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 le
vel 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?
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 le
vel 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?
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