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Cancer Express

Passenger Express 339 enters Bathinda railway station around 9 pm, as if blindfolded by the dark winter night. The sight of it brings a glint to the lifeless eyes of Balwinder Singh (42) waiting on platform number two. He is too weak and turns to his brother who will be his crutches. Praveen Donthi reports. See Graphics
By Praveen Donthi | Hindustan Times
UPDATED ON JAN 17, 2010 12:49 AM IST

Passenger Express 339 enters Bathinda railway station around 9 pm, as if blindfolded by the dark winter night. The sight of it brings a glint to the lifeless eyes of Balwinder Singh (42) waiting on platform number two. He is too weak and turns to his brother who will be his crutches.

There are many like him battling cancer, frail and fragile, waiting to board. But all the commotion and noise is on the other platforms. Here, silence hangs in the air heavily.

By 5 am, after travelling for 326 km, they will reach their destination across the state border: Acharya Tulsi Regional Cancer Treatment and Research Centre in Bikaner, Rajasthan. They come all over from Punjab’s Malwa region, which comprises nine of the state’s 20 districts and 60 per cent of the population. It’s an arduous but unavoidable journey — Acharya Tulsi is the closest government cancer hospital that is affordable. “I’ve spent Rs 1 lakh in a private hospital in Bathinda. Couldn’t afford it anymore and went to Bikaner,” says Balwinder Singh who has cancer in the oesophagus. Bathinda is at the heart of Malwa. The poor of the most prosperous state go to another state to save themselves.

Map

As many as 70 patients per day on an average travel on this train from Bathinda that it has come to be known as the ‘cancer express’, and the region as ‘cancer belt’. An epidemiological study done by the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, concluded the incidence of cancer is higher in this area than elsewhere in the state. Cancer death rate was 51 per lakh per year in Talwandi Sabo of Bathinda as compared to 30 in Chamkaur Sahib, outside Malwa.

Those onboard Express 339 are taken hostage by different types of cancers. But doctors advise all of them to switch to clean packaged drinking water. The Green Revolution that started in the mid 1960s has turned Punjab into the breadbasket of India — contributing more than 95 per cent of the food grains that feed deficit areas in other states — but it has also turned the water table into a poisonous aquifer.

Malwa consumes 75 per cent of the pesticides used in Punjab, according to a 2007 State of Environment Report. “It is the excessive usage of fertilisers, pesticides and extensive irrigation that has caused the problems, not the Green Revolution methods,” says Rattan Lal, a soil scientist at Ohio University, USA. Lal studied in Punjab Agricultural University in the early Sixties.

Punjab’s land is so addicted to fertilisers — consumption in the state is at 177 kg per hectare as compared to 90 kg at the national level — and pesticides that even cattle fodder can’t be grown without their application. “Children are more susceptible to the nitrate pollution caused by the fertilisers,” says Reyes Tirado of University of Exter, UK, who published a study on the area in November 2009 for Green Peace.

In Jhajjal village, Sarabjeet Kaur’s baby was born in the sixth month. He is nine now, but still experiences weakness neck down. A few houses away, Paramjeet Kaur has three children with the same ailment. There are 20 such children in the village of 3,500. “Reproductive health has taken a beating, number of sterile couples is increasing. Since the female foetuses are more susceptible, it will add to the dwindling sex ratio,” says G.P.I. Singh, community health expert, Aadesh Medical College, Bathinda.

But there is no proof these pesticides triggered cancer. “Chronic diseases like cancer can’t be linked to one factor. But what we know is about chronic toxins present in these pesticides and fertilisers. There are some strong epidemiological correlations,” says Singh.

Hospital records in Bathinda show 61 people have died between 2004 and 2008 by inhaling pesticides while spraying, an RTI enquiry. These pesticides have entered the food chain. Studies detected pesticides — carcinogens like heptachlor and ethion — in the farmers’ blood here. And also in fodder, vegetables, bovine and human milk. Nothing had come of the expert committee constituted by the state government in 2007. “After the first meeting nothing has happened,” says Sateesh Jain of Oswal Cancer Hospital, Ludhiana, a committee member.

The number of patients boarding the ‘cancer express’ is rising, so is the usage of pesticides and fertilisers. But there is something that is on the decline: productivity. Finance Minister Pranab Mukherjee admitted in the latest Budget speech: “The declining response of agricultural productivity to increased fertiliser usage is a matter of concern.”

Balwinder Singh, 42, Bhagawanpura, Bathindahttp://www.hindustantimes.com/images/HTEditImages/Images/Untitled-2.jpg

Balwinder Singh used to grow cotton and wheat in his two-acre land and kept his family happy. He was shocked to learn that his son Jaspreet Singh (14 now) is mentally retarded. Several studies have concluded that pesticides affected mental growth of the kids. Bigger shock awaited Balwinder in March, 2009. His severe pain in the stomach was diagnosed as cancer of the oesophagus. Now he’s given out his farm on lease.

After trying out the expensive treatment at a private hospital, having lost Rs 1 lakh, he took the ‘cancer express’ to Bikaner. “Somebody in my village told me that the treatment is cheaper there.” He’s stopped drinking water from the tube well and started spending Rs 20 on bottled water on medical advice. “When they tested drinking water, only three out of 250 houses in our village had drinkable water.”

Nirmal Singh, 54, Jagraon, Ludhiana

Nirmal Singh had been a government schoolteacher for thirty years. He had also been farming,
along with his brother Malkit Singh (42), for at least twenty years. He had to extend his summer vacation in 2006, as he was diagnosed with the cancer of the gall bladder. He has been visiting Bikaner ever since. "The doctor had said that fertilisers have gone down to the water," he says.

Like most who’ve come to catch the ‘cancer express’, he had also heard about it from fellow cancer patients in and around his village. He had spent Rs 3 lakh for treatment in a private hospital in Ludhiana in vain before going to Bikaner. “I have submitted the bills to the government, and I have been waiting forever now.”

For three years, he’s been on chemotherapy. “Every trip costs me around Rs 20,000. And my brother has to put farming on hold and take me to Bikaner.”

Naresh Kumar, 5 Jhajjal, Bathinda

Naresh Kumar, was smiling when HT had reached his home. "A very rare sight", his mother Bagga Devi says.
Fever and cold rarely leave him in peace. When he was two, they took him to Bikaner. "They didn’t even do a test and nothing came of it. Then we showed him to a doctor here, but we had no money for tests. One look at him and the doctor said he’s got cancer."

Devi and her husband Tarsem Ram, both worked on the cotton fields. Now she takes care of her son full time, who can’t move his limbs and falls ill very frequently. He is one of the twenty-odd kids in the village born with birth defects and probably cancer too. A 2009 Green Peace study says infants below four months are most susceptible to nitrate poisoning of fertilisers.

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