Parents demand accountability as the price increases | Rare Techy
When 17-month-old Nadira had a cough and flu, her mother Agustina Maulani bought paracetamol cough syrup from a health center in South Jakarta.
“I gave him medicine every four hours, because his fever wouldn’t go down. He recovered, but he still had a fever. Finally he stopped urinating,” he told the BBC. .
Nadira was taken to the hospital but was not well. Laboratory tests revealed elevated urea and creatinine; waste products that build up after the kidneys shut down. He fell into a coma and died.
“In the end he died quickly. The pain was very scary,” said Agustina, crying.
Indonesia is facing a terrible wave of deaths: more than 157 children have died this year from kidney damage and other problems, believed to be caused by contaminated medicines. Almost all are under the age of five.
Nadira died in August. In October, Indonesian authorities said he was among a wave of children who died from unknown kidney diseases.
The government then banned the sale of all liquid medicines. The ban was later narrowed down to about 100 suspected products – found in the homes of sick children.
Pharmacies across the country have pulled bottles from their shelves, advising parents to crush the pills for their children if they need the medicine.
Indonesian health minister Budi Gunadi Sadikin said traces of the harmful chemicals ethylene glycol, diethylene glycol and ethylene glycol butyl ether were found in the wounds.
Diethylene glycol and ethylene glycol are used in antifreeze solutions for air conditioners, refrigerators and freezers and as a solvent for many products including cosmetics at a minimum attraction According to the World Health Organization (WHO) it should never be used in medicine.
“It has been confirmed that (the serious kidney injury) was caused by chemicals,” said the minister.
The cases come weeks after the deaths of nearly 70 children in The Gambia. The WHO said it found “unacceptable levels” of diethylene glycol and ethylene glycol in four Indian-made cough syrups available in Gambia.
There is no doubt that the two allegations are connected. According to Indian authorities and manufacturer Maiden Pharmaceuticals the four syrups were exported only to Gambia. Indonesia says Indian-made syrups are not available at the site.
Last Monday Indonesia’s food and drug agency – BPOM – said it would investigate two pharmaceutical companies that have changed their suppliers for some of the ingredients from pharmaceutical suppliers to chemical suppliers.
“There is evidence in their products … that they are very, very toxic and can cause kidney damage,” BPOM chief Penny Lukito told a news conference.
Currently, many sick children are being treated for kidney injury, and Indonesia has asked Singapore and Australia for a rare substance – fomepizole – to treat them.
The incident has caught Indonesia by surprise. Last week the country’s health watchdog criticized the Ministry of Health and the BPOM, saying that not enough has been done to test the products being sold to meet standards.
In an angry interpretation, the Jakarta Post newspaper said that the BPOM had passed responsibility for testing to the pharmaceutical companies themselves – an “alarming” finding that showed the government had “abandoned its authority”.
“While our hearts are broken when parents continue to lose the lives of their precious children, we now see the lack of consideration and lack of oversight by the government,” he said. said the newspaper.
Professor Eric Chan at the University of Singapore told the BBC he was surprised to hear that such deaths were continuing – and described the events in Indonesia as a “human disaster”.
Diethylene glycol was once used to make medicines taste better – but is now known to be toxic, he said.
Diethylene glycol turns into diglycolic acid in the body and accumulates in it, damaging kidney cells — potentially life-threatening if not treated in time, he said. Decreased urine output is an early sign of kidney toxicity.
Professor Chan said that because cases have been found across Indonesia it is believed that pharmaceutical companies with extensive distribution networks were involved. Medical staff at local hospitals may not be used to managing drug poisoning, he said, because so many children are taken from hospital to hospital for treatment.
“We must remember that the number of deaths will continue to rise,” he warned.
In Bekasi, east of Jakarta, Siti Suhardiyati has been forced to remove her son’s toys from the floor.
Umar Abu Bakar was two years old when he died on September 24. He was also diagnosed with kidney failure, by doctors at his last hospital in Jakarta.
Just two weeks ago he had a fever and chills. He also had cancer, so Siti took him to the local clinic for treatment.
The family was given three types of medication, including paracetamol syrup. Three days later Umar stopped urinating.
“I usually change his diapers in the morning when they’re full, but this time there was nothing,” she said.
He was taken to a local hospital for treatment before being transferred to Cipto Mangunjusomo Hospital in the city. But it was too late.
“How can there be anything bad in this cough syrup? If it is approved by the BPOM, it should be tested,” Ms Suhardiyati said.
Nadira’s mother Ms Maulani is also looking for answers.
“If this is negligence … we demand responsibility for the cases that have happened to our children,” he said.