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No coming back from gramoxone

Monday, April 9, 2018

As a medical doctor over the many years, I have served many patients who were exposed to paraquat, a commonly used pesticide in T&T. The general public usually recognises this compound as “gramoxone”. This is a very dangerous weedicide which is used copiously in the agricultural sector. Sadly, of my many patients with paraquat poisoning, very few have survived. I strongly believe that stronger regulation of the access, use, education and consideration of a ban of this substance will reduce number of heartbreaking cases I have encountered over the years.

Paraquat, when it enters the human body though ingestion (most commonly in attempted suicide), skin exposure or via inhalation, leads to the development of intracellular oxidative stress which leads to end organ failure most commonly seen in the kidneys, liver and lung. There is no medical antidote. And while multiple drugs and supportive measures have been tried in the past, the outcomes remain grim.

A 1997 study by Dr Daisley and Dr Simmons on forensic analysis of acute poisonings in South Trinidad showed that of 105 deaths analysed, almost 95 per cent were cases of suicide, and almost 80 per cent of deaths was due to Paraquat.

Indeed, the problem is a grim one, but an analysis of international literature, especially a study in South Korea, showed that the introduction of national policy regulating and banning Paraquat lead to significant decreases in pesticide associated mortality. Many countries throughout the world has this pesticide under tight regulation, including the United Kingdom and European nations, but getting a bottle of this poison is as easy as buying a soft drink in T&T.

According to the World Health Organization (WHO), suicide remains a critical health issue, with over 800,000 deaths per year, and many more attempts that fortunately do not meet demise. It is an unspoken epidemic in Trinidad. A recent Joint Select Committee was told that more than 400 students were on suicide watch in Trinidad and social support remain limited, not withstanding the excellent work of NGOs like Lifeline.

Most people who attempt suicide do so impulsively and do not really have an intention to kill themselves, but the act in itself becomes a cry for help. My interactions with my patients over the years have taught me that most people attempting suicides express great remorse after the act, and anticipate looking forward to a changed life full of positivity. It therefore breaks my heart to face such persons, especially those using Paraquat in the attempt, when they look to me for hope, but I have none to offer because I witness their slow and painful demise not amenable to medical therapy. It is even more difficult to bear when the exposure to this deadly compound is accidental.

I know our small nation is riddled with many problems that will get more limelight than this one. However, I am speaking for those whose voices are seldom heard, and who are grasping for straws of hope while drowning in an ocean of depression and despair. I pray that this call will reach some influential person in authority who will see it worthy of attention.

Sangre Grande


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