ecological changes in schools and child-friendly schools);
• mental health interventions at work (e.g. stress prevention programmes);
• housing policies (e.g. housing improvement);
• violence prevention programmes (e.g. community policing initiatives); and
• community development programmes (e.g. 'Communities That Care' initiatives, integrated rural development).

Please join the WFHM initiative and help promote mental health issues in your community. To learn more about Mental Health Day, go to  http://www.wfmh.org/00WorldMentalHealthDay.htm.

For more information and to support the WFMH. 

 

 

 

Witch Hysteria Strikes Kenya's Elderly

All Ponda Changa wanted was to enjoy his retirement in peace.

After a lifetime of work, he had built a modest four-bedroom home, complete with solar power and a television set,  in his native Kibaoni village in Kenya's Kilifi District.  With an income derived from a herd of cattle and a grove of coconut trees on six acres of land,  Mzee Changa had few worries in his life.

Until one of his sons accused him of witchcraft.

Now in a refuge in Ganze District farfrom his village, Changa states that "My son has attempted to kill me several times. He once beat me seriously outside a chief’s office in Takaungu on claims that I bewitched his sister. I decided to flee to save my life".   He also states that his son has used to witchcraft accusation as an excuse to seize his property which he plans to sell.    His son has also seized his National Identity Card and his life savings of 50,000 Kenyan shillings (about US $600).  Although he reported the threats to the local police, they have been of little assistance and he claims that the officers demanded bribes which he did not have.

The accusations directed against Ponda Changa is just the latest of a series of incidents in which elderly Kenyans in Kilifi District have been targeted.  Due to widespread local beliefs that people with grey hair and red eyes were witches or wizards, many old people have faced death threats and forced to leave their homes.  Given that the witchcraft accusation provides younger relatives with an excuse to seize property that they might otherwise not inherit until after the owners death, the obvious financial incentive has fueled the attacks.

In some cases, more than threats can occur.   Youth attackers have reportedly killed accused witches and leaving the bodies hanged under trees to make the deaths appear to be suicides.  Others have been forced to drink poisonous substances with the attackers only leaving their homes after the accused witches were dead.   Although human rights groups in Kenya have demanded government intervention to protect accused witches, investigation of suspected deaths has been slow since the killings are often carefully planned by close family members to ensure inheritance.   

To protect accused witches such as Ponda Changa, a refugee centre has been established in Ganze District by the Ganze District Cultural Association.  Originally intended for cultural preservation, the centre has become a rallying p0int for many elders fighting against accusations of witchcraft.    Using traditional rituals to refute the witchcraft charges, the centre also recruited youths to carry out civic education to combat many of the local beliefs about red eyes and grey hair that have been used to justify the attacks.  Despite the centre's education campaign, Coast Provincial Commissioner Ernest Munyi has expressed concern over the rising incidence of killings following claims of practicing witchcraft.  He blames the violence on high levels of illiteracy among Kilifi villagers as well as the economic climate which provides witch accusers with a profit motive.

While district authorities have taken a closer look at suspicious deaths, the climate of fear in Kilifi District has made many elders afraid of returning to their homes.

For more information.

Remembering Minamata (Part 2)

Continued from Part 1

A fresh outbreak of Minamata Disease occurred in 1969, this time Niigata Prefecture.  While the Chisso factory was not implicated, a factory owned by Showa Denko, using similar industrial processes to the Chisso plant, was found to be leaking mercury into the surrounding environment.   Researchers familiar with the previous Minamata outbreak used their experience to prove Showa Denko's involvement in the new outbreak.   By the time this new announcement was made, public sentiment was definitely changing in favour of the Minamata victims.   Widespread publicity over the outbreaks as well as other pollution-related epidemics occurring during that same period meant that Minamata Disease sufferers were no longer regarded with the same stigma as before.   The adverse health consequences of widespread release of industrial waste spurred a major campaign to reform Japanese environmental legislation.  The two Minamata outbreaks, along with two other related cases, became known as the Four Big Pollution Diseases of Japan and spawned the environmental movement in Japan.  The publicity also forced  the Japanese government to launch its first Environmental Agency in 1971 (later expanded into a full Ministry of the Environment in 2001). 

As for the victims of the two Minamata Disease outbreaks, the government released an official announcement on September 26, 1968 acknowledging that Minamata Disease was a condition of the central nervous system caused by methylmercury exposure.  The announcement contained factual errors and completely omitted mention of the later victims who had become exposed when Chisso diverted its wastewater into the Shiranui Sea.  Still, it represented vindication of a sort for the Minamata victims and their families and provided them with the means to force better financial compensation from the Chisso Corporation.   As for Chisso itself, the dumping of methylmercury only stopped in 1968 when the old industrial equipment became outmoded and new technology became available. 

