Bloomberg News

Cancer Express Carries Sufferers of India’s Deadly Waters

October 28, 2013

Patients Wait For Treatment

Patients wait for treatment in the corridor of the Acharya Tulsi Regional Cancer Treatment & Research Institute in Bikaner, Rajasthan. Photographer: Prashanth Vishwanathan/Bloomberg

Mahendra Singh parts the crowd massed on the dimly lit platform to pull his ailing mother-in-law on board the train locals call the Cancer Express.

The farmer from northern India jostles for space in the blue train before gently laying Charanjit Kaur down on the bare wooden bench. Cradling two small bags, the couple are bound on an overnight train for a hospital a state away in Rajasthan where she’s to be tested for suspected water poisoning.

“I thought we were done with this disease,” said Mahendra, 55, who lost his mother to breast cancer four years earlier. “But it never goes away. People say we’ve dirtied our water and that’s why we’re suffering.”

Mahendra and farmers across Punjab state helped India double farm yields in 50 years, making the country a food exporter from a chronically hungry one in the 1960s. The “Green Revolution” introduced them to chemical fertilizers and pesticides that seeped into increasingly scarce water sources and contaminated food and soil. People in the second-most populous nation are now paying for it with their lives.

With health issues costing India 2 percent of gross domestic product a year at a time the economy is growing at its slowest pace in a decade, Mahendra paid less than $2 in rupees for the 330-kilometer (205-mile) trip.

About 50 others aboard the train are also bound from Bhatinda to Bikaner to the same hospital for the same tests to see whether area waters are contaminated or toxic. Some are so sick they won’t return.

Bread, Pickle

Mahendra and his mother-in-law eat Indian bread and pickle for dinner, which they fetch from a cloth bag.

Pesticide overuse on wheat fields critical to feeding Indians that ended up in drinking supplies or arsenic in water drained by wells may have led to the lung cancer that convulses the septuagenarian, leaving her gasping for air.

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Their railway car has windows with iron rods and shutters. There’s no air conditioning anywhere. A ticket checker walks past Mahendra and Charanjeet.

“The train has always been meant for the cancer patients, this is the reason this train exists,” said the checker, Munna Lal, in black trousers, jacket and a white shirt, sweat beading his forehead on a humid night.

Contaminated Waters

In a country where one in five rural households have no drinking water, sanitation or electricity, Punjab is India’s most-irrigated state. It was among the first to embrace Nobel Peace Prize-winning agronomist Norman Borlaug’s “Green Revolution” that pumped up crop production.

Four decades later, wheat yields have more than doubled to 2 tons a hectare (2.47 acres).

Yet chemicals such as arsenic and fluoride, some that found their way into waters, others naturally occurring in less potent amounts that grew more concentrated as wells and aquifers were drained, began causing clusters of diseases and health issues in India, according to the World Bank.

Deaths related to contaminated and dirty waters aren’t restricted to India. Dysentery from unclean water at an orphanage in the Democratic Republic of Congo left 31 children dead, according to the Christian adoption agency All Blessings International.

Cancer rates in Argentina, the third-biggest soybean producer, are at least double the national average in Santa Fe province as pesticide applications settled on water sources and villagers stored water in pesticide containers, the Associated Press reported Oct. 21.

‘Cancer Villages’

Heavily polluted underground water has caused more than 200 “cancer villages” with rates far above the national average to crop up in China, Wang Hao, a water specialist with the Chinese Academy of Engineering, was cited as saying by Caijing magazine on Sept. 17.

Dirty water and inadequate sanitation cause 10 percent of all deaths in India, Asia’s third-biggest economy. Severe surface and groundwater contamination has affected 65 million people across India, a report on the government website shows.

About 200,000 children four and younger die across India annually because of diarrheal diseases, according to a study in the Lancet medical journal. Waterborne diseases affect almost 38 million Indians annually, the WaterAid group said.

Over the last five years, more than 34,000 people died of cancer in Punjab alone, the government said.

