Alarming Facts about Roma Camps in North Mitrovica: Lead Poisoning of Romani Children

31 January 2006

Andi Dobrushi and Jeta Bejtullahu¹

Walking in the Romani camp in Žitkovac/Zhikoc, three yearold Nikolina does not understand the Standards for Kosovo², the division of the Mitrovicë/a town, the return of the Internally Displaced Persons (IDPs), nor does she imagine that she had a home other than the dirty huts where she lives and plays today. But she can understand that she is not well because she is teased for walking funny and behaving like a zombie.

Žitkovac/Zhikoc, situated 2 kilometers away from the Trepca mines, used to be a toxic wasteland. Nikolina, like many children born in these camps, is exposed to lead poisoning and as a result of high levels of lead in the blood she suffers from memory loss, vomiting and difficulty walking. At the time of the European Roma Rights Centre/Humanitarian Law Centre (ERRC/HLC) visit to the camp in May 2005, Nikolina was being treated for lead poisoning in Belgrade. Her parents were distressed because her sister Gjenita had died two years ago from an illness having the same symptoms.

According to Habib Habibi, the Zitkovac camp representative:

Here in this camp there are 40 families and 180 people altogether. The majority of the camp residents are children. Until now we had 40 cases of kids with lead poisoning. There are also pregnant women suffering from this illness. One child died in 2004 when she was only 3 years old. Her name was Gjenita Mehmeti. I am not sure of what she died of, but I also know that her sister Nikolina is very sick.³

The camps of Zitkovac, Cesmin Lug and Kablare were built in the summer of 1999 by UNHCR when Roma, Ashkali and Egyptian community members were driven away from their homes in Kosovo, and settled in the northern part of Mitrovica. The camps were an ad hoc response to the flow of Roma refugees and were meant to be there for only a few weeks. But six years have passed and the camps are still there, with camp dwellers more devastated and impoverished, and their children facing serious health problems. A large number of the approximately five hundred people in these camps come from the Roma Mahalla (settlement) in the southern part of Mitrovicë/a town, burned down in June 1999 by Albanians.

According to the testimony of Paul Polansky of the Kosovo Roma Foundation:

In November 1999, as a representative of the Society for Threatened Peoples, I warned the head of mission of the High Commission for Refugees in Prishtina that the location for camps appeared to be on toxic waste lands, in the shadow of slag heaps from the extensive Trepca mines. But the commission went ahead with construction, claiming they would be used for only 45 days.⁴

Another reason for the deadlock in the solution of these problems is rooted in the division of administrative responsibilities in Kosovo. Since Roma at Zitkovac are considered Internally Displaced Persons (IDPs) rather than refugees, they do not fall under the mandate of the UNHCR but are the responsibility of the United Nations Interim Administration Mission in Kosovo (UNMIK) and local structures.

The World Health Organisation (WHO) was among the first to alert authorities in Kosovo on the emergency of the issue. In July 2004, the WHO conducted an environmental health risk assessment for lead and heavy metal contamination in the Mitrovicë/a region. In fact, a random blood testing for lead poisoning for the Mitrovicë/a area was first carried out in August-September 2000 by Dr. Andrej Andrejew, a consultant to the UN. He submitted a report in November 2000 to the UNMIK and the WHO, which revealed that the only dangerous levels he found were in the Roma IDP camps. He recommended the immediate evacuation of the people from those camps.⁵ In spite of this report, there was no reaction to this situation until WHO conducted more blood tests at the IDP camps in July 2004.

