Infant Death Toll In Question On China’s Tainted Milk Scandal

Nine-month-old Li Xiaokai died of kidney failure on the old wooden bed in her family’s farmhouse on September 10.

Her grandmother wrapped her in a wool blanket, and her father handed over her body to village men for burial.   At the time, doctors and her family were not sure how she died, but media reports a day later said the type of infant formula Xiaokai had been drinking had been contaminated with the industrial chemical melamine.

However, her death, along with those of at least four other babies, are not included in China’s official death toll from the nation’s worst food safety tragedy in years. Currently, China’s Health Ministry’s death count from the incident stands at only three.

Melamine is a chemical used as a flame retardant and also serves as a binding agent to make cooking utensils and industrial coatings.  The chemical is rich in nitrogen, and has appeal as a low-cost additive to milk and other foods since nitrogen registers as protein on many common tests.

The stories of Xiaokai and other uncounted babies suggest the scandal has created a higher human toll than the government has acknowledged.  And without an official verdict on the deaths, families are concerned they will be unable to file lawsuits and would be refused compensation.

No one as of yet is suggesting large numbers of deaths are being covered up, but so many months passed before the scandal was finally exposed that it’s likely more babies were sickened or killed than official figures indicate.

China’s reluctance to acknowledge a higher toll is supports existing perceptions by some that the authoritarian government cares more about deflecting criticism than assisting families.  Lawyers, doctors and reporters have privately admitted that Chinese authorities pressured them not to highlight the human costs of the scandal or efforts to obtain compensation from the government or Sanlu, the firm that made the formula.

“It’s hard to say how the government will handle this matter,” Zhang Xinkui, a Beijing-based lawyer gathering evidence of the contamination for a possible lawsuit, told the AP.

“There may be many children who perhaps died from drinking Sanlu powdered milk or perhaps from a different cause. But there’s no system in place to find out.”

In the weeks following Xiaokai’s death, her father and his older brother have spoken with lawyers and implored health officials, to no avail.

“My heart is in pain,” her father, Li Xiaoquan, told the AP, as he pulled an old green box that once held apples but is now full of empty pink wrappers of the Sanlu Infant Formula Milk Powder his daughter nursed on.

“We think someone, the company, should compensate us.”

In coal-mining region 450 miles northwest, Tian Xiaowei removes five small photos of a baby boy from a plastic document folder, the only mementos remaining of year-old Tian Jin, who died in August.

“I want these people who poisoned the milk powder to receive the severest punishment under law. I want an explanation and I want consolation for my dead child,” Tian, an apple farmer and part-time truck driver, told the AP.

“I feel like we could die from regret. If we knew that it was contaminated, we would never have fed him that.”

Since the scandal was initially reported in September, Beijing has said that Shijiazhuang Sanlu Group Co. knew as early as last year that its products were contaminated with melamine, and that company and local officials originally tried to conceal the disaster. 

The government has pledged free medical treatment to the 50,000 sickened children, and unspecified compensation to them and the families of babies killed by the formula.

The Health Ministry is managing the government’s response, but declined to answer questions about the compensation and the extent to which it was investigating deaths and illnesses not yet counted by the government.

Though melamine is not thought harmful in very small amounts, higher concentrations produce kidney stones that can block the ducts that carry urine from the body.  In severe cases it can result in kidney failure.

According to the families, medical records or state media accounts, all eight babies who died were diagnosed with kidney failure and reportedly consumed Sanlu infant formula or powdered milk.

The fathers of Li Xiaokai and Tian Jin both have inch-thick bundles of medical reports from their children’s hospital stays. Xiaokai, a twin three minutes older than her sister Xiaoyan, was fed with Sanlu formula while the younger girl nursed on breast milk because their mother did not have enough for both, family members said.

An ultrasound of Xiaokai’s kidneys revealed a stone in each kidney that was roughly the size of a small marble and 2 1/2 times larger than what doctors call a critical threshold.

