Oil spill in Esmeraldas: a public health emergency in the context of environmental racism

Esmeraldas, a coastal province in northern Ecuador, is among the country's most vulnerable and marginalized regions. With more than 70% of its population self-identified as Afro-descendant and high levels of multidimensional poverty, it faces historical exclusion from essential public services such as health care, potable water, and sanitation. This configuration of vulnerability is key to understanding the impact of the oil spill that occurred on March 13, 2025,¹ not only as an environmental disaster but also as a public health emergency and a human rights crisis.

The Trans-Ecuadorian Pipeline System (SOTE), operated by EP Petroecuador, spans Ecuador from east to west, from the oil fields of Lago Agrio to the Balao Maritime Terminal and the Esmeraldas Refinery on the Pacific coast. In the Esmeraldas province, a section of the SOTE collapsed in El Vergel due to a landslide triggered by heavy rainfall, releasing 25,116 barrels of crude oil and contaminating the Caple, Viche, and Esmeraldas rivers.¹ The spill spread over 86 km, impacting mangroves, estuaries, beaches, and the Pacific Ocean, forcing the shutdown of water intake systems. A second spill on March 22 further worsened the situation. Approximately 500,000 people were affected in the provinces of Quinindé, Esmeraldas, Atacames, and Rioverde. This event was not isolated, as at least five of the 13 incidents involving spills exceeding 15,000 barrels occurred in Esmeraldas during the 50 years of SOTE operation.² Moreover, environmental pollution from the State Refinery of Esmeraldas, which produces 60% of the country's daily fuel, exacerbates the environmental risks for the population.³

Delayed state response and health consequences

The state's response was delayed and disorganized: the provincial emergency declaration was issued 48 h after the spill, without activating environmental health protocols or providing clear technical information. Affected communities, lacking nearby access to safe water and health facilities, relied on volunteers and donations for more than two weeks. In contrast, the Red Cross and the United Nations responded immediately.¹ Shortages of medical personnel, insecurity, and deficient infrastructure further hampered the response.

An increase in cases of gastroenteritis, dermatitis, and respiratory and ocular conditions was reported, particularly among vulnerable groups, linked to the deterioration of water and soil quality.⁴ Compounds present in crude oil, such as polycyclic aromatic hydrocarbons and BTEX (benzene, toluene, ethylbenzene, and xylene), have both acute and chronic toxic effects on human health. Prolonged exposure can lead to neurological, endocrine-metabolic, rheumatologic, and hematologic disorders, as well as increased oncological risk.⁵ However, no biomonitoring or effective health follow-up has been conducted among Esmeraldas residents exposed during this or previous events.

A high prevalence of anxiety, depression, and post-traumatic stress disorder was also documented among communities living near spill sites, exacerbated in Esmeraldas by widespread income loss (94%), reduced food consumption (80%), and displacement (31%), in the absence of adequate psychological services.⁶

The Ministry of Public Health implemented measures focused primarily on immediate containment, without releasing official data on health impacts or ensuring environmental and social remediation. Communities remain concerned about ongoing contamination and are demanding compensation measures and guarantees of non-repetition.

Environmental racism and systemic neglect

The Esmeraldas case starkly reveals the lack of transparency in environmental disaster management, the recurrent state omissions in the face of environmental emergencies, and the absence of a robust environmental public health strategy. The persistence of environmental racism is reflected in historically excluded communities facing disproportionate exposure to contamination without access to remediation or justice. In this context, Article 274 of the Constitution, which recognizes the right of decentralized autonomous governments to share in revenues generated by natural resource exploitation in their territories, represents a key tool; nevertheless, its limited application has perpetuated inequalities.^7,8 In contrast to countries such as Mexico or Chile,^9,10 where health and environmental response protocols are established for such emergencies, the Ecuadorian case highlights serious normative, technical, and ethical shortcomings.

Implications for policy

An urgent national environmental public health policy is needed, encompassing the generation of scientific evidence, assessment of contaminated sites, integration of rapid response systems, biomonitoring and epidemiological surveillance, community-based mental health care, active community participation, and mechanisms for fair reparation. Furthermore, institutional responses must be systematized, lessons must be learned, and structural reforms promoted. The Ministry of Health must take an active role in managing biological risks—from prevention to remediation—while incorporating the principles of equity, environmental justice, and interculturality.

Conclusion

Repairing Esmeraldas is not philanthropy: it is an ethical, legal, scientific, and public health obligation. Collective health cannot remain marginal in environmental response agendas. Today, Esmeraldas stands as an emblematic case that challenges the state's capacity to protect life under conditions of justice and sustainability.

Contributors

JEM conceptualized the study. DSJA contributed to data collection and contextual analysis. KSR provided critical input on toxicological and environmental health aspects. All authors reviewed and edited the manuscript, had full access to the data and sources cited, and took final responsibility for the decision to submit for publication.

Declaration of interests

The author declared no conflicts of interest.