On July 25, 2020, the Japanese ship MV Wakashio ran aground on a coral reef in Mauritius. Several days later, the ship began spilling its contents—4000 tonnes of fuel oil—and an environmental emergency was declared.
For the small island nation, known for its pristine beaches and biodiversity, the disaster is unprecedented. Thousands of volunteers, residents, and local civil society organisations, often with inadequate protective equipment, mobilised to limit the environmental damage by crafting makeshift straw-filled booms to absorb the oil, but the potential effects on health are being overlooked. Suzy Edouard, who coordinated one of the clean-up operations, described the frenetic activity:
There's so much work to be done on the ground that no one is focusing on health.
Saleem Peerally and his team at Diagnos Clinique offered free consultations to those involved in the clean-up as well as others who were affected. He reported seeing patients with a range of acute symptoms thought to be associated with exposure to oil. “People complained of difficulty breathing and burning eyes from the fumes…while others had neurological effects like dizziness and nausea.” Carina Gounden was involved in the clean-up and described her symptoms:
I was in a state of confusion, unable to focus, finding it difficult to breath. I was not the only one.
She said that one local fisherman she worked with needed to be rushed to hospital with respiratory distress.
“There are other volunteers who have been there every day though and we don't know the long-term health effects”, said Gounden. Depending on the oil's composition, these effects could include carcinogenic effects, renal and liver impairment, or long-term respiratory conditions, with exposure occurring through three potential routes: dermally, through the air, and in the food chain.
The oil spill could also have detrimental effects on the mental health of residents who have lost their livelihoods and seen the environmental damage, as well as on responders. “The mental health effects on responders doing the clean-up, fisherman, and local residents nearby will vary depending on their relationship to their environment, how close they are to the oil spill, and if their work depends on the lagoon”, explains Astrid Koenig, one of the few clinical psychologists in Mauritius. She said symptoms could range “from uncomfortable emotions such as anger, sadness, anxiety, guilt, to post-traumatic disorder”. A study of the 2010 Deepwater Horizon oil spill found that depression was more common among people who were part of the response compared with those who were not.
The Government of Mauritius has denied that the observed symptoms are a direct result of the spill and has been criticised by health experts for its response. The Minister of Health, Kailesh Jagutpal, argued that the symptoms shown by locals were general and “not directly related to the heavy oil spilled”. Jagutpal also said that studies done in southeast of the island, near the spill, showed that “no toxic product was detected”. “There has been lots of criticism [of the government] about the delay in response to the disaster as a whole”, says Harry Phoolchund, a Mauritian physician.
Although Mauritius has free health care in government facilities, as well as a burgeoning private sector, the focus is on providing curative services rather than long-term prevention and public health. There is a paucity of mental health services. Koenig said that only eight clinical psychologists work in the public health system for a population of more than 1 million, with “no support system set up for those affected”. There are also taboos around mental health. Those most affected by the oil spill are likely to be from marginalised populations and might not be aware of the mental health services available or how to access them.
“Is there going to be any monitoring of the local population?” asks Phoolchund. To his knowledge, there is no health screening, surveillance, or monitoring. He recommends that a database be compiled of all those involved in the clean-up and of all local residents.
Aside from mental health, Deoraj Caussy, a Mauritian epidemiologist, questions whether the health system is equipped for dealing with the impact of the spill. “Are the health centres equipped for the diagnostic capacity? Is there intersectoral collaboration?” He called for an immediate assessment of the health impact.