Indonesia syrup deaths: Parents demand accountability as toll rises - BBC

When 17-month-old Nadira fell sick with a cough and flu, her parent Agustina Maulani bought her immoderate paracetamol cough syrup from a wellness centre successful southbound Jakarta.

"I gave her medicine each 4 hours, due to the fact that her fever refused to spell down. She would recover, but past person a fever again. In the extremity she stopped urinating," she told the BBC.

Nadira was taken to infirmary but didn't get immoderate better. Laboratory diagnosis showed she had excessive levels of urea and creatine; discarded products that physique up aft kidneys unopen down. She fell into a coma and died.

"At the extremity she passed distant quickly. With symptom that was truly terrifying," said Agustina, crying.

Indonesia is grappling with a horrifying question of deaths: astatine slightest 157 children person died this twelvemonth from acute kidney wounded and different complications, believed to person been caused by contaminated medicines. Almost each were nether the property of five.

Nadira died successful August. In October the Indonesian authorities said she had been among a question of children to dice of unexplained kidney conditions.

The authorities past banned the merchantability of each liquid medicines. It aboriginal constricted the prohibition to astir 100 fishy products - which had been recovered successful the homes of the children who fell sick.

Pharmacies crossed the state person pulled bottles from their shelves, advising parents alternatively to crush pills for their children if they request medicine.

Indonesia's wellness curate Budi Gunadi Sadikin said traces of the harmful substances ethylene glycol, diethylene glycol and ethylene glycol butyl ether had been recovered successful the victims.

Diethylene glycol and ethylene glycol are typically utilized successful antifreeze solutions for air-conditioners, fridges and freezers and arsenic a solvent for galore products including cosmetics astatine precise debased concentrations. The World Health Organization (WHO) says they are ne'er utilized successful medicines.

"It is confirmed that (acute kidney injury) was caused by (those) substances," the curate said.

The cases travel weeks aft the deaths of astir 70 children successful The Gambia. The WHO said it recovered an "unacceptable amount" of diethylene glycol and ethylene glycol successful 4 Indian-made cough syrups disposable successful The Gambia.

There is nary proposition that the 2 scandals are linked. Indian authorities and shaper Maiden Pharmaceuticals accidental the 4 syrups were exported to The Gambia only. Indonesia says the Indian-made syrups aren't disposable locally.

Last Monday Indonesia's nutrient and cause bureau - BPOM - said it would analyse 2 pharmaceutical companies that had precocious changed their suppliers for immoderate of the ingredients from pharma suppliers to chemic suppliers.

"There are indications successful their products... that are highly excessive, highly toxic, and suspected to origin the kidney injury," BPOM main Penny Lukito told a quality conference.

Meanwhile dozens of sick children are being treated for acute kidney wounded and Indonesia has asked Singapore and Australia for supplies of a uncommon antidote - fomepizole - to dainty them.

The calamity has stunned Indonesia. Last week the country's Ombudsman criticised the wellness ministry and BPOM, which it said had not done capable to trial products connected merchantability to guarantee they complied with standards.

In an enraged editorial, the Jakarta Post paper said the BPOM had handed implicit work for investigating to the pharmaceutical companies themselves - a "terrifying" uncovering that showed the authorities had "given up its authority".

"As our hearts are wrenched arsenic parents proceed to suffer the lives of their precious children, we present find gross negligence and a deficiency of supervision by the government," the paper said.

Prof Eric Chan astatine the National University of Singapore told the BBC helium was astonished to perceive that deaths of this benignant were continuing to hap - and described events successful Indonesia arsenic a "human calamity".

Diethylene glycol had been utilized successful the past to marque medicines sensation sweeter - but was present known to beryllium a toxicant, helium said.

When diethylene glycol metabolises successful the assemblage it forms diglycolic acerb that accumulates successful and damages kidney cells - it tin beryllium life-threatening if not treated successful time, helium said. A simplification successful urination is an aboriginal hallmark of kidney poisoning.

Prof Chan said the information that cases had been seen crossed Indonesia suggested a pharmaceutical institution with wide organisation networks was involved. Medical unit successful section hospitals whitethorn not beryllium utilized to handling drug-induced poisoning, helium added, borne retired by the information that galore of the children were taken from infirmary to infirmary for treatment.

"We person to support successful caput the fig of deaths whitethorn inactive spell up," helium warned.

In Bekasi, eastbound of Jakarta, Siti Suhardiyati has forced herself to wide her son's toys from the floor.

Umar Abu Bakar was 2 years aged erstwhile helium died connected 24 September. He was diagnosed with kidney nonaccomplishment too, by the doctors astatine his last infirmary successful Jakarta.

Just 2 weeks anterior helium had travel down with a fever and a cold. He besides had diarrhoea, truthful Siti took him to a section session for treatment.

The household were fixed 3 types of medicine, including paracetamol syrup. Three days aboriginal Umar stopped urinating.

"I usually alteration his diapers successful the greeting arsenic they are full, but this clip determination was nothing," she said.

He was taken to a section infirmary for attraction earlier being rushed to Cipto Mangunjusomo Hospital successful the capital. But it was excessively late.

"How tin determination beryllium worldly that is unsafe successful this cough syrup? If it truly has been BPOM-approved, it should person been tested," Ms Suhardiyati said.

Nadira's parent Ms Maulani is besides seeking answers.

"If this was negligence… we request accountability for the cases that person befallen our children," she said.