DR Max Daunderer, internationally famed German toxicologist, arrived in the Madhya Pradesh capital with a large supply of sodium thiosulphate-the only known antidote for cyanide poisoning, within a week of the Bhopal gas tragedy. But the doctor was forced to leave the country, reportedly under threat of his life. Why? And now why a concerted campaign against the use of sodium thiosulphate?
A feeling is gaining ground that at the decision-making level in the Madhya Pradesh government and at the Centre, there is a strong lobby working in liaison with Union Carbide. That a systematic attempt is being made by an influential section to cover up the extent and scope of damage lethal methyl isocyanate (MIC) gas can cause to the internal system of the human body. And to thereby help the multinational escape paying reasonable compensation to the victims of the tragedy. Sources allege that soon after the MIC leakage from Union Carbide’s Bhopal pesticide plant, the multinational corporation pressed its public relations operations into top gear. Scores of public relations specialists were hired to contain public hostility and alarm. And many Indians, it seems, became willing performers in the multinational’s design.
First, a controversy raged over the killer effect of MIC-even though the tragedy was there for everybody to see. Then a storm blew up on the line of treatment for gas victims. Now, a new controversy has been triggered-as to whether the case against Union Carbide is sustainable in a US court of law, and whether the people entrusted with the task of sorting out the issue of compensation to the MIC victims have been “obliged” into adopting a laissez-faire attitude or are being led up a blind alley in American courts. Simultaneously, there would appear to be an insidious attempt to disprove that the cause of the havoc in Bhopal was cyanide-poisoning.
Union Carbide, in fact, has been exceptionally touchy about the cyanide-poisoning theory right from the time of the tragedy. Even though the prognosis of Dr Heeresh Chandra, head of the forensic department, Hamidia Hospital, Bhopal-where the autopsies of all those who died because of MIC-exposure were conducted-was that the cherry-red blood of the victims indicated cyanide poisoning. Dr Max Daunderer, who arrived in Bhopal on December 4, 1984, with a large supply of sodium thiosulphate, the only known antidote for cyanide poisoning, suggested that the drug be administered to all victims. But it was not. Instead, Dr Daunderer was asked to leave the country (see box). Why? Was someone afraid that his continued presence would only confirm cyanide poisoning in the MIC-exposure cases? That would have pushed up the quantum of compensation astronomically. And this is where the role of the anti-thiosulphate lobby starts appearing dubious.
About-turn: Ever since an Indian Council of Medical Research (ICMR) team identified cyanide-poisoning as the cause of the gas victims’ plight, and recommended sodium thiosulphate-treatment, the lobby has been frantically trying to persuade the Council to issue a directive that treatment with the drug is no longer necessary. And it seems to have succeeded. It is said that Dr Ishwar Das, commissioner for rehabilitation of gas victims, and Dr N.P. Mishra, head of the department of medicine, Gandhi Medical College, Bhopal, went to Delhi on September 5, 1985, to press the anti-thiosulphate case. Though Dr Mishra returned after a day’s stay, Dr Das stayed back in the Capital about a week. And soon, the directive came. Rather an abrupt about-turn for the ICMR. It is also strange that nobody has cared to raise the issue of the dangers of treatment with bronchodilators and steroids, which are being widely used on those suffering from MIC exposure. These not only have adverse after-effects on the human body, they also do not guarantee a permanent cure, reveal medical sources. As a result, so far, it is largely the symptoms that have been treated, not the real cause. It would appear that the considered opinion of many leading doctors-both in the country and abroad-carries little weight with the decision-makers. Or Union Carbide, for that matter.
Within hours of the Bhopal tragedy, Dr Avashia, medical director, Institute Plant, USA, sent a telex message to the Bombay, Delhi and Bhopal offices of Union Carbide, on December 3, 1984, suggesting: “If cyanide poisoning is present, administer sodium nitrite and sodium thiosulphate. If the patient does not respond to the amyl nitrite or if severe exposure is suspected, administer intravenously 0.3 gm sodium nitrate at the rate of 2.5=5 ml a minute, followed by injection of 12.5 gm sodium thiosulphate at the same rate and via the same needle and vein.” But the suggestion did not reach the medical community. Was it suppressed?
