The Daily Telegraph - Saturday - The Telegraph Magazine
Horror in paradise
Photographs by Nadia Shira Cohen
For years the Mafa has been illegally disposing of industrial waste in southern Italy, leading to a terrible increase in cancers among local people, including babies. Ian Birrell investigates a cover up
Afew days before I visited the rather scrufy Hospital of Saint Anna and Saint Sebastian in Caserta, southern Italy, a boy aged 11 ar r ived compla i ni ng of he ad ache s . Doc tor s feared the worst – and sure enough, he was rapidly diagnosed as another child with brain cancer. Some of these young patients arrive in agonising pain, others mystifed by falling over all the time; they do not know that lethal tumours are swelling up inside their heads. Yet more turn up with cancer in their blood, their bones, their bladders. There are so many cases that not all can be treated in the hospitals of Campania, a largely rural region.
In a town where doctors would rarely come across a child with cancer, let alone brain cancer, they now see these traumatic cases crop up almost every month. Too many young patients are ending up dead, some barely out of the womb, their bodies riddled with disease. Then there are women getting breast cancer unusually early, men who have developed lung ca ncer despite never hav ing smoked, and children born with Down’s Syndrome to comparatively young mothers.
So why is this happening in an area north of Naples, now known as the ‘Triangle of Death’? The answer, locals believe, can almost certainly be found in places such as an old quarry by the historic town of Maddaloni, which I visited with an energetic 57-year-old youth worker named Enzo Tosti. As we drove there, he told me he is having treatment to counter high levels of dioxins (highly toxic environmental pollutants) found in his blood fve months earlier. ‘My wife works for the hospital as a radiologist and she is very concerned,’ he said. ‘I thought about leaving and going to live somewhere else but where would I go? This is my land.’
It was a glorious evening after a rain-sodden day, golden sun dipping through lavenderstreaked skies as we turned of the main road and passed an orange grove, then felds full of fedgling bean plants. It was easy to understand his attachment to this striking area of Italy, some of the most fertile land in Europe thanks to the eruptions of Vesuvius to the south. But for all t he natural beauty, t he scenes confronting me could not have been more depressing.
As we cla mbered f rom t he ca r, Tost i clamped his hand over his mouth and told me to hurry. Rubbish lay everywhere, with plastic sacks, paint containers and glass bottles littering the g round. I stumbled over the undulating, pockmarked land, struggling to keep up with my guide. Descending a dip we were struck by the acrid stench of chemicals and saw a small plume of smoke seeping from the ear th. Tosti explained that the Mafia dumped huge quantities of contaminated industrial waste there, then obtained backdated permission for their actions. These hazardous mater ia ls were lef t on pr ime
agricultural land, next to a car dealership, with bingo halls and furniture stores nearby, and just a few hundreds yards from a town of 39,000 people. A criminal investigation was launched 18 months ago, but local people do not expect convictions.
This was far from an isolated incident. There are thousands of similar dumps all over this once-paradisiacal slice of Italy: in canals and caves, in quarries and wells, under felds and hills, beneath roads and properties. For many years businesses in the prosperous north of the country paid organised crime to dispose of tox ic waste illegally rather than pay far higher rates to have it dealt with safely. So the Camorra Mafa contaminated great chunks of its own backyard, littering the landscape with heavy metals, solvents and chlorinated compounds. Bar rels were bur ied, cont a iners driven into rivers, hazardous materials mixed in with household rubbish, chemical sludge spread on felds as ‘fertiliser’, asbestos burnt in open air. And only now is the tragic legacy of the Mafa’s idiocy fnally becoming clear.
But it is not just the Mafa. The story of this illegal waste disposal stains Italy. It reveals the dark side of capitalism, with allegations of state complicity, cover-ups by police, politicians and prosecutors. One Mafa kingpin even claimed trucks drove from Germany carrying nuclear waste to dumps in Campania. Doctors and scientists believe this polluted Italian landscape provides a perfect experiment in ‘exposomics’ – the evolving study of health damage caused by exposure to harmful chemicals in environmental contamination.
