We got a few more details about the program the Arkansas Department of Health will begin offering on Tuesday to Mayflower residents who say the March oil spill there made them sick.
ADH spokesman Ed Barham said people will visit with a nurse who will assess their health with a questionnaire the department developed by looking at similar surveys used around the recent oil spill disasters in Michigan’s Kalamazoo River and the Gulf of Mexico. Dr. William Mason, who headed ADH’s role in the Mayflower spill response, and other physicians will evaluate those questionnaire results and make referrals accordingly, to UAMS doctors who specialize in inhalation injuries and toxic exposure. ADH will pay for the evaluations and making referrals through its general operating budget.
“We’ve been talking about how to do this and how to answer these questions for a while,” Barham said. “This is definitely something the governor wants to have done.”
Barham called the ADH plan “a phased process,” leaving the door open for a more comprehensive response from the department. Asked whether that could lead to a community-wide health assessment of the sort advocated by Emily Harris of the Faulkner County Citizens Advisory Group, Barham said: “We don’t have a plan to do that right now. It may be that this would help lead us to decisions of that kind.”
Harris’s first impression of the ADH plan was that it amounted to too little too late. We asked her to send some thoughts after she had time to gather some facts, and here’s what she replied, via email.
FCCAG supports the efforts of the ADH to provide access to health care for effected Mayflower community residents. However, the group holds numerous concerns about this proposal for several reasons. One must wonder why these services are only being offered now 5 months post rupture in response to pressure from the community? Why were they not available immediately? What precisely the services will consist of is also in question.
Many community members have reported primary care physicians already diagnosing them with seasonal allergies, generic flu-like symptoms or simple and unrelated worsening of previously present chronic diseases with no connection to exposure to hazardous materials. The “medical specialists” referred to in the press release are not identified as having any expertise in the area of exposure to the dilbit (a toxic cocktail flowing through the pipeline) or any of the chemical mixtures utilized during the cleanup process. It is unclear why community members must be subjected to a “screening” and then ONLY if they pass the “test” have access through a video screen to a health care provider. Do these folks not deserve an actual physical exam? Why make them drive to Conway to talk to a “specialist” from Little Rock via the internet? How will the results of these assessments be analyzed and reported? How will those with continuing health issues have those concerns addressed and become eligible for compensation by the responsible party?
Potentially the most important concern is that individualized and private consultations will only be for those not already receiving appropriate health care and do not in fact reveal the true extent of the damage to the community. The offer as stated excludes those who are already receiving care, those that are not residents that may have been exposed from working in the area or those exposed from offsite holding of oiled materials and does not address symptoms that may have begun prior to the actual rupture. There is evidence to suggest that the pipeline may have been leaking for some time prior to rupture. As you can clearly see, health issues of concern relate to a much larger population than just the Mayflower residents that are willing to jump through the hoops of this proposal without any promise of hope for relief.
Early on in FCCAG efforts to advocate for the Mayflower community Dr. Mason stated the ADH would be following the Agency for Toxic Substances & Disease Registry guidance that may located here: Public Health Assessment Guidance Manual (2005 Update). Chapter 2 section1.1 reads as follows:
“A public health assessment is formally defined as:
The evaluation of data and information on the release of hazardous substances into the environment in order to assess any [past], current, or future impact on public health, develop health advisories or other recommendations, and identify studies or actions needed to evaluate and mitigate or prevent human health effects (42 Code of Federal Regulations, Part 90, published in 55 Federal Register 5136, February 13, 1990).”
Additionally the entire Chapter 4 of the document is devoted to “Involving and Communicating with the Community:
“The community associated with a site is both an important resource for and a key audience in the public health assessment process. Community members can often provide information that will contribute to the quality of your scientific assessment.”
FCCAG in support of the Mayflower community have facilitated four public meetings that the ADH and other regulatory agencies basically have ignored. The Arkansas Department of Environmental Quality did send a representative to the meeting in May to speak of environmental aspects, but as of yet ADH has failed to provide the community with linguistically and culturally appropriate information about potential human health issues. Public notifications have consistently proclaimed air and water quality levels in the community are “fine” and there is no cause for concern.
A necessary element of trust is missing in the relationship with the community and state regulatory agencies. The community was not involved with the development of this plan as offered now, as they have never been allowed to participate in previous decision-making activities concerning community health. This arrangement as offered places a burden on community members who have already waited much too long for their pleas for help to be heard. Individuals must be notified, feel confident in the ADH ability to assist them, miss school or work, travel the distance to Conway and be evaluated by a nurse to determine if they deserve further follow up via a video camera. There is no mention of an option for a second medical opinion or an appeal process to the nurse’s determination.
If you close your eyes, Exxon’s statement that all visible oil has been removed from the community becomes accurate. This may be an attempt for the ADH to make the same sort statement with a report in six months claiming all assessed individuals were found to be healthy.
Emily L. Harris, MPH
Executive Board Member, Faulkner County Citizens Advisory Group