Monday, October 29, 2007

“Earth is our Mother” establishing mother – son relation with soil:

Establishing mother – son relation with soil

Earth is our Mother”
Says Natural Farmers
The spiritual soil scientists of Punjab

Harjant Singh, Chairman KVM

A true Nanak Kheti Farmer

KVM field Workshop at Village Rai Ke Kalan

Amarjeet Sharma, village Chaina :A spiritual farmer

The Nanak Kheti : Natural Farming with passion for wellbeing of all

By Umendra Dutt

They are not environmentalists, neither economist nor religious preacher nor trained agriculture expert nor a health professional, but they still posses and practice wisdom of all these. They practice Guru Nanak’s precept Sarbat da Bhala means well being of all in their farming. They are natural farmers of Punjab.

Their farms are laboratories of happiness for all and this all encompasses every living creatures of earth, every life form. It is the Farming with passion for wellbeing of all; one can call it spiritual farming, natural farming, non-violent agriculture or simply Nanak Kheti. These farmers are even taking care of large verity of birds, earthworms, honey bees, butterflies and fireflies and whole lot of magnificent life forms.. For these farmers all living creatures are part of a family and - it is their family.

KVM preaches to adopt famous verses of Guru Granth Sahib –“Pavnu Guru, Panni Pita Matta Dharat Mahat” in farming practices. which means Air is Guru, Water is father and Earth is mother. This holy guiding principal should be part of life, practice and mission of farmers who want to do natural farming.

There is a silent and constructive revolution happening in Punjab to save the environment, regenerate ecological resources to bring back soil productivity and re-establish ecological balance in the farms. This is the natural farming movement of Kheti Virasat Mission (KVM), a civil society action group headquartered in the Jaitu town of Faridkot district. The movement is led by experienced farmers who believe in principal of Sarbat da bhala," says Amarjeet Sharma, a farmer from Chaina village, district Faridkot who heads the village level Vatavaran Panchayat. Vatavaran Panchayats are local-level community institutions working as decentralized participatory civil society initiatives.

KVM is farmers based movement dedicated to natural farming, conservation of natural resources and traditional wisdom. Most of farmers associated with KVM works through its Vatavaran Panchayats. KVM farmers are farmer with a mission, vision and action these farmers has taken pledges to start natural farming in one go or in a phased manner. KVM currently has around a 100 formal and 800 informal members.

Natural farmers of Punjab say that the land has witnessed the destruction of the environment and particularly the soil ecology in the last few decades as a consequence of chemical intensive farming. The soil has lost its nutrient pool. Burning of paddy straw has further destroyed the soil's health. But during the last four to five years, the soil in several parts of Punjab has been regenerated and rejuvenated; these natural farmers are convinced, so much so that your feet feel happy and healthy on coming in contact with the soil. You can see earthworm castings, which had completely disappeared in the fields, says a visibly happy and proud Hartej Singh of Mehta village in Bhatinda district. "Our farmers will offer you a handful of soil which you will find soft and with all the natural aromas that are associated with the infinite life of our earth. That is the kind of work we are doing," he adds.

KVM has evolved a distinct philosophy which defines soil as the 'source of infinite lives'. "Yes, it is true and we have experienced it," avers KVM chairman and a farmer from Rai Ke Kalan village of Bathinda, Harjant Singh. If the soil is rich in microorganisms, its texture is soft, full of natural essence and ample quantities of moisture are kept intact. Then the soil gives healthy crops, and there is a lesser need for irrigation.

Harjant Singh further elaborates on the scientific premises of natural farming. All living organisms require nutrition and minerals for their growth, and amongst them plants, being stationary, get their nutrition at that spot. They get carbon dioxide and water from nature and by the process of photosynthesis, the required amount of sugars is produced. Similarly nitrogen is available in the air and the rhyzobia bacteria in the soil can capture it for the plants. These microorganisms perform different functions for the plants. "By using the chemical inputs, especially the pesticides, we have destroyed the delicate microbial equilibrium of soil and tilted the game in favour of external chemical inputs thus making the situation even worst," says Singh.

KVM farmers use Jeevaamrita (a cow urine based microbial preparation) to revive microbial activity in soil. With the application of Jeevaamrita and Ghan Jeevaamrita (a solid form of Jeevaamrita), the soil is gradually becoming rich in the humus, yield has increased and other life forms are coming back in the fields, says Charanjeet Singh Punni, another KVM farmer from Chaina village and a natural farming trainer. Punni highlights another aspect of natural farming. "Although the sunlight of some of its radiation is essential for the photosynthesis, yet it is a threat to the soil bacteria. Mulching is the best answer to this."

Mulching is an essential part of natural farming. Natural farmers aver that when the soil is covered with various forms of mulching, the results are unimaginable. Earlier the soil had lost all soil bacteria, microbes and earthworms. But after adoption of Jeevaamrita and mulching, the farms are again becoming wealthy in soil health. Krishnan Jakhar of village Dhaba (near Dabawali), Vinod Jyani of village Katehra, near Fazilka, Swarn Singh of Karamgarh Shattran, Madan Lal of Bullowal in Hoshiarpur, Jarnail Singh in Meharu, Nakodar and other natural farmers of the KVM network are using inter crops, plant residue, fallen leaves, bushes, weeds and sometimes even the wheat straw or the paddy straw cuttings spread in the fields to cover the naked soil. Besides protecting the bacteria and retaining the moisture, this also keeps the temperature of the soil low and it never goes beyond the 40 degrees Celsius, which is the upper limit for the survival of microbes, tells Ajay Tripathi, associate director of KVM.

KVM farmers have redefined, reestablished and regenerated their mother-son relation with the soil. They feel a spiritual bond, an oneness with the soil. That is why they are against all forms of agro-chemicals and burning of fields - to them it is a form of violence against the earth.

There is a common question usually asked to KVM activists. Does the natural farming economics work? This spiritual soil science is also more financially beneficial to these farmers. After adopting natural farming they are spending far less from earlier chemical farming days. Natural farming is more cost effective and input efficient says Amarjeet Dhillon a small farmer from Dabrikhana village, who owns only two acres of land. For example, farmers having sugarcane and black gram in their farms have to spend virtually nothing on inputs asserts, Dhillon. He cities several examples where farmer had spend only Rs.100-200 on inputs for one acre as against Rs.3000 by a chemical farming farmer. "Some of us had stopped cash out flow to cities any more to purchase Urea, DAP and pesticides and thousands of others have reduced this out flow of cash in a big way", he adds.

On an average in Malwa's cotton belt farmers are spending Rs.7000 on chemical inputs per acre annually in normal conditions. If there are more pest attacks, then there may be no limit to this amount. There is a rough estimate that every village is spending a large sum of money -- from Rs.40 lakhs to Rs.6 crores -- purchasing agro-chemicals, depending upon area of cultivation and cropping pattern. Natural farmers want to stop the loss of village wealth by bringing down farmers' spending on agro-chemicals. This is Kissan version of Swadeshi movement says Chamkour Singh of Dhudhike village of Moga district. Dhudhike is famous for being birth place of eminent freedom fighter Lala Lajpat Rai and other martyrs of Gadar movement. “Our farmers are no more going to serve MNCs or big agro-chemical corporations. We are evolving a frame work for agricultural Swadeshi movement in Punjab. We are going to redefine Boycott and Swadeshi in present context and scenario that is why KVM has given a slogan to its farmers – MNCs quit our farms” he adds.

KVM feels that there is urgent need of Swadeshi agriculture movement to decolonize Indian agriculture and to liberate Indian farmer from clutches of westernized agriculture and developmental paradigm being convinced by ICAR and State Agriculture Universities. This prototype is philosophically alien to our cultural roots and stranger to ecological ethos and believes of our society.

The KVM’s natural farming movement has also brings another significant change in mindset of farmers. Now they are not looking towards Agriculture University or departmental experts for expert advice any more. “We feel that every farmer of ours is a expert in himself , he practice this science of natural farming, he lives natural farming every day, he is totally engulfed with the philosophy of natural farming” said Dr Harminder Sidhu a Homeopath practitioner and a practicing natural farmer from village Jalaldiwal of Raikot in Ludhiana district. “The modern agriculture paradigm has limited the all expertise in Agriculture Universities only. The chemicalised agriculture model has made farmers scientifically illiterate – who presumed to be ignorant to every aspect of science and agri technology. This is a conspiracy which has made farmers dependent on Universities, department, companies and even pesticide retailer It is a cruel joke that those who got a three or five year degree in agriculture with a alien kind of agriculture knowledge are known as experts, who are practicing a agriculture knowledge of only 40 years old, where as the farmers who inherent the agriculture wisdom of at least 5000 years were made commoners. We are not going to accept this nonsense any more. We are working to build self confidence of our farmers on their own agriculture heritage and wisdom. We are the nation with abundance in farm produces, agro-biodiversity and prosperity” adds confident Dr Sidhu.

The list of natural farmers includes names from all corners of the state. The Pingalwara Charitable Society, Amritsar, a prestigious social service institute in north India, founded by Bhagat Puran Singh has joined natural farming and is supporting the movement with its resources. Pingalwara has established the Bhagat Puran Singh Natural Farming Centre in 37 acres at village Dhirakot near Jandiala Guru. More significantly, Famous religious leader Sant Balbir Singh Seenchewal, Sultanpur Lodhi who is more known as spiritual environmentalist, who had successfully rejuvenated rivulet Kali Bain, has joined natural farming movement. Now he is promoting natural farming in his spiritual mass gatherings.

