Mombasa, Kenya - Scholastica Shikanga has been struggling with her eight-year-old grandson's health for years, since he was diagnosed with lead poisoning.
With no job and in poor health herself, the 49-year-old says her grandson's health problems have taken a heavy toll on her.
"I lost my entire livelihood on the health of my grandson. He was hospitalised for two years and doctors kept prescribing medicine after medicine, [but] his condition would not improve," laments Shikanga, who was sacked from a textiles firm after her bosses grew impatient with her continued absence from work as she took care of her grandson.
Her grandson, Kelvin, developed strange symptoms soon after falling into a trench full of dirty water near her grandmother's home.
The skin on Kelvin's foot started peeling. Between 2008 and 2009, Shikanga says, Kelvin, was prescribed a cream to use, but it did not help. His condition worsened.
"There was no change. I was really worried ... In 2010, I decided to take him to another hospital for a full check-up," she says.
"It was one of the most agonising waits. I had to wait for one full week for the medical results. When they results were out, he was diagnosed with lead-poisoning."
Shikanga says the doctors carried out tests for lead levels each year for three years on Kelvin. The last test, done in 2012, showed he had 32 micrograms of lead per decilitre in his blood. The US Center for Disease Control (CDC) considers lead exposure in blood at levels beyond ten micrograms per decilitre to be toxic.
Shikanga's story is representative of a wider public health problem in Mombasa, Kenya's main coastal city. Thousands of people face serious health consequences from exposure to poisonous lead, says the New York-based Human Rights Watch, which published a report on lead poisoning in June.
The poisoning comes from discarded rubber and battery casings, burned paper, and used motor vehicle tyres.
After several years of struggling for her grandson's health, Shikanga now says she cannot afford to pay for further tests and buy medicine for Kelvin.
"Now I do not know if his levels have gone down or up. It is so expensive to do these tests," she says. "Will I feed him or should I keep taking him to hospital? I do not know what will happen to him. I have to wait and see."
Kenyan experts say interventions to reduce the effects of lead poisoning should not only involve medical care but decontamination of houses and villages.
'High levels of lead'
"Both [treatment and decontamination] are needed, because medical treatment alone is ineffective if children return home to contaminated homes and are re-exposed to lead," says a medical doctor who works for a government hospital and could not be identified because he is not authorised to speak to the media.
"Many children over five, as well as adults, who have been tested in the affected areas also have extremely high levels of lead in their blood and may require treatment."
Environmental experts also say curbing lead poisoning requires cleaning polluted villages to ensure children who are already affected can return to their villages for recovery.
But in Kenya, where medical and environmental recommendations are hardly enforced and rules are frequently violated by well-connected manufacturing companies, the problem is likely to persist, says Human Rights Watch.
Lucky to be alive
George Charo Kiti, 29, worked at a battery recycling plant in Mombasa and is lucky to be still alive, something he owes to a friend who advised him to quit his $2,200-a-year job.
"It was a well-paying job ... but the conditions were bad. For 28 days every month, other workers and I used bare hands to handle chemicals."
I lost my entire livelihood on the health of my grandson. He was hospitalised for two years and doctors kept prescribing medicine after medicine, [but] his condition would not improve
Kiti says his Indian colleague at the plant pointed out to him that he was losing weight and did not look healthy.
"I was beginning to feel sick after years working in the plant," he says.
Human Rights Watch says at least three have died as a result of toxic lead from the same battery plant, which shut down after threats of law suits.
Kiti's family has suffered from lead-related deaths. Of the three recent deaths within the poor neighbourhood, one was Kiti's elder brother who worked at a smelting firm.
"We were employed the same time as my brother. After working for four years he started getting sick, complaining of stomach pain," Kiti recalls.
"In March 2010 he left the job, [after] his condition got worse. He started coughing blood three months later and he died, leaving behind two children."
Kiti said the working conditions were bad and they were only given protective gears once a month or when officials from government health bodies were coming to inspect the plant.
David Mahala, who retired from the Kenya Ports Authority (KPA), which manages East Africa's largest port of Mombasa, tells an equally sad story.
Mahala lived just a stone's throw from the hazardous smelter.
"I was forced to move the family and grandchildren away from the slum area for fear they may get infected with the poisonous lead. I was one of the few people to get tested for lead in the area. The result turned positive and the result showed that I had about 30 micrograms in my body," Mahala told Al Jazeera.
"I feel lots of pain in every part of my body, I cannot sleep at night. I have to use sleeping pills to get sleep.
"That shows how the toxicity has hit me. These days I have to walk using a stick. I am very weak and in pain," said Mahala.
Lost eye sight
Cosmos Otieno Oundo is suffering even worse consequences of the lead poisoning. At the advanced age of 80, his health is deteriorating.
"I cannot see clearly, my nose is itchy and I cannot sleep. My back hurts and I have no strength," Oundo said. "I have not received treatment... Medicines are expensive. I do not work, I retired more than 20 years ago I cannot afford the medicine."
Authorities say measures are being instituted to combat the problem and have advised Oundo to either seek treatment or move out of the area.
"Where can I go? This is the place I have known all my life. Let me die here instead of dying somewhere else I do not know."
Phyllis Omido, a former employee at the battery plant, has been forced into the role of local environmental activist.
"I was nursing my baby and he started feeling sick because I was breast feeding him. He was brought to the plant and I would breast feed him. I did not know I was feeding him lead poison," she says.
After years of inactivity, Omido decided to start a campaign involving the residents to push for the closure of the battery plant.
She said the owners tried to bribe her so that she would not tell others the effects their company product had had on the local the population and the environment. The battery recycling plant was opened in 2007.
Residents told Al Jazeera the owners of the smelter fled three months ago as a result of local pressure.
When Al Jazeera visited the former battery recycling plant, the security guards said the company had shut down and the whereabouts of the directors remain a mystery.