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REPORTS
Bhopal: The Continuing Toll Anil Sadgopal Sujit K Das
Freshly available medical evidence, collected by an
investigation conducted under the aegis of the ICMR, shows that the
poison from the Bhopal gas leak is still persisting in the bodies
of the victims. This medical evidence of systemic and persistent
toxicity renders Union Carbide Corporation liable for all
multi-systemic ailments that the gas victims are suffering from as
well as the teratogenic, carcinogenic and mutagenic risks they
face.
FRESHLY available medical evidence, recently submitted to the
Supreme Court of India, shows that the poison from the Bhopal gas
leak may still be persisting in the bodies of gas victims This
finding would have major consequences on the very nature and
quality of the compen-sation case against Union Carbide
Cor-poration, USA (UCC). An out-of-court compromise between
government of India (GOl) and UCC is reported to be immi-nent. This
scientific evidence was collected by a team of investigators of the
Depart-ment of Endocrinology and Metabolism of the A l l India
Institute of Medical Sciences (AIIMS), New Delhi, led by Dr M G
KarmaKar. The results of their in-vestigation, conducted from July
1985 to March 1987, incontrovertibly established that urine samples
of gas victims contain ed a significantly higher amount of a
chemical called thiocyanate. Although this investigation was
carried out under the aegis of Indian Council of Medical Research
(ICMR), the premier medical research organisation of the country,
the ICMR authorities failed to see the pro-found significance of
this new evidence and terminated the project prematurely
Consequently, the toxicological status of gas victims could not be
monitored beyond March 1987.
BACKGROUND: T H E M E D I C A L CONTEXT
Ironically, this was what the ICMR authorities along with Dr
Heeresh Chan-dra, head of Bhopal's Medico-Legal In-stitute, had
claimed from January 1985 onwards. They had, however, hastily
con-cluded that this observation implied that MIC exposure led to
cyanide poisoning. This was in contrast to the theory pro-pounded
and vigorously pursued by UCC from the very beginning that since
MIC was the only component of the toxic emis-sion, there could not
be any question of systemic and persistent toxicity. According to
UCC, M I C is instantly transformed into harmless methylamine on
contact
with water on body surfaces, e g, eyes and lungs, MIC,
therefore,' cannot enter the blood stream and cannot cause any
syste-mic and persistent toxicity, MIC, at high concentrations,
could at most cause only varying degrees of local injury at the
point of contact (i e, eyes and lungs); multi-systemic disorders
reported by gas victims are due to the secondary effects of hypoxia
(lack of oxygen) resulting from lung in-jury. In order to bolster
up this theory, UCC suppressed all vital information in its
possession regarding (a) chemistry of exothermic reaction and
thermal decom-position-of MIC that took place in the fateful Tank
No 610, (b) identity of the components of the toxic emission, (c)
bio-chemical fate of MIC in the human body as well as toxicological
impact of the leak-ed gas, and (d) antidotal treatment of systemic
poisoning by MIC '
However, a number of Indian investi-gators, at quite an early
stage, detected significant pointers towards the possibility of
systemic and persistent toxicity of the gas-exposure Medico Friend
Circle's epidemiological study reported presence of multi-systemic
ailrrients including high frequency of non-respiratory symptoms in
a significant number of victims. Among the hospitalised patients,
ICMR noted that in about 40 per cent patients suffer-ing from
respiratory symptoms no organic damage to lungs could be detected.
Laboratory investigations revealed presence of carbamylated
haemoglobin (haemoglobin linked with,MIC) and anti-M1C antibody in
blood samples drawn from gas victims. Animal experiments, conducted
at Defence Research Develop-ment Establishment, Gwalior,
established that MIC could cross air-blood barrier in the lungs to
enter the blood stream.
