The use of asbestos in buildings was banned in the UK in 1999. Originally touted as a useful, effective insulation material, it is now widely known that asbestos can have a very damaging effect on the human body. Particularly dangerous when breathed in, asbestos particles have been shown to cause respiratory infections, mesothelioma, and lung cancer. Despite subsequent efforts to manage asbestos filling in buildings, previous exposure to the substance still kills 4,500 people annually in the UK. Due to the usual long-term delay (from 15 – 60 years) of the development of symptoms following asbestos exposure, this remains a widespread health concern across the world. As of 2019, 66 countries globally have banned its use, and yet the WHO estimates 125 million people a year are still exposed to its effects.
And on a global level, we are not just dealing with pre-existing asbestos already in buildings. Countries such as Russia and Kazakhstan continue to export asbestos worldwide, mainly to developing countries engaging in large scale building projects. Notable consumers and users of asbestos include China, India, Thailand, and Indonesia.
Of particular importance is the widespread use of asbestos in Indonesia. This is because Indonesia is one of the most disaster-prone countries in the world, with an average of nearly 400 significant disasters befalling the country annually since 1990. The Indonesian government spends an average of $300 - $500 million a year on post-disaster reconstruction and recovery, following earthquakes, cyclones, flood events, volcanic eruptions, landslides, and tsunamis. That’s a lot of reconstruction. And that’s a lot of asbestos usage.
As the practice of asbestos management in the UK demonstrates, for the most-part, if asbestos is securely contained within the shell of a building, it is relatively safe. But if it starts to break down, for example when a building is demolished, then asbestos particles become very dangerous indeed. Therefore, the removal of asbestos is a highly specialised job that is tightly regulated. This is all well and good in a routine demolition project, as risks can be managed and precautions taken. However, when a building fitted with asbestos collapses due to a disaster, or when damaged buildings are bulldozed to make way for quick redevelopment of post-disaster shelter, as happened in Indonesia following the Sulawesi earthquake and tsunami in 2018, asbestos particles are released and contaminate the surrounding earth, air, and lungs of those sifting through the wreckage.
This poses a dual problem for humanitarian organisations responding to the disaster. Firstly, it directly impacts the capacity of humanitarian actors to respond. As mentioned, regulations for the handling and removal of asbestos are extensive, and many humanitarian organisations lack the personnel capable of undertaking these procedures. Even if they had such personnel, most of the asbestos guidance assumes that the material is still in the building, not seeping into the ground, water supply, and contaminating the air around the disaster area. As a result, many of the first-responders found themselves in a dangerous position in the immediate aftermath of the tsunami. Unprepared, and without appropriate hazmat clothing, many were concerned that they had been exposed to the deadly particles. As agencies became aware of this concern, it was clear that certain international humanitarian personnel were to be prevented from travelling to the affected area. Most humanitarian insurance policies, which can support staff in the cases of kidnap or attack, simply refuse to cover the risk of asbestos exposure. Such a lack of coverage raised serious concerns around the capacity of response operations to continue in Sulawesi and poses serious challenges to the continued presence of humanitarian responders in disaster areas where asbestos is present.
The second, and far more impactful, issue, is that of the threat to the affected population themselves. Globally, the estimated annual death rate due to asbestos exposure is around 200,000. In Indonesia, the impacts of exposure are still poorly understood, and many communities are at high risk of developing health complications as a result of the continued use of asbestos in pre- and post-disaster construction. Whilst local NGOs are working with communities to raise awareness of the issue, and in some cases win compensation for the dangerous practices of the government, there are still a significant number of people living in toxic buildings.
There is considerable debate in humanitarian circles around how best to quantify deaths as a result of disasters. For example, following the devastating 2010 earthquake in Haiti, the resulting displacement and lack of clean water supplies brought about largely by the destruction of infrastructure across the country led to the first cholera outbreak on the island in over a century. Should the 8,183 confirmed deaths from this outbreak be included in the death statistics for the earthquake itself? In the US, many of the first responders that were on the scene of the collapse of the Twin Towers on September 11th 2001 have since fallen ill or died as a result of what is referred to as World Trade Center illness (likely also mostly as a result of asbestos exposure). Are they further victims of the Al Qaeda attackers? And how many people in Indonesia and across the world that have been inadvertently exposed to asbestos poisoning as buildings collapse in disaster situations, who either have or will in the future develop severe respiratory problems, can claim they were victims of a natural event that occurred decades previously?
We know the risks of asbestos. In the West, its maintenance and removal has become a routine, if still difficult and relatively dangerous, activity. But as the global humanitarian system wrestles with the complicated and incredibly high-stakes challenge it poses, we must focus our attention on the affected communities and individuals now rebuilding their lives in a toxic environment. A session at this year’s Humanitarian Networks and Partnerships Week was dedicated to discussing the challenge of asbestos in humanitarian action, and this should be the start of a real investigation into the solutions to a global challenge.
Until an answer is reached, we must do our best to educate ourselves and others about the dangers of asbestos exposure around the world. And we must do what we can to support those victims of disasters or conflict, now striving to rebuild their lives on top of poisoned ground.
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