LAGOS, Nigeria — Children eat dirt. Everywhere in the world, this is true. They play on the floor, touch the ground and put their hands into their mouths. In most places, a little dirt can’t hurt you. In Zamfara State, in northern Nigeria, it can be a death sentence.

Zamfara, one of Nigeria’s poorest regions, has large deposits of gold. For generations, people in the state lived mostly impoverished lives as farmers. Since the global financial crisis sent the price of gold soaring, villagers have turned to gold mining. Using shovels and picks they dig shafts hundreds of feet into the ground, haul up earth, crush rocks filled with ore, and look for small specks of gold. In the process, they release lead-contaminated dust which spreads everywhere. The concentration of lead is so high that in 2010 at least 400 children died of acute lead poisoning. Thousands more were sickened and the number of miscarriages soared.

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Death is rarely caused by lead poisoning but in Zamfara unusually high levels of lead in ore led to an initial mortality rate of more than 40 percent among symptomatic children. The main symptom parents can see is convulsions. Children also vomit and have stomach pain. Lead poisoned children also tend to be lethargic.

With a major environmental health crisis unfolding, an international coalition and the Zamfara state government cleaned up seven contaminated villages. The aid group Medecins Sans Frontieres (Doctors Without Borders — MSF) started treating 1,500 children. The treatment is known as chelation therapy.

A chelating agent is a chemical compound that is used to trap or remove heavy metal such as lead. In this process, the chelating agent is injected or taken orally. It binds to the lead and is then excreted from the body in urine. MSF treats the most severe cases as inpatients for a short period, but the vast majority of children are now treated on an outpatient basis, taking a daily dose for either 5 or 21 days, with outpatient follow up twice per week. Most children have had several rounds of chelation therapy.

As a result of the treatments, children stopped dying. But MSF can only treat children from decontaminated villages because exposure to lead during treatment can cause even worse suffering.

In March, funds for the cleanup ran out, leaving the largest village, Bagega, contaminated and its thousands of children exposed and unable to access urgent, life-saving, medical care.

Initial surveillance by the US Centers for Disease Control indicates that numerous other villages also require extensive cleanup and medical treatment for sick children. But funds for addressing the epidemic are not forthcoming: many international donors and aid groups are providing some support, but say that the Nigerian government should step up and pay towards the cleanup effort. The Zamfara state government recently promised to clean up Bagega, but alone it doesn’t have the resources, expertise or personnel to address such a widespread and severe public health crisis.

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On a recent visit to Bagega, I saw a small girl rolling around on the ground in her family’s compound. She put her hands in the dirt and then in her mouth, smiling. Goats and dogs wandered lazily around her. A few weeks later the Zamfara cleanup team measured the level of lead in that dirt at 23,000 parts per million. A safe level is under 400 parts per million. Ten children have died in that compound so far.

As worried mothers looked on, the state cleanup team cautioned that they could not promise to clean up the compound: They had run out of money and did not know if long-promised government funds would come through.

Getting children to stop playing in dirt is impossible. Addressing the worst lead poisoning epidemic in modern history is not. Experts say that ending this health crisis requires political commitment and adequate funding. It’s clear what needs to be done: implementing safer mining practices to minimize lead exposure, cleaning up contaminated villages, testing and treating children for lead poisoning. The region is remote, but accessible, the number of people affected is manageable.

The Nigerian government has more than a moral obligation to protect the health and welfare of its people. Nigeria is a party to the Convention on the Rights of the Child, so it is bound to ensure the development and survival of the country’s children, and to protect them from work likely to be hazardous to their health or physical and mental development. The International Covenant on Economic, Social and Cultural Rights obligates the government to protect the rights of all citizens to the highest attainable standard of health.

Until the authorities in Abuja give Zamfara the resources needed to address the lead poisoning crisis, children will keep playing with poisoned dirt and they will keep dying.

Jane Cohen is a researcher on health and human rights at Human Rights Watch

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