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Community Health Learning Programme: 200809

Adithya P
Fellow, Community Health Cell

Why I joined the fellowship:
Since a very young age I have been a nature lover but circumstances were such that I
was not able the dwell much into this passion I had. While doing pre-university I
decided to become a doctor and pursue my interest in environmental issues as a hobby.
Tough we had a subject called Community Medicine it did little to show the importance
of nature in the matters of our health and it was a mere extension of the hospital based
approach. I speak now in retrospect about the subject when I say that a lot more could
have been done to improve a medical student’s perspective into the origin of diseases
and to sensitize about social and environmental issues. The subject was taught in a very
politically correct method which doesn’t help too much at the end of it. As my final
days of internship approached, I started to consider this as the right time to explore my
options in the field of environment and health and that is when I approached Drs. Ravi
and Thelma Narayan and I learnt that the Community Health Learning Programme
may just be what I am looking for.
Over the years I was getting more and more confused and critical about the
consequences of the dominant societal paradigms of education and development and I
felt that the experience at Community Health Cell will be very useful.
It was a matter of great fortune that I did get chosen for the programme as I had applied
in the last minute. Not just that, my CV spoke mostly of my interest in the field of
environment and showed absolutely no practical exposure of which I could speak of. I
had never worked in an NGO or through a nature club.
Through this experience I was hoping to get a better understanding on the
interconnectedness of various issues, be it health or social or environmental. I was also
hoping for field visits, on-hands learning experience and connecting with other
individuals and groups with similar interests.

Acknowledgements:
Due to the limitations of my literary skills and vocabulary I can only express my
deepest gratitude with the following words.
Despite my absolute inexperience in the field of community health and social issues,
and despite my last minute application for the programme, the interview committee
was so very graceful in accepting my application for it. I thank Drs. Thelma and Ravi
for considering me worthy of the programme and encouraging me to apply for it.
I thank Dr. Sukanya for the wonderful way that the programme was arranged and for
creating an atmosphere conducive for discussions and learning. In addition to that, she
played the role of my mentor and has given so much of her valuable time to help me
whenever I needed it. The structure of the programme was very appropriate for the
kind of learning and experience I was hoping for.
Community health cell as an organization itself is to be thanked, wherever I went I felt
confident when I mentioned that I was from CHC. I felt the importance of being
connected with so many organizations to make movements successful.
I have not had one uncomfortable moment at CHC as everyone made the experience
feel like home and family. Even during discussions, sensitive social issues had been
handled with great skill to ensure better understanding without an emotional
lobotomy.
The CHC library has been of great help to me and I have borrowed books and kept it
for weeks on end with and without Mr. Swamy’s permission.
I thank Mr. Premdas and Dr. Rakhal for the sharing their wonderful experiences with
us and for always being there to guide us.
I thank the office staff of CHC for bearing with us and for helping Sukanya make
arrangements for us throughout the programme.
I thank my field mentors – Mr. Jayakumar, Mr. Shridhar and all the other members of
Thanal, Trivandrum for giving me the wonderful opportunity to spend 6 weeks with
them and to learn from their organization and their personal experiences.
I thank Dr. Shirdi, Mr. Ananthu, Mr. Pratap Agarwal and Mr. R Rajagopalan from
Navadarshanam; Mr. Leo Saldahna and the other members of Environment Support
Group; and Ms. Swetha N from Corporate Accountability Desk

I thank the authors of all the books I have read during the internship, as these are books
of great value and have been written for a cause and not for money.
I thank my co-interns – Varsha, Sudha, Ria, Savithri, Lakshmi, Jeyapaul, Karibasappa,
Sabyasachi and Sapna for the wonderful times we’ve had together, teaching me very
valuable lessons and sharing their journeys with mine. The smile on their faces and the
commitment in their hearts has been one of the driving forces for me during my
internship. I wish them all the best and I hope to keep in touch with them in future too.

Learning objectives:
At the end of the 5 week orientation, the things I wanted to do during the next 6 months
were:

1. To increase my knowledge on the various environmental issues and to learn
about its link to various health problems.

2. To learn about and connect with various environmental groups and with
individuals in this field.

3. To look into the various models of environmental education followed by schools
and by NGOs.

4. To experience fieldwork in environmental health.

5. To understand environment as a dimension of health and health as a dimension
of environment.

6. To learn how communities can get together to improve and protect their
environment.

Orientation:
The 5 week orientation was the perfect way to prime us for such a programme. I felt
comfortable with the group very early on the first day itself. During this time there were
many sessions conducted as group discussions, talks by authorities in their respective
fields and visits to some model projects.
Best sessions during orientation:
I personally enjoyed every session and there were so many things to learn from each
session. But the ones that made maximum impact were:
1) The story of Malur by Dr. Ravi Narayan
He shared with us his experience about the health cooperative that was setup in Malur,
Kolar with the help of St. John’s Medical College in the 70s. This centre was initially
successful and a lot of people were able to access healthcare at the cooperative hospital,
but due to certain state and national level policy changes the village eventually turned
from being productive and self sustained to a village plagued with desertification and
debt.
Learning: One is not in complete control of his/her own health. A decision made
elsewhere can lead to the death of a person far removed from it. Whatever work one
may be doing, it is worth being observant to the happenings around the world.
2) Globalization by Dr. Thelma Narayan
One is often not completely clear on the concept of globalization and its implications.
This session was very well laid out and brought out the main positive and negative
effects that globalization has led to. Though it may have been started with a good
intention, it has now resulted in greater poverty and also to further ignorance about
poverty.
Learning: Any tool can be used for right or wrong depending on how it is used. On one
hand the sharing of knowledge across borders is a boon but the increased exploitation
of poor countries by the west has led to the worsening of the health situation. Now
communities and forests and even countries often stand defenseless against the might
of multinational corporations.
3) People’s health movement by Drs. Thelma and Ravi Narayan

Both of them have been such integral parts of the movement from its initiation and
hence it was wonderful to listen to the entire story, from why the movement was
needed and how various communities from various countries came together for it.
Learning: Even in a democracy which is supposed to be ‘for the people, of the people
and by the people’, communities have to make a lot of noise to be heard by the
authorities. Such a situation calls for powerful people’s movements and the PHM is one
such example. Health being such a universal topic, the PHM is associated with many
other social movements, supports them and is supported by them.
4) Indigenous systems of medicine by Dr. Shirdi Prasad Tekur
It is very rare to find a person who has internalized the various forms of healing. He is
indeed an authority to speak about the pros and cons of each system. An allopath is
usually skeptical of the practices of Ayurveda, Siddha, Unani and Homeopathy. Dr.
Shirdi being an allopath himself is someone any allopath would be willing to listen out.
The session clearly brought out the ideology behind each system and the scope each of
them has. He also spoke of his experience with the army and with communities. He is
also a teacher of spirituality and hence it added another interesting dash to the already
interesting session.
Learning: No authority can decide what science is and what isn’t. There many forms of
science and one could learn a lot if open to these new perspectives. In a country like
India, local systems should be encouraged and strengthened to ensure healthcare for all.
The indigenous systems should be protected from the companies with vested interests
in exploiting them for their knowledge.
Popular understanding on a subject can be created if a critical number of people are
educated about it.
5) The Tribal Health Initiative experience with Dr. Lalitha
Doctors being there in the midst of a tribal community, being accepted by them and
now even supporting them in livelihoods and agriculture was something very
heartening to see. It was a great example of holistic community development. THI is a
model project which can inspire many such efforts. Dr. Lalitha was involved with the
project from its initiation and has seen it bloom to its current state. It was very inspiring
to hear about her experience with THI.
Learning: Health centered community development models are a definite possibility.
Through sustained and thoughtful efforts a community’s destiny can be changed for the
better. If the interest is there, one can get involved in avenues without prior experience
or knowledge. Drs. Lalitha and Regi have been able to settle the hospital in the hands of

capable young doctors and nurses and now concentrate on issues of agriculture,
marketing and livelihoods.
6) Personal experiences shared by Premdas and Rakhal
Both of them have a lot of experience working with communities in the areas of health
and development. The sessions mediated by them were rich with personal stories and
the wealth of knowledge they have. These sessions helped me a lot in opening up to
new and broader perspectives.
Learning: The communities of rural India and also the urban poor face several demons
every single day of their lives. Health apart, they have to worry about where the day’s
meal will come from. In the name of development, several million people lose their
homes, jobs and lives each year. The term development has lost its meaning.