In September, Tian Xiaowei sent bags of Sanlu infant formula to a government laboratory. An October 8 Xi’an Product Quality Supervision Institute report revealed melamine levels of 1,748 milligrams per kilogram, more than 800 times the government-established limit.

Wang Siyu, the daughter of an accountant and owners or an Internet cafe in Shangqiu, was fed Sanlu products from birth and developed recurring kidney problems in May of last year at age 3, said her mother, Li Songmei.

After twice being hospitalized, she was taken off Sanlu milk and started to recover, but later fell ill again when the family began to give her Sanlu products, Li said. She died of kidney failure at the Zhengzhou Children’s Hospital on May 2 after falling sick and swollen third time, Li said.

“Ever since she was born, she had been using Sanlu milk. Only when she felt sick and couldn’t eat did she stop taking Sanlu,” Li told the AP.

Other among the five include an infant in Xinjiang province whose story was reported on the government Web site, and a 6-month-old boy in Jiangxi province reported by the New Legal Daily.

A reporter who worked on the story would give only his surname, Liu, and said the newspaper was careful not to blame Cai Cong’s death on Sanlu because “the local government has not yet reached a verdict.”

Experts say kidney stones in infants are rare, but doctors in several parts of China began noticing a rise in cases over the past two years. Pediatric urologist Feng Dongchuan tried to warn of the events, posting an item on his Web site in July about a jump in cases at his hospital in the central city of Xuzhou and in neighboring Nanjing city.  Feng said infant formula was the likely cause.

“The chance for infants or small children to come down with kidney stones is very small, and having stones that obstruct both kidneys is even more rare,” Feng said in an e-mail to AP, after having first refused requests for interviews.

Like the others, the Li family became concerned when Xiaokai became fussy in July.  By August, the infant was running a high fever despite higher doses of medicine.  Alarmed after Xiaokai stopped eating and urinating, the family took her to the Runnan county hospital on August 18, where doctors diagnosed her with kidney failure and rushed her by ambulance to Zhengzhou Children’s Hospital.

“They knew right away,” said Li.

Xiaokai was run given multiple tests and put on intravenous solutions to try to shrink the kidney stones.  Unable to afford a hotel, Li and his mother slept on the pavement outside the hospital.  Five days later, the hospital said it could do no more.

“The doctors wouldn’t operate because they said ‘she’s too small,'” said Li. They suggested taking Xiaokai to Shanghai or Beijing.  

The hospital stay in Zhengzhou cost 7,331 yuan, or $1,070, roughly one year’s income for the family, who had already borrowed money to pay for Xiaokai’s healthcare.

So Li brought Xiaokai home to die. They took her to a traditional medicine doctor, who could only confirm the grim prognosis.

“The old doctor told us ‘the child will die in 10 to 18 days,'” Li said.

Early on September 10, Xiaokai’s grandmother called Li into the side room where she and the baby slept.

“Her stomach was puffy and she wasn’t breathing,” he said.

In many parts of north China, the death of a child is considered a bad luck that can bring misfortune on a family and is therefore best concealed.

So Li Haiqin, a cousin, and three other men took Xiaokai to a creek on the far side of the village fields for burial. They put a brick in the blanket with Xiaokai’s body and placed it in a hole under a path between rows of poplar trees. Then they returned home in somber silence.  No close family members were present at the burial, and none were told the location of the grave.

Xiaokai’s family says Beijing had waived traditional inspections of Sanlu because its quality controls were believed to be excellent.
“The government should shoulder its responsibility. This was a national brand, inspection-exempt products,” Xiaokai’s uncle, Li Shenyi, told the AP.

Since Xiaokai’s death, Li Shenyi approached the Runnan county Health Bureau to attribute the death to the tainted formula.

“They said the upper levels (of government) were working on it,” he said.

According to an AP report, county health bureau referred calls to its supervisors in Zhumadian city, who said ultimately Beijing’s decision.

“Right now, the Health Ministry has no clear explanation on how the victim’s families should be compensated,” said Ms. Shang at the Zhumadian Health Bureau’s medical affairs office.

“Nobody knows.”