‘Spreading Death’

“Poison has got into our water and our food,” Chander Parkash, assistant professor at Punjab Technical University, said. His study of contamination and depletion of groundwater tables and soil revealed a link with cancer deaths in the state’s Malwa region. “We’ve used so much chemicals that our rivers and aquifers are now spreading death,” he said.

The government has tried to make more people aware of the dangers of pesticides, with farmers told to use only safe chemicals as recommended on product labels, Agriculture Commissioner J.S. Sandhu said.

Jarnail Singh, 72, a retired teacher in Punjab’s Jajjal village, noticed cancer numbers growing in 1998. Back then his village of 3,500 had 10 cancer cases. In four years it doubled. About 55 villagers have died from cancer in Jajjal the last 15 years, Jarnail said.

He has sowed cotton and planted vegetables in his 5-acre field for years, spraying pesticides to try to get 20 kilograms (44 pounds) of cotton from each acre. Without the fertilizers and pesticides, he said his yield is 4 kilos an acre.

“We’re stuck,” said Jarnail, sitting on a bed in a bare white-washed room by his 80-year-old brother at their ancestral home. “This is slow poison but we can’t get out of it.”

Food Program

Back in the 1970s when Jarnail was younger, then-Prime Minister Indira Gandhi charged geneticist Monkombu Sambasivan Swaminathan with developing high-yield crops to help reduce imports in India, whose government runs the world’s biggest food program for the poor.

In the last century, India endured three droughts and two famines including in Bengal in 1943 in pre-partioned British India that killed at least 1.5 million. Swaminathan brought seeds to India developed in Mexico by Borlaug cross-bred with local species to produce a higher-yielding wheat.

The hybrid seeds, coupled with higher use of fertilizers, helped India raise food grain production from 82 million tons in 1960 to 250 million tons in the fiscal year ended March 2012.

Though they increase harvests, chemical compounds in fertilizers and pesticides contaminate agricultural runoff that pollutes adjacent waterways such as canals and seeps into the groundwater, said David Michel, Washington-based director for environmental security at the Stimson Center.

About 55 cubic kilometers of wastewater gets dumped in the Indus River every year, with 90 percent of the effluents from agriculture, according to the United Nations Environmental Programme website.

Rejected Exports

In the first nine months of 2013, the U.S. returned 1,613 export items to India. A basmati rice cargo exported from Amritsar in Punjab on Sept. 16 was rejected by the U.S. due to the presence of pesticide chemicals, according to the website.

Fertilizer use in India has climbed to 26.5 million tons in the year ended March 2010 compared with 6.1 million tons in 1981-1982, government figures show.

The nation’s imports of chemicals jumped to as high as 9.1 million tons in 2009-2010 from 2 million tons in 1980-1981 as the population climbed to 1.2 billion in 2012, second only to China, from 454 million in 1961.

‘Aren’t Counseled’

Most fertilizers and chemicals are used without monitoring or guidance by farmers, many of whom can’t read, said Ajay Jakhar, chairman of the farm group Bharat Krishak Samaj. Illiterate farmers frequently rely on traders for word on how to use the chemicals. Seven in 10 Indians live in rural and semi-urban areas where literacy rates are as low as 46 percent.

“We always ask farmers not to spray the pesticides before the outbreak of any disease or pest attack,” Sandhu, the agriculture commissioner, said yesterday. “If they apply before, they take the risk. Farmers should use those chemicals which are safe, should be made aware that the produce should not have chemical residues, otherwise it will not fetch returns.”

The equipment that farmers use to spray pesticides often is washed in canals and rivers. The same contaminated water that flows through these canals is then stored in village tanks that people use for drinking, Jakhar said.

“Farmers aren’t being counseled on how much fertilizer and pesticides are needed to grow a crop and this has led to abuse,” he said. “India became complacent in advising farmers after achieving the ‘Green Revolution’ goals. Governance has obviously failed.”

India’s department of chemicals and petrochemicals isn’t mandated to educate farmers about pesticide use, director Sanjay Bansal said. It’s the farm ministry’s role to reach out to growers on use of chemicals, he said.

Water Scarcity

Water and soil contamination are high in Tamil Nadu, Maharashtra and the northeastern states of India in addition to Punjab, said Bharat Sharma, New Delhi-based principal researcher at the International Water Management Institute.

