KETTLEMAN CITY -- María Saucedo shook her head in frustration last Tuesday evening as Dr. Rick Kreutzer of the state Department of Public Health provided an update on the incidence of birth defects in this tiny farmworker community in Kings County.
Between 2008 and 2009, the two-year rate of birth defects in the community inexplicably shot up to 8.51 per 100 births -- more than five times the rate of birth defects in the county. That caused grave concern in the community, and spurred a high-profile state investigation that stalled the permitting process for the proposed expansion of a hazardous waste landfill at a nearby facility.
Since then, the rates of birth defects in the community appear to have returned to pre-2008 levels, Kreutzer said, citing complete 2009 data, and preliminary 2010 and 2011 data from the California Birth Defects Monitoring Program.
That caused Saucedo -- who wore a yellow T-shirt featuring a photo of Ashley, her infant who was born with birth defects and died in January 2009, and the phrase 'madre en la lucha' (mother in the struggle) -- to uncross her arms, and raise her hand.
"Do you know why no babies have been born with birth defects recently?" she said in Spanish. "Because we are losing our babies."
Saucedo, a 44-year-old mother of two daughters, wiped tears from her eyes as she recounted the harrowing experience of miscarrying last fall during her first trimester. She said at least four or five women in her Avenal neighborhood also lost babies around that time.
"For this reason, there have been no more cases," Saucedo said. "It's because we are losing our babies before they can be born with defects."
The state does not track miscarriages, since most occur before a woman knows she is pregnant, or outside of a hospital or clinic setting.
The emotional exchange underscored a concern that community residents repeated throughout the public meeting at Kettleman City Elementary School: Despite the state's ongoing work to record and analyze birth defects and other health conditions in the community and surrounding areas, the updated report could not capture the daily health and environmental concerns of area residents.
Dr. Ron Chapman, state Department of Public Health director and public health officer, acknowledged the dilemma. Given the time lag in data collection and the size of Kettleman City, it is difficult for state reports to reflect current health issues in the community, he said.
"What we are doing is an ongoing process of collecting information and reporting it at certain intervals, so to say (the report) is incomplete is somewhat accurate, because it is never complete," Chapman said. "Every time we report, we can look back, and say, 'this is what happened in the last few years' -- but the people here are living it today."
Chapman said the state partners with promotoras (community health workers,) who report local health concerns to the agency. The meeting, state officials said, was an opportunity to learn more about health issues in the community.
But Maricela Mares-Alatorre, a longtime resident and the leader of a community environmental justice group, asked why state officials did not speak with affected residents before issuing the report.
The report, she said, failed to mention that one baby was born in June 2011 with facial deformities, and was missing fingers and part of a hand. There have also been two troubling cases of childhood cancer in the community, and concerns about male infertility, she said.
The California Cancer Registry, which tracks cancer cases in adults and children, has nearly completed its reporting for 2010, and is in the process of reviewing data from 2011, according to Heather Bourbeau, with the state health department's Office of Public Affairs.
"If you wanted to know updates about the community in Kettleman City, why didn't you come and ask the residents of Kettleman City?" Mares-Alatorre said.
"Why not get all the information before issuing a report that agencies are going to take as the word of God? People are going to take this report and say, 'See, there is nothing wrong in Kettleman City.'"
Brent Newell, general counsel for the Center on Race, Poverty & the Environment, also questioned the content of the report, as well as its publication date. He suggested it was released now for political reasons.
The Kings County Board of Supervisors approved in December 2009 the expansion of a hazardous waste landfill at Waste Management's Kettleman Hills Facility, located about 3 1/2 miles from Kettleman City. Since then, the permit process for the landfill expansion has been stalled by the state's birth defects investigation.
In its study, the state tested the air, soil and water around the community and the facility, and discovered no specific environmental factors that could have caused the birth defects.
"Why couldn't the agency wait a few months to release more complete data, instead of announcing the birth defect rates in Kettleman City have declined?" Newell said. "It seems to me you have released this report at this time and spun it in this manner to the media to support a (Department of Toxic Substances Control) decision on the permit."
Raymond Leclerc, an assistant deputy director at DTSC, said that absolutely was not the case.
"We were expecting this report to come much sooner than now, and we are not anywhere ready to make a permit decision anyway," he said. The agency also is waiting on other reports, he said.
The state health department will continue to monitor birth defects in Kettleman City and Kings County.But Saucedo, the Avenal mother, said she would always be skeptical of the state's reports, and would continue to voice her concerns.
"You all take this situation like it's normal," Saucedo told the state officials. "You don't live in Kettleman City."
After the meeting, she added: "As a mother, with everything that has happened to me -- I don't believe them."
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