According to the July 2004 report produced by the WHO, lead has chronic multi-system effects in the human body, but the most significant effect is on IQ levels where meta-analysis of numerous studies shows increases in blood lead from 10 to 20 micrograms/dl was associated with a decrease of 2.6 IQ points. These impacts are irreversible.⁶

Out of a total of 58 children tested, 34 were found to have blood lead levels (BLLs) above acceptable levels. The report states that: "Twelve children were found to have exceptionally high levels. Six of them possibly fall within the range described by the United States Agency for Toxic Substances and Disease Registry (ATSDR) as constituting a medical emergency (=> 70 ug/dl). (Our instrumentation is only able to read up to 65 micrograms per deciliter)."⁷

The US Center for Disease Control and Prevention (CDC) has set a "level of concern" for children at 10 micrograms per deciliter. At this level, it is generally accepted that adverse health effects can begin to set in. However, recent medical research provides new evidence that there could well be very harmful effects occurring at even lower levels of exposure, even as low as 5 micrograms of lead per deciliter of blood. In other words, science is now telling us that there is in fact no level of lead exposure that can be considered safe.⁸

Even small amounts of lead can harm a child's brain, kidneys and stomach. Lead poisoning can slow a child's development and cause learning and behavioral problems.

A child may have lead poisoning and not feel sick. Or the child may have stomach aches, headaches, a poor appetite or trouble sleeping, or be cranky, tired or restless.

A third camp, Kablare, one hundred meters from Cesmin Lug, was also occupied in January 2000. No blood testing has been done in this third camp, although many children there also show symptoms of lead poisoning, such as loss of memory, loss of coordination, vomiting and convulsions.

Children conceived in these camps are born with high levels of lead poisoning which are likely to cause either death between the ages of two and six or irreversible brain damage. Jenita Mehmeti, a four-year-old Ashkali girl died in the Zitkovac camp after being treated for two months in a Serbian hospital for lead poisoning, in July 2004. Her two-year-old sister, Nikolina, has demonstrated the same symptoms and has been in and out of hospital in Belgrade for treatment. However, without immediate evacuation, medical treatment will have no effect. Every day children pass in these camps is a punishment and will mark their life (if they manage to survive) forever.

The second report produced by the WHO in October 2004 signalled alarm that the Roma case was urgent because the blood lead results from the National Institute for Public Health and Environment in the Netherlands (RIMV) confirmed the WHO results of July. According to the report, Romani children have consistently had the highest blood levels in the entire population sampled. 88.23% of soils in both camps are unsafe for human habitation and for gardening. It is obvious, the report continues, that soil contamination is a major source of exposure to the Romani population. In the Zitkovac camp some soils were 100.5 times over and above recommended levels. For the Cesmin Lug camp, the situation is even worse with levels exceeding 359.5 times the safe limits.⁹

The WHO recommendations for immediate evacuation of the children, relocation of the camps, and immediate treatment, however, were not taken into consideration.

Following the WHO October 2004 report, in November 2004, the ERRC sent a letter of concern to the UNHCR, the UNMIK and the responsible Zvecan authorities, expressing alarm that despite being aware of the extreme health concerns posed by the location of the camps, the UNHCR, the UNMIK and local government officials had failed to take actions to ensure the safety of the affected families. No action had been taken to move the affected Romani families.¹⁰

There have been few efforts to inform the Roma about the issue of lead poisoning risking the lives of their children. Some doctors in the north Mitrovicë/a hospital have gone far enough to even blame low hygiene as causing the illness.¹¹

The Ministry of Health of Kosovo, failed to raise the issue as an emergency health problem. Since the 2004 WHO reports, a number of task forces on risk management, relocation and temporary housing have been established; WHO has initiated a special program on lead and health; and UNICEF has joined in educational efforts. While work started on clearing land in August 2005 for medical evacuation, this work was stopped when the land was found to be unsuitable, and no further plans to continue were made public.

The Link with the Return Issue

Initially, the municipal structures in Mitrovicë/a claimed that there was no land available they could allocate for relocating the camp into a safer territory in the north. Although the WHO and the International Committee of the Red Cross (ICRC) demanded an immediate evacuation of the camps on grounds of health, UNMIK Office of Returns and Communities (ORC) decided to link the lead poisoning to the return to the Roma Mahalla.