Even the initial recommendation of the ICMR that sodium thiosulphate be administered to those showing symptoms of cyanide poisoning was short-circuited. In the second week of December, the director of health services, Madhya Pradesh, ostensibly on an order from the Union health ministry, banned the use of sodium thiosulphate. It was only after a fatal lapse of two months that this decision was officially reversed. But no clear guidelines were issued. Nor was any arrangement made for the drug’s availability in the quantity required for detoxification of the affected people. Of the over one lakh needing sodium thiosulphate, only five per cent have been lucky enough to get the injection, informs K.N. Pradhan, member of parliament from Bhopal.
Pradhan feels that Union Carbide was aware of the possibility of cyanide poisoning in the event of leakage of MIC. The multinational, however, claimed that the gas was harmless and not a killer. But then, certain sections point out, an admission to the contrary would have left the company highly vulnerable in compensation cases. The Carbide vice-president for health, safety and environmental affairs, Jackson Browning, said in March this year that the corporation would sponsor a metabolism study on animals to see whether a single large exposure to MIC could lead to cyanide poisoning. Curious indeed, considering that in a report on MIC published by Union Carbide in 1976, it is clearly stated that thermal decomposition of methyl isocyanate may produce hydrogen cyanide. More curious is the fact that all information about the nature of the gas which leaked from the Bhopal plant as well as the autopsy findings were withheld from the medical community as well as the public by both Union Carbide and the government.
The medical officer of Union Carbide, Dr Jaeger of the World Health Organisation, and the committee set up by the MP government to enquire into the cause of the deaths insisted that there was no evidence of cyanide poisoning and only the lungs and eyes of victims were affected. The role in this regard of Dr M.N. Nagu, director of health services, MP, is also intriguing. Dr Nagu, it is said, kept the ICMR recommendation regarding sodium thiosulphate to himself. He also did not release the thiosulphate stock that he had for some time. When faced with a hostile demonstration, he told a delegation of the Sangharsha Morcha that the drug was available to “whoever wants to have it.” But he did not arrange for its supply. Could his attitude have something to do with the fact that his brother, R.N. Nagu, a former inspector-general of police, had a Rs. 4 lakh-a-year contract for the security arrangements at Carbide’s Bhopal plant? When contacted, Dr Nagu said he had no time to meet PROBE. So it was impossible to get his clarification.
Dubious role: The man most blamed in the thiosulphate controversy, however, is Dr N.P. Mishra. He was among the first to suggest that the MIC victims needed only bronchodilators and steroids. This was in tune with the Union Carbide stand. Incidentally, Dr Mishra has been a long-time medical consultant to Union Carbide. He also visited the USA after the tragedy-despite a government order prohibiting him from doing so. When asked how he was allowed to go, Chief Minister Motilal Vora claimed that he got to know about Mishra’s trip only after the doctor had left the country.
It is also telling that Dr Mishra, R.N. Nagu and a few others have been used in the British Broadcasting Corporation’s television film, The Poison City, to give the impression that the Bhopal tragedy was the result of callousness on the part of the state and Central governments. It is learnt that Union Carbide is rather keen on using the film in its defence in court. And while Dr Mishra’s role in the film may be dubious, his continuing opposition to sodium thiosulphate is inexplicable.
