Bhopal gas tragedy: Wrong medication killed more people, reveal PMO files; 20-25 dying per month even after 34 years
Tragedy did not strike Bhopal on the intervening night of 2-3 December 1984 but thereafter as horrible relief and rehabilitation measures including wrong medication killed thousands, reveal documents accessed from then prime minister Rajiv Gandhi's office
Editor's Note: More than 700 documents accessed from former prime minister Rajiv Gandhi’s office reveal how horrible relief and rehabilitation measures by the authorities, and a company determined to hide the truth led to more deaths in the aftermath of the Bhopal gas tragedy. This three-part series uncovers how a dysfunctional administration at the state and Centre failed to contain the crisis 34 years ago, and how it's taking lives even today.
Tragedy did not strike Bhopal on the intervening night of 2-3 December 1984 but thereafter. The massive leakage of Methyl Isocyanate (MIC) gas from the Union Carbide plant resulted in colossal loss of life and an estimated 8,000 died within two weeks and more than five lakh were affected.
More than 700 documents accessed from the Prime Minister's Office during Rajiv Gandhi tenure reveals horrible relief and rehabilitation measures including administering wrong medication to the victims and a dysfunctional administration.
The Bhopal gas tragedy was the biggest industrial disaster in terms of loss of human lives, in the history of the world. The tragedy, for the first time, made people aware of the magnitude of a peace-time calamity. The lingering impact of the tragedy is horrific and at least 20-25 victims are losing their life every month even now. Do the successive government's care about the 5,74,376 survivors? No. Was the then government's response to the lethal gas leak swift and accurate? The answer is an absolute ‘No'. The facts buried in the secret files and the reality of present day is disturbing and shocking. The victims are forced to live on an island without a government.
Confusion over medicines led to more deaths
Immediately after the tragedy struck Bhopal, a doctor from Germany rushed to the grief stricken city. He advised that the gas affected victims should be given Sodium Thiosulphate. The drug had desired impact. But, within a week, government doctors as per recommendation from the Central Government on 11 December 1984 decided against it and instead steroids and bronchodialators were recommended. Almost three months later in March 1985, the government reversed the treatment by recommending Sodium Thiosulphate injection. But, it was disrupted again in June 1985. It was a callous decision and only 5 percent of the population could be given the right treatment.
Then prime minister Rajiv Gandhi came to know about this cold blooded murder about nine months after the tragedy. It is hard to imagine how many people might have suffered and continue to be suffering due to wrong medication.
The government and bureaucratic apathy was colossal. The then government however, argued they were not prepared to tackle such a situation and tried to play down the impact. They were totally clueless. Amidst the confusion over the correct medicines, then health secretary Sarla Grewal wrote on 18 March 1985 that long term complications were difficult to predict, though, rejecting the reports about victims losing their eyesight.
Grewal letter (DO No. T-19011/7/85) said: “The real crux of the problem was that a disaster of such magnitude caused by such a highly toxic chemical was unparalleled in living memory. The experts, both Indian and international, were unanimous in their opinion that while symptomatic treatment must go on there would be need to have long-term clinical and epidemiological follow up.... The long term complications are difficult to predict. There is not much of experience about this type of poisoning and the text books do not throw much light on this subject. Only a systematic and long-term follow-up would reveal the different facets of the problem. However, the available medical evidence does indicate that the reports about large number of people becoming blind or likely to become blind as a result of the gas poisoning is grossly exaggerated. Most of the people having temporary eye-ailments have recovered and only a small percentage of people, who were severely exposed could have corneal ulcer leading to opacity. However, the major problem is likely to be in the lungs. It does appear that a large number of severely exposed cases may develop permanent damage to the lungs due to fibrosis for which there is no effective cure. These conditions can worsen with super added infection."
Sometime in August 1985, a committee constituted by the government under chairmanship of BJ Heerjee, then additional secretary, Ministry of Home Affairs, informed the Prime Minister’s Office that the medical opinion on the benefits of Sodium Thiosulphate therapy differs.
"Since knowledge about the effect of poisonous gas on human and animal bodies, in fact, the nature of the poison itself was limited, the initial treatment has to be symptomatic,” the report said further adding that the antidote supplied was more than one lakh but only 22,000 were used and number of persons covered must be smaller.
On the issue of wrong treatment, the government was of the view that it happened due to lack of information from the Union Carbide that triggered considerable amount of confusion for the doctors, who had an opportunity to come in contact with the patients or carried out autopsies.