The most significant finding, however, was ICMR's claim that
urine thiocyanate levels of gas victims were elevated 2-3 fold and
administration of sodium thiosulphate injection, a known antidote
of cyanide poisoning, resulted in further 8-10 fold
elevation. ICMR's diagnosis of cyanide poisoning based on this
finding had scien-tific basis. It is commonly believed that cyanide
is such a poison that even a drop causes instant death. This is not
true. Cyanide radicals enter the human body everyday through
certain foodstuffs or through consumption of tobacco. Com-bining
with sulphur by enzymatic action in the body, cyanide is converted
into thio-cyanate to be excreted through urine. In case of acute
cyanide poisoning when lethal amount of cyanide enters the body,
the victim dies unless an extraneous large source of sulphur (e g,
a sodium thiosul-phate injection) is quickly made available. When
it transpired that there was no recorded case of chronic cyanide
poison-ing, ICMR invoked the theory of 'enlarged cyanogen pool'
implying that the poison had somehow been existing in a
com-paratively stable form to act as a con-tinued source of cyanide
and steadily been converted into thiocyanate in the body in
increasing amounts It is on this basis that ICMR recommended mass
therapy of the symptomatic gas victims with sodium thiosulphate
The MP government not only did not implement ICMR's
recommendation but went to the extent of closing the volun-tary
health clinic Janaswasthya Kendra where sodium thiosulphate was
being ad-ministered to gas victims with palpably beneficial results
Acting on a petition*x>f the gas victims and their physician Dr
Nisith Vohra, the Supreme Court of India ordered restoration of
Janaswasthya Kendra and constituted a seven-member expert committee
with five members from official bodies including MP government and
two non-official representatives from voluntary organisations. The
Supreme Court Committee was entrusted, inter qIiq, with preparing a
scheme of detoxi-fication and medical relief, to arrange for
monitoring the implementation of medical relief, and to carry out
proper epidemio-logical and house-to-house survey which will be
"necessary for the purpose of determining the compensation payable
to the gas affected victims and their families". The committee,
however, after one year of deliberation, decided to submit two
reportsone by a majority of official members and the other by the
minority constituted by the two non-official members. The minority
members submit-ted a preliminary report of concern to the Supreme
Court on October 26,1987. This report presented the evidence
collected by the AI IMS team and recommended im-mediate
consideration of this scientific evidence by the concerned
authorities, including GOI, for the purpose of urgent
Economic and Political Weekly November 28, 1987 2041
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medical relief and, intervention in the imminent compromise in
the compensa-tion case.
lCMR's postulation of cyanide poison-ing had not found favour in
scientific circle for a number of reasons. First, presence of
cyanide in the toxic emission or evidence of conversion of cyanide
from MIC could not be demonstrated. Second, and most important, the
data on urine thiocyanate levels and sodium thiosul-phate therapy
collected and presented by ICMR were scanty, confusing and bereft
on any scientific validity. Indeed it may be observed without
hesitation that the standard of scientific and medical'
in-vestigations carried out on Bhopal disaster by most of the top
class research organisations is so poor as to be rejected at the
undergraduate level One example will suffice. It was in December
1986, after two years of study and research, that ICMR discovered
that no proper control study was undcrtaken;*conclusions arrived at
and recommendations issvicd were without any proper control
study.
Medical Implications
The status of the latest findings differs in this respect that
the A l l MS team ap-plied rigid scientific norms. They used a more
reliable and specific method of estimation of urine thiocyanate;
used a
statistically valid method of sampling both gas-exposed and
control popula-tions; took into account the effect of tobacco
consumption on the output of urine thiocyanate; carried out a
follow-up analysis six months later on the same in-dividuals.
According to the Report, "our rigorous statistical analysis of the
AIIMS' data. . . shows that the elevation of urine thiocyanate
levels was highly significant on a statistical basis and that, even
as late as in March 1987, about 25 per cent of children and 37 per
cent of adults were found to be excreting abnormally high amounts
of thiocyanate. This clearly signifies the possibility of some
poisonous chemicals remaining in the body for a long time after the
tragedy".
This evidence of systemic and presistent toxicity explains the
underlying cause of various observed phenomena relating to gas
victims' ill health, e g, multi-systemic ailments, respiratory
distress without organic damage to lungs, loss of work-power, easy
fatiguability. It also explains the alarming findings of Medico
Friend Circles' Pregnancy Outcome study show-ing an almost
four-fold increase in the spontaneous abortion rate in gas-exposed
women, including even those women who conceived 10 months after the
gas leak. Carcinogenic and mutagenic risk of the gas-exposure is
yet to be monitored and assessed.
Elevated urine thiocyanate levels, how-
ever, do not necessarily imply cyanide poisoning alone, as has
so far been assum-ed by ICMR scientists. A lot of other avenues
stared us in the face for explora-tion but peculiarly the
researchers have so far turned a blind eye to them. The widely
published report of the Varadarajan Com-mittee, presented to the
parliament in December 1985, identified at least a dozen other
toxic chemicals in the residue left in the exploded tank. For
unknown rea-sons, toxic effects of those chemicals on human body
have not been studied. Methylamine, to which MIC was conver-ted on
contact with water according to UCC, is actually a highly toxic
chemical. What happened when such an enormous amount of methylamine
was formed in the lungs? Nobody seems to have asked this question.
Finally, multiple evidence of systemic invasion .of MIC are now
available. Given its propensity to react with proteins, M IC itself
and its metabolites should have been vigorously investigated with
regard to the biochemical basis of their persistence in and
pathways of their removal (i e, detoxification) from human body,
sodium thiosulphatc could very well have a detoxifying role against
MIC-rclated poisons as indicated by the Gwalior study which showed
that prior administration of sodium thiosulphate had a protective
effect on animals expos-ed to MIC. Particularly strange is the
jet-tisoning of an ICMR research project, conceived within eight
weeks of the gas leak, entitled 'Clinical and Forensic
Toxi-cological Studies in MIC Affected Per-sons'. This was the only
research projcct, among a score, which had a declared ob-jective of
studying the toxic effects of MIC and its derivatives on human body
and searching for appropriate antidotes. The entire research
efforts carried out by giant organisations like ICMR, CSIR, ICAR,
DRDH, etc, are devoid of any cen-tral toxicological
perspective.
