When baby Rayvan had a mild fever six months ago, his parents weren't too worried.
Like other toddlers, he had just had a measles jab and doctors prescribed paracetamol in a syrup form for babies.
But a week later, he was still unwell. His body started to swell and he couldn't urinate.
His kidneys had suddenly failed.
Very soon, he was admitted to the ICU ward with Acute Kidney Injury (AKI).
"We had to put him on dialysis," his mother Resti Safitri says.
"It took a while before he could pee again. Once he could pee it was so dark, he needed a second dialysis. Then his blood was so thick it couldn't re-enter his body so he needed a blood transfusion."
Tests later showed the paracetamol was contaminated with two toxic compounds, ethylene glycol and diethylene glycol, which are dangerous in all but the tiniest amounts.
A once normal, bubbly baby – who was already crawling – was now seriously ill.
The toxicity in Rayvan's body has damaged his neurological system and caused cognitive impairment. Today he can barely move and has lost the ability to swallow properly.
"He can't bend his legs. He can't eat properly. He can only drink milk through a tube. He can't breathe without a device. His eyes are unresponsive," his mother says.
Doctors can't tell his parents if their son will ever recover.
But Rayvan is not an isolated case.
Families seeking answers and justice
Since August, hundreds more Indonesian children have suffered AKI after taking contaminated syrup medicines – some for coughs, others for fever.
Almost 200 children have died, most of them under the age of six.
Many more like Rayvan have debilitating injuries and neurological impairment.
"These children took the prescribed medicines; a few days later their temperatures dropped but a new illness kicked in," says lawyer Awan Puryadi.
"They were throwing up, they couldn't urinate, their kidneys were damaged, very quickly some died."
Mr Puryadi is now representing 25 families in a class action to sue several pharmaceutical companies and their suppliers, as well as the Indonesian government and the food and drug regulator BPOM.
They accuse all parties of negligence.
"If BPOM recognised it early, then the ministry could have recognised it early too, and would have had protocols in place in how to handle intoxication of ethylene glycol and diethylene glycol," Mr Puryadi says.
"But there were no standards. There were no protocols."
Ethylene glycol and diethylene glycol are solvents — one is typically found in paint or antifreeze in cars, the other in dyes, plastics and manufacturing.
"Very, very small amounts of these substances for short periods of time, are safe. But there's a difference between what is essentially a speck and what could be a couple of teaspoonfuls of a substance, which can kill a young child," says John Skerritt from Australia's Therapeutic Goods Administration.
How such high concentrations made it into children's cough syrups and liquid paracetamol is still unclear.
"Knowing that they're toxic, I think it would be remarkable that a company would deliberately add them. I think it is much more likely that it's a contaminant in propylene glycol that's being used in raw materials for these cough medicines."
In the human body, toxic levels of ethylene glycol or diethylene glycol damage the kidneys and attack the neurological system, leaving children like Rayvan cognitively impaired.
Many children still in hospital are now paralysed. Some can no longer recognise their own parents.
"One victim is Alfaro. His father is David. His condition is no better," Mr Puryadi says.
"He can't recognise his surroundings. He can't communicate with his parents even though he can open his eyes."
Rayvan's illness has devastated an already poor family. His father has had to quit his job to care for his son full-time.
Several days a week he takes him to specialist doctors.
The couple can no longer afford to rent their own home and have moved in with his wife's parents.
They say neither the hospital, the government nor the pharmaceutical companies want to help them.
"This device in Rayvan's neck, I had to buy it myself because the hospital never has one available … it's like we keep getting kicked after we're down," his mother Ms Safitri says.
Hundreds more families are grieving the loss of young children.
Safitri Puspa and her husband want justice after their son Panghegar died from AKI in October, a few weeks after his eighth birthday.
When he developed a fever doctors prescribed him a similar syrup medication, unaware it would soon kill him.
"Day by day, my son kept getting worse," she says.
"He went through haemodialysis twice. After the second time, my son never regained consciousness. He should have woken up after the sedation wore off. But he never woke up again."
'Victims of a failed system'
In October, Indonesia banned the sale of more than a hundred medicines until they were deemed safe or not.
The drug regulator has since destroyed all contaminated drugs. But the families claim that the agency breached its duty.
"BPOM should have recognised this as a danger and set up a procedure for medicines manufacturing in [the] pharmaceutical industry where they must strictly monitor them," says Mr Puryadi.
"What's important is the government admits these victims are the victims of a failed system. They're victims of a pharmaceutical industry crime that happened because the system failed."
One of the drug makers involved, Universal Pharmaceutical Industries (UPI), denies responsibility and instead blames its suppliers for adding the two lethal compounds to its chemical mixture, without telling the company.
It also blames BPOM for not carrying out proper checks.
"Arrest the suppliers of this substance and improve BPOM's regulations," says UPI's own lawyer Hermansyah Hutagalung.
"In order to resolve this problem, then all the medicines in Indonesia have to be under serious supervision from BPOM."
Neither BPOM nor the Indonesian health department responded to 7.30's interview requests.
But the drug authority has previously denied responsibility, saying pharmaceutical manufacturing standards don't require it to test drugs for contaminants.
Mr Hutagalung says BPOM must be held more accountable.
"They're the supervisory agency for drugs. And there's a job to supervise – they're the gatekeeper. We [only] found out about these contaminants after there were victims," he says.
"BPOM should have supervised the medicines before they were distributed to the public, because they're the one that decides if drugs can be distributed or not."
The Indonesian government is also being sued for negligence.
Families say the government and its institutions haven't done enough to help them.
They claim state-owned hospitals have abandoned them. Many parents have had to carry out medical procedures at the hospitals themselves, such as feeding their paralysed children via a tube or changing bandages.
"A professional should do this, the nurses, the doctors," says Mr Puryadi.
"Why do the parents need to be trained to do it? And according to these parents, 80 per cent of the medical procedures, the parents have to do it all themselves."
Rayvan's parents now spend every spare moment caring for him.
"Almost every day we have to take him to the hospital for therapy, to get his health checked at the clinic," says Ms Safitri.
"We need a lot of money to go back and forth to the hospital every day. My salary is not much for his condition."
Lawyers will demand 2 billion rupiah ($200,000) in compensation for each family in the class action when it goes to court in Jakarta in January.
But for most families, it's not about money.
"It's enough for them to show that the government and the industry have admitted that a mistake was made and that they are willing to make some improvement. That's the most important thing for them," says Mr Puryadi.
Ms Puspa says she hopes the death of her son Panghegar will serve as a lesson to BPOM and the pharmaceutical industry.
"The flaws in our system, the loopholes in our law, the people who failed to do their job, they must be punished," she says.
"I don't want my son to just end up as a number in statistic. Being forgotten just like that."
For Ms Safitri, the tragedy has not only cost her baby his health, but it's robbed her of any chance of having another child.
"After what happened to my son Rayvan, I'm scared to have another child. Because I'm afraid something like this could happen again."
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