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Bhopal Gas-hit Survivors
Still Afflicted with Diseases, Progenies Being Born with Birth-related Defects
By Pervez Bari
Despair and depression is writ large on the faces of the survivors of Bhopal
Gas Tragedy, the world's worst industrial disaster, as they continue to suffer
silently with death staring them in their faces. The helplessness of these
victims is to be seen to be believed as they watch their progenies afflicted
with stunted growth born with a host of birth-related defects. With the
upcoming 25th anniversary of the catastrophe a new generation has come up
which is handicapped physically, mentally and emotionally.
This scenario
and state of affairs is thanks to the fall-out of the poisonous. 40 tonnes of
Methyl Iso Cyanate, (MIC), and other lethal gases that spewed out of the Union
Carbide Corporation’s pesticide plant in Bhopal, the capital city of central
Indian state of Madhya Pradesh, on the intervening night of December 2-3,
1984, exposing over 5,00,000 people to the toxic fumes. While 25,000-35,000
people have died since then and hundreds of thousands of persons have been
maimed for life.
Children still being born in Bhopal to badly affected survivors are blind,
lame, with limbs twisted or missing, deaf & mute, brain-damaged, with
hare-lips, cleft palates, webbed
A Bhopal child with tumour in her eyeball
fingers,
cerebral palsy, tumours where there should be eyes etc. The still-born often
cannot be recognised as human. They were damaged in the womb by chemicals
leaking from the same Union Carbide factory that killed thousands in 1984 and
to-date still counting.
Bhopal is well known as the site of the world's worst industrial disaster in
1984. What is less well known is that a medical disaster of unmatched
proportions continues to re-victimize the gas victims to this day.
Following the gas disaster the Indian Council of Medical Research,(ICMR), a
government agency – concluded, on the basis of mortality figures, that over
520,000 exposed persons had poisons circulating in their bloodstream causing
different degrees of damage to almost all the systems in the body.
Today, well
over 120,000-150,000 chronically ill survivors are in desperate need of
medical attention and an estimated 10 to 15 people are dying every month from
exposure-related illnesses. Breathlessness, persistent cough, diminished
vision, early age cataracts, loss of appetite, menstrual irregularities,
recurrent fever, back and body aches, loss of sensation in the limbs, fatigue,
weakness, anxiety and depression are the most common symptoms among survivors.
The alarming rise in cancers, TB, reproductive health problems and others such
as growth retardation among children born after the disaster remain
undocumented. The official agency for monitoring deaths has
Adil, child of a gas-victim, born with croocked
legs
been closed
since 1992.
According to Dr. N. Ganesh, an expert from Jawaharlal Nehru Cancer Hospital
and Research Centre, the research conducted by him revealed that 53 per cent
of the gas victims suffer from chromosomal aberrations as compared to 10 per
cent common people. Also the rate of infertility and abortions are four to
five per cent higher in gas victims, he added.
A recent survey says that 43 per cent of the gas victims still suffer from
respiratory problems, 10 per cent from heart-related problems, nine per cent
with eye problems, eight per cent with general depression problems and six per
cent with gastro-intestinal problems.
To this day, the treatment of the Bhopal victims is impeded because
Dow-Carbide callously refuses to share all its medical information on the
toxic effects of the gases released that night, regarding the information as a
“trade secret”. As a result, effective long-term medical treatment has been
hampered. Even worse, the effects of the gases on future generations remains
unclear even as health effects manifest themselves with disturbing regularity
among the children of gas-exposed parents. Since the disaster, the city has
been plagued with an epidemic of cancers, menstrual disorders and what one
doctor described as "monstrous births.”
It may be recalled here that in a show of publicity as the bodies stacked up,
Carbide flew a series of “top medical experts” to Bhopal to sing a chorus of
reassurance. Dr. Hans Weil - reprimanded for unethical conduct by a US court
for fudging medical data on behalf of the Johns-Manville corporation -
predicted that ‘most victims would fully recover’. Pulmonary specialist Thomas
Petty, also flown to Bhopal by Carbide, said that victims were ‘recovering
rapidly’. No report made by Carbide-sponsored doctors was made available to
the Indian government.
It may be
recalled that in March 1985, a column of frightened mothers-to-be wound
towards a government hospital with bottles containing urine samples. The women
asked for the samples to be tested to check whether their babies could be born
damaged, and to ask for sodium thiosulphate injections to rid their bodies of
toxins inhaled on ‘that night’.
