When 17-month-old Nadira fell sick with a cough and flu, her mother Agustina Maulani bought her some paracetamol cough syrup from a health centre in south Jakarta. I gave her medicine every four hours, because her fever refused to go down. She would recover, but then have a fever again. In the end she stopped urinating, she told. Nadira was taken to hospital but didnt get any better. Laboratory diagnosis showed she had excessive levels of urea and creatine; waste products that build up after kidneys shut down. She fell into a coma and died.  At the end she passed away quickly. With pain that was really terrifying, said Agustina, crying. Indonesia is grappling with a horrifying wave of deaths: at least 157 children have died this year from acute kidney injury and other complications, believed to have been caused by contaminated medicines. Almost all were under the age of five. Nadira died in August.

In October the Indonesian authorities said she had been among a wave of children to die of unexplained kidney conditions. The government then banned the sale of all liquid medicines. It later limited the ban to about 100 suspect products - which had been found in the homes of the children who fell sick. Pharmacies across the country have pulled bottles from their shelves, advising parents instead to crush pills for their children if they need medicine. Indonesia health minister Budi Gunadi Sadikin said traces of the harmful substances ethylene glycol, diethylene glycol and ethylene glycol butyl ether had been found in the victims. Diethylene glycol and ethylene glycol are typically used in antifreeze solutions for air-conditioners, fridges and freezers and as a solvent for many products including cosmetics at very low concentrations.

The World Health Organization (WHO) says they are never used in medicines. The cases come weeks after the deaths of nearly 70 children in The Gambia. The WHO said it found an unacceptable amount of diethylene glycol and ethylene glycol in four Indian-made cough syrups available in The Gambia. There is no suggestion that the two scandals are linked. Indian authorities and manufacturer Maiden Pharmaceuticals say the four syrups were exported to The Gambia only. Indonesia says the Indian-made syrups aren t available locally.

Credit: Independent News Pakistan-INP