My learning at the end of orientation:
1. The magnitude of my ignorance. The sheer number of issues and the complexity
of the situation and the difficult quest for possible answers.
2. The inappropriateness in attempting for change in a unidirectional manner.
Almost all issues are inter-related and hence must be addressed simultaneously
if results are to be expected.
3. The present education system is misleading and the information is inappropriate
and inadequate. The education prepares children for the faulty dominant societal
paradigm of development and hence it is a matter of great concern.
4. Witnessing the reality is far more powerful than telling about it.
5. However good a plan or idea may seem on paper, its actual worth will only be
seen when performed on the field.
6. From my fellow interns and mentors, I learnt about unconquerable spirit,
courage, commitment and laughter.

List of organizations visited and projects undertaken:
Thanal, Trivandrum:
Zero Waste Concept: visited Zero waste centre at Kovalam, attended GAIA conference
on ‘waste to energy’ issues and read books from Thanal library.
Eloor Panchayat which is affected by industrial pollution: Read past reports, visited the
area for a fact finding mission, worked on a compilation on Eloor reports and also
wrote a report using data from Pollution Control Board.
Kasargod district - endosulphan affected community: read past reports, saw the
documentaries shot at kasargod related to the issue of endosulphan and health effects,
helped in preparing content for campaign website, visited the district where I met
doctors to ask about present health situation and met government officials to learn
about the Endosulphan cell and the relief activities.
Environmental education classes by Thanal faculty in Trivandrum schools: attended a
couple of classes and learnt about Kerala State policy on environmental education.

Environment Support Group, Bangalore
Namma Raste, Namma Uru: This initiative questions the logic behind the government’s
operation to widen the roads as an answer for traffic congestion in Bangalore, involved
in public meetings, gave presentation on health effects of road widening, took part in
demonstrations against road widening activity, was a part of awareness raising
campaign.

Navadarshanam, Krishnagiri:
Visited the ashram, learnt about self-sustaining community, Gandhian principles, learnt
about some environmental education textbooks.

Community Health and Environment Skill Share:
Attended the workshop in Bangalore, attended another workshop at Cuddalore, was
involved in the initial research for the Echangaadu school cognitive study, visited Jeeva
at Chitradurga to learn about occupational health of manual scavengers, visited Bidar’s
Labor Union to learn about occupational health of unorganized workers.

Other workshops attended:
‘Peas versus Pills’ – diet for healthy living through veganism, Dr. Nandita Shah of
SHARAN and Quiet Healing Centre, Auroville.
‘The politics and science behind genetically modified foods’ at Bangalore.
‘Globalization and Bangalore’ – a talk by Lata Mani
‘Parliament of religions – pre-parliament summit’ at Trivandrum

My experience at Thanal
Thanal is an NGO in Trivandrum working on environmental issues since the late 1980’s
and has had significant impact on the environmental movement in Kerala. They work
on the following issues:
Zero waste and community livelihoods
Industrial pollution and environmental justice
Organic farming
Anti- GM campaign
‘Ban endosulphan’ campaign in Kasargod and are part of the relief cell
Active members of GAIA (Global alliance for incinerator alternatives) and IPEN
(International persistent organic pollutants elimination network)
Environmental education
I spent almost 6 weeks with them – from july 30th 2008 to august 24th 2008, and between
September 29th 2008 to 9th October 2008.

Zero waste:
The concept is a relatively new one and has been looked upon as the answers to waste
related issues. Thanal came across this concept when they were challenged to give an
alternative to setting up 3 incinerators at Kovalam beach which was being plagued by
the wastes generated by the tourism industry. They worked tirelessly for 5 years to get
the ‘zero waste kovalam’ project going. They have also setup a Zero Waste Centre at
kovalam to create livelihood opportunities for the local women by using waste products
as raw materials.

The concept of Zero waste involves trying to reduce waste generation to a great extent
by re-analyzing the sources of wastes, improve waste segregation, re-use products,
increase recycling, repair and rejuvenation. It also involves making changes at policy
level to ensure producer responsibility to waste and also local government’s role in the
issue of waste.
It eliminates the need for destructive processes like incineration and land-filling. It is a
far more efficient and economical process and can create a lot of job opportunities.

What I did:
I spoke at length to Mr Shibu and Mr Raju of Thanal who were instrumental in getting
the process started along with the ministry of tourism of kerala and the local
community of Kovalam. Their experience in relation to this was valuable. I also read 2
compilations on the concept of Zero Waste at Thanal Library to get a better
understanding of this important concept. I visited the Zero Waste Centre and spoke to
the women who were employed there on their experience at the centre.

Interviews with the members of the ZWC
It is a resource cum livelihood centre and also a training centre. The women in the
livelihood groups report everyday and work on the production of articles using wastes
generated by the various industries. There are three sections using the raw materials:
used paper, used cloth and discarded coconut shell. This centre has been in operation
for almost 6 years and the women have gained adequate experience to give trainings to
other groups who ask for it. A nominal price is charged for it.
They receive orders from various organizations for cloth bags, coconut shell cups and
utensils etc. They also take part in several local and national exhibitions and earn
through them.
The women have also learnt a lot from the organization about environmental issues like
organic farming and waste management. This centre is now a resource centre for other
NGOs, officials and individuals to get a better understanding on the above concepts.
Another section of the ZWC concentrates on organic farming and a concept called
organic bazaar. They have a few young persons trained in the principles and practical
aspects of organic farming, who have now become resource persons and train local and
regional farmers about the benefits of organic farming and help them to adopt the
method. They also produce organic fertilizer and pest repellent at the centre which is
available for the farmers. To further support the farmers growing organic products, a
bi-weekly organic bazaar is conducted where local producers send their vegetables to

the ZWC early in the morning and are paid for it then and there. These vegetables are
taken to Thanal’s office premises in the middle of the city and are kept for sale. The
bazaar has become popular in the area.

A centre for environmental education:
The premise of the ZWC is also used as a classroom for young children to teach the very
important subject of environmental education. They are conducted monthly for the
local children between the age groups of 10 and 16. Through the centre, Ms. Sujatha is
conducting weekly practical classes on environment for children from 8 schools in
Trivandrum. These classes have received a lot of appreciation from the children and the
teachers alike. During summer vacations, a camp is organized for interested children
which includes theory sessions, talks, discussions, field visits and practical exposure.
These camps too have seen good success. At the centre there is some resource material
like videos and books pertaining environmental education.

The GAIA meeting on 10th and 11th of august, 2008:
The global anti-incinerator alliance conducted a national meet at Tricandrum and it was
also attended by experienced persons from England and Indonesia. The topics of
discussions were:
Waste to energy: is it a solution?
This talk was about the technology of the Waste to energy concept and was analyzed in
detail and was shown to be an expensive and ineffective solution for the wastes
generated in India. Incinerators lead to the production and concentration of some of the
most toxic chemicals like dioxins and heavy metals and the residual wastes from an
incinerator eventually finds its way to a land-fill.
It is clear that even from a technological perspective that WTE plants are not the answer
for managing waste, especially municipal wastes from growing cities in India. Certain
processes like biomethanisation though can be explored further with regards to organic
waste management.
WTE: A clean development mechanism?
This was a talk on the concept of carbon credits, the Kyoto Protocol and the WTO. It
was clear by the end of the talk of how the west plans to continue polluting at the cost
of developing countries.

