Dr M.I. Ahmed is a specialist in aquatic medicine with the Department of Veterinary Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Maiduguri. He has done a lot of research on heavy metal content in fish in the Lake Chad. In this interview, he explains how global warming has forced some fishermen to use organophosphorus chemicals to catch fish and the implications of eating this fish by man.

Tell us about your research on heavy metal content in fish in the wetlands of Yobe.

Yes, I did some work in Yobe, and I realised that River Yobe is a good water body for fish production but, like most inland waters, it has heavy metal deposits in them and fish, as you know, is an important dietary protein. And again, there are other important aspects of fish like fish oil that contains Omega 3 fatty acids, which is a very important medicinal product. In this area, fish is not only a source of livestock protein, it also helps fishermen to earn a living.

How has climate change affected this important aspect of people’s lives?

Climate change, as a result of global warming, has affected particularly countries in sub- Saharan Africa in the sense that it has affected their production as well as resulted in the prevalence of diseases in their environment. And again, the change in temperature has also indirectly affected their health because fish prefers a particular temperature range for it to be comfortable and for it to be productive.

With this low production and rapid population growth, don’t you think man will be desperate in his search for survival?

Actually the feral fish that we depend on (that is, catching fish in the wild) is dwindling greatly both as a result of global warming and as a result of indiscriminate use of fishing gears. There are certain sizes of fish that should be caught but, unfortunately, because of the desperate position of the artisan fishermen around these water bodies, they use what we called taru, a fishing gear that is, honestly, criminal to use. It catches not only table size fish but even fingerlings; this takes away everything from the water, rendering it barren.

This translates to deficiency in protein in the population of the immediate community. People have to lean on other forms of protein from larger livestock which is not certainly easy to come by. The prices are going higher as a result of global warming too.

The implication of all these, when the artisan fisherman becomes desperate, [is that] he can go to the extent of poisoning the water where he cannot reach with his fishing gears. He may use some chemicals such as insecticide, called Gamalin, which is an organophosphorus compound. It is used to poison the fish so that the fish will float on the surface of the water. But mind you, this is at a cost because you are not only poisoning the fish but also man, at the top of the food chain, who is feeding on these fish and the water he drinks and even the crops he grows in the vicinity.

Man will be faced with the problem of bio-accumulation of these heavy metals in his body, particularly in the brain, the kidney and in the liver tissues. The implication of these toxic metals in humans is associated with central nervous system disturbances and cancerous diseases.

Are the activities of the dry season farmers who apply fertilizers to their farms by the shores of these water points causing the same problems?

Yes, farming in these wetlands results in the leaching of synthetic fertilizers into the water and can best be described as a fluid within a fluid; such an association what ever is found in this environment will go into the fish because it takes in a lot of this water involuntarily or voluntarily and it is absorbed within its gills, the gills area have some epithelium where exchange of gas takes place.

Even the crops that are grown from organic fertilizers in the developed world, they have a premium price than with synthetic fertilizers because of bio-accumulation. If one eats these plants grown with synthetic fertilizers it accumulates in your body over time and because it is not degradable it triggers one or two forms of diseases.

In specific terms, how do these chemicals affect their victims?

These chemicals end up in the tissues at different [levels of] concentration. They accumulate in different tissues of the fish and we don’t look at fish as one and the same thing. We have the muscle, the kidney, the liver and others, so the concentration of these toxic chemicals varies with different tissues. If you look at the liver, it varies because it is the detoxification centre of the body of any living creature.

When these chemicals are taken in large quantities by fish, they become toxic; as a result, the oxygen-carrying capacity of the blood will be hampered. Again, the mere presence of GamalinR or DDT on the surface of the water also reduces the oxygen absorption of that water at that level. That is to say, when you have a large quantity of organophosphorus taken in by the fish it will be absorbed through the intestine, then the blood system, then the red blood cells that carry oxygen to the tissues will be impaired while tissue respiration will be affected and they will be damage to those tissues.
     
“Artisan Fishermen use Chemicals to catch fish out of desperation”
 
“Chemicals are making people to come down with Leukemia”

Doctor Usman Ali Abjah, a consultant Hematologist with UMTH who had special training in stem cell transplant or bone marrow transplant in Singapore . He believes the use of chemicals to catch or preserve fish etc may be responsible for the high prevalence of Leukemia particularly in the riverside areas of Yobe state. Ahmad Salkida reports!

How often do you receive patients with bone marrow malignancy in UMTH?

As this is the only referral center in the whole of the north east region, we see patients referred to us from the catchments areas like Adamawa, Bauchi, Gombe and Yobe states etc and some international patients from Chad , Cameroon and Niger . Leukemia is a common health problem. In fact it is one of the second largest diseases afflicting humankind after infectious diseases.

From where do you get most of your Leukemia related referrals in the region?