Instead of injections, tests, medical advice and kindness they were driven
away by police with sticks. Ironically, even as these scared women were being
chased away, the Indian Council of Medical Research, (ICMR), was carrying out
a double-blind clinical trial to test the efficacy of sodium thiosulphate
injections as
Six year old Sarmil born blind
a detoxifycant
for the gas-exposed.
Other ‘expertise’ included Carbide’s Dr. Bipin Awasia, who sent a telex to
Bhopal recommending treatment with sodium thiosulphate. When in Bhopal,
flanked by lawyers, he said he’d been mistaken. As a result, tens of thousands
of ailing victims were denied a treatment that double blind clinical trials
had shown to be effective. Success of the treatment would have proven that the
gases had crossed into the bloodstream, thus generating more expensive damages
against Carbide.
And while the
fears of mothers-to-be were all too soon realized in what one Swedish doctor
described as ‘a spate of horrific births’, the ICMR results took 22 years to
be published, when they revealed – a whole generation too late – that the
injections could indeed have saved tens of thousands of lives. The disaster
has faded in the world's memory, but in Bhopal the damaged births continue.
Union Carbide (now Dow Chemical,
Foetus of an unborn child of 3rd December 1984
Bhopal gas leak preserved in formaldehyde in Govt. Hamidia Hospital.
following the
February 2001 merger) continues to claim over 60 years of research (including
research on human 'volunteers') on MIC (the gas that leaked from the Bhopal
pesticide plant) as “trade secrets”. There is more than enough research to
suggest that by withholding information, propagating misinformation and the
withdrawal of funds meant for medical care, Union Carbide has impeded the
health care efforts of the victims to help themselves. The ICMR in turn
stopped all research into the health effects of the gas in 1994 and is yet to
publish the findings of the 24 research studies it had carried out up to that
point involving over 80,000 survivors.
From the start, the medical response ranged from inadequate to catastrophic.
On that night, hospital officials frantically called Union Carbide, seeking a
treatment protocol. When they finally got through, they were blithely assured
that the gas which was killing thousands was “nothing more than a potent tear
gas” and that victims merely had to “wash their eyes with water.”
In the absence of medical information, no treatment protocols specific to
exposure-induced multi-systemic problems exist and symptomatic treatment
remains the mainstay of medical response. Of the two official publications
resembling treatment protocols, the most recent by the ICMR is 11 years old
and covers little except the management of respiratory problems, and the vast
majority of the medical community in Bhopal is not even aware of its
existence. As a result, drugs for temporary symptomatic relief have been the
mainstay of medical care ever since the morning of the disaster. This
indiscriminate prescription of steroids, antibiotics and psychotropic drugs
continues to compound the damage caused by gas exposure.
In the prevailing situation of despair, the Sambhavna Trust, which is a
charitable trust run by a group of eminent doctors, scientists, writers and
social workers who have been involved with various aspects of the Union
Carbide disaster ever since its occurrence in December 1984, believes in
creating possibilities by generating compassion. At Sambhavna, survivors are
offered free medical care through Allopathy, Ayurveda (an indigenous system of
medicine based on herbs) and Yoga. The 21 staff members of the Sambhavna
clinic (among whom 9 are survivors themselves) include five physicians, two
yoga and two Panchakarma therapists and five community health workers who
carry out health surveys, health education and community programs for better
health. Satinath Sarangi, the metallurgical engineer-turned-activist, who
arrived in Bhopal a day after the disaster and has stayed on to help the
survivors in every way. Better known as Sathyu, he is a founding trustee of
the charitable Sambhavna Clinic for the gas victims. The work carried out by
the Sambhavna Trust since 1996 has shown that it is possible to evolve simple,
safe, effective, ethical and participatory ways of treatment monitoring and
research for the survivors of Bhopal. However, Sambhavna is small compared to
the magnitude and complexity of the disaster. While an estimated
120,000-150,000 survivors of the disaster are today chronically ill, the
clinic run by this trust has provided direct treatment to little over 16,000
people and provided support to about the same number through its health
initiatives in 10 communities close to the Union Carbide factory.