India’s stand on WTE:
India is planning to start several new WTE projects all over the countries despite the
stiff protest and scientific reasoning. This talk was mainly on the politics behind the
proposed projects. WTE becomes profitable only after triple subsidies from State
Government, Central Government and carbon trading.
The central ministry for non-conventional energy is forcing states to adopt RDF and
other WTE projects in their waste management agenda despite the fact of previous
failures, high investments, high running costs and obvious ineffectiveness due to some
vague arguments of WTE as a technology which is also in violation of Kyoto protocol.
Carbon credits are being used as the primary weapon for fighting climate change.

Waste and livelihoods:
Livelihood issues are directly linked with waste management policies. This cannot be
forgotten when such strategies are discussed as the waste pickers depend on 'waste' as
their only source of income. They can be directly involved in opposing WTE. The wastepickers policy will go along with the policy for zero-waste strategy.
A Coordinated nationwide campaign:
The points of consideration are that the groups will have to be in constant touch with
each other and dedicate some time every week for the campaign against WTE. The
groups will share information with each other and also reach out to other peripheral
groups regarding these matters to strengthen the movement. The persons in charge of
the various activities will try to stick by the deadlines to keep the process moving which
will include preparing the FAQ, getting information regarding biomethanisation, the 31
proposed projects, about the subsidies available to each of the projects at state and
national levels, about the past projects in India and about the technical arguments that
will help the case here in India. The products for the EPR campaign will also be
discussed and a co-ordinated effort will have to be made to get the full impact. The
groups will have to discuss and agree on what the strategy of what they would convey
about the alternate strategy 'zero waste'.

IPEN conference:
The international persistent organic pollutant network conducted an international
conference at Trivandrum between 14th and 17th of August. The main topics of
discussions were:
Stockholm convention and the COP-4:

The convention is for the gradual elimination of POPs and is a binding treaty for the
various countries to follow. IPEN has been a mojor force in pushing for the elimination
of several toxic chemicals all over the world.
Public perceptions on various environmental issues:
The information that popular internet search engines dish out on typing key words is
very thought-provoking. More often than not, environmentalists come out as antinationals and villains due to the well portrayed web pages by coporations to discredit
the environmentalists stand.
Heavy metals and nano particles:
When we have our hands full with issues of toxic pesticides, the issues of heavy metal
pollution and lately of nano particle pollution are also coming to the forefront.

The Eloor Project:
Eloor is a panchayat near Kochi city and is on the banks of the river Periyar. Since 1946
it has housed around 250 industries which have created havoc in the lives of the local
people’s lives. The pollution caused by the industries affects the river, the air and the
land of Eloor. It has affected their health, livelihood and culture drastically. A local
group called the PMVS (Periyar malinikarna viruddha samithi) has been working since
over 10 years to get some kind of regulation enforced on the industries to control the
level of pollution which they have succeeded to achieve to some level.
Over the years several groups like Greenpeace, Thanal and the government have
conducted studies at Eloor and they have all shown that the health situation at Eloor is
very bad as compared to other areas. The evidence also goes to show that the pollution
is the most likely cause for the poor state of health.
To further familiarize myself with the issues at eloor I read all the reports and studies
conducted at eloor over the past few years. These include:
-1999 greenpeace report – chemical analysis around HIL
- toxic hotspots – greenpeace
- 2003 health survey greenpeace
- 2003 review on chemical pollution – greenpeace
- 2004 – biodiversity loss along the periyar
- 2005 – health survey – thanal
- 2005 Local are environment committee report to SCMC
- 2008 government commissioned health survey

To support the cause of the people of eloor, a fact finding team comprising of Dr.
Romeo Quijano, Mr. Shridhar and myself went to Eloor to study the situation first hand
and see what more could be done.

THE FACT FINDING TEAM'S VISIT TO ELOOR
August 17 and 18, 2008
Team members:
Dr. Romeo Quijano (Toxicologist, Philippines), Mr. Shridhar R(Thanal), Ms. Christine
(Thanal), Ms. Bella Whittle (PANAP, Malaysia), Ms. Tinchu SK(Thanal), Dr. Adithya P
(CHC)
Detailed Summary:
The fact finding team visited Eloor, Ernakulum on the 17th and 18th of August with the
agenda to see the area, meet the persons involved in the campaign (Periyar
Maalinikarna Viruddha Samithi), and understand the problem in better detail, to see
how a strategy can be evolved to help the campaign.
We were welcomed cordially by the PMVS members including Purushan, Anwar,
Kunjappan and Sakkir. The initial meeting took place in the Clean Development Project
office.
From the discussions it was clear that the PMVS had fought, along with the community
a long battle which has met with some degree of success, but even then the industries
still continue to pollute, and the Pollution Control Board and the related government
bodies turn a blind eye towards them. The PMVS itself is a close knit group which is
very dedicated to the cause and have worked with the help and support from groups
like Thanal. They showed us the photographic evidence of the pollution of Periyar and
of the effluents the industries dump in the river. The media has been actively involved
in the Eloor campaign and this issue is still being featured quite regularly in the papers.
The discussion moved on to aspects regarding the orientation of the industries in
relation to the clusters of the houses in Eloor, and the position of the river with respect
to the landmarks. Also certain details about the previous studies done at Eloor were
discussed with them for more details.
We visited certain industrial sites and also various points of the river and its branches
which flow along the industries and the homes of people downstream. The various sites
provided us with the diversity of smell and colour the industrial wastes had to offer.
The Kuzhikondam Creek has been a site of excessive toxic dumping which had thick
smell of Ammonia, sulphur compounds, BHC and had oily residues floating on the
water and staining the sidewalls of the creek. When the bottom sediments were

disturbed it brought out a new colour and smell to the water and air respectively. We
also saw the frustration of the locals to the appearance of another team that has come to
Eloor, that too with persons from abroad, and the young men openly voiced their
dissent to it. They had indeed fought a long battle and they felt that such effort would
prove futile and just a waste of time.
We visited certain sites where the wastes from the Hindustan Insecticides Limited were
being dumped and there was a clear smell of BHC along with other chemicals preset in
the air. By then, most of us very experiencing mild headaches and Dr. Romeo had
already experienced nausea when he took a deep whiff of the creek sediments.
By the time we got back to PMVS office, we had seen the wards which were affected
and the various sites of the polluted Kuzhikondam creek and the Periyar River.
The orientation of the houses, the industries, the river and the effluent movement were
better understood by Dr. Romeo and the team by then. Certain other queries regarding
the wind directions in relation to the clustering of houses is yet to be understood by
further discussions. By dusk, we had also heard of the various struggles and the cases
which had been fought against the polluting industries and by then we were really
wondering about what more is left for us to do. The situation is indeed very difficult.
The few successes they have had were when the LAEC ( expand)was in force between
2004 and 2006, and also the supply of clean water to the communities of Eloor. Few
industries had adopted cleaner technologies but most of them have evaded the law
through unscrupulous means. Also a local Pollution Control Board was setup at Eloor.
The chemical monitoring of the creek and the river are being done on a monthly basis
for various parameters like toxic by-products, heavy metals and other chemicals
indicating the pollution. These reports show the elevated levels of poisons in the river
and hence Dr. Romeo suggested that we take a copy of all the chemical investigations
that have been conducted on the river, put them in a database and analyse them. Also
we learnt that Purushan and his close friends have considerable influence with the local
community and also with the Govt authorities involved.
On day 2 of the visit, we saw a few patients at Eloor who had chronic conditions and
had lived in Eloor for a long time. Cases included maxillary sinus cancer, breast cancer,
rheumatic heart disease, repeated upper respiratory infections and vague myalgia and
arthralgia. Though individual cases cannot be correlated with the presence of industrial
toxins, the high prevalence of these cases in this area would definitely point to it. But
few conditions like myalgias have been associated with cadmium toxicity and therefore,
it may have to be explored with blood tests and further study. The local doctors have
been very vague in tackling such cases so far.
We also visited the Environmental engineer, Mr. Farooq Shet at the local Pollution
Control Board office and had a brief chat with him. Though perplexed with the whole
situation of being confronted with an international delegation and understandably