W H Y COMPROMISE ?
Medical evidence of systemic and per-sistent toxicity renders
UCC liable for all multi-systemic ailments that the gas vic-tims
are suffering from as well as the teratogenic, carcinogenic and
mutagenic risks they face. Such liability, obviously, cannot be
discharged by a single-shot compensation. Medical relief, research
into the toxic properties of the poisons and their appropriate
antidotes, monitoring and management of long-term effects all these
call for allocation of enormous resources and scientific manpower.
It is apparent that the GOI has not been think-ing in these terms.
It is reported that about 5 lakh claims for compensation have been
received by GOI through its authorised claim-forms which asked for
information on urine thiocyanate levels of the claim-
ants. Whatever happened to all that in-formation? It is apparent
that GOI had not been able to present a comprehensive picture of
physical illness of the gas vic-tims to the Bhopal Court, nor does
it feel confident enough to rebut the argument of UCC denying its
liability. Otherwise, there is no ground for opting for an
out-of-court compromise. Here lies the re-levance and importance of
the aforesaid medical evidence which explains all fragmentary
findings of non-respiratory ailments, increased rate of spontaneous
abortion, persistent loss of work-power and easy fatiguability,
symptomatic relief on sodium thiosulphate therapy, presence of
carbamylated haemoglobin, anti-MIC anti-body, disturbed immune
parameters. Wil l the GOI make use of this evidence?
Why does not the government make its arguments public? Secrecy
in this respect appears to be counter-productive. Even if it does
not have a watertight case, an open public scrutiny of the
government's brief would rather be helpful. Evidence col-lected by
all non-official bodies and organisations might add to its
strength. But then evidence is required in case of a court fight;
it is irrelevant to an out-of-court compromise. Since the GOI is
reported to have come down from its original claim of $ 3.3 billion
to $ 500 million, the question of a fight appears to have been
ruled out in the government's legal strategy.
An out-of-court compromise releases UCC from all of its
liability for ever. Such an end to the tragic drama of Bhopal will
have far-reaching implications. In "the midst of agony and despair,
Bhopal created hopes for better preparedness for future unforeseen
disastersbetter legal safeguards, better medical relief and
research, better control on multinational operation and liability,
and of course, bet-ter awareness and alertness. Nothing seems to
have followed.
A l l said and done, why compromise? What do the gas victims
have to lose, i f they are allowed to opt against com-promise?
Union Carbide has, in any case, already admitted its liability for
the gas leak and instant deaths. There will also be no difficulty
in convincing any judge as regards UCC's liability for later deaths
and injury to the eye and respiratory system. In the perspective of
equivocal conduct of UCC in suppressing informa-tion on poisonous
effects of MIC and therapeutic measures, a most conservative
judgment may carry an award of more than $ 500 million. What is
there, one may ask again, to Jose?
There are people who argue that, in case of a court fight, many
embarrassing acts of omission and commission on the part of the
Indian authorities might come to light. Be as it may, such a
contingency will not alter the fact of gas-leak and its
2042 Economic and Political Weekly November 28, 1987
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persisting ill effects. One may even argue that, left to their
own efforts, the gas victims might have obtained a better
com-pensation in the courts in the US or in India. The Bhopal Gas
Leak Disaster (Processing of Claims) Act, 1985, however, pre-empted
the victims, depriving them of their right to sue UCC. In the
absence of a legal or constitutional right to informa-tion, the gas
victim? do not know why
THL consequences ot famine are not con-fined to those who are
its victims It also afleUs those who are on the othei side of the
production relations in which ihe vic-tims are enmeshed Its cffects
spread from the agricultural scctor into the industrial sector and
even into the countiy's inter-national economic relations In bnef
the whole economic system is affected
I amine ^ i l l wipe oui part of the con-cessions wrested by the
peasants and agricultur.il labourers When the rents peasants pa>
aie detei mined not so much by the economics of ihe market, as by
the force or extia-economic coercion that the landlotds can bring
to bear, the weaken-ing of peasant economy will make more difficult
resistance to the landlords1 at-tempts to increase rents and other
ap-propriations Similarly with respect to usury rates A number of
poor peasants (marginal farmers in the incorrect, official jargon)
will be forced to sell then land Some among them are likely to be
turned into tenants-at-will, sharecroppers on the same lands, and
others into agricultural labourersr Among the agricultural
labourers bondage would increase There are already reports of
agricultural labourers being forced into bondage and destitute
women into prosti tut ion Pauperisation (which is not the same
thing as proletarianisation) and bondage are in-evitable results of
iannne Famine weakens the old mode of production. It, in a sense,
helps clear the way for some form of capitalism But to what extent
capitalism, the capitalist organisation of production, takes over
depends on a number of fac-tors (including the nature of the old
mode of production and imperialism's necessity or otherwise of a
reorganisation of pro-duction) and not on the extent and seventy of
famine itself. Rather than a strengthen-
their right for a just compensation is being compromised.