They proposed to the Special Representative of the Secretary General of the UN (SRSG) to convince the Roma to voluntarily return to land next to the Roma Mahalla.¹² On the other side, the Romani leaders in the camps were skeptical and considered the proposals that had been made to them with suspicion. As one Romani person explained it:

We have asked to be relocated and they have offered to put us in containers in the Roma Mahalla in the south of Mitrovicë/a. We have not accepted that because we wanted a long-term solution. We will only agree to the reconstruction of our houses exactly on the land where they were. However, many of us have no documentation for the land or the houses. Now the municipality is asking for these documents in order to rebuild the houses. They want to move us 200 meters away from the river bank, where the municipality would like to build a park. We will not accept this. The best solution for us is to be transported to western countries.¹³

The municipal structures in south Mitrovicë/a, on the other hand, see this issue only as a return issue of the Roma, Ashkali, Egyptians (RAE) to the Roma Mahalla. For months, UNMIK, municipal structures in south Mitrovicë/a and RAE representatives were involved in negotiations about the reconstruction of the Romani homes in the Mahalla.

Elizabeta Bajrami, representative of the RAE communities working in the south Mitrovicë/a municipality, commented:

The municipality is trying to move us away from our Mahalla. According to their project, the municipality will rebuild the homes of the Roma who possess land and property documents but some of these will be meters away from the riverbank. For those who have no papers, the municipality will build two big buildings with apartments. You know, the project looks good but we are being moved away from our land. The people blame me that their land will be taken, and they are right.¹⁴

The project that both UNMIK and the RAE representatives support was put forward by the Danish Refugee Council (DRC). The DRC project provided for the reconstruction of all the houses as they were before the war broke out, without changing the original location.

Despite disagreements on the reconstruction, another issue appears to loom over this complicated case. It was the Albanian majority that drove away the RAE in June 1999, thus many RAE are concerned about their security and freedom of movement if returned to south Mitrovicë/a.

After weeks of negotiations, on April 18, an agreement was signed by UNMIK, UNHCR, OSCE and the Mitrovicë/a Municipal Assembly President creating pre-conditions for the return of former residents of the Roma Mahalla to their homes. The municipal structures agreed to changes in their project: "As a municipality, we agree to build their houses exactly where they used to be, although this project does not fulfill urbanization conditions. The houses will be located at the very edge of the river bank where there is always a possibility of floods," said Fejzullah Haxhani, the new director of the Urbanisation Department of the Mitrovicë/a municipality.

While the UNMIK and the Provisional Institutions of Self-Government in Kosovo (PISG) structures have so far addressed this issue only in respect to the return of the Roma to their Mahalla in the southern part of Mitrovicë/a, they have failed to engage in the problem from the health perspective. Despite serious warnings and recommendations by WHO for immediate evacuation in October 2004, not only was the issue neglected, but there was also a lack of public information about the alarming facts.

At the time of the ERRC/HLC visits to the camps on March 24, 2005, a four-month-old baby, Robert, looked like a newborn because of a growth disorder. His mother thought that lead poisoning had affected her and consequently the baby during her pregnancy. Robert has been falling in and out of a coma. The ICRC has offered to cover the costs for his treatment in Belgrade since neither the UNMIK nor the PISG responded adequately.

The Humanitarian Law Center and European Roma Rights Centre support the position of the WHO and ICRC and have requested immediate evacuation of the camps, as well as immediate treatment of the children affected by lead poisoning. The reconstruction of the Roma Mahalla will take time, and the agreement between the authorities in Mitrovicë/a and the international institutions to do that does not release these authorities from the obligation to secure a healthy environment for the Roma in the camps. UNMIK, PISG and the Mitrovicë/a municipal structures should take measures to evacuate the children to a safer place and offer treatment and accommodation until the Roma have homes to return to. It is the duty of the power-holders to act to save lives.

