Invisible danger

No testing lab

"The challenge in Bangladesh is that the Ministry of Health and Family Welfare currently does not have a national reference laboratory for blood lead testing," Wobil said. This limits the country's ability to reliably identify suspected cases among children and pregnant women and to monitor lead exposure through a national environmental health surveillance system.

In other words, discovering that a child has an elevated blood lead level is only the beginning. A functioning response should help identify where the exposure occurred, investigate the surrounding environment and prevent the children from being exposed again.

Rahman similarly points out that while equipment exists in research institutions, it is not yet broadly available as part of a routine public diagnostic service. He said building a national laboratory and point-of-care testing capacity would require investment, equipment and trained personnel.

But both the health and environmental evidence suggest that testing alone cannot be at the center of the response, as prevention has to come first.

The consequences of lead poisoning appear across health, education, the environment, industry and household consumption. Its sources can include a recycling yard, a manufacturing process, a product sold in the market or contaminated soil.

Wobil's priority for the government is therefore not a single campaign or an isolated intervention. "No single intervention can address poisoning comprehensively, because children are exposed through multiple sources and the response requires action across several sectors," she said.

Her immediate priority is stronger regulation and policies directed toward the highest-risk sources, using the environmental assessment to determine where action should be concentrated.

Ultimately, she argues, the responsibility cannot rest mainly with families. "The most effective way to protect children from lead poisoning is to prevent exposure at its source. Rather than relying mainly on families to avoid lead, we need policies that make the products and environments around children safer."

THE DAILY STAR, BANGLADESH