Cisitu is a small-scale gold mining village in Indonesia. Mercury (Hg) is used to extract gold from ore, heavily polluting air, soil, fish and rice paddy fields with Hg. Rice in Cisitu is burdened with mercury. The main staple food of the inhabitants of Cisitu is this polluted rice. Villagers were concerned that the severe diseases they observed in the community might be related to their mining activities, including high mercury exposure. Case report of the medical examinations and the mercury levels in urine and hair of 18 people with neurological symptoms. Typical signs and symptoms of chronic mercury intoxication were found (excessive salivation, sleep disturbances, tremor, ataxia, dysdiadochokinesia, pathological coordination tests, gray to bluish discoloration of the oral cavity and proteinuria). Mercury levels in urine were increased in eight patients (>7µg Hg/L urine). All 18 people had increased hair levels (>1µg Hg/g hair). 15 patients exhibited several, and sometimes numerous, symptoms in addition to having moderately to highly elevated levels of mercury in their specimens. These patients were classified as intoxicated. The situation in Cisitu is special, with rice paddy fields being irrigated with mercury-contaminated water and villagers consuming only local food, especially mercury-contaminated rice. Severe neurological symptoms and increased levels of mercury in urine and hair support are possibly caused by exposure to inorganic mercury in air, and the consumption of mercury-contaminated fish and rice. The mercury exposure needs to be reduced and treatment provided. Further research is needed to test the hypothesis that mercury-contaminated rice from small-scale gold mining areas might cause mercury intoxication.
Mercury (Hg) isotopic signatures were characterized in polished rice samples from China, U.S., and Indonesia (n = 45). Hg isotopes were also analyzed in paired hair samples for participants from China (n = 21). For the latter, we also quantified the proportion of methylmercury intake through rice (range: 31–100%), and the weekly servings of fish meals (range: 0–5.6 servings/weekly). For these participants, 29% (n = 6) never ingested fish, 52% (n = 11) ingested fish < twice/weekly, and 19% (n = 4) ingested fish ≥ twice/weekly. In rice and hair, both mass-dependent fractionation (MDF, reported as δ202Hg) and mass-independent fractionation (MIF, reported as Δ199Hg) of Hg isotopes were observed. Compared to rice, hair δ202Hg values were enriched on average (±1 standard deviation) by 1.9 ± 0.61‰, although the range was wide (range: 0.45‰, 3.0‰). Hair Δ199Hg was significantly inversely associated with %methylmercury intake from rice (Spearman’s rho = −0.61, p < 0.01, n = 21), i.e., as the proportion of methylmercury intake from rice increased, MIF decreased. Additionally, hair Δ199Hg was significantly higher for participants ingesting fish ≥ twice/weekly compared to those who did not ingest fish or ingested fish < twice/weekly (ANOVA, p < 0.05, n = 21); Overall, results suggest that Hg isotopes (especially MIF) in human hair can be used to distinguish methylmercury intake from rice versus fish.
SANIMAS (Sanitasi oleh Masyarakat) or Sanitation by Community is a nation-wide sanitation program for urban poor settlements in Indonesia and has already been implemented since 2003. Population density in urban settlement range between 600 to more than 1000 people per square km, which provides no room for proper sanitation infrastructures. The decentralized, communal, community-managed and cluster wise approach to solve sanitation problems in such high density has many types of challenges: technical, environmental, social and financial. Therefore there is the need to have concerted efforts for a careful yet reliable, high quality standard design, good supervision, sustainable operation and maintenance, as well as for continual monitoring and improvements. In the past, water and sanitation facilities in urban poor settlements were built for quantity and appearance not for quality and performance. As a result most of the infrastructures collapse and disfunction only a couple of months after the construction has been handed over to the community. Leaking or bottomless septic tanks are usually the reality and lack of maintenance is a common problem as no community committee is assigned to oversee or monitor the facilities. As a national program, SANIMAS is implemented in more than 70 urban poor community clusters or approximately 8,000-10,000 people every year which previously identified as unserved population. It is implemented in sequences of activities and accomplished only by good team work, guided by standardized steps. All team members, coordinators, field facilitators, technical team, relevant government officers and community committees must build and maintain good coordination and communication. Several capacity building packages are designed for and delivered to different groups to ensure that implementation steps are understood by the relevant team members. Various training modules are developed and delivered to technical teams, senior facilitators, field facilitators and community committees. Each training aims at communicating the minimum standard activities required to accomplish the program. To ensure that facilities serve their function in a sustainable way, a monthly community participatory monitoring has been designed. That way technical, environmental, financial and institutional aspect is mainly monitored by the community in assistance of team members. The monitoring results are used as inputs for improvement, local policy development and strategy. This paper shows that through the decentralised sanitation approach, a sustainable sanitation service for the poor is possible.
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