The ICMR minutes show that on February 14, 1985, at a meeting which discussed the findings of clinical trials conducted by a team of doctors under noted cardiologist Dr P.S. Narayanan, it was decided to recommend thiosulphate for MIC victims who showed respiratory, gastrointestinal and neuro-muscular complications-all symptoms of cyanide poisoning. Dr Mishra also attended this meeting and pointed out that out of 200 victims who had been administered thiosulphate injections, two had shown signs of adverse reactions. To which Dr Narayanan responded that of 90 victims who were administered 322 injections under his close observation, only two had shown any sign of a reaction. Dr Mishra’s objection was thus overruled, and the ICMR decided to recommend sodium thiosulphate for the gas victims. Further Dr Mishra, on behalf of the department of medicine, deposed before a gathering of scientists on May 4 that in his study of 200 cases, 60 per cent got relief with sodium thiosulphate. Why, then, this subsequent volte face?
Curiously enough, neither the ICMR nor the MP government released the thiosulphate recommendation. Dr M.N. Nagu, for reasons best known to him, sat on the ICMR report. The state health department, too, chose to keep various findings under wraps. As Dr Punuavratha Goon of the Drug Action Forum and Dr A.R. Phadke of the Medico Friends Circle-who are helping the gas victims-point out, Dr Daunderer had demonstrated the presence of cyanide in the blood of gas victims as early as December 4, 1984. The two trials conducted by the ICMR further confirmed cyanide poisoning and proved beyond doubt the efficacy of sodium thiosulphate in treating it. But the report is yet to be seen.
Then again, what prompted the ICMR, shortly before the Union government appointed a committee to investigate the gas tragedy, to declare that there was no reason to believe that there would be any long-term effect of MIC poisoning on the human system? This opinion-though subsequently denied-greatly helped those who wanted to underplay the tragedy. And came in handy for the anti-thiosulphate lobby-which seems determined to establish that the theory of cyanide poisoning is sheer nonsense, despite Dr Heeresh Chandra’s assertion that even today, thiosulphate is effective in treating MIC cases. According to Dr Phadke, too, it is advisable to administer thiosulphate to all the victims. For studies in the West have shown that cyanide poisoning can be chronic. But, he says, it will take over a month to give thiosulphate injections-even if they are available-to the MIC-affected population of about 1.5 lakh. For the 10 clinics in Bhopal are severely handicapped by a lack of trained personnel.
Suspicious activities: There are other sides to the thiosulphate controversy, too. The Madhya Pradesh government spokesman and the anti-thiosulphate lobby describe the whole thing as a question of conflicting medical opinion. Dr Basaria, former Congress mayor of Bhopal, who is also said to be a beneficiary of free medical aid from the USA, feels that the controversy is unnecessary. Many responsible citizens-among them two Congress (1) MPs and a senior doctor-also believe that the tank from which the lethal gas leaked out contained some new chemical, which either went out of control or was “deliberately released” on the poor people of the area as “part of a diabolical chemical warfare experiment.” While this may sound somewhat far-fetched, the activities of Union Carbide’s research and development centre at Bhopal do raise suspicions.
While the pesticide plant had been running at a loss for some years, the company continued to make investments of up to Rs 20 crore in it every year. To screen new formulations, it is claimed. The unit has 2,700 sq ft of the most sophisticated greenhouses and two hectares of farmland. Surprisingly, however, it conducted studies without getting projects cleared by the high-level screening committees of the government of India-of which the secretary, ministry of external affairs, and the defence adviser are members. The company also conducts biological research in the strategic area of North-East India. When Dr Vasadarjan, secretary, department of science and technology in the prime minister’s secretariat at the time when technical sanction for the Bhopal research and development centre was given, was asked whether he was aware that the centre conducted studies on lethal chemical and bacteriological formulations, he said he was not.
Against this backdrop, it is interesting to note how, over the years, the multinational has been at pains to keep men of means under obligation. A Congress (I) leader is the Carbide lawyer. Besides, prior to tragedy, the company’s guest house in Bhopal was always at the disposal of the ruling party. A Central minister used to stay there whenever he visited the city. During the Congress (I) regional conference, many Central ministers were accommodated there. It is always alleged that senior politicians and civil servants were “obliged” by giving their relations jobs in the company “on fat salaries.” In fact, among those on the Carbide payroll is the nephew of a former education minister. According to a Congress (I) MP, even chief ministers were accorded “lavish hospitality by Union Carbide when they visited the USA.” This nexus of big business, bureaucrats and politicians is what, perhaps, stands in the way of justice being down to the gas victims. Some allege that it is the main reason why the N.K. Singh Commission, constituted by the state government to enquire into the gas tragedy, has not made any headway yet.