Similarly many professionals such as those from the medical field, college and university lecturers and professors, advocates, journalists, even government officials and civil servants have joined this movement for rejuvenation of the soil. They are in contact with the KVM and participate in its activities.

Now KVM is concentrating few villages for change the entire village in natural farming field. Two villages in Faridkot district -Chaina and Dabrikhana were chosen for this initiative.

In the just commenced wheat season -- from now to mid-April -- KVM activists are planning to reach out to at least 60 blocks of the state. These activists are committed farmers who work in the fields, not experts who come by when they can spare time by choice. These farmers the true sons of soil are trainers, scientists and leaders of this ecological initiative, in the service of Mother Nature.

Author is Executive Director of Kheti Virasat Mission, JAITU, 151202, District-Faridkot, Punjab. Phone: 09872682161, 01635-503415.

Thursday, September 6, 2007

Making a meal of Bt cotton by Bhaskar Goswami

Making a meal of Bt cotton

By Bhaskar Goswami

In the Malwa belt of rural Punjab, mile after mile of Bt cotton fields are under attack by the mealy bug pest. Bathinda, Muktsar, Faridkot and Ferozepur, Punjab’s four major cotton-growing districts, have been badly affected. The so-called ‘magic bullet’, Bt cotton has turned into a bitter pill for farmers who were promised profits but who are now faced with huge losses

Anyone overhearing Hartej Singh on his cell phone would find the conversation strange. “Dho ditta ji Bt nu safed chichra ne,” (“mealy bugs have devastated the Bt cotton”) he bellows at the caller. Standing in his field in the mid-July sun, Hartej is busy fielding numerous calls of a similar nature. He is an exception -- the sole cotton farmer in Mehtawali village in Bathinda whose crop has not been affected by the dreaded mealy bug.

These days, travelling across the Malwa belt of rural Punjab is a revelation. Mile after mile of unending Bt cotton fields, which appear healthy from a distance, are facing unprecedented attack by the mealy bug. Bathinda, Muktsar, Faridkot and Ferozepur, Punjab’s four major cotton-growing districts, have all been badly affected.

The crisis

While Bt cotton made an official entry into Punjab in 2005, enterprising farmers here began cultivating bootlegged varieties from Gujarat a year earlier. According to official statistics, around 60% of farmers in the state are growing Bt cotton this year. In the four cotton-producing districts, Bt cotton coverage is almost 100%.

Unlike in Andhra Pradesh, Bt cotton in Punjab lived up to its promise of protecting against the dreaded American bollworm, and the number of sprays needed dropped from a high 30 to less than five. This is the main reason why farmers switched to these varieties.

However, Bt cotton protects the crop only against one pest; cotton is attacked by no less than 165 pests. This raises the chances of a resurgence of secondary pests and farmers end up spraying the same quantity of pesticide (if not more) on their crop as they did earlier. In Andhra Pradesh, the number of attacks by aphids, thrips, jassids, etc, has risen since the introduction of Bt cotton in 2002. Tobacco leaf streak virus, tobacco caterpillars, etc, have emerged as new diseases and pests of Bt cotton in the state. This year, reports of fungal root rot in Bt cotton are beginning to pour in from Warangal district in Andhra Pradesh. The emergence of the mealy bug as a Bt cotton pest in Punjab also appears to be a case of secondary pest resurgence, and no amount or type of pesticide has been able to control it.

Scientists at Punjab Agriculture University (PAU) are yet to figure out an effective way of tackling the pest, or, for that matter, what is causing it to assume such epidemic proportions. On July 9, Dr N S Butter, head of the department of entomology told the press that the attack was mainly due to a reduction in pesticide sprays on Bt cotton, and also the proliferation of weeds like Congress grass (Parthenium hysterophorus), which is a major host of the pest.

This is bizarre, considering the fact that Congress grass has been growing in the state for decades. What’s more, the reduced number of sprays was against American bollworm, not the mealy bug, and the type of pesticide used against the two is quite different. Also, American bollworm attacks during the monsoon while the mealy bug is mostly active during summer.

The mealy bug feeds on around 300 crops on the subcontinent. Attacks are generally intense during summer; they subside when the temperature drops. Bt cotton crop in Punjab was attacked by the mealy bug last year as well, but the damage was not substantial as the crop was close to maturity. This year, however, the attack was intense during the second month of sowing.

The devastation

Unlike the Doaba and Majha regions of Punjab, the four cotton-growing districts in the Malwa belt have poorer soil and fewer irrigation canals. Cotton is the major cash crop, while wheat is the staple crop that meets the food requirements of relatively less well-off farmers in this belt. Bathinda district alone accounts for a quarter of the cotton produced in Punjab. Destruction of the cotton crop in this district therefore affects thousands of farmers.

According to the state agriculture department, over 2,000 acres of cotton crop were destroyed by the mealy bug by July 10. This appears to be a conservative estimate. During my trip to the region in mid-July, every village reported having uprooted at least five acres of Bt cotton crop every day. In the village of Raike-Kalan, in Bathinda, over 100 acres of mealy bug-infested Bt cotton had already been uprooted when I visited the area. It’s the same story across hundreds of neighbouring villages.

That pesticides are not working against this pest is evident from the farmers’ accounts. Balwant Singh, a farmer in Mehtawali village in Bathinda, consulted scientists at both the PAU and the state agriculture department. He was advised to rotate sprays of the carbamate and organophosphate pesticide groups. Balwant understands how this is done, for he is the insecticide retailer in the village. Four rounds of sprays later, he has given up.

The same story is being repeated in Badal village in Muktsar district, the birthplace of Punjab Chief Minister Prakash Singh Badal. During my visit, pesticides were being feverishly sprayed on Bt cotton fields in the village, but to no avail. The bug subsides and re-emerges within a week of spraying.

“We used to cuff our children if they touched even one sapling of cotton. Now we use our own hands to uproot what we planted,” says Nachhatar Singh of Raike-Kalan. Nachhatar owns two acres of land and has leased-in five more to grow Bt cotton. Each leased acre of land costs him Rs 16,000, while the cost of cultivating Bt cotton on the land is around Rs 5,000. All this is now lost. Since his land is irrigated and he could also source some paddy seedlings, Nachhatar uprooted the damaged Bt cotton crop and replaced it with paddy, thereby incurring an additional expenditure of Rs 5,000 per acre. As a result his total expenditure has now shot up to Rs 26,000 per acre -- for paddy! This is a far cry from the Rs 4,000 per acre profits promised by Mahyco-Monsanto while marketing Bt cotton seed!

Sharecropping is practised quite routinely all over the Malwa belt. Since the introduction of Bt cotton in Punjab, the practice of leasing-in land to cultivate cotton has increased among marginal and small farmers. Due to the mealy bug attack, these sharecroppers are now uprooting Bt cotton and replacing it with paddy. This is being done to somehow reduce the huge losses arising out of Bt cotton cultivation.
But unless farmers sell their paddy at a minimum of Rs 1,600 per quintal, they will not recover even their cultivation costs this year. The minimum support price was a mere Rs 650 per quintal last year.

The writing on the wall is therefore quite clear for small farmers. Like neighbouring Sangrur, the four cotton-growing districts of Punjab may soon begin reporting increasing numbers of farmer suicides.

The response

While the state agriculture department and PAU are groping in the dark for a solution, the response from the Centre is a not-so-surprising dead silence. According to the International Seed Federation, this year the estimated size of India’s seed market is around $ 1.3 billion (approximately Rs 5,200 crore) -- the sixth highest in the world. By opening up the seed sector to biotech seed manufacturers, the Centre had signalled, a long time ago, that profits to these corporations weigh higher than the concerns of farmers.

When asked by local journalists about the steps being taken to stem the mealy bug epidemic in Punjab, the Ministry of Agriculture (MoA) passed the buck back saying that agriculture was a state subject.

This is ironical. After all, it wasn’t the Punjab government that approved 135 varieties of Bt cotton in the last five years but the Genetic Engineering Approval Committee (GEAC) of the Union government, of which the MoA is a member. The fact remains that the GEAC has permitted cultivation of Bt cotton varieties without carrying out adequate testing for the resurgence of secondary pests and diseases. As has now become the established norm with respect to genetically modified crops, farmers are being made to pay a steep price for the incompetence of the regulatory body and the greed of biotech companies.

Not only has the introduction of Bt cotton brought disaster in the form of the mealy bug, it is also affecting yields of the subsequent crop -- wheat. Farmers reported an up to 30% drop in wheat productivity on land that had previously been cultivated with Bt cotton. This is similar to reports from Andhra Pradesh where the Kisan Call Centre in Hyderabad received a number of complaints from farmers about declining yields of subsequent crops.

According to Vyavsaya Panchangam -- a farmers’ almanac -- published by the Acharya N G Ranga Agriculture University, Hyderabad, Bt cotton uses more fertiliser than its non-Bt counterparts. If adequate amounts of fertiliser are not applied, the subsequent crop receives fewer nutrients. Further, the Bt toxin also expresses itself in the root zone of the plant and can affect soil biodiversity and ecosystem function, as reported in a research study by the Australian government. These may partly explain why yields of subsequent crops are declining, although nobody is paying much attention to this aspect.

