The Aftermath - years of unending suffering

Official Health Findings| Non-Official Health Findings| Medical Care | Loss of Work|

Economic Deprivation| Rehabilitiation| Fiancial misapropriation|

Mounting Death Toll

Ten years after the disaster, exposure-related deaths in Bhopal are a continuing and painful fact. Even the Indian government, prone to under - reporting casualities, has acknowledged the ever growing death toll. According to figures from the Welfare Commisioner's office in Bhopal at least 5325 people have died due to Union Carbide's poison gases up till December 1992. The official figures of death on December 15, 1984 being 2500, more people died in the subsequent eight years than in the immediate aftermath of the disaster. Actually there are several reasons for the official figures to be incorrect. They do not take into account uncounted dead bodies that were dumped into government trucks on the morning of the disaster. Deaths among the over four hundred thousand people who left Bhopal after a week of the disaster were not monitored, nor was there ever an effective system of recording all exposure related deaths in the following years. Unoffical and more correct estimates of exposure related deaths to date number over 16,000

Since December '92, the government committee that monitored exposure related deaths has been dissolved and registration of death claims discontinued. About 10 persons continue to die each month from exposure related illnesses.

Health inpact- Government findings

Similar to death figures, most of the information on the immediate and long term health effects of gas exposure had been collected by government agencies, chiefly, the Indian Council of Medical Research (ICMR) which initiated twenty five research projects in early '85 to study the effect of the toxic gases on different body systems. In line with the Indian government's unwritten policy on Bhopal, these studies are biased towards underestimating exposure-related damages. Their findings and observations are however, indicative of the physical miseries caused to the people of Bhopal by Union Carbide. According to ICMR, the total estimated exposed population in 1984 was 521 262. to gas exposed in the subsequent years were also found to be affected.

Some of the findings of ICMR on the health status of persons who have directly or indirectly suffered exposure are as follows:

The toxins from Carbide's factory have crossed into the blood stream through the lungs, and have caused damage to the lungs, brain, kidneys and muscles, as well as gastro-intestinal, reproductive and immune systems of those who the poisonous gases.
Of the patients treated at one government hospital immediately after the disaster, 98.9% suffered from breathlessness, 85.8% had eye problems, 91 % had gastro-intestinal problems and in varying degrees there were at least 16 other complications. At least 10 of these "symptoms"e; persisted among the survivors till as late as 1992 (when the last ICMR report was published) with the addition of menstrual irregularities, spontaneous abortions, numbness in the limbs and mental health problems. Current unoffical estimates suggest that at least 120 000, survivors acutely suffer from one or more of these problems.
By December '85, serious disturbances in immune parameters of the exposed people as well as chromosomal aberations in an abnormally large percentage of the population were noticed. Fibrosis of the lungs was reported as well as neurotic depression, anxiety and psychosis in 22.6% of exposed people.
Studies from '87 to'89 show that gas exposed children (up to age 5 years at the time of the disaster) suffered two to four times more from fever, breathlessness, vomiting, cough and other sicknesses, compared to children among similar unexposed populations.
As late as 1990, spontaneous abortion rates among gas exposed women were more than three times that among unexposed women. Mental and physical growth retardation has been documented among children born to gas exposed women years after the disaster.

Six monthly morbidity surveys from '87 to '91 show that the number of people with exposure related symptoms is actually increasing. There were 3 times more people with respiratory symptoms in 1991 as compared to 1987.

By 1992, a marked rise was seen in corneal opacities and cataracts, among gas exposed people leading to permanently diminished vision.

The yearly reports made by ICMR on the basis of investigations carried out on more than 80 000 survivors remain offical secrets till today. There is an official ban on publication of ICMR studies and the survivors have been given no information on research findings by the ICMR.

All but two ICMR projects on Bhopal have been already terminated, many much before completion.

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Non Government findings

Studies carried out by non-government professionals both in India and abroad have presented more accurate information on the health consequenses of the disaster, besides investigating injuries overlooked by ICMR.

A study carried out by Medico Friend Circle in March, 1985 showed that between 50% - 70% of the non-hospitalised population in exposed areas of Bhopal had one or more symptoms implicating different body systems.
According to an epidemiological study sponsored by Jawaharlal Nehru University, New Delhi, in October 89, 70% to 80% of the people in the severely affected and 40% to 50% in the mildly affected communities continued to suffer from exposure related illnesses five years after the diaster. The same study reported nearly 40% exposed persons as suffering from post traumatic stress disorder.
On the basis of laboratory research and community based studies, Dr. Neil Anderson of London School of Hygiene and Tropical Medicine reported damages caused by gas exposure to the immune system in 1989.
A house to house symptom survey in one community conducted as part of a doctoral dissertation in Delhi University in early '93 showed 65.7% people suffering from respiratory symptoms, 68.4% with neurological problems and 49% with ophthalmic symptoms. Among the women in the reproductive age, 43.2% suffered from reproductive disorders.

The International Medical Commission on Bhopal (IMCB) consisting of 14 medical specialists from 11 different countries visited Bhopal in January '94 to assess the health situation of the survivors and make recommendations for improvement of their medical care. The interim report of the Commission has stated that:

A substantial number of the survivors still have very significant respiratory and neurological problems directly related to gas exposure.
clinical examination of individuals from exposed and unexposed communities show significant lung impairment, marked reduction in control over limb movements and reduced memory function caused due to exposure.

