Bhopal Gas-hit survivors still afflicted with birth-related defects
and other disease
Wednesday, December 02, 2009 12:18:42 PM,
Pervez Bari ummid.com
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 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 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
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 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
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, 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
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
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
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
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
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.
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