The alternative

This brings the story back to Hartej Singh, an organic farmer associated with the Kheti Virasat Mission. Singh grows cotton intercropped with rows of pigeon pea, sorghum, maize, soybean, cluster bean, etc. Some of these are leguminous crops that are uprooted and used as green manure. He grows F-1378, an early-maturing American cotton variety and LD 327, a high-yielding desi variety that is also tolerant to Fusarium wilt. His yields are slightly lower than those of the Bt cotton in neighbouring fields.

But while the neighbouring fields are heavily infested by the mealy bug, Singh’s cotton crop is completely unaffected. Likewise for the 100-odd farmers of the Malwa belt who, as part of the Kheti Virasat Mission, are growing non-Bt cotton following the principles of organic farming. Intercropping with several different crops stops pests from migrating to the next row of cotton, and since these crops have never been sprayed with pesticide, predators like beetle larvae can be seen feeding on the mealy bugs. Whenever the pest concentration goes up, a combination of neemleaves and pods, along with Datura, etc, mixed with cow urine, is sprayed on the crop. The attack subsides and damage to the cotton crop is negligible.

Umendra Dutt, Executive Director of the Kheti Virasat Mission, sums it up thus: “Farmers were promised a magic bullet in the form of Bt cotton which has turned into a bitter pill.” Meanwhile, the PAU and state agriculture department are now consulting Dutt to work out a way to tackle the mealy bug. Speaking to the media on August 9, the head of the department of entomology recommended using traditional methods to destroy the mealy bug -- remove the weed hosts and use neem-based insecticides…

(Bhaskar Goswami is with the New Delhi-based Forum for Biotechnology and Food Security)

Saturday, September 1, 2007

Final Report of PGIMER Epidemiological Study of cancer cases in Talwandi Sabo block

Final Report
An Epidemiological Study of cancer cases
Reported from villages of
Talwandi Sabo block,
District Bathinda, Punjab

Conducted by:

School of Public Health
Department of Community Medicine
Post Graduate Institute of Medical Education & Research
Chandigarh 160012, India


Abbreviations Full Name
As Arsenic
Cd Cadmium
Cr Chromium
Ni Nickle
Se Selenium
Hg Mercury
DDT Dichloro Dipheny Trichloroethane
BHC Benzene Hexachloride
AIDS Acquired Immuno Deficiency Syndrome
ppm Parts per million
OR Odds Ratio
ND Not Detected
NGO Non Government Organization
CBO Community Based Organization
USEPA United States Environment Protection Agency
COPD Chronic Obstructive Pulmonary Disease



Dr. J.S Thakur
Assistant Professor
Department of Community Medicine,
PGIMER Chandigarh
Prof. Rajesh Kumar
Department of Community Medicine,
PGIMER Chandigarh
Prof.Arvind Rajvanshi
Department of Gynecological Pathology
PGIMER Chandigarh
Field Staff
Dr. Prabh Sharan Singh, MBBS

Dr. Arwinder Singh, MBBS

Dr. Mahesh Singla, MBBS

Mr. Rajesh Paul, M.Sc

Mr. S.S Sangwan, M.Sc

Mr. Harsarbjit Singh, MA

Mr. Manoj Kumar, M.A

Mr. Deepak Kumar, M.A

Mr. Bhupinder Singh, B.Sc

Mr. Amarjit Singh, B.Sc

Mr. Rajinder Singh, B.A

Mr. Par minder Singh, B.A

Ms.Sukhmail Kaur, B.A

Ms. Akhwinder Kaur, B.A



Executive Summary 1-2

Introduction 3

Objectives 3

Methodology 4-7

Results 8-43

Discussion 44-49

Recommendations 49-51

Reference 52

Annexures 53-68



It is our proud privilege to express a sense of gratitude to Professor K.K. Talwar, Director, PGIMER Chandigarh for allowing the faculty and staff of the institute to participate in the study. We thank Mr.Tripal Inder Singh Baja, MLA & Chairman Punjab Pollution Control Board, Patiala for reposing confidence and entrusting this study to us. We are also grateful to Mr. Malwinder Singh, Member Secretary, Punjab Pollution Control Board, Patiala for his valuable guidance. We also express our sincere thanks to Prof. B.D Gupta, Former Professor and Head, Department of Radiotherapy, PGIMER, Dr. G.L. Goel, Director Health Services, Punjab and Er.Manmohanjit Singh, Chief Engineer Public Health Punjab, Members of Technical committee of this project for guidance and critical review of the project over a period of time. Prof. Gupta could also spare his valuable time for editing this report.

We thank Er. N.S.Tiwana, Executive Director, Punjab State Council for Science and Technology, Dr.S.k Goyal, Civil Surgeon, Bathinda and Dr. Rana Harinder, Civil Surgeon, Roop Nagar for their guidance and help.

We express our special thanks to dr. (Mrs.) H.K. Parwana, Senior Scientific Officer and other Scientific and field officer of Punjab Pollution Control Board (PPCB) for their valuable support and suggestions. Special thanks are also due to SMO's of Talwandi Sabo, Morinda and Chamkaur Sahib, representative of panchayats for extending their active support in fieldwork, without their assistance this study would not have seen possible.

We extend our gratitude to Dr. K.S. Sandhu, Director Punjab Horticulture Post Harvest Technology Centre, PAU, Ludhiana for laboratory support for the project. We are also thankful to Dr. Jai Raj Behari, Scientist (F) ITRC, Lucknow and their support staff namely Mr. B.K. Singh, Mr. Satgur Parsad, Mr. Ramesh Chander, Ms. Poonam Saxena, Dr. Rakesh Kumar and Mr. Ranjan Kumar for evaluation of heavy metals and pesticides in water, vegetable. Blood and urine samples.

We are also thankful to Prof. Suresh Sharma, Head, Deptt. Of Radiotherapy, PGIMER Chandigarh, Head, Deptt. Of Radiotherapy at Acharya Tulsi Regional Cancer Treatment and Research Institute, Bikaner and Mohan Dai Oswal Cancer Hospital Ludhiana respectively for allowing us to retrospectively review of their records and of patient data.

Last but not the least we are indeed very grateful to staff of Community Medicine and Cytology and Gynecological Pathology department for their assistance.

Prof. Rajesh Kumar
Department of Community Medicine

Executive summary

In the developed world, life expectancy has increased substantially during the last century. Deaths due to infectious diseases also declined in these countries whereas deaths due to cancer and other cardiovascular diseases increased. With the rising socio-economic status, similar health transition is occurring in some of the developing countries. In India, though infectious diseases continue to be a public health problem but an increase in the occurrence of non-communicable diseases has also been noted particularly in urban areas and in economically advanced states.

Citizen groups has observed a rising trend of cancer deaths in jajjal and Giana villages of Bathinda District. Punjab Health Department conducted a preliminary inquiry and found that the prevalence of cancer cases in these villages is similar to the other parts of India. The reasons for higher number of cases were attributed to better awareness about the diseases and availing of medical facilities for its diagnosis. As local population has suspected water to be cause of this problem, Punjab Pollution Control Board tested the water samples and found traces of DDT and BHC in the canal-based water supply. However, these insecticides were not detected in the underground water. Based on these preliminary observations, it was decided that Community Medicine Department of PGIMER Chandigarh should conduct an epidemiological study to investigate weather cancer cases are higher in Talwandi Sabo block of District Bathinda compared to other areas and if that is the case then what are the possible causes of this problem?

A house-to-house survey was conducted in Talwandi Sabo Block in Bathinda District and Chamkaur Sahib Block of Roop Nagar District to identify the number of existing cancer cases, and the number of cancer deaths that have occurred in last 10 years. Cancer cases and deaths were found to be significantly higher in Talwandi Sabo compared to Chamkaur Sahib Block. The prevalence of confirmed cancer cases was 103 per lakh at Talwandi Sabo (107/85315) and 71 per lakh at Chamkaur Sahib (71/97928). Cancer of female reproductive system, i.e., breast, uterus/cervix and ovary were more common in Chamkaur Sahib Block. Cancer deaths per lakh per year were 52 in Talwandi Sabo compared to 30 per lakh at Chamkaur Sahib.

A comparison of the characteristics of randomly selected individuals, from the villages where a cancer cases existed of death due to cancer had occurred in last 2 years, revealed that involvement in cultivation, pesticides use, alcohol and smoking were more common in Talwandi Sabo Block as compared to Chamkaur Sahib Limited studies show that in drinking water the levels of heavy metals such as As, CD, Cr, Se, Hg were generally higher, and pesticides such as heptachlor, ethion, and Chlorpyrifos were also higher in samples of drinking water, vegetables, and blood in Talwandi Sabo as compared to Chamkaur Sahib.

The cancer cases and deaths are higher Talwandi Sabo probably due to more use of pesticides, tobacco and alcohol. It is found that multiple factors were responsible for cancer cases in the Talwandi Sabo area. Therefore, a multi-pronged strategy to provide safe water supply, discouraging the indiscriminate use of pesticides. Tobacco and alcohol is recommended. A cancer registry should be established in the region for monitoring the trend of cancer cases in future.


Recommendations: As cancer cases and deaths are significantly higher in Talwandi Sabo due to multiple factors such as indiscriminate use of pesticides, tobacco and alcohol, the technical committee of the project recommended that

Agriculture Department should educated people involved in agriculture about pesticides storage, use, and proper disposal of the empty pesticides containers. Steps should be taken so that pesticides are used judiciously and safely.

