It's quite complicated to be someone who loves order and cleanliness and live in a place where it’s completely normal to find garbage everywhere.

Often in such situations, you suffer, because you wish everything looked like it does back home, in a village or city in the Global North, when in reality, you're living in any of the so-called Third World countries. In my case, it was first in Peru 25 years ago, and now in Mozambique.

You leave your house, and wherever you look, there’s trash. It might be scattered—a bag here, a disposable diaper there, or a sandal a little further away—or it might be small piles in every corner, clogging up riverbeds or forming actual mountains. Trash reigns supreme.

The easiest and also the simplest (in the worst sense of the word) thing to do would be to think that this happens because people in impoverished countries haven’t yet developed an ecological awareness that would lead them to value, care for, and maintain clean ecosystems and habitats.

But it’s not that simple: economic development and current consumption patterns are global and take place in much the same way in Berlin and Maputo, albeit with different resources to handle the consequences.

The way we live everywhere has caused a dramatic and drastic increase in waste, and the worst part is that a large portion of this waste is plastic. It’s estimated that 60% of solid urban waste is plastic.

This greatly complicates the situation. So much so that people now speak of a plastic pandemic, and the United Nations has declared it a planetary crisis. In fact, by 2050, it’s expected that plastic waste in the oceans will outweigh the fish [1].

When you're someone who loves order and cleanliness and you begin to see the consequences of living surrounded by garbage in your immediate environment, you don’t just suffer—you start to worry deeply. Due to my professional background,

I’ve had the opportunity to work on social projects in Global South countries in the health sector, and I’ve seen firsthand what garbage does to people’s health, especially the youngest and poorest children [2].

At first, I couldn’t understand the severity of the medical conditions in these children, until local colleagues explained it in a wonderfully simple way: if you live in garbage, eat garbage, and breathe garbage, the garbage ends up coming out of your pores.

But this isn’t about living in garbage, breathing garbage, and eating garbage intentionally or because there are no other options—it’s about the fact that waste, especially plastic waste, is in our water, our air, our soil, and our homes.

Plastic, once considered a miraculous product in the 20th century, has become the curse of the 21st. We can’t imagine daily life without it; it’s essential to modern civilization. In 2023 alone, 300.4 million metric tons of plastic were produced worldwide.

It makes life easier and offers many apparent benefits, but we use it without understanding its toxic effects on our health, on other organisms, and on the environment [3].

I began to see these effects in the children of Villa el Salvador. Plastic products can be both physically and chemically toxic. Once in the environment, plastic breaks down due to sunlight, water, wind, or biological processes involving bacteria, enzymes, or even insects and rodents.

This decomposition creates smaller fragments called microplastics (MP) and nanoplastics (NP), which are physically toxic. It also releases many of the over 40,000 chemical substances in plastic that are responsible for its chemical toxicity: neurotoxicity, endocrine disruption, heart damage, increased cancer risk, immune system impairment, male infertility, allergies, and more [4].

Physical toxicity occurs through the accumulation of microplastics in our bodies: we inhale them, ingest them, and absorb them through our skin. The smaller the particles, the more they accumulate and penetrate biological barriers, reaching tissues and spreading systemically.

MPs have been found in the colon, placenta, and human blood, indicating their ability to travel throughout the body and disrupt organ function. Once there, the chemicals in plastic exert their toxicity [5][6].

When you're someone who loves order and cleanliness and you start to see how living surrounded by trash affects the smallest children, you not only suffer, you start to investigate.

And what you discover, far from easing your concern, is deeply unsettling: the toxicity of plastic—both physical and chemical—affects us throughout life, at every stage of plastic’s lifecycle and the human lifecycle [7].

Plastic’s life stages are: 1) extraction and transport, 2) refining and manufacturing, 3) consumer use and packaging, and 4) waste management. Unfortunately, each of these stages negatively impacts human health [8].

99% of plastics come from fossil fuels. The hydraulic fracturing used to extract their raw materials involves over 170 substances known to directly harm the skin, eyes, liver, brain, and respiratory, nervous, and digestive systems.

When fossil fuels are transformed into plastic resins and additives, carcinogens and other highly toxic substances are released into the air, continuing to harm our bodies: nervous system damage, reproductive and developmental issues, cancer, leukemia, and more.

These substances also contaminate water, air, and soil, affecting all life forms that come into contact with them.

Once manufactured, plastics are used in countless ways, many related to food. Research has focused particularly on NP particles transferred from packaging to food.

A deeply concerning example is baby bottles and plastic food containers, especially when used with hot liquids or food, as large amounts of plastic particles are released—and ingested—along with their hundreds of toxic substances.

Once used, particularly single-use plastics, they become waste. All waste management technologies, including incineration, release toxic substances like lead, mercury, dioxins, furans, acid gases, and others into the air, water, and soil.

People living nearby drink contaminated water and irrigate crops with it, leading these toxins into the body where they accumulate and exert their chemical toxicity.

In most cases, less than 15% of plastic waste is recycled or incinerated. Sadly, 80% ends up in landfills or natural habitats.

We are all exposed—no one is exempt. This is a global tragedy we’ve collectively agreed to create without much questioning. But exposure is not equal. People working in plastic production or waste management, and those living near these facilities, are more vulnerable. Another high-risk group is children, especially the youngest.