trying to push the questioning to the municipal secretary, he did come out with a few
points and acknowledged the fact that industries were polluting Periyar and Eloor and
the life they housed. He requested not to be quoted and also to meet his superiors as
things were really out of his power. Though he has issued for the closure of HIL a few
times, it has not happened. When asked about his opinion if the chemicals were
affecting the health of the people of Eloor he again requested us to spare him the agony
and to ask his superiors about it.
After that, we visited Dr. Indira, Head of Dept of Community Medicine at the Cooperative Medical College, Kochi. She was involved with the drafting of the Govt health
survey questionnaire (July 2008), through a Govt order. She was not directly involved in
any other way. She was quite unaware of the pollution situation till she was called upon
for her services, since she was in Delhi till recently (2003). She seemed a little
ambiguous about her understanding of community medicine and toxicology and stated
that her area of interest was restricted to mother and child welfare, and that her
involvement in the survey was not out of interest but due to lack of personnel. Even
though she accepted that the methodology of the survey had its shortcomings she was
not ready to accept any criticism about it because the report was as good as the team she
was provided with. This, according to her was the best that the given team could produce.
She also made it a point to highlight that she is in support of the issue but her
involvement would be restricted by her age and health and the fact that other doctors
are also ignorant of such issues and the link with health problems. She was also
negative about the possible involvement of the other doctors of the hospital in this
campaign. Since her experience at Kochi has been limited she suggested we should
speak to other doctors too about this.
That evening after bidding goodbye to the PMVS, we headed back to Trivandrum. The
next morning the fact finding team met at Thanal along with Jayan and Usha to discuss
the findings and the opinions on how to move forward from here on.

Some of the key points of the discussion back at Thanal were:
A database/spreadsheet has to be prepared with the information available from the
chemical studies conducted on a monthly basis by the pollution control board. After
that, mathematical deductions, pictorial representations and graphical comparisons can
be made with the relevant data.
The previous health surveys should not be discredited, and the information available
there has to be looked into carefully and new conclusions can be drawn from them. The
information can be studied aggregate wise/disease wise/ward wise etc for a better
understanding. This will help decrease the confusion with so many numbers around.

Another approach that should be used is to collate data on the quantity of exposure high exposure, moderate exposure and low exposure. Dr. Romeo suggests that the
control population of Pindimana can be used as the population with 'low exposure'. For
this, individual diseases will have to collated with the ward, the location with respect to
the tainted factory(upstream/downstream to the factory) and other considerations like
wind direction in cases of respiratory diseases. This 'dose-dependent' study itself can
further validate the fact that the ill health in Eloor is due to the polluting industries.
Hence it is of importance.
A master report should be prepared with the information from all the existing reports.
The confounding data about the high chemical pesticide use in Eloor households will
need looking into, but Dr. Romeo says that the factor is too trivial to be used for counter
argument.
The issue of empowering and mobilising the community was discussed next. Dr.
Romeo feels that the community are not involved enough and that people like
Purushan can do it, though more women need to be involved. Some of the suggested
strategies for this were the conducting of medical camps with interns and young
doctors where the people will receive treatment and also get more educated about the
issue and how to get involved. Training of local health workers to treat minor ailments
and also to empower and mobilise the women of the community is also to be
considered. These methods would provide a sort of immediate and temporary relief to
the affected persons there. The local children can be informed and empowered with
health and environmental education. Dr. Romeo also mentions the importance of
making it a membership based campaign where more people are to be recruited and
more leaders are to be identified.
The local doctors' community can eventually be involved once all the data has been
collated and some kind of a workshop can be conducted for them regarding the toxics
issue and the diseases that are caused.
Biological monitoring in the community with certain plant and fish species has also
been suggested.
There was a suggestion of conducting blood tests for levels of chemicals and heavy
metals and compare with the standard levels. Once it is shown that levels are high, the
authorities can be forced to take over and address the issues.
Also a proper epidemiological study can be done with the agenda to prove the
extent/burden of the diseases, by trained medical personnel.
Immediate things to be done:

The spreadsheet has to be prepared showing the relation between chemical levels with
time is to be prepared. Details regarding the actual method and format of entry are to
be discussed further.
Few details of cadmium and other chemical toxicity on health are to be looked into, in
relation to how the testing process would proceed.
The collation of the existing reports can be started.

My involvement with the report:
The studies which have been done at Eloor over the past 10 years have been collated
into one report; deductions and comparisons have been made looking at data from the
various reports in relation to the links between the poor health of the people of Eloor
with the pollution occurring there.
The reports have been attached in the annexure.
Also, we received some river pollution monitoring data from the Kerala pollution
control board which I have analyzed. The results show clearly that the monitoring
techniques are highly inadequate and that most of the safety standards are not met.
This report too has been attached in the annexures
Learnings from my involvement with the Eloor project:
There are many such rural communities all over India which have been marginalized
by industrial pollution. The pollution causes several short and long term effects. This
includes adverse health effects, damage to livelihood and to local environment. The
pollution control boards are hand in glove with the industry and hence there is never
adequate monitoring and regulation of the activities of the industry.
The visit to Eloor with experienced persons like Dr. Romeo and Mr. Shridhar were very
beneficial to me. The learnt the method to approach a pollution impacted community
and how to look for the various factors that could be compounding the effects of
industrial pollution on the local people. This was also my first experience in writing a
report.
I learnt about the various provisions in our constitution to safeguard our air and water
and also the regulations for the establishment of industrial complexes. There are several
standards that have been laid by the Central Government for the regulation of the
pollution levels but most often these standards are not met with.

The locals have become tired of demanding for their rights. They are now quite
skeptical about any improvement. They do recognize that the health problems at Eloor
are due to the pollution.
Epidemiological studies of good quality are essential in such areas but very often they
are not good enough tools to get the point across. It then becomes difficult, because how
else can one prove the obvious point of the effects the pollution is having on the health
of the residents of Eloor.
This system of needing to prove the hazards of industrial byproducts is wrong in itself.
Why should the public bear the burden of that? Shouldn’t it be the job of the industry to
demonstrate the safety of its operations? Why then does such a situation exist?
The price of the subsidies the industries receive is eventually paid in medical care by
the poor residents of industrially polluted neighbourhoods.
( you can add the chemicals report after this , also number the annexures, so it is easy
to refer)

My visit to Kasargod
Kasagod is the northernmost district of Kerala which borders Karanataka. Since the
1970s the residents of Kasargod had been exposed to the hazardous pesticide called
endosulphan which used to be sprayed from helicopters over cashew plantations. The
villages skirting these plantations also received the full dose of the chemical. There had
been various health problems faced by the people due to this chemical – cancers, birth
defects, neurological problems and endocrine disruption being the common effects. In
2002, the high court issued a ban on the use of endosulphan in Kerala. Since then,
certain relief activity has also taken place there. A government approved cell called the
endosulphan cell has been instituted in the zilla panchayat office in Kasargod. My
objectives were to get a better understanding on the history of the endosulphan issue
leading to the ban of the use of the chemical, learn about the functioning of the
endosulphan cell and speak to the victims and families on the relief activities that have
taken place. For this purpose, I read all the reports written about the issue, the
newspaper articles, and the health surveys and also saw the many movies made about
it. I finally visited Kasargod between the 15th and 19th of October, 2008.
The details of my findings are in the report titled ‘The situation in Kasargod’ in the
Annexure.
My learnings from the Kasargod readings and visit:

Despite the overwhelming evidence, the ban was given through precautionary
principle. The WHO declares this chemical as an extremely hazardous chemical. How
difficult is it to prove that the health effects are due to the chemical? Logic would say
without doubt that it is. Epidemiology may indeed be a weak science, giving the
violators of environmental law a free hand in whatever they want to do.
Even then, this is the first time an order of this magnitude has been given in India and is
therefore of great significance. The relief measures are also one of a kind.
This issue taught me the harm that can be caused by man made chemicals to the health
of people and other creatures and to the environment. And yet, we introduce hundreds
of new chemicals into the world every year.