When the Mutual Aid Society approached Chisso about a new compensation package however, the corporation in turn asked for a binding arbitration settlement from the Japanese government (as opposed to formal litigation).   What followed was a government-run arbitration committee which initially offered to have Chisso pay 2 million yen for dead patients (approximately US $5,600) and 140,000 to 200,000 yen a year for surviving patients (US $390-560).  Outraged over the proposed settlement, the victims' group  representatives rejected the binding arbitration agreement and pushed for litigation.  The political furour over the announced settlement was met with rioting and arrests of protesting victims.  In 1969, twenty-nine families of Minamata victims filed a lawsuit against Chisso and the media coverage of the trial gripped all of Japan.  Graphic news footage of protesters being arrested and beaten, sit-ins outside Chisso's Tokyo offices, and officials from Chisso being confronted with one of the disabled children dominated headlines during the four years that it took for the trial to be completed.   The most damaging testimony came from Hajme Hosokawa who told the court about his research which had been deliberately suppressed by Chisso's executives.  Although Dr. Hosokawa died three months after giving his testimony, Chisso officials admitted that the dumping had continued despite the known risks.

The turmoil surrounding the Minamata trial also led to considerable social and political upheaval, especially since Chisso continued to be the largest employer in Minimata.  When American photojournalist Eugene Smith began documenting Minamata Disease, he was brutally attacked by Chisso employees in an attempt to suppress his work.  Although Smith survived the attack, the sight in one eye was left permanently damaged.  Despite his injuries, Eugene Smith released this work on Minamata victims to critical acclaim.  One of his most haunting pictures, Tomoko Uemura in her Bath, is considered to be Smith's greatest work although it has since been withdrawn from publication at the request of the victim's family.

In March of 1973, the Kumamoto District Court ruled in favour of the families.  In handing down a verdict, the court ruled that the Chisso Corporation "could have prevented the occurrence of Minamata disease or at least have kept it at a minimum. We cannot find that the defendant took any of the precautionary measures called for in this situation whatsoever. The presumption that the defendant had been negligent from beginning to end in discharging wastewater from its acetaldehyde plant is amply supported. The defendant cannot escape liability for negligence."    The original "sympathy money" agreement was scrapped and Chisso was ordered to pay 18 million yen for each deceased victim (US $66,000) and 16-18 million yen for each surviving victim (US $59,000-69,000).   It was the largest settlement ever awarded by a Japanese court. 

The actual number of Minamata Disease victims may never be known for certain.   To receive compensation, disease victims needed to be officially certified by one of the various ad hoc committees that sprang into existence following the original 1959 agreement.  Since the committees adhered to a rigid definition of Minamata Disease, many victims often needed to wait for decades for official recognition.   Not all Minamata cases have manifested the full range of symptoms associated with organic mercury poisonin and the lack of government certification has delayed compensation.  In a case that garnered recent headlines in Japan, Toshiyki Kawakami and his wife Kazue were only officially recognized this year despite their original application 38 years ago.   Their application was only processed following medical checkups in May of this year.  Recognizing the Kawakamis has raised the official Minamata toll in Kumamoto Prefecture alone to 1,782 but the actual number of cases across Japan is likely much higher (some estimates have placed it higher than 40,000). 

And what of Minamato Bay?  After decades of reclamation efforts, including reclamation of more than 58 hectares of land, cleanup efforts have produced some positive results.  While fish and seafood were declared safe to eat in 1997, levels of mercury concentration have slowly declined and official estimates suggest that background levels have dropped to normal as of 2011.   The fight for offical recognition and compensation for many Minamata sufferers is still ongoing with one group of 2,123 Minamata sufferers reaching a settlement with Chisso and various levels of government only last year.   Many of the congenital Minamata victims are now in their forties or fifties and often completely dependent on their aging parents for support.   Despite active community support programs, the tragedy of Minamata Disease is likely to continue for decades more.

 

 

 

 

Remembering Minamata (Part 1)

It was a tragedy that never should have happened in the peaceful city of Minamata in Japan's Kumamoto prefecture.  

Beginning in 1950, seabirds and household pets were struck with a strange epidemic in which the animal seemingly went "mad" with convulsions followed by a rapid death.  The first case involving a human victim was identified on April 21, 1956.  The victim, a five-year old girl, was presenting a range of symptoms including convulsions as well as difficulty walking and talking.  When her younger sister developed similar symptoms, she was also hospitalized and authorities became alarmed to discover that eight additional cases were found nearby.  By May 1,  local public health officials announced an "epidemic of an unknown disease of the central nervous system" which would be later termed Minamata disease.   