“The full onslaught of the Green Revolution and fertilizer was first unleashed in Punjab and it’s now coming back to hurt them the most,” said Om Rupela, adviser to the United Nation’s Food and Agriculture Organization and a former scientist with the International Crops Research Institute.

“Some pesticide residues remain in the soil and food for as many as 30 years and these show up as diseases many years later,” said Rupela, based in the southern city of Hyderabad.

Back at Jarnail’s home, cancer is a way of life. He has cremated three relatives in four years. When he has guests, Jarnail assures them his water is purified and safe to drink.

That’s in part because both he and his elder brother have had to take the Cancer Express that starts north of Bhatinda in Abohar.

‘Biggest Crisis’

“Providing safe drinking water, maintaining aquifers and keeping the water flowing is the biggest challenge for India,” said Rajendra Singh, winner of the Ramon Magsaysay award for bringing water to parched areas of Rajasthan. “Water is quickly becoming India’s biggest crisis and threatening economic growth.”

More than a fifth of India’s land area and 17 percent of its people may face “absolute water scarcity” by 2050 as farmers, cities and industries compete for the resource and climate change affects its geography and weather patterns, according to a farm ministry report. Per capita availability of water, about 1,704 cubic meters in 2010, is projected to drop to 1,235 cubic meters by 2050, the report said.

In 2000, almost all of India’s major rivers had already exceeded their nitrogen-absorbing capacity -- nitrogen’s the principal component of many man-made fertilizers, Michel said. The OECD projects that by 2030, nitrogen effluents in India’s wastewater will quadruple from 2000 levels to almost 2 million tons of nitrogen annually as phosphorus surges almost fourfold.

Water-Quality Study

A year ago, India’s Central Ground Water Board started studying Punjab’s water quality and whether pesticide and fertilizer pollution is killing people, Chairman Sushil Gupta said. The study will take another year to complete.

“It is possible people are falling ill because they spray pesticides without protective gear,” Gupta said. “I wouldn’t like to say more because we’re still studying it.”

In the hospital at Bikaner, Mahendra is paying 30 rupees (46 cents) a day for a bed and 5 rupees for a meal for the care of his mother-in-law.

Free Medicine

That the hospital offers free medicine and doctor visits makes the rate worth traveling twice as far instead to a hospital in Faridkot that started a cancer ward in 2009.

Almost 70 percent of the cancer patients the hospital treats are from Punjab and Haryana, states that supply more than a third of India’s wheat.

Bikaner treated about 7,000 cancer patients in 2012, 1,100 more than the previous year, said Ajay Sharma, head of the radiotherapy department at the Acharya Tulsi Regional Cancer Treatment & Research Institute. He expects 8,000 to visit this year.

Cancer replaced heart disease as the world’s leading cause of death in 2010. For India, still struggling with tuberculosis and hunger among its poorest, it challenges an already overburdened medical system.

Angry God?

India has spent 1.56 trillion rupees on water supply and sanitation projects the past 60 years. Still, infrastructure has struggled to keep pace with demands of industry and a growing population.

“Add to this mix the problem of water quality and it looks very scary,” said Chandra Bhushan, deputy director at the Delhi-based Centre for Science and Environment.

The dilemma remains that almost 90 percent of chemicals used in farms to boost yields end up in water sources in India, Bhushan said. “We focused so much on growing food that we may not have enough clean water for future generations.”

At the hospital, Mahendra and Charanjeet don’t know why cancer is killing villagers. Fly ash from two old power stations in Bhatinda and a refinery increased the arsenic content in the soil, locals say. Sitting on the train that stops at 27 stations during an eight-hour journey, Mahendra holds out little hope for his mother-in-law.

“She understands she’ll probably die but I don’t think she’s afraid,” he said. “Are people dying in other parts of India or is God angry only with us?”

To contact the reporters on this story: Rakteem Katakey in New Delhi at rkatakey@bloomberg.net; Archana Chaudhary in New Delhi at achaudhary2@bloomberg.net

To contact the editor responsible for this story: Randall Hackley at rhackley@bloomberg.net


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