Namma Raste initiative
Bangalore over the last few years has seen ‘growth’ at a very high rate. The city has
literally boomed in the recent past. The result has been many including the major issue
of transport. The roads have been getting more and more crowded with vehicles, more
cars and bikes, which has lead to the congestion of traffic. To combat these issues, the
BBMP in its wisdom has decided to widen all the roads of Bangalore as an answer to
slow moving traffic. The project has been thus:
It covers a 400 km stretch in 140 key roads in Bangalore costing Rs. 24,000 Crore
according to current estimates.
The road widening scheme plans to cut a total of 40,000 trees in Bangalore.
It plans to break 50,000 established shops like the ones on Avenue road etc thereby
destroying livelihood and also places with historical significance to Bangalore.
It plans to break many thousands of houses along many of the roads.
Footpaths and green spaces along all these roads will be severely affected.
The plan is in direct violation of the Town Planning Act of the Constitution.
Because of all these points, a Public Interest Litigation was filed against the project,
following which the project has been halted and a committee has been set up to review
the project.
Even then, the government continues to allow the tree-cutting and road widening to
continue which is illegal and in direct violation of the high court order.
But the chairman of the committee has not heeded to any of the reasoning of the NGOs
and has made a statement saying: “if you want metro and good roads, trees have to go”.
The issue is that the concerned citizens of the network Hasiru usiru are neither against
the metro nor to commuting, in fact they have proposed much better plans for

improved connectivity in Bangalore. But the City corporation refuses to understand that
road widening is not the only solution, and the fact that it is not a solution at all. Such
projects have failed miserably in every city worldwide where such measures have been
tried. Those cities realized their mistakes and then resorted to other measures.
After all, how much and for how long can you keep widening roads?
The merits and demerits of the projects are thus:
Merits: a temporary solution for the ever increasing traffic of the city (but it is expensive
and the vehicles which will saturate the widened roads soon).
Demerits:
Loss of green-cover: The micro-climate of Bangalore has already changed dramatically
over the past few years. It can be directly attributed to the rapid loss of green cover and
the increase in vehicular pollution. This will further deteriorate with the project. A
predicted rise is of 3 degrees.
Loss of health: There are studies which show the dramatic increase of patients with
asthma and allergy over the decades and it is almost 30% among the children of
Bangalore now. That is an outrageous statistic.
Loss of pedestrian space: There will also be reduced pavement space which will
discourage people from walking (the best way to commute) and also increase the
chance of pedestrian accidents. Already Bellary road has seen 22 deaths over the past 2
months following the Road widening.
Loss of livelihoods: The shops that would be destroyed and also the livelihoods of the
pavement vendors are all under threat.
Loss of residence: It would be difficult to understand this but it is of importance that we
do. Just imagine people wanting to demolish your house for this project. Would you
like that?
Loss of landscape permanently: if the trees and cut and the shops broken down, it can
never be returned to its former self. It would be a permanent loss.
Heavy investments for nothing: All this money ( 24000 crore) that will go into this
project can be used far more productively to improve the traffic situation in Bangalore.
I did attend a workshop where the alternatives were discussed and it was clear that
road widening was not an option.
The public workshop to educate about the road widening and metro rail projects:
In July 2008, a workshop was conducted by Hasiru Usiru to educate public about the
projects and also to evolve a strategy to counter it. I was invited to speak of possible
health hazards of the projects. I read the project proposal and researched on the internet
for information and it showed that many negatives effects on health can be expected.

I have attached this presentation in this annexure.
Since the initial public meeting, I have been involved with the Hasiru Usiru network to
educate more people about the faulty projects and also in two public demonstrations
which were conducted. One was a walk from Lalbagh west gate (which is to be
destroyed for a metro station) to Townhall. The second demonstration was at Townhall
to reiterate our position on the project. I also visited high court to attend an adalat to sort
out the issue of the committee not listening to what Hasiru Usiru was saying.
About ESG:
Headed by Leo Saldhana, they are a very dynamic group working on a lot of
environmental and social issues. Almost 10 years since their conception, they have
worked on urban planning, environmental education, industrial pollution and
protection of green spaces.
My learnings:
There is inadequate understanding in the Government on how to solve issues. But there
is also inadequate understanding amongst the public. Most people have a single
dimension approach to look at them. Here for example, the width of the roads has been
looked upon as the problem but in actuality, the problem is the increasing number of
vehicles on the road, poor public transport and inadequate encouragement to cyclists
and pedestrians.
The government will not think twice in violating court orders. It is up to the public to
take the government to court again in such a case. There is a requirement for constant
monitoring of government action.
This issue gave me a great deal of understanding on development projects in general.
There is seldom any consideration for the people who will get affected by them, which
usually means lakhs of people.
The number of people who are to be affected by the project is around 2 lakhs. Even
then, just 500 people came out to protest. Most people will not realize the threat until
the bulldozers come in front of their shops and homes.

The CHESS workshop and occupational health
CHESS - 3 workshop at Bangalore
This was the fourth time that this workshop was held. The CHESS workshop helps
groups working on environmental and occupational issues to get a better
understanding on health, basic epidemiology, health rights, primary prevention and
health advocacy and the health professionals to get a better understanding of health
impact of environmental and occupational hazards. (Refer to the Health Action article
on CHESS)
In this workshop, the focus was on occupational health. of organized and unorganized
workers. Representatives of groups working with people employed in the agriculture,
mining, manual scavengers, domestic workers, garment industries, plantation workers
and stone cutters; and also had communities affected by industrial pollution.
Labour unions and groups working on issues faced by workers seldom consider health
to be a priority issue. Through this workshop they realized the importance of
occupational health and safety, the responsibility of the managers to ensure
occupational safety and also about the government schemes available to workers for
medical compensation, advocacy and relief. I got to learn that the conditions in
workplace are pathetic and there is absolutely no regulation taking place. The workers
are completely unaware of their rights and continue to live in ill-health and poverty. It
is this poverty that drives so many people to do dangerous jobs.
(more reflection /reporting is necessary – the 2 day training on occup health ! )

CHESS workshop at Cuddalore
Cuddalore is a town almost 25 km from Pondicherry in Tamil Nadu. It houses an
industrial complex called ? which has created a lot of problems for the village
communities surrounding the ……. Since 6 years,volunteers from some of the villages
with the help of Corporate Accountability Desk of Chennai have started a process of
community environmental monitoring using simple tools to make regular notes of the
air and water pollution in the area surrounding the factories. This process of monitoring
has been used by them to prepare reports to improve regulation of pollution in the area.
The level of pollution has decreased in this area to a significant extent though not fully.
This was a 2 day workshop for communities from Trichi and Nagapatinam which are
also being affected by industrial pollution from a cement industry and its associated
mining (is it quarrying/sandblasting ? – verify with Shwetha) and oil drilling
respectively. They wanted to learn about environment, health and community

monitoring. It was dealt with in simple language, communicating the importance of
health, of the need of a clean environment for good health and sharing of experiences
with community monitoring as an advocacy tool.
There was also a tour around the ………industrial complex to give us a taste of what
they get everyday. The odour is nauseating, strong and persistent. The local primary
school is also located in the proximity of this complex. Despite the strong efforts and
persistent protests from the community environmental monitors, the companies still
continue to pollute . Most of these industries are Chemical industries ( including
Pharma companies which portray themselves as providers of health while they are
severely affecting the health of communities around the factories.

Follow up after the CHESS workshop
Some groups have shown interest to include occupational health in their agenda after
the workshop and have asked for CHC for assistance. One such group was Jeeva of
Chitradurga which works with manual scavengers. Since one of my interests was to
explore issues of occupational health, I decided to go there and interview the group.
This interview I have attached in the annexure. You add a separate section on the
Chitradurga visits , also the field project work and keep the interview and the fgd notes
in the annexures.
Bidar :

My Learnings through CHESS:
Many groups working with labor unions and communities affected by industrial
pollution have little understanding of health, especially occupational health. The
approach adopted in the CHESS workshops has helped these groups understand these
issues in much better light. Using occupational health rights and rights to a safe
working environment will help these groups put pressure on the factory owners to
improve working conditions.
Simple techniques like Area map and body mapping can be used effectively by groups
working with unskilled and semi-skilled labourers to understand the dangerous effects
their work and workplace can have on them through their own knowledge. Also,
different groups share their experiences with each other which strengthen the support
structure and networks. Successes or failures seen by a group can be an important
learning for another group.
Each type of work has its own set of occupational health effects. The ones who are most
affected by these are the ones working at the grassroots. The poor are kept poor by low
wages. They don’t demand safety measures and are willing to do risky jobs. The factory
owners use this to their full advantage.