Public Health Department should monitor the level of pesticides and heavy metals in drinking water periodically and monitoring reports should be communicated to Director, Health Services for necessary action

Local Health Authority designated by Health Department under the prevention of food Adulteration act should monitor the level of pesticides and heavy metals in food

Medical colleges/institutions should set up a cancer registry in the state for monitoring the trend of cancer cases and should also enhance prov- ision of screening, diagnosis and treatment facilities for cancer cases.

Health Department should start a Non-Communicable Diseases Control Programme focused on behavior change communication so as to change the harmful life styles, i.e. tobacco, alcohol, and other substance abuse.

A comprehensive study of the status of environmental health in other cotton growing areas of Punjab should be conducted for which a scheme may be prepared in consultation with Punjab Pollution Control Board and forwarded to Ministry of Environment and Forests for the sanction of founds.



Cancer patterns very not only throughout the world but also between different population groups within the same country including India. With the control of infectious diseases and increased longevity of the growing population in a country like India the spectrum of diseases is changing and the burden of cancer is on the increase. Of the ten million new cases of cancer diagnosed every year over half and from the developing world. It is estimated that by the year 2020, over 10 million people worldwide would die of cancer every year and that 70 percent of these would be from the developing world. Study of the magnitude and patterns of cancer is the first step in determining clues to the cause of cancer and in having a baseline to plan and Asses control measures. Epidemiologic studies help in knowing what is happening and what can be done about it. In India, though infectious diseases continue to be a public health problem but an increase in the occurrence of Non-communicable diseases has also been noted particularly in urban areas and in economically advanced states.

Punjab is one of India's most prosperous states. This prosperity has been largely due to its success in the agriculture green revolution. Seventy percent of the population is directly or indirectly associated with agriculture. As per 2001 census, 70% people live in villages and 30% in the urban areas. The villagers of Jajjal and Giana of Talwandi Sabo Block had reported increased occurrence to unhygienic living condition and poor quality of drinking water. Preliminary investigation conducted by Punjab Health services, and Punjab Pollution Control Board (PPCB) was inconclusive (report in annexure 1). Hence a study was planned to find out weather the cancer cases are higher in Talwandi Sabo as compared to Chamkaur Sahib and if it is so, than what were the possible reasons for the same?

Detailed study was planned with the objective to find out.
Whether cancer cases are higher in the area of Talwandi Sabo Block?
If yes, what are the possible reasons for increased occurrence of cancer in this area?

3. Methodology

3.1 Area

In this study the number of cancer cases in Talwandi Sabo Block of Bathinda district (study) was compared with those in Chamkaur Sahib Block of Roop Nagar district (control). The reasons for selection of Chamkaur Sahib Block as a control or reference area were similar socio-economic conditions butt different cropping pattern and source of drinking water.

Talwandi Sabo
Chamkaur Sahib
Rationale of Selection
Water supply
Canal Water
Underground water
To see if canal water is responsible
Cropping pattern
Cotton needs more pesticides/insecticide

Study: 36 villages of Talwandi Sabo Block of Bathinda district were surveyed, starting at Talwandi Sabo and proceeding concentrically till the required sample size was achieved.

Control:93 villages of Chamkaur Sahib block of Roop Nagar district were surveyed; starting at Chamkaur Sahib and proceeding Concentrically till the required sample size was achieved.

3.2 Study Design: Ecological cross sectional study followed by a case control study.

3.3 Household Survey:

A total sample size of 356000 (178000 at Talwandi Sabo and 178000 at Chamkaur Sahib) was calculated on the basis of estimated cancer prevalence of 1.1/1000 in the unexposed population and 1.4/1000 in the exposed population with 95% confidence level and 80% power. It was to detect 25% difference in the exposed and unexposed populations. In the mid term review of the project by the technical committee, it was observed that prevalence of cancer was about two times higher at Talwandi Sabo as compared to cancer prevalence at Chamkaur Sahib. So it was decided to reduce the sample size, thus a sample of 85315 at Talwandi Sabo and 97928 at Chamkaur Sahib was surveyed.

3.3.1 Study Tools:

(a). Village Profile Proforma: A detailed villages wise environmental profile of the area was made pertaining to the cropping pattern, water and food sources including local as well as outside sources of food for the last 30 years period to see the trend over a period of time (annexure 2).

(b). Household Proforma: A pre-designed and a pre-tested questionnaire was used to survey families in both the areas. It included history of symptoms of cancer, information about deaths in the family during the last 10 years (1993-2003) above the age of 5 years and self reports of various life style diseases like cancer, diabetes, stroke, cardiovascular diseases etc (annexure 2).

(c). Verbal diagnosis report: For any suspected case of cancer in the family, a detailed verbal diagnosis report, I.e., symptoms, signs, investigation and treatment was written which was reviewed by two physicians to make the diagnosis of cancer ( annexure 4).

(d). Verbal autopsy report: To find out the cancer deaths in the area, all the deaths above 5 years of age over last 10 years were enlisted and cause of deaths was assigned by verbal autopsy method by a physician (annexure 5).

3.3.2. Survey Teams: Two teams having 4 surveyors and I supervisor each with one physician conducted house-to-house survey. The staff had received 6-days intensive theoretical training and one week field training. They were sent for field surveys after the investigator were convinced about their competence for undertaking the activity.

3.3.3 Survey Techniques: The supervisor filled the village profile proforma by recording the information given by the village sarpanch / panch (head of village or member of village committee) about village population, cropping pattern, water sources and food sources. Each surveyor visited about 30 families per day recording the name of the head of family, all the family members above 5 years age with their age and sex, any history of chronic diseases (Hypertension, Heart Diseases, Stroke, Diabetes, Cancer, Asthma, HIV/AIDS) and any person with following symptoms i.e. a non healing ulcer of blister in mouth, unusual bleeding or discharge from genital tract in women, lump in the breast, difficulty in swallowing or indigestion, continuing of cough and hoarseness of voice, change in bowel or bladder habits and change in wart or mole. If there was any member in the family who had any of these symptoms, the symptoms and signs, investigation and treatment taken was inquired. For deaths in the family in last 10 years above the age of 5 years then verbal autopsy form was filled noting the sequence of events leading to death of the person. Physicians reviewed the case reports and categorized the detected cases and deaths into confirmed benign tumor, confirmed malignant tumor, suspected benign tumor, suspected malignant tumor and no cancer.

3.4. Laboratory investigation: Relevant laboratory investigation were undertaken which included examination of surface and ground water for heavy metals and pesticides, vegetable and fruits testing for pesticides, blood and urine examination was also done. The sampling was done for three months from March 2004 to May 2004. Three samples each of tap, ground and vegetable/fruits were taken from study and reference area. Three samples of blood (2 from cases and 1 from a control) and three urine samples (2 from cases and 1 from control) were taken in the month of May 2004 from each of the study and reference area.

3.5 Case Control Study: Case was defined as any person living or dead who has any of the seven symptoms of cancer (described earlier) and was diagnosed as having cancer by a qualified medical practitioner or died due to cancer in year 2002-03 in the area.

3.5.1 Sample size: A total of 179 cases were selected from Talwandi Sabo and 129 from Chamkaur Sahib who were histologically. Proven cancer cases/deaths and 264 controls were chosen from Talwandi Sabo and 182 from Chamkaur Sahib. Out of 179 cases at Talwandi Sabo, 83 were histologically confirmed cancer cases and 96 were cancer deaths in the year 2002-03. Similarly, out of 129 cases at Chamkaur Sahib, 46 were cancer cases and 83 cancer deaths. Controls were selected from the same village randomly by matching age group, sex who had no sign/symptom of cancer. For each case two age group and sex matched control (1:2) with one control from Talwandi Sabo and second from Chamkaur Sahib were taken. The number of controls selected from both the areas were higher because initially controls were also selected for clinically diagnosed cases. Although some people refused on first visit however on subsequent visit they agreed to participate in the study.

3.5.2 Method of data collection: A pretested questionnaire was used for collection of information from cases and controls regarding source of water, health profile, use of pesticides, dietary habits, life style and menstrual history (in case of females only) (annexure 6).

3.6 Exclusion Criteria: Camps were organized at Talwandi Sabo and Chamkaur Sahib to confirm clinically suspected cancer cases by biopsy/FNAC. Those who were found to have no cancer were excluded from the study. Only histological proven cancer cases were taken into consideration.

3.7. Data entry and analysis: Every from was given a code number and data was entered in EPI INFO 2000 and SPSS package. The data was further crosschecked and analyzed using standard statistical methods.

3.8 Quality Control: Following measures were taken to maintain the quality of data

O The supervisor independently re-assessed one death per village per surveyor and physician checked one death per village randomly

O Physician reviewed the work done by surveyor and supervisor every week.

O Regular feedback was given to supervisors and surveyors about the quality of the work done.

O Re- survey of one village per team covered by other team to check quality of work.

O All diagnosed and suspected cancer cases were visited and verified by physician.

O Camps were organized at Talwandi Sabo and Chamkaur Sahib for confirmation of the suspected cancer patients.