Women's Health: Given the official neglect towards monitoring and care of
gynaecological complications caused by the disaster, special attention is paid
by Sambhavna in this area. While officials continue to deny any
exposure-related gynaecological health consequence, data collected at
Sambhavna shows that of 190 females, aged between 13 and 19, who came to the
clinic between 1st June 1999 and 31st March 2000, 113 reported menstrual
problems, including painful and irregular menses, heavy bleeding and excessive
vaginal secretions.
The secretions, locally as ‘safed pani’ (literally white water), are not often
openly discussed because of social taboos. Community health worker Aziza
explains, "Women do talk about it more now but are often confined to their
houses and can’t talk to their husbands about their problems or get
education." Worryingly, Sambhavna’s pathologist has found a high proportion of
abnormal PAP smears among women survivors, increasing fears for a connection
between cervical cancer and gas exposure. Already in India, cervical cancer is
the highest occurring cancer for women, but there is no provision for routine
cervical screening in Bhopal. Women who are referred to local hospitals after
producing abnormal smears have been reluctant to attend, given that the most
common medical procedure for cervical abnormalities is an immediate
hysterectomy. This is referred to as a "blind hysterectomy" because no one
including the doctor knows how far or how little the malignancy is.
Meanwhile, the Indian Supreme court directed Carbide to build a 500 bed
hospital from its own money. Instead, Carbide put £1000 into a trust in London
and tried to transfer into this its shares in UCIL that had been seized by the
Bhopal court due to Carbide’s non-appearance to face manslaughter charges. In
1994 it succeeded, thus evading the Bhopal court where the judge declared the
transfer ‘malafide’. The 350-bed hospital took nearly ten years to build and
within a year of opening was found to be profiteering with private patients,
despite being bound to treat gas victims for eight years ‘in the first
instance’.
So many government hospitals have been built in Bhopal since the 1984
disaster, that, as the International Medical Commission on Bhopal, (IMCB), has
observed, there are more hospital beds per 1000 population here than in the
USA or Europe. The Comptroller and Auditor General's annual reports suggest
that excessive commissions, and not concern for victims' welfare, is the real
motive for building these huge hospitals that house seldom-used expensive
equipment.
Government initiatives towards identification of survivors have resulted in
confusion, corruption and utter discrimination. Consequently there are no
credible official figures of the number of victims and the degree and extent
of injury. Similarly lacking are systems to document the health status and
treatment given to hundreds of thousands of survivors under long-term medical
care.
Given the nature of chronic exposure-induced illnesses and the need for
continuous medication, systematic efforts towards finding non-toxic drug
alternatives or drug-free therapies is long overdue. Such initiatives are even
more imperative in the context of the rich possibilities offered by
long-established indigenous systems. However, systems of health care such as
Ayurveda, Unani and Yoga that are known to provide sustained relief – without
contributing to the toxic load – have been given only token recognition within
the official system of medical care in Bhopal. The government budgetary
allocation to “alternative” medical care is under 1 per cent.
Despite repeated advice from medical professionals, including the IMCB, a
community health perspective has failed to inform health care delivery among
the gas-affected population. Budgetary allocations to community health
services have remained under 2 per cent. As a consequence, such vital areas as
health education and community involvement in medical management remain
neglected.
While the corporation continues to evade liability for contamination of
community water sources, the government has done little to protect over 5000
people from additional exposure and injury. Both Union Carbide [now Dow] and
the Indian government are in possession of information on the hazardous and
persistent nature of these pollutants, yet no effort is being made to assess
the damage, or plan for remediation.
The failure of Madhya Pradesh Government agencies(despite spending over US $43
million of public money) to offer sustained relief has meant big business for
private doctors and nursing homes. In the severely affected areas, most of the
meagre compensation has been spent on private doctors, nearly 70 per cent of
whom are not even professionally qualified, yet they constitute the majority
of the medical care providers.
The BMHT (originally set up by Union Carbide) has also been found to be
prescribing drugs that do more harm than good. Dr. Rajiv Bhatia, Medical
Director of the Department of Public Health in San Francisco, has audited over
400 prescriptions given to chronically ill patients in the Trust's community
clinics with alarming conclusions.
It is indeed a shocking situation – people surviving against the most gruesome
odds – a company carrying on with “business as usual" – a government that is
about to close its files on the "expendable people" of Bhopal – and the
prevalent system of health care most probably doing more harm than good.
(pervezbari@eth.net)
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