There is also inadequate understanding on provisions like the Factories Act, the ESI Act
and the Workmen’s Compensation Act. These too were introduced through the
workshop. There are a lot of provisions that labour unions can use.
Health Communication workshop by Dr. Mohan Deshpande:
This was a 3 day wokshop conducted for all the fellows at the Community health cell.
Dr. Mohan has over 20 years of experience working with rural communities in
Maharashtra, Gujarat and Rajasthan. He has simple yet beautiful techniques to
communicate health information to communities. He lays great importance on song and
music as a medium for health communication. We were expected to perform songs,
drama and picture stories as a part of the workshop which helped each of us come out
of our shell to express ourselves.
Peas versus Pills workshop by Dr. Nandita Shah:
This is a one day workshop covering various issues. In effect it is about health,
nutrition, allopathic medicine and veganism. She presents a lot of information and
evidence which shows the many positive and few negative aspects of a vegan diet in
improving health in a holistic manner. She is a part of SHARAN and Quiet Healing
Centre at Auroville.
There are many sources of information, some more than mere information, some which
could give you close-to-actual-experience kind of a feeling. Books and movies played a
major role during my internship and these are the reviews of the books I read.

Books:
1. The One Straw Revolution - M. Fukuoka
Masanobu Fukuoka was a microbiologist in his youth. Through some experiences he
decides to give up his career and take up farming. He put to practice a method of
farming he calls as Natural Farming or No touch farming. It is a technique he has
mastered through years of trials; using no modern implements and very few inputs he
has been able to produce more than farms which use chemicals for production. His
principles in farming reflect his philosophies on life which are mainly derived from core
Buddhism and Taoism. The words just flow throughout the book and at no time does it
seem heavy with philosophy. It is indeed a delightful read for anyone.
It primes a process of questioning, which is the basic step towards understanding the
truth. One may not be able to immediately agree with or appreciate whatever he says
but with time it would all seem to make sense. This book is especially useful for those

working with agricultural communities to get a better understanding on holistic
healthy farming.
2. The Limits to Growth - Club of Rome
This book was written in 1972, a few years after the environmental movement began.
The authors were renowned professors and development experts from universities like
the MIT in the U.S, who studied the trends of growth and consumption patterns. They
then extrapolated these values, played around with it, made optimistic assumptions in
the development of cleaner and more efficient technologies in the future and using
these various scenarios came up with predictions for the next 30 years and the next 50
years. The book is both technical and philosophical. It is rich with graphs and tables
which portray their findings, but the highpoints of this great book are the
interpretations of the findings and the conclusions. At the end of the book the authors
pose questions on what the word development and growth mean to them and how
growth can be achieved even in an equilibrium world which was a very interesting
perspective.
The language in the book is very light and the explanations are simple enough. It is a
book that can be enjoyed by anyone, from high school kids to retired persons.
3. Silent Spring: Rachel Carson - 1962
Believed by many to be the initiator of the modern wave of environmentalism, this book
is a landmark publication which attempts to unite science, ecology and the truth of
inter-dependence. With detailed research, Carson goes on to prove without doubt about
the terrific dangers of using chemicals in agriculture and industrial processes. With the
detailed research to support her claims she also explains how chemicals may
completely alter the course of all the life-forms on the planet through mutations, cancers
and endocrine disruption.
This book also led to environmental advocacy. This may or may not have been the
intention of Carson but is has inevitably led to the same. The followers of deep ecology
have termed this as an unfortunate and seemingly unexpected outcome of Carson’s
work which has led to the further commoditization of the environment. Even then, for a
reader who is not much aware of environmental issues it is still a great read and is of
complete relevance even today.
4. The Anil Agarwal Readers: volumes 1, 2 and 3 (Former director of CSE India).
These books are a collection of articles which Anil Agarwal had written in a column for
the Economic Times in the early 90s and for his magazine called Down to Earth. They
reflect issues on environment, economics, development and politics. Absolutely brilliant

views, great reasoning, and he offers probable solutions to current environmental and
sociological problems. He was actively involved in several public meetings with top
Government officials but his advice and reasoning mostly fell on deaf ears. Despite that
he was active in his pursuit until he died of cancer in 2002.
5. Caterpillar and the Mahua Flower - Tremors in India's Mining Fields.
As we sit comfortably at home enjoying the comforts that modern life has to offer, the
tribals and villagers living around forested areas face a major threat to their very
existence. Forested areas have a major problem due the rich ores their soils contain.
The power of the corporate and mining lobby, the government's handicap and the
destruction of the environment and livelihoods of poor people has been shown in vivid
details in this book. It is a book about reality in rural India which we cannot see because
of ‘Shining India’.
6. Our Planet Our Health - WHO (1990)
This was an important publication by the World Health Org where they explore the
various connections between environment, development, industry, policy,
pollution and health and conclude reasonably that a majority of the health problems can
be solved if basic needs are met and the environment is protected and preserved. It is
now clear that romantic environmental activism is not a very effective tool
unfortunately. Hence an alliance between the health groups and the environmental
groups is inevitable if some improvement is to be expected.
7. Textbook of Environmental Education - R. Rajagopalan (Oxford publications)
The author is a trustee of the Navadarshanam foundation. The books are unlike any
textbooks I've seen. The layout is in the form conversation between children who
actually explore the world and realize the importance of various aspects of the natural
world. They understand the interdependence of all living creatures and with nature.
They also realize how human presence and activity affects various systems and
processes, and how they can work individually and a group to help preserve and
protect the world. The one written for undergraduates is called - "Environmental
studies - From crisis to cure", which is a must read.
If there was any book children should read, it's probably these textbooks.
8. Ecological visions - 1989 (out of print)
This book is a collection of articles and essays from various environmental activists,
scientists and reports, written almost 20 years ago, but have complete relevance even

today. The articles range from discussing concepts, major environmental happenings,
harmful technologies, eco-friendly alternatives, practically proven methods, quotes etc.
One particular author caught my attention - Ms. Hazel Henderson. The language and
the understanding shown through her writing is captivating. She is the author of
‘Creating alternating futures’ and ‘Politics in the solar age’.
9. Hind Swaraj : M K Gandhi - 1908
This is the book that made people describe Gandhi as the greatest anarchist of the 20th
century. The book is in the form of a conversation between a confused and hot-blooded
youth with Gandhi and through detailed reasoning Gandhi goes on prove the strength
of non-violence in the truest sense. Non-violence in its deepest and holistic sense has
been explained here and this is a very important concept to understand.
10. Chaos - James Gleick
This book was written in the 1987 and has the description: "The making of a new
science". Indeed, anyone who reads this book will concur with what Douglas Adams
has to say after reading it "It feels like someone just found the switch to the light bulb".
But what I found most interesting about the book was not just the scientific explanation
for chaos, dynamic systems or geometry of nature (which themselves make a
fascinating read, with the many humorous overtones); but it was the fact that how we
become restricted by our foundations in our thinking and the way we look at the world.
The sciences we are taught in our schools forms our foundations and it would be
difficult to think outside the box with that background. That's why it is the foundation
that one should work at, as everything else gets built on it. As is said in a line in the
book "Over time, physicists have learnt how to ignore chaos". This can be generalized to
the public and the government regarding many issues including the environment.
11. The Paradox of Environmentalism – York University Symposium 1983
This is the book that took me to the deepest of depths in understanding the meaning
and implications of being a nature lover. It dwells into history of the environmental
movement in a very critical way, they discuss the change in ideology and objectives
over the decades, then they discuss the role of media in informing and misinforming
the public and finally they discuss "Deep Ecology". This is a concept of paramount
importance and is reflected in the teachings of the Buddha and Gandhi. Arne Naess is
the one who has laid down the deep ecological principles. It revolves around the
biocentricic perspective. One can look at human health from a totally new light after
familiarizing with these principles.
12. Environmentalism – A global history – Ramachandra Guha