Looking from all angles, the decision for an out-of-court
com-promise appears to be politicalmedical, scientific, legal,
humanitarian factors have been discounted One would be resigned to
conclude that the entire exercise actually provides political
protection to the giant multinational, Union Carbide Corpora-tion,
USA
ing of capitalist production, there might well be an
intensification ot feudal forms of exploitation
In industry, an immediate effect of the diought is that
production of agro-based industries, like sugar, has been hit A
fall in cotton and oilseeds output is certain Industries supplying
inputs to agriculture are facing a crisis situation, with stocks
piling up In the next round, industries supplying consumer goods
(textiles, bicy-cles, soap, etc) to the agricultural sector, will
be affected by the fall in agricultural incomes Faced with a
shrinking market, the first response of industry is to postpone
expansion plans and cut down on investments Equipment suppliers are
already facing a fall in orders It has been estimated (by Isher 1
Ahluwaha and others) that a one per cent fall in agricultural
income will lead to a 0 5 per cent fall in industrial income
Spokesmen for industry are foreseeing a possible recession for
industry from March 1988 Some of the industry predictions must be
taken with a pinch of salt, as they are meani to induce govei nment
to give more concessions But it is certain that in-dustrial growth
will slow down. The ques-tion is only about whether there will be
an actual fall, as FICCI expects Given the government's slackness
in running relief works, a fall in industrial demand is most
likely
The famine, then, represents a serious crisis for the economy
The claims foi both the much-vaunted stability of Indian
agriculture and the new growth path of the economy, will be tested
and the reality revealed The targe-scale destruction of rural
(agncultuial and non-agricultural) incomes will reduce the market
for mass consumption goods Along with increas-
ing the rural-urban gap, the famine wil l further narrow the
already narrowly-based industrial growth
The considerable stock of foodgrains with the government may
make it seem that the drought will not adversely affect the
external payments position But, while imports of foodgrains may not
be needed, there will, however, have to be increased imports of
oilseeds along with sugar and even cotton Whatever the scale on
which relief works are undertaken, the govern-ment's financial
position is going to worsen 'I he recently-announced tax
sur-charges may be moie than offset by the reduccd collections due
to the industrial slow-down
I he external payments position and the overall resource
position of the govern-ment are bound to deteriorate The economic
crisis is affecting agriculture, in-dustry, external payments and
the resource position ol the government. It means not just
increased misery for the toilers and small to middle property
owners. The economic crisis will not leave the ruling classes
untouched In agriculture, though (he asset-holdings of landlords
and moneylenders may increase, their incomes have fallen In
industry profits and ac-cumulation have fallen
It is in such a cnsis that imperialism can apply the greatest
pressure on the in-digenous luling classes in order to force the
changes in policy that it wants It was during the 1965-66 famine
that the US president refused to commit food 'aid' un-til the
Indira Gandhi government an-nounced its acceptance of the 'Green
Revolution' package A few years later in 1972, the US held up
shipments of food to Bangladesh, till that government agreed to end
jute exports to Cuba Today, the Indian government does not need to
im-port food, but the large imports of edible oils, sugar and
cotton will make it very vulnerable to balance of payments pressure
Such pressure can come not only from the suppliers of credits and
com-modities, but also from the buyers of Indian commodities The
shrinking inter-nal market for industrial commodities en-tails
greater reliance on external markets. With the world trade position
not very favourable and growing protectionism in the West, the
Soviet bloc market will grow in importance, allowing the Soviet
Union more scope to apply pressure on the Indian government
Fxternal markets, or at least some of them, can be captured by
force The air invasion of Sri Lanka and the subsequent sui render
of the Jayewardene government, have opened up the Sri Lanka market
to Indian big business We will have to wait and see which of the
neighbours next feels the weight of India's 'Monroe Doctrine', a
doctrine of regional sub-hegemony
Shrinking markets wil l force other
Some Consequences of Famine D N
The famine represents a serious crisis for the entire economy.
The much-vaunted stability of Indian agriculture and the new growth
path of the economy will be tested and the reality revealed. It is
in such a crisis that imperialism can apply the greatest pressure
on the indigenous ruling classes to force the changes m policy that
it wants.
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