Lessons from Bhopal – nearly 25 years on
Today’s blog is by Jack Watson, a Leeds medical student taking a break between 3rd and 4th year to travel and work abroad. He writes on the Bhopal disaster, now nearing its 25th anniversary. As well as being involved in campaigning through the Bhopal Action Group at Leeds University, he is currently working at a clinic in the area and shares his perspective. We’ve also posted a great elective report in the form of an interview with a student who went to work in Ethiopia in the summer. And finally, we’d like to give a big plug to the Lancet series on Trade and Health, which is now online. It discusses the impact of international trade and economic policy on health outcomes worldwide; particularly relevant in the current climate. Look out next week for a blog about the launch and the series itself.
I cannot sleep. I escape from my mosquito net hanging over my bunk and make my way along the top floor of the Clinic to the Volunteer’s room, climbing up the ladder to the rooftop above. From my vantage tower I look out across the horizon where in all directions I see the faintly glowing lights emitted from the sprawling dwellings of Bafna Colony. It is hard to imagine, hearing the horn of a train leaving Bhopal Station, and the occasional bark of a dog, that on such a night, nearly 25 years before, this city in the heart of India was plunged into a deeper darkness that they still have not got out of.
On the 3rd of December, 1984, on an evening just like this one, thousands were woken from their slumber gasping for air, their eyes and throats burning and their screams only masked by the expectorant cough of white froth, streaked with blood. You do not need to be a medical student to know that is a bad sign, but just how bad, is still being determined.
A pesticide factory, situated in the heart of the slums of Bhopal’s Old City, leaked 42 tonnes of deadly Methyl Isocyanate (MIC) and other gases into the homes of over half a million people. Within 72 hours 8000-10,000 had died with an estimated 23,000 killed from gas-related illnesses to this day. The aftermath of the disaster is bleak, with the life of at least one gas victim being claimed with every day that passes. This is not a man-made disaster that can just be swept under the carpet and forgotten about. The gas leak may have occurred before some of us were born, but it is a current global health issue, now more than ever. With the toxic effects of MIC now presenting in the 3rd generation and 30,000 Bhopalis having their sole water supply contaminated by the lingering chemicals, the advent of the 25th year since the disaster is the year for international action.
I am a medical student from the UK and am currently volunteering in the Sambhavna Clinic, situated 400 metres South of the factory, in an area crippled after the disaster. It is an independent, non-governmental medical and educational initiative, which through primarily individual donations, provides free healthcare to the victims. At Sambhavna, I have observed how Ayurvedic medicine, Yoga and Panchakarma works alongside modern allopathic medicine to treat patients and alleviate symptoms. Whether it is through using indigenous herbal medicine grown in the garden, adopting specific Asanas and breathing techniques or detoxification with medicinal enemas and oil massages; alternative medicine is at the forefront of Sambhavna’s founding philosophy.
I have obviously taken a lot from my time here, but have also tried to give something back and contribute by starting a literature review intended to help guide the 2nd International Medical Commission for Bhopal. From sifting through 24 years worth of medical research I have learnt of the true horrors of how MIC and contaminated water affects the victims. Bronchial asthma, pulmonary tuberculosis, chronic obstructive pulmonary disease and pulmonary fibrosis may be expected after exposure to such a toxic irritant, but what I was not expecting was the multi-organ effect of the gas, with victims suffering from ocular, psychiatric, neurological, immunological, gynaecological, and genetic problems. The most alarming effect of MIC and other gases released in the toxic cloud is its ability to claim victims years after the disaster. Studies suggest a mutagenic capability, chromosomal abnormalities have been identified and babies that survive to term are born with pigeon chest, syndactlyly, and congenital diseases.
With such devastating health effects, and an abandoned factory plant that is contributing to further ground-water contamination with each successive monsoon, certain questions may be asked. Compensation for the victims, proper medical relief and the urgent need for those responsible to clean up the factory are passionately campaigned for as part of Sambhavna’s global outreach mission. They collaborate medical research and epidemiological studies with the ICJB, the International Campaign for Justice for Bhopal. Anyone who has heard about the legal battle of the Bhopal victims in recent years will not be surprised to hear that a lot of their political lobbying surrounds the demand for corporate accountability.
What transforms the Bhopal disaster from a national tragedy into a pressing global health issue is the questions that arise in the 24 years of demonstrations and campaigning that have followed. Two American juggernauts of the chemical industry have received most of the wrath from angry Bhopal survivors and national campaigners, namely The Union Carbide Corporation, who owned the factory, and now The Dow Chemical Company, who has taken over the company and its responsibility for Bhopal, as the ICJB argues. Dow’s factory that was under construction in Pune, Maharashtra was burnt down by egalitarian religious devotees and local residents in support of the survivors, other future factory plans have been repeatedly opposed, and the company’s recruitment scheme is in tatters through persistent “Don’t Work for Dow” demonstrations.
Whether the campaigners are “despicable and perverse” as recently stated in a Dow press conference in response to local protests by children is open to judgement. However, what has significant undertones, is the fear of the production of toxic chemicals so close to human habitation. Chemicals from such factories are well known for polluting the waterways and ecosystems of our planet, but what is often overlooked is the severe effect that they have on our bodies. A pesticide factory built on your doorstep would cause an outcry, but what about the intoxicants we willingly take into our systems through our pesticide treated food? Biomonitoring and body burden studies have found over 400 potentially harmful chemicals in breast milk, blood, tissues, and in neonates. The internal pollutants are believed to be carcinogenic, teratogenic, and have effects on the endocrine, nervous, renal, immune, and reproductive systems.
I would like to highlight that harmful chemicals do not just come from the likes of pesticides. Dow Chemical, along with making MIC, have a large pharmaceutical branch and manufacture drugs and medication. With increasing medical research and pharmaceutical developments, more chemicals are formulated everyday in an effort to improve the health of an individual. At Sambhavna, these medications are recognized as chemicals, which potentially may overload an already intoxicated system of a gas victim. Allopathy has its merits here, but in the philosophy of first do no harm, chemical medicines are limited to necessity, and the break-through practices of Ayurveda, Panchakarma and Yoga shine through as increasingly effective treatment in reducing symptoms and toxins polluting the body.
The horrific human tragedy of the gas leak may still be felt down each narrow alley, and every congested home of the neighbourhood. But if anything good can come out of such loss, it may be Sambhavna, the shining beacon of hope amongst an otherwise poisoned community. And perhaps with Sambhavna, comes the holistic approach to medicine needed the world over, where allopathic has embraced ayurvedic, integrating a care system that treats, without intoxifying. As for Bhopal, with the 25th anniversary since the disaster arriving next December, the global community will unite alongside organizations like the ICJB to finally achieve justice for the victims, and an end to the poisoning.
Or that is what I reassure myself, so that I can finally get to sleep.
Jack Watson, medical student at the University of Leeds, UK ugm5jdmw@leeds.ac.uk