Before looking ahead one must look at the history. This book was unlike any history
book I’ve seen. It discussed transition of ideas rather than just dates and events. The
various approaches that have been used to look at environmental issues throughout
history have been discussed. World Bank in 1945 to the developing nations: We are here
to help you enjoy the material benefits on an earth infinitely blesses with natural
resources.
13. A citizen’s agenda for zero waste – Paul Connett and Bill Sheehan
Incineration and land-fills are a dead end. The only possible solution to waste is to
make use of waste as a raw material for industry. The perspective is called “Creating
wealth from waste”. Responsibility is shared by the community, politicians and
industry to ensure zero waste. The paradigm is also to move away from ‘managing
waste’ to ‘eliminating waste’.
14. Compilation on Zero waste: Thanal
This compilation contains several essays by various authorities on zero waste. There is
clear explanation on the concept of zero waste, with a lot of examples from around the
world on how zero waste strategy is being implemented.
15. Publications of Pesticide Action Network Asia Pacific:
- Warning! Pesticides are dangerous to your health:
It deals with the chemistry and consequent health effects of pesticides. It also contains a
questionnaire to monitor effects of pesticides amongst farmers who use it regularly.
- Profits from poisons:
It demonstrated the vicious debt cycle the farmers get into once they start using
pesticides which eventually leads to suicide.
- Hazards of GM foods:
The science behind GE is still incompletely understood, despite that it has found its
wasy into or food and also our environment. The gene pool is now threatened with
engineered genes.

Movies/Videos:
1. Story of stuff - Annie Leonard.
This video is available at www.storyofstuff.com. It is a brilliant video which takes us
through the actual journey of the things we buy at our local store, where it comes from
and what its fate is after we dispose it, through animation. It is just 20 minutes long but
a must watch, because everyone is a consumer. This video is the improvisation of a
PowerPoint presentation which she had made earlier.
2. Earthlings
Coming face to face with violence is not something people want to do, even then they
don’t mind being part of it if it doesn’t happen in front of their eyes. Commentary given
by Joaquin Phoenix, this movie takes us on an amazing journey about the amazing
thing called life, but also shows what horrors take place regularly in our world, things
that don’t happen in front of our eyes, but things we should know, because only when
we see and only when we know can we make an informed decision and protest the
wrongs. Violence is given a new definition through the realities shown in this movie.
3. Bhopal victims
The movie highlights the ongoing protests taking place in Bhopal by women of the
affected communities to demand safe drinking water and for the remaining chemicals
to be cleaned up. It is strange and sad how they need to demand for such basic needs
even after 25 years of the tragedy.
4. Sprays of misery:
This movie and the other movies like ‘Endosulphan – the silent killer’ contain very good
accounts on the issues at Kasargod. There are many interviews of the local doctors and
victims to improve our understanding on the subject.

( Can you mention if you have accessed them for CHC
Library and Information centre CLIC- as a foot note: will
help for future reference )

Annexure

Health Aspects
related to the road widening scheme

Dr. Adithya P
Community Health Cell, Bangalore

World Health Organization defines Health as:*
‘A state of complete physical, mental and social well being, and not merely the
absence of disease or infirmity’

Humans are social beings.

Factors affecting Health:
Social
Political
Economical
Cultural
Environmental

( * - Textbook of Preventive and Social Medicine, K. Park)

Health being so integral to every subject, how to understand the health effects
such a scheme?

The benefit of the road widening is a short term smoother flow of traffic,
coming at what cost?

Health effects can be looked at from the perspectives of:
1. Pedestrians
2. Drivers
3. Vulnerable groups
4. General public

Who and how?
Around 15-20% of all people in Bangalore commute by walking most of
whom are daily wage earners.*
These ‘Transport challenged people’ will now be forced to use public transport
leading to compromises on basic needs.*
Pedestrian accidents leading to death:
*2004 - 390
*2005 - 368
*2006 - 463 out of 800.**
Pedestrians are at a higher risk for accidents including fatal ones.
Elders and children constitute a significant 16 per cent of pedestrians
killed in road accidents.
Therefore, on further compromising the side-walks, the number of pedestrian
accidents will only rise. Most of them being earning members, will lead to loss
of livelihood and hence health of their families too will be affected.
(* -DH - 14/6/07,Hindu – 24/10/04,** -bprd.nic.in/writereaddata/presentation/File20.ppt )

Loss of Green cover along the roads:
Trees help by:*
1. Providing oxygen and purifying the polluted air.
2. Absorbs noise from vehicles, therefore reduces noise pollution.
3. Maintains temperature of the city, improves rainfall.
4. Drivers usually slow down on tree-lined roads, because of cooler
atmosphere. Provide shade for pedestrians and motorists.
The green colour of trees itself is a relaxant to the strained eye muscles.
By encouraging motorization and cutting trees:
1. Respiratory conditions like Asthma, Allergies and Bronchitis increase**
2. Allergic disorders of eye, chronic diseases, fatigue.
3. Affects children’s health more, because they breathe more than adults and
are also more active (high incidence of Asthma among urban children)**
(* - www.treesforfree.org, ** - Asthma and pollution- Dr. George D’souza, SJMCH)

Bangalore and asthma
Year

Prevalence(%)

79

9

84

10

89

18

94

24

99

29

(Asthma and pollution- Dr. George D’souza, SJMCH)

Bangalore & Asthma(Children)
Group

n

%

I

Heavy traffic
affluent

3722

19

II

Heavy traffic
less affluent

273

31

III

Low
traffic
affluent

2565

11

(Asthma and pollution- Dr. George D’souza, SJMCH)

Stress:
- for pedestrians- because of inadequate foot-path and risky conditions*.
- for the Elders- will find it difficult to cross the broad roads with fast moving traffic.
Sky-walks are of limited use for them. Also for handicapped persons.
-for parents whose children walk or cycle to school.
-Physical stress, due to the heat leading to dehydration.*Loss of tree cover
increases exposure to sunlight also.**
-These lead to easy fatigability, frequent headaches and poor work efficiency.
For motorists – as they drive faster, it demands more concentration and skill***.
Such conditions also increase chance for accidents.*

( * - Textbook of PSM – K. Park, ** - nativeremedies.com,*** - safespeed.org)

Encourage Positive health by improving side-walks and tree cover:
Good tree-lined sidewalks will encourage more people to use them, there-by
improving health – *
Staying fit physically and mentally
Better air quality
Decreases blood pressure
Decreases blood-sugar levels

( Textbook of Preventive and Social Medicine – K. Park)

Looking at these health effects from the current model, it is clear that
other methods have to be introduced for addressing the traffic problem in
the city.
More long term and sustainable methods
should be looked into.
These could start from state policy and
implementation level,
city planning level. Such decisions may
seem drastic, but that’s what the situation
calls for.
Many people want to walk, many have to
walk. Walking is, after all, the most sustainable
mode of commuting. Therefore it should
be given as a choice for mode
of communication.
( www.sochara.org)

A comprehensive
compilation and analysis
of the studies conducted at Eloor
and the river Periyar
Thanal
Dr. Romeo Quijano Professor, University of the Philippines Manila, and President of
PAN Philippines
Dr. Adithya P, Community Health Cell

Background information:
Eloor is a panchayat in the district of Ernakulum, Kerala, just 17 km north of Kochi city.
The river Periyar, the main river of Kerala flows by this village and had been the
important source of livelihood and food for the local people. It has been called the
lifeline of Kerala.
From the last 60 years the lives of the people of Eloor has been infringed by an ever
growing number of factories near their village which has, with time, affected all aspects
of their lives. The industries have used the river and the surrounding land as dumping
grounds for all the wastes they produce. Since most of the factories here produce

chemicals, there has been large scale dumping of toxic chemicals at Eloor and Periyar.
These have taken their toll on the fishes in the river and the people and animals at
Eloor. There has been a constant struggle by the local community to enforce regulations
on the pollution created by the factories but their pleas have been falling on deaf ears.
Despite several efforts no strict norms have been followed and the pollution continues
almost unchecked. Nothing has been spared - the air, the water or the soil.
Several groups have conducted chemical analysis and health surveys at Eloor and have
found alarming results but this too has not pushed the Pollution Control Board to take
any action. The regulations are being blatantly violated by the industries all at the cost
of the health, livelihood and happiness of the denizens of Eloor.
Objectives:
- To summarize and compile all the previously conducted studies at Eloor
- To compare the findings of the various reports and look for trends and changes over
the years
- To take a second look at the studies and the findings and draw new correlations and
conclusions from them

Map of Eloor Panchayat: The numbers represent the location of the wards. The
industries are mainly located around wards 4, 19 and 20.