O Retrospective study of the recorded cancer cases belonging to study and control are registered in following institutes i.e. PGIMER Chandigarh (Radiotherapy Deptt), Acharya Tulsi Das Regional cancer Research institute, Bikaner and Mohan Dai Oswal Cancer Hospital, Ludhiana
4. Results/observations

4.1. House Hold Survey Results

A total population 1,83,243 was surveyed consisting of 39,732 families in 129 villages. A total of 7,441 deaths were recorded which occurred in last 10 years (1993-2003). The crude death rate in Talwandi Sabo area was 4.48 as compared to 3.69 per 1000 for Chamkaur Sahib. Similarly, the crude death rate of adults>15 year was 4.7 per 1000 at Talwandi Sabo as compared to 4.5 per 1000 at Chamkaur Sahib (p<0.05). n="489" n="314" href="" target="_blank">Sr.No.
Chronic Disease

Prevalence per 1000 population

Talwandi Sabo
Chamkaur Sahib
Hyper tension
< n="36" n="93" n="179" n="264" n="443" n="129" n="182" n="311"> 0.05) (table 9).

Table 10
Sex distribution of cases and controls


Talwandi Sabo (T.S)

Chamkaur Sahib (C.S)

Figures in parenthesis are percentages

Table 10 shows the sex distribution of cases and control of Talwandi Sabo and Chamkaur Sahib. A total of 179 cases were selected from Talwandi Sabo out of which 66 ( 36.9%) were males and 113 (63.1%) were females. Similarly, 129 cases were selected from Chamkaur Sahib (reference are), out of which 45 (34.8%) were male and 84 (65.1%) were females (table 10). As shown in Table 11 sources of water used for drinking among cases and control were hand pump, canal water and tap water. The main source of water among cases at Talwandi Sabo was hand pump ( 61.5%) followed by tap water (41.3%). While at Chamkaur Sahib 78.6%) controls were using hand pump water and 23.6% tap water as source of drinking water (Table 11).

Table 11
Source of Drinking Water

Source of drinking water

Talwandi Sabo (T.S)

Chamkaur Sahib (C.S)

Hand pump
Canal Water
Tap water
Figures in parenthesis are percentage

Table 12
Perception of people about water pollution and water treatment

Talwandi Sabo (T.S)

Chamkaur Sahib (C.S)

Water pollution

Treated Water

Figures in parenthesis are percentage

Table 12 shows that 31.8% cases at Talwandi Sabo reported that the water used for various purposes including drinking was polluted, while among the controls at Chamkaur Sahib only 2.2% said so. The difference between the two was statistically significant (p<0.001). n="179" n="264" n="443" n="129" n="182" n="311" or="3.37(1.38-8.48)" n="179" n="264" n="443" n="129" n="182" n="311" p="0.001)" n="179" n="264" n="443" n="129" n="182" n="311" n="179" n="264" n="443" n="129" n="182" n="311" n="179" n="264" n="443" n="129" n="182" n="311" r="0.27(0.12-0.59)," x2="12.28" p="0.0004" p=" 0.0004)." n="179" n="264" n="443" n="129" n="182" n="311" p=" 0.0002)." p="0.01)." p="0.002)" n="179" n="264" n="443" n="129" n="182" n="311" p=" 0.001)." p="0.001)." n="179)" n="129)." n="264)" n="182)." n="3" n="3" n="3" n="3" n="3" n="3" n="179)" n="264)" n="129)" n="182)" n="4430" n="311)" or =" 2.70)." 1="Yes," 2="No" 1="Industry," 2="Chimney" 3=" other" 1="Yes," 2="No" 1="sewerage," 2=" industry," 3=" pond" 4="other" 1=" Tubewell," 2=" Handpump," 3="other" 1=" Canal" 2=" pond" 3="other" 1=" Yes," 2="No">_15
yrs .
Is there any history
Of chronic diseases?
1=yes, 2=No
If yes.
(Write code)
No. Of
Deaths in
Last 10
Form filled ( √- Yes, X-No)

Cancer form II A
Form II B
Form III

HH-Household. MM-Member
*Chronic disease:
1- Hypertension, 2-Heart disease, 3-Stroke, 4-Diabetes, 5-Cancer, 6-Asthma, 7-HIV/AIDS, 8-None
**Suspected cancer symptoms: Name of investigator____________


2- A persistent change in digestive and 5- A swelling or sore that does not get better 8- A Excessive loss of blood at the
bowel habits1- A change in wart or mole 4- Blood loss from any natural orifice 7- A lump or hard area in the breast
period or loss of blood outside the usual dates


Is there any history
Of chronic diseases?
1=yes, 2=No
If yes.
(Write code)
No. Of
Deaths in
Last 10
Form filled ( √- Yes, X-No)


Cancer form II A
Form II B
Form III


Annexure – 4

Cancer Survey, Bathinda

Department of Community Medicine, PGIMER, Chandigarh

Verbal Diagnosis Report

1. Household ID
2. Member ID___________
3. Name of the village_____________________________ Block District
4. Name of Household_____________________________________
5. Name of Respondent_____________________________________
6. Respondent's age in years_______________
7. Respondent's sex (Male –1, Female-2)
8. 8. Respondent's education (lIliterate-1, Literate (without formal education)-2,
Below primary-3, Primary-4, middle-5, Secondary/metric (class 10) –6, Hr
Sec/Sec/Class XII/Pre-univ-7, graduate and above-8, Unknown-9)
9. 9. Religion (Hindu-1, Islam-2, Christian-3, Sikh-4, Buddhist-5, Jain-6, No religion-7, other-9)
10. Occupation (Agriculture labour-1, Cultivator-2, Service-3, Business-4, Non worker-5 other-9)
11. 11. Main health services used during illness (Government hospital-1, private hospital-2, qualified professionals-3, Untrained functionaries-4, other-5, None-6, unknown-9)
11. Past history of cancer diagnosed by doctor. Yes-1, No-2
12. If yes, specify site of cancer
If there was any suspected cancer symptom as given in form –1, and/or past
History of cancer, then write verbal diagnosis report.


Member Id

1. Cancer
1=Y, 2=N

2. If yes, site of cancer
Specify Details

3. Was some investigations done for diagnosis?
1=Y, 2=N

4. If yes, specify.
1=X-Ray, 2=Endoscopy, 3=Blood film,
4=Cytology, 5=Biopsy for histopathology
6=Clinical only, 7=other (specify)

5. Clinical extent of disease.
1=Localized, 2=Regional lymph nodes,
3= Direct extension, 4=other (specify)

6. If there was regional (Neek, Axilla,
groin etc) lymph node enlargement,
then specify site.
1=Neck, 2=Axilla, 3=Groin,
4=other (specify)

7. If Biopsy/Cytology, specify
a) Report_________________

c) Site of tumor___________
d) TNM_______________

8. Have you any treatment taken for the same?
1=Y, 2=N

9. Is yes, Name of the Hospital.

10. Treatment received
1=Surgery, 2=Radiotherapy, 3=Chemo
therapy, 4=Combination, 5=Unknown

Name of Health professional______________________________

Signature___________________ Date_____________

Cancer Survey, Bathinda


Verbal Autopsy Report

12. Household ID
13. Name of the village__________________Code Block District
14. Name of Household_________________________________
15. Name of respondent_________________________________
16 Relationship of respondent with deceased (Head-1, Spouce-2, Son or Daughter
-3, Son-in law or Daughter in law-4, Grand child-5, Parent-6, Parent in law-7,
Brother/Sister-8, other relative-9 Neighbour/no relation-10)
17. Did the respondent live with the deceased during the illness
that led to death? (Definitely yes-1, definitely no-2, Unknown-9)
18. Was the respondent present at the time of death?
(Definitely yes-1, definitely no-2, Unknown-9)
19. Respondent's age in years_________________
20. Respondent's sex (Male-1, Female-2)
21. 10. Respondent's education (llliterate-1, Literate (without formal education)-2,
Below primary-3, Primary-4, Middle-5, Secondary/matric (class 10) –6, Hr
Sec/Sec/Class XII/Pre-univ-7, graduate and above-8, Unknown-9)
22. Deceased full name________________________________________
23. Sex (Male-1, Female-2):
24. Age at death days____ months_____ years____
25. Address: __________________________________________________________
26. Father's name/Mother's name/Spouse name__________________________
27. Date of Death (DD/MM/YY): _______/_____/______
28. Place of death (Home-1, Hospital-2, other place-3, Unknown-9):
29. 18. Main health services used during illness in the period leading to death:

(Government hospital-1, private hospital-2, qualified professionals-3,
Untrained functionaries-4, other-5, None-6, Unknown-9)
30. 19. Religion (Hindu-1, Islam-2, Christian-3, Sikh-4, Buddhist-5, Jain-6, No
religion-7, other-9)
31. Marital Status (Never married-1, Married-2, Remarried-3,
Widow / Widow-4, Divorced-5, Separated-6, Unknown-9)
32. 21. Education (llliterate-1, Literate without formal education-2,
Below primary-3, Primary-4, Middle-5, Secondary/matric (class10
-6, Hr Sec/Sec/Class XII/Pre-univ-7, graduate and above-8, Unknown-9)
33. Occupation (Agriculture labour-1, Cultivator-2, Service-3, Business-4, Non
Worker-5 other-9)
3.4 23. In your opinion what did this person die of (allow the respondent to Tell the illness in his or her own words):

35. Write Verbal Autopsy report for any death in the last 10 years in the family. Use separate page in case of more than one death in the family during the period.
Please describe the symptom in order of appearance, doctor consulted or hospitalization, history of similar episodes, report of the investigations if available.