“Even from the early autopsy findings, a strong suspicion was entertained about the possibility (of) cyanide poisoning, causes apart. There were suggestions to a similar effect from a visiting German toxicologist, who not only advocated but promptly (provided) samples of Sodium Thiosulphate for treatment of the gas victims. However, there was a fairly big group of physicians who could not reconcile to such a possibility. They were rather hesitant about the utility of Sodium Thiosulphate as an antidote until and unless positive evidence of cyanide being present was established,” report said.
At least nine pages long, the report, which scrutinised the medical relief, minced no words in concluding that such confusion was regrettable. It also pointed out that despite the fact that sufficient presumptive evidence about the presence of cyanide in victim’s body was made available by middle of January 1985, the skepticism regarding the use of Sodium Thiosulphate continued.
"It is rather regrettable that many unrelated considerations should have prevented the wider use of Sodium Thiosulphate in the primary detoxification of the symptomatic patients, with physical weakness and fatigability out of proportion to pulmonary signs, X-Ray findings and even lung function tests. No special care seems to have been taken to find out those who are likely to be benefitted from Sodium Thisulphate treatment. During the course of its deliberations on 9 and 10 August 1985, the group interviewed representatives of practically all shades of opinion, both professional as well as public. It was apparent, that apart from dissenting note of a few physicians, there was widespread feeling of a great relief and satisfaction following the administration of Sodium Thiosulphate injections,” report further added.
Union Carbide used money, power to keep cyanide poisoning under wraps
The PMO files reveal that in spite of the lapse of several months, the stage was not ready for trouble-free functioning of baseline and sophisticated laboratory equipment in August 1985. There was an urgent need to provide essential equipment like spectrophotometers of indigenous make and get them standardised and operationalised by trained technicians.
On 6 July 1985, 'Medico Friend Circle', an all India group of doctors wrote to Gandhi protesting against the wrong prescription of medicines to the Bhopal victims. However, the letter was merely marked to the then joint secretary to the prime minister and action taken on the communication remain in domain of speculation. In the letter, the group had informed that effort to provide Sodium Thiosulphate treatment to the gas disaster victim was forcefully closed by police action on 24 June, 1985.
“This action included arrest/harassment of the doctors, confiscation of medical records and equipment and closure of the health centre. We are shocked at the disgraceful treatment meted out to this group of voluntary doctors who had come from different parts of the country to Bhopal in response to the human tragedy that took place there. This action has resulted in discontinuation of essential and life saving medical treatment for hundreds of patients in the bastis (localities) of Bhopal,” Ravi Narayan, convener of Medico Friend Circle wrote to Gandhi.
Why the doctors trying to save lives were lathi-charged and thrown out of the medical camps? A confidential PMO note has all the answers. The note said: "It appears that a powerful lobby of Union Carbide has been active in Bhopal ever since the gas tragedy, to distort evidences of Cyanide poisoning and experiments earlier conducted on the Union Carbide premises. Many voluntary medical units have been driven away by police threats and intimidation of other kinds. Attempts have been made to sabotage the administration of Sodium Thiosulphate which would establish a case of Cyanide poisoning.... It seems that Union Carbide has persistently resorted to money power and pressure to distort realities of the tragedy, and to obstruct relief work to the detriment of the ailing persons. It would also seem that it is the objective of Union Carbide to safeguard its high stakes at any cost; and the future of all pesticide/herbicide/pharmaceuticals multi-nationals who are covertly behind Union carbide in this matter. Their manipulation/actual working need to be closely monitored.”
The state government, however, refuted these charges and argued that such reports were highly motivated and based on political consideration. During a meeting with the then cabinet secretary PK Kaul on 9 July, 1985, the state government said: “Some doctors had be arrested because they were directly involved in inciting violence and disorder, and not in relief work.”
Exactly a year after the tragedy on 3 December, 1985, Dr CR Krishna Murti, Scientific Commission on Bhopal Gas Leakage, reiterated what the doctors initially said about the cyanide poisoning and use of antidote. In his letter to S Varadarajan, then director general for Council of Scientific and Industrial Research (CSIR), Murti said the cyanide content of serum samples of victims were measured through a sophisticated procedure.