When the city doctors and local authorities formed the Strange Disease Countermeasures Commitee, they were baffled over what was causing the new mystery illness.   Out of fear that it was contagious, Minamata cases were isolated from the local community and their homes thoroughly sterilized.  Although these measures eventually proved to be unnecessary, they contributed to the stigma that victims were forced to endure.   As university researchers began investigating the disease more thoroughly, the first Minamata cases began dying.  By October 1956, forty patients had been discovered and fourteen had died (a fatality rate of 36.7%).   Researchers eventually traced the disease outbreak in humans and animals to the high concentrations of mercury found in the shellfish that represented one of the main food staples in the coastal city. 

Once mercury poisoning was identified, suspicion immediately fell on a nearby chemical factory run by the Chisso Corporation.  First opened in 1908, the factory produced a variety of chemical products (including fertiliser, acetic acid, vinyl chloride, and octanol) and waste products were directly released into Minamata bay.  Despite previous compensation paid to local fisheries over reduced catches, no cases of human exposure to the pollution had been identified.    That all began to change as researchers found high concentrations of heavy metals such as manganese and thallium in the organs of the deceased.    In 1948,  visiting neurologist, Donald McAlpine, suggested that organic mercury exposure was the likely culprit in Minamata disease given the nature of the symptoms which had also been observed in other cases of mercury poisoning.    Testing for mercury, researchers were shocked at the high concentrations  they found in the local sealife and even in samplings taken from the bay's sludge.    The highest concentrations were found immediately adjacent to the factory's wastewater canal (Chisso would later set up an operation reclaiming the mercury from the sludge to sell for a profit).

In subsequent research, it was determined that Chisso had been using metallic mercury as an industrial catalyst which was then discharged into the wastewater.  The process did not end there though.   Once the mercury entered the environment, it came into contact with the methylating bacteria that lurk at the bottom of ponds, rivers, and oceans.  Ordinarily converting sulfate into sulfide, the bacteria combined the released mercury with carbon to produce methylmercury, a fetal toxicant.   Since persistent poisons become concentrated as they move up the food chain (through a process known as biomagnification),  the concentration of methylmercury in the sealife hauled into the fishing boats was as much as a million times greater than in the surrounding water.

By 1959, the Ministry of Health and Welfare was able to make a public announcement linking Minamata Disease to mercury exposure.   The Chisso Corporation, already knowing that they were under suspicion in the Minimata deaths, changed the course of the wastewater discharged from the plant directly into Minamata River.  This reduced the amount of discharge into the harbour (which was being investigated by researchers) but spread the contamination over a much wider area.  Further Minamata Disease cases occurred in fishing villages up and down the coast of the Shiranui Sea.   As well, the corporation continued to stonewall investigators seeking information about the plant and its industrial operations.   When Chisso's hospital director, Hajme Hokosawa, launched research which confirmed that the factory waste was causing the disease, he was ordered to stop and all information about the research was suppressed.  Chisso and other industrial interests also funded research looking into alternative causes of the disease.

Following a partial ban on fishing by the Kumamato prefecture (as opposed to the total ban which would have forced higher compensation), fishing cooperatives were able to win some grudging settlements but the human victims were not so fortunate.   The stigma surrounding Minamata Disease ensured that sufferers faced continuing ostracism and discrimination from the community at large.  Even the formation of the Minamata Mutual Aid Society did little to improve matters.  Only a sit-in at factory gates in November 1959 forced local governments to include victim compensation as one of the conditions of the compensation package being negotiated for the fisheies.  Chisso eventually agreed to pay "sympathy money"  for those victims duly certified as suffering from Minamata Disease.  The compensation package was not large with adults receiving 100,000 per year (equivalent to U.S. $ 278.oo) while children received substantially less (families of deceased Minamata Disease victims received a lump sum equivant to 889 U.S. dollars).  

Despite assurances by Chisso that factory wastewater would be chemically treated to prevent further mercury poisoning, nothing was really done and "ten years of silence" followed from 1959 to 1969 during which mercury pollution spread thoughout the Shiranui Sea.   Despite surveys by the Kumamato and Kugashima prefecturates showing that mercury levels were still dangerously unsafe, the results were never made public and deaths were listed as being due to "unknown causes".    During the early 1960s, medical professionals found that children in the Minamata were developing cerebral palsy at an abnormally high rate.   The disease was eventually proven to be congenital with mothers being symptom-free while their children developed many of the same symptoms found in adult Minamata Disease sufferers.    Not only were many of the children blind and deaf, but some had unusually small heads and deformed teeth.   Following autopsies on two children and identification of a congenital form of the disease, doctors pressured Chisso into paying "sympathy money" to the families of the children under the 1959 agreement.  Since not all affected children demonstrated the full range of symptoms that characterized Minamata Disease, the full extent to which the children in the contaminated areas were affected may never be known.   At least one study suggested that as many as 29 per cent of all exposed children born  between 1955 and 1959 showed signs of mental deficiencies.

Continue to Part 2.