What I observed here is that there are some ‘hot spots’ for this disease especially in Yobe state like the Bade-Nguru area and the Potiskum axis, then Yola in Adamawa state. These are the areas we have seen the highest population of people coming with Leukemia which has to do with the bone marrow but for other diseases like Lymphoma which is the malignancy of the lymphoid tissue comes from virtually everywhere in the region.

Can you give us percentage of the total number of patients you receive from each community in the region? 

We have not sat down to look at the total number of patients we have seen in the last 10 years but Yobe has the highest percentage with about 4 out of  10 patients concurrently, followed by Adamawa. And this is certainly alarming because the disease were not commonly seen in the past or may be, because we don’t have specialists at that time to detect the disease, and also the general perception in many of these areas where the victims of the disease come from has always been that the disease is harbin jeji so they end up staying at home to die.

Most of the people in Nigeria do not budget for health, so the spend their money on other matters. The motive behind it is that belief of incurability of the disease. Be that as it may, the patient can get cured provided they come to the hospital early enough and diagnoses is established, then appropriate treatment is made. Provided the patients is in dire need of treatment any way.

In the absence of high tech equipments in Nigeria , is it possible to attribute the use of organophosphorus compound to Leukemia?
    
Actually it is better said than done, these organophosphorus chemical agents that is found in chemicals like gamalin 20 and you have the so called DD GON, these are the things found commonly to contaminate water and to catch fish or migratory birds in most of these communities.

And because most of these chemicals are not bio-degradable they tend to accumulate in either the kidney, liver of the fish that are hardly thrown away or in the tissues of the dead bird. When they are consumed by humans it moves into vital organs of that human, causing severe health problems.

But if you look at it critically, when the Yiroshima Nagasaki war was fought and that atomic bomb was dropped in Japan a lot of people came down with Leukemia. Then are you going to imply that all of them have genetic predisposition?

It is possible it might be an environmental factor; could it be possible due to the presence of certain viruses; it is possible age has a rule to play and also the eating habits of people which had changed over time. One will not know until research is done in those areas, what we know of course is, Leukemia is the second largest disease here after infectious diseases and we know something serious is causing it.

What are the symptoms of the disease?

The symptoms of leukemia are bleeding from the gum and other openings of the body, infectious and the feeling of being unwell. The bleeding is after doing innocent things like tooth brushing or while picking of the teeth after a nice course meal. Infections where patient with come to the chemist and buy malaria or typhoid fever drugs and after taking the drugs. The fever will come back after 2 or 3 days. You see a person who cannot do the work he has been used to. So it is always good for them to visit the hospital for advice. 

Tell us about treatment of the disease?

There are lots of ways you can treat Leukemia. This depends on the stage of the disease. If the patient present much earlier and the facilities are there, you can give cytotoxic drugs. These drugs can be able to displace the Leukemic cells from the bone marrow so as to restore normal marrow activity and then the disease may be controlled.

If the disease progresses the best acceptable form of treatment is stem cell or bone marrow) transplantation. BMT is very expensive, and it can range from about 250,000 to 500,000 US dollars. These procedures are not being practiced today any where in Nigeria, even though there are few people trained to do it, but unfortunately the facilities are not there.
 
“People need to be enlightened about their actions in the rural areas”

Alhaji Idrissa Mai Bukar Machina Yobe state Commissioner of Health bears his mind about the prevalence of Leukemia in his State. Ahmad Salkida reports.

Sir records at the UMTH revealed that 4 out of every 10 patients with Leukemia come from Yobe alone. What can you say about this?

These records may be true or untrue. But as you have stated records have shown, I will answer you from my little experience in the health sector, which is the bulk of work of health personnel is not just to go to a hospital and start diagnosing patients with certain type of diseases. This bulk of work lays with the administrators, information dissimulators and the doctors them selves.

I can rightly say that prevention is better than cure; to get such disease of such magnitude prevented there must be education. So people are supposed to be enlightened, people are supposed to be informed. Those in the rural areas, the traditional institutions supposed to enlighten their people, we in the administrative sector supposed to give policy directives to the information dissimulators and the educators to go to the grass roots to educate people through jingles, the media and what have you.

What can you say about the use of gamalin in these areas, scientists claimed it may be causing Leukemia?

Government has so many laws and bi-laws and at the same time people are ignorant. So it’s almost the same, we have to go and enlighten the people. If the policies are not stated it is our responsibility to make the policy stated. It is the responsibilities of all the stake holders including the media to enlighten the people.
    
What about treatment for those already afflicted?

Curative medicine is also good because without it nothing can seem good enough in medicine. Those that are already affected, the government and people of Yobe are equal to the task, as you are aware we are building a state- of- the- art hospital in Damaturu.

In every disease we have the epidemiological unit, if records have shown that these practices are prevalent and the disease is there existing the epidemiological unit will alert the Ministry of Health and we will then work it out and everything will be a thing of the past.