Underlying causes of death in words_________________________________________
Underlying Causes of death, ICD 10 (3 digit minimum):

Name of Health professional____________________________________

Signature__________________Date (day, month, year): _______________

Cancer Survey, Bathinda

Environmental and Health risk assessment


1. 1. ID No.

2. 2. Household ID: Member ID:

3. 3. Proxy/Direct interview (with name): _______________________________

4. 4. Status Code (1= Cases, 2= Control):
5. 5. If case, write code1= Clinically suspected, 2= Histologically proven, 3=Cancer death.
6. 6. Name ___________________________________

7. 7. Father's/ Husband's Name: ___________________

8. 8. Age _________(Yrs.) Sex: 1=m, 2=F

9. 9. Address: Village: __________________ Mohalla Name: ____________
Tehsil/Block: ________________ District: ______________
10. Number of years residing in the present place? ______________ Yrs.

11. (a) If migrant, area/state from which migrated: _________________

(b) If migrant, write years of migrated: _____________

12. Locality of house (1= Residential area, 2=Industrial area, 3= Market place,
4=Farm land)

A. A. Water pollution

1. What is the source of drinking water:
Source of drinking water
Hand Pump

Canal Water

Tap (Govt. Supplies)

Other, specify

2. Do you think water is polluted? 1=Yes, 2=No
If yes, specify ____________________________________________________
3. Do you provide any treatment to water before drinking the water? 1=Yes, 2=No
4. If yes, specify the purification method used.
Purification method
Code: 1= Yes, 2=No
1. Boiling

2. Filter

3. Chlorination

4. Bleaching Powder

5. Specify others:

5. Where do you store the treated drinking water (specify the equipment used like utensils etc).

Code: 1= Yes, 2=No
1. Pitcher

2. Hodi

3. Plastic Container

4. Aluminium Container

5. Specify others:

B: Occupational Exposures

1 a) Which is your usual occupational? Please give exact title of your Job.

Code: 1= Yes, 2=No
1. Cultivator

2. Agriculture Labourer

3. Construction worker

4. Business

5. Service:

6. Specify other:

b) What kind of work do you do in the job? Your main activity:

c) Do you have to supervise other worker? 1=Yes, 2=No

2. Is your occupation is agriculture? (1=Yes, 2=No)

a) Do you use pesticides & insecticide? 1=Yes, 2=No

b) If yes, (I) For Rabi crop (hari)
1=Leader, 2=Topic, 3=Metsulfuro, 4=Orilolon, 5=Puma power
6=Tata mattery, 7=other (specify) _______________________
(ii) For Karif crop (Sauni)
1=Mono croto fas, 2=Imida Super, 3=Rogon, 4=Action-999,
5=Endo sulfan, 6=Ethion, 7=other (specify)
(iii) For Karif crop (Rice)
1=For eight,, 2=Pedam, 3=Hero don, 4=Beta carlo,
5=Anelo Phose, 6=Alert, 7=other (specify) ________________

c) Were you involved in spraying insecticides/pesticides? 1=Yes, 2=No
d) If yes, do you use any protective device while using pesticides or
insecticides? 1=Yes, 2=No
e) If yes, specify (1=Face mask.2=Cloth, 3=other specify __________)
f) For how many years do you use insecticides?
g) How many times to use the pesticides/insecticides in the last one year.
h) Were do you store insecticides/pesticides? (1=Home, 2=Farm)
i) Where do you make mixture for spraying insecticides? (1=Home, 2=Farm)
j) Where do you wash your utensils after spraying? (1=Canal water, 2=Home,
3=Farm water, 4=other, specify___________________)
k) On average how many hours do you work per day? ___hrs. ____min
i) Average hours of exposure to direct sunlight per day. ______hrs. ___min.

C. Industrial Air Pollution

1. Is there an industry close to your residence? 1=Yes, 2=No
2. If yes, (a) specify type of industry (N.A. =9) ______________
(b) Approximate distance of industry from your residence (in Km.)

3. How many smoke emitting factories are situated near your house?
4. How much is exposure to smoke. 1=Occasional, 2=Frequent

D. Diet
On how many of the last seven days did you eat each of the following foods?
In cash row, please give code of one of the choice given and specify quantity in gm/day:
1. Not at all in last 7 day 2. On one day only
3. Tow or 3 days in last 7 days 4. On most days

Freq. Quantity
Per in grams
a) Vegetables Week

1. Cauliflower
2. Cabbage
3. Reddish
4. Turnip
5. Brinjal
6. Peas
7. Potato
8. Green leaf vegetables
9. Beans
10. Other (specify)
b) Rice
c) Chapati
d) Parontha
e) Dal
f) Milk & its products
g) Tea
h) Fruits
i) Chicken
j) Mutton
k) Fish
l) Egg
m) Oil
1. Sarson oil
2. Vanaspati
3. Desi Ghee
4. other vegetable oil (specify)
n) Spices & Pickles


Ask the following question with code definite yes=1, definite no=2 and unknown=9

Case / Deceased
1. 1. Did she/he smoke tobacco?
1 2 9

1.1 If yes, what type? Bidi=1, Cigarette=2, other Specify=3 ………
1 2 3 9

1.2 How may per day?

1.3 What age did she/he start? (age in years)

1.4 Did she/he ever quit smoking?
1 2 9

1.5 If yes, for how many yrs did they quit?
1 2 9

2. 2. Are you exposed to passive smoking?
1 2 9

2.1 If yes, specify the place.
1=Home, 2=Worksite,
4=Other (specify)

3. 3. Did she/he chew tobacco
1 2 9

3.1 If yes, what type? Pan with tobacco (1),
Pan with out tobacco (2)
1 2 9

3.2 How many times per day?

3.3 What age she/he starts? (age in year)

3.4 Did she/he ever quit chewing?
1 2 9

3.5 If so, for how many yrs?

4. 4. Did she/he drink alcohol at least once
a week during most weeks?
1 2 9

4.1 If yes, number of days per week drink
Was taken (1 to7, or unknown-9)
1 2 3 4 5 6 7 8 9

4.2 If he drink alcohol, then write quantity
1=Pauwa, 2=Adhia
3=Full Bottle 4= __ml.

5. 5. Have you had yellowness of eyes?
1=Y, 2=N

6. 6. Have you ever been told that you had
Hepatitis B or C?
1=Y, 2=N

6.1 If yes, specify.
Hepatitis B=1, C=2

7. History of any drug abuse
1 2 9

7.1 Type of drug used

8. History of any unprotected sexual
1 2 9

9. Is there any baby in your family born with any congenital disorder?
1=Y, 2=N

9.1 If yes, specify.

10. Do you have any skin problem?
1=Y, 2=N

10.1 If yes, specify


1. What was her age at menaeche (in years)? _____________Yrs.
2. What was her age at the time of marriage? _____________Yrs.
3. How many kids did she had? ___________
4. Whether the women had taken any contraceptive pills during her lifetime? 1=Y, 2=N
4.1 If yes, for how many years? __________Yrs.
5. Whether the women had taken any harmone replacement therapy? (1=Yes, 2=N)
5.1 If yes, for how many years? _____________Yrs.
6. Whether mother/sister of the deceased died of breast cancer (1=Yes, 2=No)


1.Whether his histology of tissues done? (1=Yes, 2=No)
2. Any other sample taken. 1=Urine, 2=Blood, 3=Both, 4=other

Consent of the interviewer:

I have been explained the objectives of the study entitled "An epidemiological study of cancer cases reported from villages of Talwandi Sabo block, District Bathinda. Punjab" By the investigator. Iherby give my consent to participate in the study.

Name of the investigator______________ Name of respondent_________

Date___________ Signature____________

Monday, August 27, 2007

Punjab in horrifying situation of environmental and health crisis

Punjab in ecological and health devastation: An activist perspective for mitigation

By Umendra Dutt

For the last three months, our visits to over 100 villages in Malwa region of Punjab have left us upset and speechless. Each one of these villages where my colleagues from Kheti Virasat Mission (KVM) and I spent time is in severe health crisis. During our visit, we noted that there was not a single village in Malwa which has not witnessed cancer deaths in last five years. I might not be and “expert” in the scientific sense; but being one who believes in nature’s glory, it is evident to me that that this present scenario is clearly a result of the environmental devastation caused by green revolution agriculture technologies and nature abusive developmental paradigm.

The village visits were at different points of time. For instance, during KVM's Water Literacy Yatra during third week of July we visited 21 villages in six districts Ferozepur, Faridkot, Muktsar, Bathinda, Mansa and Sangrur and interacted with farmers from around 50 villages. KVM had also did a preliminary survey in 55 villages of Faridkot district and apart from this we had an interaction with farmers in nearly 18 village or cluster level workshops on natural farming in Malwa.

Every where there is same miserable story; one can get the sorrow tales in whole of Malwa region, once called Makheon meetha Malwa The Malwa - sweeter then honey. But now things have been changed drastically.

What is most astonishing is dance of death by cancer every where. Every village has faced cruelty of deaths- young, old, married, single, man, women, rich, poor, farmer, laborer – there is no distinction. Even children are not spared. No discrimination at all. The death count starts from 4-5 and goes upto 60 or even more in a single village and one can find same number of cancer patients too.