“Autopsies done by Dr Heeresh Chandra very clearly reveal that the exposure to the toxicants has affected a multiplicity of tissues including lungs. The contraction of stomach, the curdling of blood in gastric mucosa are according to Chandra and published literature noticed in autopsies of cyanide poisoning. The hemorrhage pattern noticed in brain and liver was also typical of cyanide exposure effects. The clinical findings currently being reported on affected persons include not only ailments of the lungs but also of the gastroinfectinal (sic) system, neuro-behavioural changes particularly in children (3-15 years) and continuing eye irritation and photofobia in several cases. There is no published literature on autopsies of humans exposed to MIC, but published literature on phosgene and HCN do reveal the above kind of manifestations. We have been searching for actual evidence of exposure to the suspected entities in the Bhopal disaster. It will be obviously difficult now to get estimates of phosgene, MIC or HCN or other chemicals as they were present during the critical 4-6 hours after release of the toxic gases on 2-3 December 1984."
The letter makes it amply clear that right prescription that was abruptly abandoned by the authorities could have saved many more lives and the injured could have received better treatment. A day later on 4 December, 1985, Varadarajan cautioned that in the absence of adequate animal studies which distinguish the effects of MIC and those of HCN or phosgene, to my mind, it is difficult to come to a definitive conclusion on the constituents of gas emission at Bhopal.
“Toxicological studies with rats, now in progress at ITRC, Lucknow, show that the material is highly toxic, causing immediate death. At all low concentrations, the first symptoms are high irritation in the eyes and foaming in the mouth and in some cases blood in mouth. After death or sacrifice in all animals stomach and intestines are bloated. Work carried out on hydrogen cyanide shows animals die with eyes open,” Varadarajan wrote in his letter.
Rajiv Gandhi government admits Union Carbide’s double standards
In the last 34 years, the debate on Bhopal gas tragedy was centered on one man — Warren Anderson — who political parties accused, was allegedly assisted by the Rajiv Gandhi government to escape from the law. He couldn’t be extradited to stand trial. The then government denied any wrongdoings, hiding the facts related to the tragedy or colluding with the most wanted accused, but a secret note by Ministry of Chemical and Fertilizers under Gandhi’s administration squarely blamed Anderson and team for the biggest disaster. The three-page note said the management of Union Carbide Corporation (UCC) tried to minimise its responsibility by shifting the blame on its Indian subsidiary.
“But there is no doubt that (the) UCC owned and operated the Bhopal plant. The UCC was responsible for the designing of the plant and had warranted that the design was based on best manufacturing information available; and that they would provide the plant with the best and most up-to-date technical data and information in its possession for the manufacturing, processing, handling and storing MIC. There are several major flaws in the design of the Bhopal MIC plant, vis-à-vis the institute plant, Virginia, particularly on the safety aspects and installations. Let us realise that MIC as a chemical, is extraordinary toxic and inflammable. It is one of the most dangerous substance known to man. One would expect a large multinational such as UCC, to offer the best and most up-to-date technology available with them and not dilute them when it comes to developing countries. The theory ‘they are not as good as us’ is pernicious and not acceptable,” the note said.
A 6-page secret note that was sent to Gandhi by then cabinet secretary Kaul also blamed UCC alleging they deliberately did not share the requisite information on lethal gas with the central and state government. The note said that the public was totally unprepared for the catastrophe and provision of full information would have led to the stopping of bulk storage and higher preparedness of government and of the public to meet consequences of any unexpected event.
"The corporation has not supplied information it possessed on the serious damage that could be caused to human and animal population, even at low concentration of MIC in air. No details have been given by the corporation of remedial and therapeutic measures that could be taken in the case of affected persons. There have been more than 80 cases recorded of leakage of MIC in USA plants and ill-effects, as revealed by the company sometime after the tragedy at Bhopal. Yet no information on these had been made available to Bhopal medical professionals before the accident or even immediately after the accident. Even till date, the corporation has failed to reveal any details of possible effects and remedies,” the note dated 19 March, 1985 said.
Three decades of neglect
Even after more than three decades, the state government is struggling to provide a healthy environment to the survivors. In an affidavit filed in the Supreme Court on 27 August, 2018, the state government said: “Construction of drainage system in the gas affected localities is being executed in 15 different packages and the work orders were issued in the months of May, July and August 2018. For the purpose of laying down sewage line in 42 gas affected localities in Bhopal, a detailed Project report for laying down sewerage lines and establishing sewage treatment plant for Bhopal city was submitted by WAPCOS Limited (a government of India undertaking) on 7 May, 2018. The state government has sanctioned the amount of Rs 145 Crores for laying down the sewage lines in the Bhopal city which includes the 19 gas-affected localities also. The work order was already issued on 5 May, 2018 and the work for laying down the sewage lines in these 19 localities is under progress. For the remaining 23 gas-affected localities also the budget will be sanctioned soon and the process is underway,” the state government said.
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