Pregnancy and early childhood are periods of heightened vulnerability to environmental toxins. Early exposure to dangerous chemicals can affect health not only in early childhood but for life. “Early exposure” includes the first 1,000 days of life. NP and MP have already been found in human placentas, newborn meconium, and breast milk [5][9].

Young children also crawl, drag themselves on the floor, put everything in their mouths, and suck their fingers. These habits expose them to the environment in different ways than adults.

They also eat, drink, and breathe more per unit of body weight, meaning environmental contaminants affect them disproportionately. Cox et al. estimated that in the U.S., girls consume 203 plastic particles daily and boys 223, depending on their diet—especially seafood, honey, salt, and bottled water [10].

All this exposure occurs while their organs are still developing. Their neurological and immune systems are maturing even as these toxins enter their bodies. Many of these substances act as epigenetic factors. Zaheer et al. showed in 2022 the link between prenatal/postnatal exposure to NP and MP and autism spectrum disorder [9].

We're all exposed to pollution, but children suffer the most—even though they have a recognized right to a healthy environment. Governments are responsible for ensuring this through policies that prevent and reduce exposure to toxic substances or harmful environmental conditions.

These policies vary widely across countries. And although all children are impacted by pollution and trash, the poorest children are hit the hardest.

Why do Milagrosa, Gercio, Anercia, or Jacira have such extreme dermatological conditions? Is it simply due to neglect or ignorance from their caregivers, or are there heavier reasons hidden behind it?

Africa in general is often considered to be one of the major contributors to plastic pollution in marine systems. Egypt, Algeria, Nigeria, and South Africa are among the top 15 countries (out of 192) for oceanic plastic waste from rivers.

But this waste is not produced in Africa—it comes from China, Europe, and the U.S. Some African countries have enacted laws to tackle the problem, such as banning plastic bag imports or banning single-use plastics (as 34 African countries have).

Yet, over 90% of plastic waste still ends up in landfills or is openly burned, releasing toxic gases. Children like Milagrosa, Gercio, Anercia, and Jacira are not only affected by local pollution but also by global marine and atmospheric pollution caused by NP and MP [7].

Poorer countries like Mozambique face the worst pollution. Everything that bothers us or harms our health in Europe or the U.S.—like hazardous waste from electronics—we pack into containers and ship to impoverished countries, so it doesn’t poison us [5].

I don’t know the best solution to this problem—one that we all cause and suffer from, especially (I repeat) the youngest and poorest children in the Global South. But as a practical woman, I can suggest a few possible steps—thinking out loud:

1. Eliminate plastic from our lives as much as possible, especially single-use plastics, which are both useless and harmful.

2. Learn to live with less, and make that "less" last as long as possible.

3. Demand the end of planned obsolescence.

4. Ensure that children enjoy the highest attainable standard of health through state measures that prevent and reduce exposure to harmful substances or conditions.

I believe we need to relentlessly ask ourselves what’s happening to us as humanity that allows us to turn our planet—our home—into a giant garbage dump and remain indifferent.

What is happening that we consciously harm our own health and remain still? What’s going on that we put the present and future of the most vulnerable at risk and stay mere passive observers?

I believe it will be them—Milagrosa, Gercio, Anercia, Jacira, and many others—who will one day ask us, bewildered and hurt, why we did nothing when we still had time.

Ana María Leyda Menéndez is a pediatric dentist and a member of the Creation Care Task Force of the Lausanne Movement in Spain. This article is part of a series of the Spanish Evangelical Alliance called 'Imagina'.

Notes

Bibliographic references

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2. Maquart PO, Froehlich Y, Boyer S. Plastic Pollution and infectious diseases. Lancet Planet Health. 2022;6:e842-45.

3. Prakash S. Impact of plastic pollution on environment and human health. IRE Journals. 2017;1(5):53-9.

4. Winiarska E, Jutel M, Zemelka-Wiacek M. The potential impact of nano and microplastics on human health: understanding human health risks. Environmental Research. 2024.

5. Sripada K, Wierzbicha A, Abass K, Grimalt JO, Erbe A, Pál-Weihe HB et al. A children’s health perspective on nano and microplastics. Environmental Health Perspectives. 2022;130(1):015001.

6. Xu JL, Lin X, Wang JJ, Gowen AA. A review of potential human health impacts of micro and nanoplastics exposure. Science of The Total Environment. 2022;10:851(pt1):158111.

7. Adenian AA, Ayesu-Koranteng E, Shakantu W. A review of the literature on the environmental and health impact of plastic waste pollutants in sub-Saharan Africa. Pollutants. 2022;2:531-45.

8. El plástico y la salud. Los costos ocultos de un planeta plástico..

9. Zaheer J, Kim H, Ko IO, Jo EK, Choi EJ, Lee HJ et al. Pre/post-natal exposure to microplastic as a potential risk factor for autism spectrum disorder. Environ Int. 2022;161.

10. Cox KD, Covernton GA, Davies HL, Dower JF, Juanes F, Dudas SE. Human consumption of microplastics. Environ Sci Technol. 2019;53(12):7068–7074