What is important to note is also that cancer does not just bring death to a family but also carries burden of debt. Several farmers are forced to sell piece of their lands to get their wards treated properly. But then it is not just cancer which is chasing the people and their prosperity. We met large number of teenagers with gray hair, joint pains and other ageing abnormalities. It is very dark to see teenagers of fourteen and fifteen years developing such ageing effects. We also came across the several cases of childhood arthritis.

I have no words to spell the feeling which has shaken my spine during interface with youth.

Then there are diseases related to reproductive health, with women being the worst victims. The number of childless couples was also found to be alarmingly high. There is a related social baggage with this, as it is the women who have to bear the sufferings and is blamed for not being able to bear children. Most people don’t even know what went wrong in last few years and beyond imagination.

We also met quite large number of kidney patients, mentally challenged children, diabetic patients and young males with infertility in these villages. Most of people feel that the general graph of health is slumped significantly. They also added that despite their being hardly any medicine shop and hospital in the area, the number of diseases and death toll was much less earlier than now.

Aged people have seen the link. Interestingly, we found that their general perception was that all this doom began after introduction of chemical fertilizers and pesticides.

It is important to talk about this issue with reference to whole of Punjab or Malwa in this regard. Talking about a single village like Jajjal, Gyana or Mal Singh Wala will only present a distorted picture. When disease, death, debt and displacement become far-reaching and wide, one cannot help but delve into the gravity of the crisis. The fact is that whole of Malwa is on brink of ecological and environmental health collapse, which ultimately will lead to a severe economic, social and civilizational calamity.

Today, Punjab needs a fresh thinking and bold initiatives to deal with this reality. The present government needs to look beyond stereo-typed solutions. Here are few suggestions for that:

I. Research Project on Pesticide consumption and residue: As Punjab has one of highest levels of pesticide consumption in India, it subsequently has the highest pesticide load on its people and eco-system. Punjab is already facing severe adverse impacts of agro-chemicals used in last four decades. Now at this crucial juncture, the Punjab Government should take bold steps to ensure a safe environment and eco-system to the future of generations of Punjab. For this the Government should:

1. Complete a detailed study on pesticide consumption patterns in Punjab.
2. Ban aggressive marketing of pesticides including all forms of advertisements, publicity and promotion schemes for pesticides and other agro-chemicals. This needs to go along with a stop on all incentives given to the pesticide and agro-chemical dealers' network.
3. Raise awareness about the dangers of pesticide use through well-financed education campaigns. These must ensure the dissemination of information on ill effects of pesticides to all users.
4. The government should evolve an action plan for the immediate and time-bound phasing out of the most deadly pesticides: class I a, I b and II
5. The vital task of properly compiling residue data, already generated by the agriculture universities.

II. Epidemiological and environmental Mapping of Punjab : The first and foremost thing the government should do is to undertake a widespread and multicentric epidemiological and environmental mapping through an extensive study and participatory research, to assess the magnitude and specificity of ill-health especially due to contamination of food, water and air with pesticides and other chemical inputs of agriculture. At present there are no statistics available to know the type of health problems being caused by these poisonous agriculture inputs . In addition to that industry is shamelessly throwing its toxic waste in the water bodies-rivers, canals, seasonal drains, sewers and even in the groundwater through pits, wells and tube wells etc. Burning of fossil fuels is the third devil in this context. Strangely there is either no monitoring for these criminal acts or if it is there, no remedial action is taken. The latest revelations about gross pollution of Kali Benin, Buddha Nalah, Sutlej River and ground water of Ludhiana are well known. The people have a right to know the type and extent of damage being done to our water bodies by the polluting industry. We also want to know what type of health problems are being caused by these acts. But unfortunately there are no research/statistics to know all these vital facts.

This is particularly true about the long term and chronic ill-effects of these poisons like falling body immunity, increasing prevalence of various types of cancers, increasing incidence of spontaneous abortions, congenital abnormities in the new born children and many more.

The existing infrastructure of the health department for the collection, compilation and analysis of data about various diseases is very poor. This is even truer about these newer problems being caused by the toxic effects of various chemical poisons.

The statistics regarding acute poisoning which is also very common are available to some extent. But here also, the reported cases of acute poisoning are only a fraction of the total problem. The reason being that because of the police harassment and social stigma associated with poisoning, people don't come to the government hospitals because they are bound to report to the police (it is worth mentioning here that otherwise also only 25% of the sick people come to government hospitals for treatment).Private hospitals are not reporting such cases- neither to police nor to the health department. If the patient survives it is fine and if he or she dies it is silently cremated. It is an open secret that accidental acute poisoning because of the pesticides is quite common because the prescribed precautions are rarely followed while spraying or handling these insecticides.

These are newer health problems not taught to the doctors by standard textbooks. There is an urgent need to sensitize and train health professionals to identify such health problems and then to evolve the ways to treat, mitigate and educate the people to take preventive measures. This will be possible only if our doctors know the epidemiology of these diseases. To do that, we need public health specialists, who have been fully sensitized to these health problems. We should put at least one such epidemiologist in each district and appoint a team of senior and experienced epidemiologists at the state level to analyze the data and evolve a strategy for the entire state. As there are increasing numbers of reports that the prevalence of cancers has increased significantly, particularly in the cotton belt, the health department should spread awareness to make the cancer easily detectable and should make a cancer registry compulsory in all government and private hospitals.

III. Institute for Environmental Health Research and Studies : Considering the urgency of the situation, and also to act as a research support centre for the Environment Commission and for conducting the environmental audit etc., it is proposed that an Institute for Environment Health Research and Studies be setup. An eminent environmental epidemiologist of international repute and experience must head the institute; with its headquarters preferably at an area worst affected with acute environmental health problems, like Bhatinda. The institute should have regional centers in various regions of the state, and must work collaboratively with environmental, health and farmer-based organizations.

IV. Environmental Health Crisis Mitigation Task Force : Even while the assessment is being done, an environmental health crisis of this intensity can only be mitigated by large scale community intervention and participation. The Punjab government should form an Environmental Health Crisis Mitigation Task Force under the aegis of Institute for Environmental Health Research and Studies with the majority participation from NGOs and farmer groups. A senior Epidemiologist or Environmentalist should head this task force with powers minimum of the secretary rank of the government. This task force should be constituted by taking members from medical fraternity, social activists, and teachers of life sciences, farmers and experts from various governmental departments. The primary work of this task force would be to prepare and implement a Comprehensive Relief and Remedial Programme in the acutely affected areas. The entire medical fraternity and medical students must be involved in this programme to rejuvenate the health of the community. The medical fraternity needs to be sensitized and for that the syllabi of medical studies must be suitably augmented to include specific content on toxicology and contemporary issues.

V. Declare ecological and environmental health emergency in South Malwa: The southwestern Malwa region has been identified as facing the most severe environmental health crisis. The use of toxic chemicals is the highest in this belt. This entire area should be treated as a toxic hot spot. To focus its efforts, the government must declare and impose immediately the state of ecological and environmental health emergency in the entire belt. For this, specially drawn plans are needed with a specific focus on natural and organic farming, with adequately allocated funds for the targeted problem.

Establishment of cancer detection and Cancer Hospital in Malwa: Since cancer has emerged as a major health problem of Punjab, establishment of cancer detection centers and cancer treatment centers is the need of the state. For this, urgent funds may be provided to all medical colleges in the state to establish oncology departments. Post Graduate Institute for Medical Education and Research Chandigarh may be provided funds and asked to supervise establishment of these departments and to provide oncology physicians and surgeons and technical manpower for running the support facilities. In addition to this, Cancer Hospital must be established in Malwa to provide comprehensive advanced care to cancer patients. Presently there is no such center in this part of the country. Patients have to go to neighboring Bikaner and other places for basic treatment of cancer. At the same time, its oncology department may be expanded and upgraded to act as apex referral institution in the line of Tata Memorial Hospital , Mumbai for the patients referred from Medical Colleges and other hospitals in the state. In fact, this should be announced in the budget session of the Punjab assembly. This issue was identified by the SAD and has been promised in their election manifesto also.

The time is running short and so are the hopes of sustainability of Punjab. May some true son of Punjab having clout in government challenge to do some thing?

