Band-aids over landfill-sized holes
Why are we ignoring the impact of waste on health?
Image credit: Unsplash
In Tipitapa, a city adjacent to Managua, Nicaragua, a small community emerged around a large landfill. People living below the poverty line moved there to salvage what valuables and scraps they could. Although it began with workers arriving and then leaving the site each day, gradually more people decided to remain, forming a permanent settlement. People upgraded their temporary huts from four wooden posts and a cloth roof, to multi-roomed properties with tin roofs and walls complete with fences and clotheslines. Using the discarded metal, residents of the dump could build homes for free and fill these homes with kitchen supplies, bedding, and extra sets of clothes.
They successfully established an entire make-shift village, and after more than two decades, they had even built a small primary school and a church building. The nearest clinic, however, was still over an hour drive away. As nobody owned a car or a moped, there was little to no access to formal medical care except for the occasional temporary ‘pop-up’ clinic funded by one organisation or another. On a trip to set up one of these pop-up medical clinics, I met and spent time with Juan, a nine-year-old who lived there. After school was out, he would go into the landfill with his parents and siblings searching for items they could use or potentially sell, depending on how lucky their day’s findings were. Their home was conveniently situated across a gravel path from the public dump, giving them easier access to the landfill.
At the time, I thought it was sad. Sad that my new friend had to wade around in garbage all evening and missed school in the months when the sun set early. Sad that he was desensitised to an odour that had (embarrassingly) made me find somewhere private to vomit. What I didn’t think about at the time was the impact of climate catastrophe on Juan’s family and their opportunism. Their reliance on recycled materials meant they were living the most sustainable life possible, yet their circumstance was born out of the direct and indirect consequences of the actions of others. I also didn’t think about how absurd of a notion it is that we even have these dumping grounds. The giant rubble pile was normal; it was the people living in it that were ‘abnormal’. We have normalised the existence of these massive piles of near-indestructible waste that emit oncogenic toxins, methane, and smog.
“Their reliance on recycled materials meant they were living the most sustainable life possible, yet their circumstance was born out of the direct and indirect consequences of the actions of others”
Landfills like the one in Tipitapa are estimated to be the third largest source of methane emissions in the United States. Landfills are constantly spewing out methane—a gas that is 84 times more effective at absorbing the sun’s heat than carbon dioxide. In addition to producing methane, Juan and his family’s source of means was also silently leaking ammonia, causing eutrophication in their water sources. The increased ammonia causes excess plant and algae growth leading to the depletion of oxygen in the water, and the subsequent death of fish in aptly dubbed ‘dead zones’.
This landfill is this community’s source of goods, but these ‘goods’ backstab by leaking toxins in their water, imprinting birth defects on their children, and cursing them with respiratory disease. The impact of landfill pollution on human health is extensive, not just those who live in proximity to waste. As the chemicals seep into our water, they poison the crops we eat and the meats and milk we consume from animals that graze on the contaminated crops. We poison ourselves from our waste. This poison that we consume and breathe affects you and me. It affects our patients. We readily accept and acknowledge that hazardous waste can cause a variety of health conditions, not limited to congenital defects, respiratory disease, neurologic conditions, and cancer.
The question is what do we do about it? Clinicians have been treating the symptoms, placing band-aids over landfill-sized holes, but shouldn’t we be practising medicine in a way that prevents disease? Engaging in climate reform is engaging in preventative medicine. The climate crisis is a public health crisis. It is an issue that demands change, and physicians should be at the forefront.
“The climate crisis is a public health crisis”
Every time I see a half-used item carelessly tossed in a waste receptacle, ignoring the adjacent recycling bin, I think of Juan. I wonder if he’ll have the opportunity to have healthy children, to live a full life, and to be free of the health repercussions he is at risk from in his daily efforts to survive.
