How Gambian children died from toxic cough syrup
STORY: Ebrima Saidy's three-year-old daughter Adama had a fever in September 2022.
Saidy bought some paracetamol syrup from a local pharmacy in Gambia, hoping it would help bring his daughter's temperature down.
But instead, Adama's fever spiked after taking the syrup.
Nine days later, she died in the hospital.
"When she passed away, I had to go hold her, kiss her forehead, crying bitterly. The doctor said to me, consoling me, 'She is gone, she is gone, so you just have to take heart.' It wasn't easy for me. It wasn't an easy moment."
It was around the time of Adama's death that Gambia's medicines regulator sent a statement to pharmacies suspending syrup sales following a series of suspicious deaths.
One month later, the deaths of more than 70 Gambian children from Acute Kidney Injury or AKI were linked by global health officials to cough syrups made in India.
The syrups were contaminated with ethylene glycol or EG, and diethylene glycol or DEG.
DEG is used in vehicle brake fluid and radiators.
The patients were among 300 children killed worldwide last year by contaminated cough syrups - not all of them made in India.
It was the deadliest total poisoning on record from toxins that were known to scientists for decades.
The World Health Organization sounded the alarm over the safety of cough syrups globally in January 2023.
Tests showed the medicine sold in the Gambia contained extremely dangerous levels of the toxins.
Reuters found some had been sold in bottles wrongly labelled as WHO-approved.
Cherno Jallow, a pediatric surgeon at the Banjul Teaching Hospital in Gambia's capital, said his staff had been traumatized by the sheer volume of fatalities.
"Practicing here as the only pediatric surgeon, I have never seen anything like this. We've been having mortalities, but not this number. This is the first time we have seen anything like this."
The Indian factory that made the drugs was closed down by authorities in October 2022.
Government inspectors found Maiden Pharmaceuticals Ltd had violated rules "across its manufacturing and testing activities" but later said that they did their own tests and found no toxins in the syrups.
India’s health ministry said no direct link had been established between the syrups the children took and their deaths.
Maiden Managing Director Naresh Kumar Goyal told Reuters he had "not done anything wrong" and did not respond to further questions.
Gambia, one of Africa's smallest and poorest countries, has no pharma industry, no means of testing imported drugs...
...and just over two dozen pharmacists registered for 2.5 million people.
Yet even as doctors' evidence mounted, Gambian government officials said they wanted more proof.
For two months, the government did not mention the risk of the syrups in public statements.
Medical workers said lives could have been saved had authorities acted quicker.
Health Minister Ahmadou Lamin Samateh did not respond to that point, but told Reuters in November he acted fast when he became aware that drugs were the most likely cause.
But it was too late for many.
Ebrima Sagnia lost his son after taking syrup to treat his fever.
Sagnia now speaks for a coalition of parents calling for systemic reforms.
He and other parents said the government initially offered them $200 each.
But they rejected the sum.
Their main goal is to ensure this never happens again.
"We are already working on it, to get lawyers, of course good Gambians, to stand with us, to fight with us, to claim justice for the kids. Because we have already lost, but we do not want it to happen again."