Thursday, August 23, 2007

Mealy bug infestation : Bt cotton falls flat in Punjab

Mealy bug takes away glory of Bt. Cotton

By Umendra Dutt

So, once again it is boom time for the pesticide manufacturing companies in Punjab. Harping on the desperation and fear psychosis among the farmers over the attack of a new pest-Mealy Bug- on the cotton crop, the pesticides have already sold pesticides over worth Rs 500 crores in Punjab, in the last three months.
Not making only a big whole in the pocket of already distressed farmers, the mealy bug has demolished the so called hype over the Bt Cotton. While the governments and the Bt cotton manufacturing and distribution companies were claiming panacea for the farmers in the introduction of Bt cotton, claiming there will be no attack of pest on Bt but the mealy bug has broken the hype and illusion. As mealy bug is destroying cotton crop in Malwa region of Punjab, in desperation the farmers are making intensive pesticide spray on cotton, which are toxic and even costly. A major portion of the profit which farmers hoped to reap from the cotton crop, has already gone into pocket of pesticide companies, thus making the farmer once again the ultimate looser. First he purchased expensive Bollgard Bt seeds, believing its resistance towards pests and after mealy bug made meal of it, the farmer made huge investment on pesticides. The seed companies had already cornered lion share in the cotton crop by selling the farmers expensive seed and now it was the turn of pesticide companies to squeeze the farmers. Our farmer is surrounded by merchants of Venice; there are Shylocks all around him. There are more tragic situations with mealy bug attack on crops. When the farmers were gripped with mealy bug panic, and some of them started ploughing their fields, the Directorate of Agriculture, Punjab published advertisements in vernacular daily papers with official photo of Chief Minister Parkash Singh Badal and Agriculture Minister Sucha Singh Langah, prescribing a list of pesticides for spry to control mealy bug. The advertisement has heading "To Control Mealy bug attack on cotton" and then it gives the list of pesticides namely Carbryl, Thiodicarb of Carbamate group, Quinalphos, Prosenofos, Chloropyrifos and Acephate of Organophas group. Even the advertisement suggests using Holocon nozzles while spraying. This advertisement is look-alike of any advertisement placed by pesticide companies. It is a tragedy that two years back the Punjab government had published similar advertisements having photo of then Chief Minister Capt Amarinder Singh, describing the introduction of Bt cotton as great achievement. At that time government advertisement has made tall claims about advantages of Bt cotton, stating increase in yield by 25% to 28% per hectare, net increase in income by Rs 10,000/- to 15,000 per hectare, Saving on agro-chemicals upto Rs 1000/- per hectare. But, this season, which is third year of Bt cotton introduction in Punjab, the things goes just opposite way.
Surprisingly, Punjab is the only state where one could find government advertisements with CM's photos either for the promotion of Bt cotton or for propagating use of pesticides. Apparently, the agri business companies could not find state patronage more then this. Punjab seems to be heaven for these companies. The agriculture establishments here are advocating all sorts of, agrochemicals, Hybrid seeds, Bt seeds and whole lot of poisons more loudly then the manufacturers. The Government has very right to issue advertisements about its achievements whenever they want to communicate to the people, but how do a government advertisement can do propagation of Bt cotton or pesticides? We have to question the very mind set and thought behind these advertisements. The agriculture establishments in Punjab are looking for solution of every problem with the eyes of farm input companies and agribusiness corporations. This indicates the intellectual bankruptcy of the peoples at the helm of affairs in the state. What could be more ironical that solutions which they are suggesting are not only more problematic but also totally unsustainable. These solutions bound to bring more and more devastation. Those who are prescribing these solutions are not legally bound to any action if their prescription brings any adverse effects after few years. The, so called agriculture experts will go scot-free but poor farmer will certainly loose his money, land, health and may be life too. After break of mealy bug infestation pesticides were sold like any thing. The pesticides such as Prosenofos, Acephate, Methyalparothion, Monocrotophos, DDVP, Acetomiprid, Chloropyrifos, Imidachloprid and Clothidin sold in 100s of Kiloliters or Metric tons. Within two months span these pesticides sold up to the tune of Rs 500 crores and if the trend continues the total sum may surpass Rs 800 crores. It is notable that farmers apart from these pesticides farmers had also applied chemical fertilizers like DAP and urea. The economics of Bt cotton has already lost its shine. The tall claims made by Government, Agriculture University and companies regarding increase in yield and profit have washed away by one attack of mealy bug. But, no body is talking about the loss to farmers. The farmers who sow Bt cotton seeds are now feeling being cheated. Their dreams have turned into nightmare. Mealy bug had destroyed large portion of cotton crop this year. Even the Director Agriculture himself apprehend drop in cotton production despite increased area under cotton cultivation this year. Last year the cotton crop was cultivated in 5.70 lakh hectares and this year it is 6.48 lakh hectares, thus it increased by 78,000 hectares. However cotton production is expected to be 22 lakh bales this year against 27 lakh bales of last year.
Mealy bug attacked cotton in all most whole of Malwa. The white sticky bug made cotton fields as they were covered by snow. Even it has entered the house and kitchen gardens. Though it has attacked cotton last year also but damage remains in a limited scale. But this year it becomes so widespread that in hundreds of villages' farmers after farmers ploughed their Bt cotton field to get rid of mealy bug. The phenomena can be found in all pockets of cotton belt. There is large number of farmers across the cotton belt who had ploughed their fields to sow paddy.
A farmer in Rori Kapura village ploughing his Bt cotton field infested by mealy bug
The government departments pressed the panic button, they had worked on Sundays even, discussing which pesticide is better and how to made pesticides available to farmers. They declared war against mealy bug but ammunition is being provided by a private company, Syngenta. And it is the poor farmers who are bearing the cost of this expensive ammunition. The agriculture development officers had become brand campaigner for Actara, another pesticide manufacturing company. The entire agriculture establishment of Punjab seeks asylum in poisons only. While promoting pesticides they had also advised farmers to spry Weedicides all along the farm to prevent weeds. This means more poison load on all ready devastated eco-system of Punjab. The chemicalisation and monoculturing of agriculture in Punjab has made its agriculture experts bounded royal labours of chemical farming paradigm. They can not think and see beyond that and even they do not want to think and see. They had fixed notions, theirs no desire to break the present agriculture thought process and paradigm. They can not dare to do so, as it does not suit to masters of present agriculture system. Today the monoculture is at gene level ‘bt’ gene fighting lepidopteron pests across crops.

Unfortunately the agriculture scientists in Punjab cannot think any solution other than poison. That is why, now they had brought amusing justifications for mealy bug infestation. According to Head of Entomology department of PAU Dr N S Bhutter, "Prior to the introduction of Bt cotton, we used to spray the crops with chemicals which killed these pests. Now as the pest umbrella has been lifted because Bt cotton does not need so many sprays, these pests are becoming dormant". He is responding to Indian Express correspondent. He goes further when asked by journalist why PAU didn't think of this attack when it was rooting for Bt cotton as a panacea for Punjab farmers' problems, the reply given by him reflects that there is some thing seriously wrong with the vision of Punjab agriculture establishment. Dr Bhutter says "At that time there was no mealy bug, and we were dealing with just American Bollworm. With chemicals, we will be able to control this bug too" This is approach of not only PAU but also of department. The agriculture experts encouraged farmers to spray pesticides, resulting misshapings and accidental exposure of pesticides. Large number of farmers and labours who got exposed to deadly pesticides hospitalized at several towns in Cotton belt. Two deaths were also reported due to pesticide exposure. Mobile vans carrying big banners of pesticide companies are criss-crossing villages to educate farmers about mealy bug attack. But educating farmers is a money minting exercise for pesticide companies.
This means there neither is any holistic approach, no farsightedness, no concern about destruction done by chemicals, nor was any thought for ecological, economic and social implications of this highly toxic agriculture. It is very disgusting that agriculture establishment does not want to come out of vicious cycle of pesticides and agrochemicals. Now they take refugee in blaming adverse weather for mealy bug menace. The agriculture establishment has become selective dump, deaf and blind and do not want to see what is happening elsewhere. When lakhs of farmers are successfully growing cotton without using any sort of chemicals and even without Bt seeds, why this cannot be happen in Punjab. But our politicians, bureaucrats, scientists and planners all are hypnotized by companies. Even companies are powerful enough to demolish every type of political difference. All main parties of Punjab become mad in the craze for Bt is so much so that every one want to claim on credit for Bt cotton release and its further expansion.
A Farmer in Chaina villages showing his Bt cotton crop destroyed by mealy bugs

It is also quite interesting that both main political parties had a fight over credit of bringing Bt cotton into state. Not only this, after assuming power the new Akali Dal regime has declared that they shall sell more packets of Bt cotton then previous Congress government. The euphoria for Bt cotton not ends here, despite mealy bug attack on Bt cotton the agriculture minister Sucha Singh Langah proudly announced in his Independence day address at Muktsar on 15 August at Muktsar that his government is proud of distributing 15, 35, 500 packets of Bt cotton seeds at the rate of Rs 760 per packet. But question is who is paying the royalty for these packets. Certainly neither Mr. CM or Agriculture minister nor VC, PAU or Director Agriculture is going to pay . The Farmers of Punjab had already paid some 100 crores rupees to Monsanto as royalty in last three years and this process may continue till farmers dare to come out of Bt seeds deceive.
But in this darkness of chemical farming, there is a ray of hope also. The natural farming is making inroads in Punjab. Mealy bug does not worry natural farmers at all. The farmers who are practicing natural farming neither use Bt cotton nor do any pesticide. But still their cotton crops are healthy and free from any destruction caused by mealy bug. First of all they witnessed very mild mealy bug attack, courtesy multiple cropping system. Their cotton field has as many as 8 crops to 15 crops. Secondly if mealy bug even attacked their crops they controlled it with neem, dhatura and cow urine. There are large numbers of farmers who are proud owner of naturally treated farms. These farmers are erecting the foundation for paradigm shift in Punjab. A constructive change is taking place but minus experts and the establishment. It is a community initiative and farmer driven movement called Kheti Virasat Mission. The growing numbers of farmers practicing natural farming is an indicator that society wants a change in agriculture perspective and paradigm. These farmers are already walked out of Bt and pesticide trap and now leading the Punjab for a imperishable prosperity, free from exploitation of farmer as well as Mother Nature.
The mealy bug gives a lesson to agriculture establishment and protagonists of chemicalised agriculture that their pest control design is faulty. The small insect dares the agriculture scientists to change their view, but who has guts to do so? Punjab devastated by ecological crisis, debts, suicides and cancers waiting for this.