By all accounts the Bhopal survivors have an ominous medical future. Damages caused to the immune system has made them vulnerable to secondary infections and incidence of tuberculosis is a high. Early ICMR studies have reported pre-malignant conditions in the gastro-intestional system and cancer is not ruled out as a possible future epidemic in Bhopal. Chromosomal aberrations found in abnormally large number of exposed people and high rates of spontaneous abortions that are indicative of the mutagenicity of inhaled chemicals point towards possible genetic defects in babies born to the survivors in the years to come.

end note:

On the midnight of June 24, 1985 a peoples health clinic run by survivors' organizations was raided by the police and six volunteer doctors working for relief and research were arrested and incarcerated. Since then there has been no let-up in the Indian government's repressive policy against the generation of alternative information on health consequences of the Bhopal disaster.

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Medical Care

The medical care of the survivors in Bhopal today remains essential the same as on the morning of the disaster. Doctors still do not fully know the effects of Carbide's chemicals on human beings or the means to ameliorate these effects. They still prescribe symptomatic drugs that provide temporary relief and the hospitals are still heavily crowded with patients (current average attendance at the four government hospitals is 4 000 per day). Lack of medical information on the leaked chemicals is a major unpediment in the medical care of survivors. Whatever little medical information Union Carbide has give is either misleading or of doubtful value. Repeated requests for relevant medical information made to UCC by survivors organizations have gone unresponded. In the absence of information, doctors in Bhopal continue to indiscriminately prescribe antibiotics, steroids and psychotropic drugs. A study carried out in June '90 by a team of volunteer doctors has shown that the incidence of hazardous and unnecessary medication in government hospitals is as high as 36.7%. The major emphasis of the government's medical care programme has been on increasing hospital based services for survivors.

Most survivors, however, visit private doctors rather than government hospitals. A visit to a goverment hospital involves standing in long queues for uncomfortably long hours only to be able to see the doctor for two to three minutes. Feeding on the inadequacies of the government hospitals, private doctors nourish. Most government doctors operate in private clinics charging anything between Rs. I0 to Rs. 100 per consultation and the disaster has been a windfall for this community. In the severely affected areas of Bhopal, 70% of the private doctors are not even professionally qualified, and yet they form the mainstay of medical care in Bhopal.

Survivors organisations have called for the setting up of a National Medical Commission on Bhopal with government and non-government professionals to oversee medical Care, research and monitoring of the health of the survivors. But the government, intent on closing the files on Bhopal, is unwilling to consider the suggestion.

end note: Survivors report medicine consumption not in numbers but in kilograms. Individuals have consumed upto 10 kilograms of medicines in the last ten years. Included among them are medicines manufactured by Rhone-Poulenc, the corporation that bought over Union Carbide's agricultural products division.

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Loss of Work

The physical and mental suffering due to toxic exposure have been further exacerbated by the loss of capacity to work and the resulting loss of dignity and livelihood. Over 80% of the affected people earned their living through wage labour or petty trade that required hard physical work. Men and women who pushed hand-carts, carried loads, dug soil, repaired cars, drove tongas and rolled beedis before the disaster, could no longer pursue their trades after being exposed to the gas. Gas exposed factory workers in textile and paper mills were more sensitive to occupational hazards and had to stay away from work for upto 20 days in a month.

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economic deprivaition

The loss of jobs played havoc with the family economy and often the bread earners of the family have had to strain their abilities to satisfy the bare needs. For the survivors, these included costly medicines which would often be bought at the cost of food. Pushing oneself harder often leads to exacerbation of exposure related symptoms and the survivors go through a cycle of work/sickness/rest/work almost routinely. Loss of income has also made people borrow money from local money lenders who charge upto 200% interest, so chances for paying back are low and the debts are always growing. Loss of job and income is for most survivors a loss of their sense of personal dignity. What they asked the government for, was jobs not dole. But that never happened. There was no shortage of government plans and official promises. Most were not implemented, few of those implemented worked and the ones that worked were folded up. Currently less than one hundred survivors have been provided with jobs while at least 50,000 require economic rehabilitation.

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Rehabilitation

In 1987, a special industrial area for training and employment of survivors was inaugurated. 170 worksheds were built at the cost of Rs. 8 crore (US$ 222 000), the money being taken from the sum allocated for the economic rehabilitation of Bhopal survivors, and training in 34 trades and jobs for 10,000 survivors were officially announced. The industrial area was later handed over to the Deparment of Industry and Commerce and today the worksheds are being sold off to private industrialists at one-tenth of the prices. The number of jobs proposed for the survivors has now been reduced to a mere one thousand.
A programme offering women survivors tailoring jobs, ran successfully from '86 to '92. It employed 2300 women and earned an yearly profit of nearly Rs. 1 crore (US$ 3.3 million) for the government agency in control. The rehabilitation centres where these jobs were offered were also places where women survivors could gather, share their concerns and organize themselves. Perceiving this as a threat, the state government stopped the program in July'92 throwing the women out of jobs .

Exposure to Carbide's gases and consequent damage to the immune system necessitate healthy living conditions for the survivors. Yet, over the last 10 years, the government record in housing, environmental rehabilitation and provision of essential facilities like safe water has been scandalously dismal. The government housing policy for survivors, is to provide the family of every person who died due to exposure with a two room house. However, budgets till 1995 mention proposals of building only 3000 houses. A little over a 1000 houses have actually been built not far from the Carbide factory the area is popularly known as Widows Colony. Most of the buildings here are four stories high - not exactly conducive to people with respiratory complications.

How was the money Spent?

From 1986 to 1993, Rs. 32-16 crores (US$ 10.7 million) have been spent on environmental rehabilitation on government programmes like resurfacing of roads, planting of trees and construction of drains. With the rare exception of one or two programmes, they have never touched the shanty towns where majority of the severely affected people lived. Money meant for improving the living conditions of the survivors was spent routine municipal activities. The bulk of this expenditure has been on street lighting, construction of public toilets at bus terminals and railway stations and import of huge mechanized garbage collectors.

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