Sources reveal that neither Union Carbide nor the state government are cooperating with the commission. The chief minister, however, denies that there is any move to wind up the enquiry. “Not at the moment,” he asserts. But then, his government, too, seems to have done little in the matter. It has not yet identified all the victims and the dimension of the damage. Nor has it made out a case for suing Union Carbide. The commissioner of claims is still-nearly 10 months after the tragedy-wading through the files to classify the victims. The Tata Institute survey on the gas victims has been another joke-with only 11 wards adjacent to the Carbide factory having been covered by it.
The Tata Institute survey could identify only 9,000 persons who are suffering from the after-effects of MIC exposure-when local doctors put the figure around 1.5 lakh. The survey also took an inordinately long time to be completed. One reason for this is said to be the institute’s insistence on taking the data collected to Delhi for processing by computer-even though computer facilities are available in Bhopal. It is learnt that for two months, the papers did not reach the Capital. A subsequent station-to-station hunt for the consignment led to its recovery from the godown at an obscure railway station between Gwalior and Jhansi. Was a deliberate attempt made to “lose” the papers in transit? Or was this just another instance of bureaucratic apathy? Is there a motive behind the latent callousness?
Prolonging misery: every non-official agency has placed the number of those who died in the tragedy at between 3,000 and 10,000. But the state government has arrived at a static figure of 1,754 dead. The comparatively low official figure is bound to help Carbide when it comes to paying compensation. Besides, only 1,196 of the dead have been identified to date. This apart, the government has not been able to classify the injured, the disabled and the affected. And the chief minister claims there is progress in the work? To claim compensation, as K.N. Pradhan puts it, the government needs to prepare a sound case with a detailed medical and clinical report on the victims. But this, again, is not there. Its absence is only proving of advantage to those who do not appear too keen that sodium thiosulphate should be administered to the MIC victims. For acknowledging the efficacy of this drug would be tantamount to accepting the fact that the victims are suffering from cyanide poisoning. There are other indications, too, that a deliberate attempt is being made to prolong the misery of the gas victims-by denying them effective treatment.
The mid-August, the Madhya Pradesh health department got a consignment of 10 lakh tablets of Rheo-dur-a bronchodilator-from key Pharmaceuticals Inc, Miami, Florida, for treatment of gas victims. The medicine, worth around $ 50,000 (about Rs. 6 lakh) was donated by the company to a Bhopal gas victims’ relief organisation of Indians settled in the USA, headed by one Dinesh Chandra. The organisation, reportedly through some “helpful sources in the prime minister’s secretariat,” succeeded in persuading the government to waive duty on the consignment. Only later was it discovered that the donated tablets’ expiry date was September 1985. But this did not deter the authorities from distributing the tablets to gas victims-that too, it is alleged, without informing them about the expiry date. One can only wonder why this was done. And what could have been the motive behind sending an expired batch of life-saving medicine for the Bhopal victims?
It is being alleged in certain quarters that there is a move to establish that the general physical condition of the Bhopal victims-predominantly from the low-in-come group-was such that their system was more susceptible to MIC exposure than a healthy individual’s would have been. As a result, the gas had a more crippling effect than it would have on a “normal” person. In this way, it is said, the multinational hopes to minimise its responsibility in the Bhopal tragedy. But the ploy would fail if it is convincingly established that cyanide-poisoning is the cause of the gas victims’ misery. Which is why the determined opposition to thiosulphate, allege sources.
Can this be true? Are human live so expendable when it comes to safeguarding a multinational’s interests?