Endnotes:

1. Andi Dobrushi is a staff attorney at the ERRC. Jeta Bejtullahu is Director of the Pristina-based office of the Humanitarian Law Center (HLC). This article is based on ERRC/HLC research in the camps for internally displaced persons in the northern part of the Kosovo town Mitrovicë/a in April-May, 2005.
2. The Standards for Kosovo are a set of targets that Kosovo must meet in order for the talks about the future political status of Kosovo to begin. The Standards for Kosovo were launched by Special Representative of the Secretary general of the UN Harry Holkeri and Prime Minister of Kosovo Bajram Rexhepi on 10 December 2003. They were agreed between the Kosovo provisional institutions of self-government and UNMIK, and were approved by the United Nations Security Council. The document is available at: UNMIK Online.
3. ERRC/HLC interview with Habib Habibi, April 24, 2005.
4. Published in the International Herald Tribune, April 26, 2005.
5. See Sandra Molano, Andrej Andrejew. First Phase of Public Health Project on Lead Pollution in Mitrovica Region. November 2000. A copy of the report is on file with the ERRC.
6. World Health Organisation. Preliminary report on Blood Lead Levels in North Mitrovica and Zvecan, July 2004. Document on file with the ERRC.
7. Ibid. According to the US-based international public service non-governmental organisation National Safety Council (NSC), there are many different health effects associated with elevated blood lead levels. Young children under the age of six are especially vulnerable to lead's harmful health effects, because their brains and central nervous system are still being formed. For them, even very low levels of exposure can result in reduced IQ, learning disabilities, attention deficit disorders, behavioral problems, stunted growth, impaired hearing, and kidney damage. At high levels of exposure, a child may become mentally retarded, fall into a coma, and even die from lead poisoning. Within the last ten years, children have died from lead poisoning in New Hampshire and in Alabama. Lead poisoning has also been associated with juvenile delinquency and criminal behavior. In adults, lead can increase blood pressure and cause fertility problems, nerve disorders, muscle and joint pain, irritability, and memory or concentration problems. It takes a significantly greater level of exposure to lead for adults than it does for kids to sustain adverse health effects. Most adults who are lead poisoned get exposed to lead at work. Occupations related to house painting, welding, renovation and remodeling activities, smelters, firing ranges, the manufacture and disposal of car batteries, and the maintenance and repair of bridges and water towers, are particularly at risk for lead exposure. Workers in these occupations must also take care not to leave their work site with potentially contaminated clothing, tools, and facial hair, or with unwashed hands. Otherwise, they can spread the lead to their family vehicles and ultimately to other family members. When a pregnant woman has an elevated blood lead level, that lead can easily be transferred to the fetus, as lead crosses the placenta. In fact, pregnancy itself can cause lead to be released from the bone, where lead is stored - often for decades - after it first enters the blood stream. (The same process can occur with the onset of menopause.) Once the lead is released from the mother's bones, it re-enters the blood stream and can end up in the fetus. In other words, if a woman had been exposed to enough lead as a child for some of the lead to have been stored in her bones, the mere fact of pregnancy can trigger the release of that lead and can cause the fetus to be exposed. In such cases, the baby is born with an elevated blood lead level. Exposure to lead is estimated by measuring levels of lead in the blood (in micrograms of lead per deciliter of blood). Further information available at: www.nsc.org.
8. See National Safety Council.
9. World Health Organisation. Kosovo. ?Capillary Blood Lead Confirmation and Critical Lead-Related Health Situation of the Roma Camps Children.? October 22, 2004. Document on file with the ERRC.
10. Available at ERRC website http://www.errc.org.
11. See Institute for War and Peace Reporting (IWPR) report, Illness Plagues Camps for Displaced Communities, dated April 14, 2005.
12. Action Memorandum of the UNMIK Office of Returns and Communities (ORC), dated March 6,2005, on file with the ERRC.
13. ERRC/HLC interview with H.H., April 24, 2005.
14. ERRC/HLC interview April 24, 2005.