The saga’s roots can be traced back to a devastating Italian ear thquake that lef t almost 3,000 people dead and 280,000 homeless in November 1980. Billions of pounds in aid poured in, although most ended up in the wrong pockets. Rebuilding the ruined roads and buildings boosted Mafa profts, since they dominated construction in the region – a handy way to launder profts from drugs and prostitution. As cash fowed in, the clans expanded interests into areas such as quarrying, which provided raw materials for their work. Then an enterprising businessman with gangland links who owned several waste dumps realised big money could be made hiding industrial waste amid domestic detritus. So in the late 1980s, the Mafa moved into a lucrative new business.
Soon farmers began to notice that the new liquid fer tiliser they had been given was so strong that it corroded metal tanks, leaked from lorries and stunted plants. One day a forestry ofcial in Brescia gave a young journalist named Enrico Fontana a vial of this fertiliser; the reporter recoiled at the bitter stench since it contained cyanide. So in 1990 he published two exposés in L’Espresso, a prominent news weekly, disclosing that organised crime was dumping dangerous materials on felds and in landfll sites.
Evidence to support his claims slowly began to mount. A Mafa supergrass called Nunzio Perrella told investigators in Naples about the new trade, leading to scores of arrests of gangsters and corrupt ofcials in March 1993. They were soon free, however. The following year Fontana – now working for Legambiente, an environmental g roup – published a repor t called Garbage Inc, revealing the same people trafcking illegal waste in other parts of Italy. There was a public outcr y, a parliamentar y commission, and polluted parts of Campania
were declared an off icially deg raded zone.
‘We thought we had a result. Our job was done,’ Fontana told me as we sat drinking coffee outside Legambiente’s Rome headquarters. ‘But then nothing happened. Nothing. What was missing was that we did not put together legal dumping with illegal dumping. And while it was obvious this was bad for the land, we did not notice any health outcomes at that stage since they are not obvious immediately.’
Fontana coined the phrase ‘eco-mafa’ and began issuing annual reports into their actions. He was unaware of two other important developments. First, a police ofcer in Campania named Rober to Mancini stumbled on the Mafa’s new activities, discovering they were hiding tox ic waste from businesses in the industrial north among local household waste poured into landfll sites in the south. He wrote a memo for his superiors detailing his fndings. But the report was buried and Mancini later transferred to Rome. With cruel irony, Mancini died two years ago from cancer.
Then came the case of Carmine Schiavone, one of the most important superg rasses in Italian histor y. As a leader of the notorious Casalesi clan in Naples, he confessed to losing count of the number of people killed on his orders. His explosive test imonies revealed widespread bribery of politicians and eventually put 16 crime bosses behind bars for life after trials that dragged on for years and left fve witnesses dead. Schiavone claimed to have broken the Mafa code of silence out of fears for the environment. His disclosures were given in private to a 1997 parliamentary committee in Rome about toxic waste dumping – then, astonishingly, kept secret for almost 17 years.
‘We are talking about millions of tonnes,’ Schiavone told the committee. He described dumping operations taking place at dead of night, guarded by men in military uniforms and with the connivance of senior police ofcers, politicians and business people. The superg rass showed state ofcials the locations of sites because, he predicted with startling accuracy, nearby residents would be ‘dying of cancer within 20 years’.
This illegal trade was a by-product of ta x dodging in a country with one of the highest levels of evasion in western Europe. Businesses massaging their income had to mask the scale of their activities – and that meant hiding huge amounts of hazardous waste. By the turn of the century, so much was being dumped in Campania it could not be hidden easily in rubbish dumps, so the Mafa began burning it. Trucks would turn up at night, waste would be emptied, then huge fres star ted. Locals lined doors with damp towels to keep out the vile chemical smells – and the area was branded ‘Land of Fires’.
The fres intensifed environmental damage and healt h r isks. Soon doctors not iced an upturn in birth defects and cancers. Among them was Alfredo Mazza, a lively Neapolitan t ra ining to become a ca rdiolog ist. Mazza requested cancer data from health authorities in an eastern region of Campania with high levels of dumping – and the results showed ev idence of links between environmental degradation and rising incidence of tumours. Male death rates from bladder and liver cancer were about twice national levels in this rural district, and female mortality from liver cancer more than three times the Italian average. And while improved diagnosis and treatment were boosting survival rates elsewhere, local medics were seeing not only r ising mortalit y but younger patients. ‘The age was important,’ he said. ‘Cancer is usually found in older people but these were younger people dying.’
The pugnacious young doctor took the data to a local prosecutor, demanding action, but was fobbed of. So he wrote to The Lancet, which publ i shed hi s la nd mark work i n September 2004. The article provoked a furore, f uelling local protests over a planned new incinerator, yet led to little real action from the authorities – although Mazza told me he learnt later f rom a f r iend t hat Italian intelligence began monitoring him as a ‘troublemaker’.
Now an established heart consultant who has published further studies into the consequences of hazardous waste, Mazza admits it is impossible to prove precise links between toxic materials, tumours and congenital malformations. But he believes they are only just beginning to see the full scale of health problems. ‘We are living in the Triangle of Death. We do not know how many areas are afected, how bad the damage will be or how long it will last.’
Two years after the Lancet report, tales of gangsters driving across Italy to dump toxic waste in rivers and bury contaminated containers under lush felds reached a wider audience with the book Gomorrah by journalist Roberto Saviano. Among the six million people who bought the book was an oncolog ist in Naples named Antonio Marfella, who had long been bafed by both his increasing number of patients and their decreasing age.
Marfella, who was then head consultant at Fondazione Pascale Napoli, a 235-bed hospital that is the region’s only cancer centre, said they started seeing the surge in cases around the year 2000, with the average patient age plummeting from 60 to under 40. Suddenly oncerare bone cancer cases became commonplace in children and the age of most breast cancer patients fell below 40. ‘Although we are a city on the sea and not industrial, it was like we
The supergrass showed ofcials locations of dump sites, predicting that residents would be ‘dying of cancer within 20 years’
were living in one of the world’s worst industrialised areas,’ he said.
Naples had long had been infamous for inept management of its r ubbish. Suddenly the white-haired consultant understood what was going on around him: ‘It opened up a vision that seemed unbelievable,’ he said. ‘We knew there was mismanagement of household waste but we did not know organised crime had gone outside its usual activities of drug dealing and prostitution into hazardous waste.’
In the nearby town of Acerra, sheep were being born deformed and dying soon after. Then in 2007 a 50-year-old shepherd turned up at the hospital with such aggressive cancer riddling his bones and blood that doctors could not determine where it had started; one month later he was dead. His daughter asked for tests on his body, which revealed high levels of dioxins. After it emerged his sheep had been tested four times with similarly disturbing results, she launched a court case for damages.
Marfella gave exper t ev idence in cour t, which led to a request to speak at the Italian parliament early the follow ing year. ‘I said there were the same levels of toxins in these agricultural areas as were found in industrial sites, which was a paradox.’ He was demoted on his return from Rome for being ‘alarmist’.
Around this time Anna Magri gave birth to Riccardo, her second son. When I met the 39year-old car retailer in her neat fat in a village near Caserta, the boy’s tiny shoes were displayed alongside his picture on a dresser: he died shortly before his second birthday, having spent most of his short life fghting the leukaemia that was discovered when he was six months old. ‘We thought he was teething, which was why he was so upset, crying all the time. I was breastfeeding him but I could not pick him up because he would scream. He was in so much pain,’ said his mother.
Magri, who was pregnant during a 2007 crisis caused by overfowing dumps, remembers thick black smoke rising over her village from waste set alight on a nearby hill. ‘I had seen fres all over the place but now I know what they were. I am convinced his death was due to the toxic waste when it was burning, with all the illegal dumping.’
The exact cause of her son’s death will never be established. One study, however, indicated signifcantly higher levels of dioxins in breast milk from mothers in the worst-afected area than from others living in surrounding areas. Other research has found animal milk containing worrying concentrations of dioxins and polychlorinated biphenyls (PCBs – man-made compounds once used widely in elect rical products that are now banned in many countries), even in that of the bufalos used to produce the region’s famous mozzarella cheese.
In 2004 there were more than twice as many known dumping sites in Campania as in the northern region of Lombardy; four years later, this number had more than doubled. The fres burnt, but ofcials ignored them. One paedia- trician showed me a map of these microdumps, each one a black dot and heavily clustered in the ‘Triangle of Death’ zone around Acerra, Nola and Marigliano. Then he showed me another he had made with red dots denoting cases of child brain cancer overlaid on top; almost all overlapped in the same small area.
Only now is the full extent of the scandal coming to light. Partly this is thanks to a campa ig n i ng lo ca l pr ie s t na med Reverend Maurizio Patriciello, who writes for Avvenire, a newspaper for Italian bishops, and enjoys stirring things up on social media. One hot night in June 2012 he could not sleep because of the smoke and stench of burning chemical waste, so went on Facebook at 3a m a nd asked if others were suffering. By 6am he had more than 1,000 responses from neighbouring villages, so went to his bishop and demanded action.
‘Families here are terrifed,’ the silver-haired Catholic priest told me when we met in his church on a grim estate, watched intently by a gang of hooded men outside the heavy iron gates. ‘They have to go for treatment in the north because hospitals here are full.’
Pat r iciello helped g r iev ing parents for m protest groups, lobbied politicians in Rome,
There are worrying concentrations of dioxins in animal milk, even in that of the bufalos used to produce the region’s famous mozzarella
penned polemical ar ticles, organised huge marches and joined with campaigners who sent pictures of mothers with their dead children to the Pope and Italian president. He even met Schiavone before the supergrass died two years ago. The priest claims the gangster confessed his crimes but said the worst ofenders were industrialists dealing with the Mafa since they knew the devastating damage from their deeds. It is hard to disagree.
It also emerged two years ago that the United States nav y, whose European command is based in Naples, had conducted its own threeyear, $30m study into local air, soil and water. It tested hundreds of contaminated or alarming locations, f inding ‘unacceptable health risks’ in private wells and worrying levels of uranium in fve per cent of samples. It found no impact on military personnel but three areas near its base were placed of-limits, tap water banned and troops advised to avoid groundfoor accommodation, where risk of inhaling contaminants was highest.
Tha nks to t he c a mpaig ners a nd hef t y European Union fnes for failing to combat illegal waste disposal, Italy ’s polit icians were f inally prodded into act ion. Fa r ming was banned around some contaminated sites. Then they passed a special ‘Land of Fires’ act of parliament in 2014, which banned burning of waste and put extra cash into cancer detection and public health promotion in the region. It also ordered the National Institute of Health to collect epidemiological evidence. An earlier study by the body had found a correlation between hazardous waste and health outcomes such as cancer mortality and birth malformations, but no direct cause.
The results of the inquiry, which looked into mortality, cancer incidence and hospital admissions in 55 municipalities, emerged earlier this year – and were devastating. Life expectancy in Campania is two years lower than in the rest of Italy, with 2,000 excess deaths estimated over a 15-year period. Mortality rates in the ‘Triangle of Death’ are 10 per cent higher for men than elsewhere in the region, 13 per cent higher for women. There has been a 17 per cent rise in cancers of the central nervous system for children under 14 around Naples. And a 51 per cent rise for infants in their frst year.
‘It is not that every case is down to the toxic waste but you can see a clear pattern,’ said Pietro Comba, one of the authors of a report. ‘There were particular sig ns with stomach, liver and lung cancer, plus breast cancer in women. And it was signifcant these excesses are not uniform across the region.’
These fndings add to a growing body of evidence linking pollution to health problems. Slowly but surely, Italy is moving to clean up these dumps, although as yet there have been few prosecutions and campaigners are pessimistic that key perpetrators will ever meet justice. ‘These people will never come to court because they are important industrialists,’ said Marzia Caccioppoli, 40, a seamstress whose only child died three years ago of a type of brain cancer usually seen as the result of exposure to harmful radiation in adults. ‘They have poisoned our land and stolen our children.’
When I visited the Hospital of Saint Anna and Saint Sebastian in Caserta, I met a paediatrician named Gaetano Rivezzi, a doctor for three decades, born in a village seven miles away. He was the man who showed me the disturbing maps overlaying child cancer cases on dump sites. ‘Before it was paradise here – there were one thousand things you could grow.
‘Campania is a laborator y to understand the link between the environment and health. The damage can’t be undone but it is important and we must learn from this.’ This is an edited version of an article that frst appeared on mosaicscience.com and is republished here under a Creative Commons licence