This map is a sketch of the industrial complex in relation to the Kuzhikannom Creek (a
tributary of the Periyar). Ward numbers 19 and 20 of the Eloor Panchayat are adjacent
to the Creek:

Greenpeace Report - 1999

Greenpeace conducted this study to identify any toxic chemicals in the effluents
that was being discharged from the Hindustan Insecticides Ltd (HIL) plant to the
Kuzhikkandom creek. Greenpeace international visited the Udyogamandal Estate on

22nd May 1999 and collected samples of water and sediment from the creek and of
soil/sediment from the adjacent wetlands, for analysis of organic contaminants and
heavy metals.
A total of six samples were collected in the vicinity of the HIL site on 22nd May
1999, including one sample of water/effluent from the creek, two sediment sample from
the same creek (one upstream from HIL and another downstream) and three samples of
soil /sediment from the surrounding wetland area. All soil samples were collected at a
depth of approximately 20-30 cm.
All samples were collected and stored in pre-cleaned glass bottles (rinsed
thoroughly with nitric acid and analytical grade pentane in order to remove all heavy
metal and organic residues). Soil/sediment samples were collected in 100ml bottles. The
single aqueous sample was collected in a 1 liter bottle, ensuring that no air bubbles were
present. All samples were immediately sealed and cooled upon collection, and returned
to the Greenpeace Research Laboratories for analysis.

The results of the analysis were:
Sediment from the creek sampled 10m downstream from HIL contained more
than 100 organic compounds, 39 of which were organochlorides, including DDT and its
metabolites, endosulfan and several isomers of hexachlorocyclohexane (HCH).
Sediment collected immediately downstream from the HIL and Merchem plants,
showed very heavy contamination with a wide variety of organic compounds,
including a predominance of chloride chemicals. Among the organochlorides identified

in this sample were two isomers of DDT, several DDT metabolites, four isomers of
HCH, including the gamma isomer lindane, two isomers of endosulfan and its
metabolite endosulfan ether.
The samples collected from the wetland area contained the wide range of
organochlorine compounds. DDT and metabolites, dichlorinated benzophenone and
cyclohexadecane, aliphatic hydrocarbon were also found. The sediment collected from
Kuzhikkandom creek downstream from the HIL plant identified a similar range of DDT
metabolites and chlorinated benzophenones.
Analysis of nine metals was undertaken for all the samples in this study. Sample
sediment collected upstream from the HIL site, contained the highest levels of heavy
metals. The samples contained concentrations of cadmium, chromium, copper,
mercury, and zinc.
The results gives a strong indication that the HIL have resulted the significant
contamination of the Kuzhikkandom creek with DDT, endosulfan, HCH (BHC) and a
wide range of other hazardous organochlorine and are resulting in the ongoing release
of many of these chemicals to the environment. DDT and other organochlorides were
also detected in the wetlands surrounding the plants (see page no. 8 and 9).
This was one of the first significant scientific studies conducted at Eloor and it
successfully brought to the notice of the Government and the public the high chemical
contamination of the water and soil in Eloor produced by HIL.

Greenpeace Follow up Study-2003
In 2002, another study was conducted by Greenpeace to look for any
improvement in the environmental situation and to investigate the levels of pollution
through the Kuzhikkandom creek of the Periyar River. The study was conducted as
follow up to the 1999 Greenpeace study. It focused on throwing light on the high levels
of contamination in water bodies at Eloor.
A total of six samples were collected in the vicinity of the HIL site on 12 th
November 2002, including one sample of water/effluent from the creek upstream of
HIL and five sediment samples from creeks downstream of HIL. The samples collected
were sediments from Unthi creek, Panachi creek and Kuzhikkandom creek and effluent
from effluent channel leaving the Fertilizers and chemicals, Travancore (FACT) plant,
upstream of HIL. All samples were collected and stored in 100ml glass bottles. The
sample selection was done with the cooperation of the Periyar Anti pollution Group
(PMVS). Samples were analyzed at the Greenpeace Research Laboratories at the
University of Exeter, UK.
Analysis of samples by gas chromatography/mass spectrometry identified
organochlorine and hydrocarbon compounds in all of the sediments. Sediments
contained between 20 and 30 identifiable organochlorines as well as numerous
hydrocarbons. A gradient of organochlorine pollution was seen from the plant to the
south of the island, where the contamination enters the river Periyar. Also heavy metals
like zinc, mercury, cadmium, copper, lead and chromium were identified in the

sediment samples. The study focused more on the samples near the factories such as
HIL, Indian Rare Earth (IRE), FACT, Merchem, Binani zinc and TCC.
Sample collected from Kuzhikkandom creek immediately downstream to the
HIL territory, contained a wide range of organic contaminants, including isomers of
DDT, DDT metabolites, and isomers of HCH.
Analysis of the water and sediment samples collected around the HIL plant
reconfirmed the contamination of Kuzhikkandom creek with a wide variety of
hazardous chemicals including DDT, HCH and heavy metals, which were previously
seen in the Greenpeace study in 1999.

Comparison between levels of organic chemicals from
the 1999 and 2003 study
Groups of chlorinated

Sediment(2002

Sediment(1999

Effluent(1999

compounds

study)

study)

study)

DDT and its metabolites

14

11

7

Chlorinated benzenes

4(7)

8

5

Chlorinated
alkylbenzenes
Hexachloro cyclohexanes

3

3

n/d

4

4

2

Pentachlorocyclohexenes

n/d

1

n/d

Chlorinated
cyclopentenes

n/d

n/d

1

1

1

1

4

1

n/d

Hexachlorobutadiene
PCBs

Comparison between the levels of heavy metals in samples which were collected at
the same location of the riverbed in 1999 and 2003
Sediment(1999 study)

Sediment(2002 study)

Mg/kg

Mg/kg

Cd

n/d

<1

Cr

57.6

103

Co

5.7

5

Cu

22.6

52

Pb

30.2

79

Mn

142.5

97

Hg

0.7

0.8

Ni

6.6

19

Zn

67.7

215

Name of heavy metals

Hence the follow up study also revealed that the water bodies of Eloor were
highly contaminated by the toxic wastes from the industrial plants surrounding it. The
levels of the chemicals in the river had increased between 1999 and 2003.

Status of human health- a Greenpeace study
After basic epidemiological training at the CHESS (Community health and
environment skillshare) Workshops - I and II, Greenpeace decided to coordinate a
health survey at Eloor on September 2003.
Greenpeace initiated the survey with the alliance with Occupational Health and
Safety Cell, Mumbai, which has prior experience in epidemiological research. The
ethical guidelines developed by the National Committee for Ethics in Social Science
Research in Health.
The Greenpeace team started field based work on health assessment in April
2003 and continued the field investigation till July 2003. The first step was to obtain
consent to do the assessment and to ensure participation and cooperation from the local
Panchayat and local community. The second step was to collect all needed information
from the community.
Training of the interviewers, community sampling exercise, and pilot surveys to
identify the practical difficulties in the field were also performed. The universe of the
study was 9122 individuals from both Eloor and Pindimana. And the data collection
was done by 10 trained interviewers and the duration was 45 days.
The analysis of the collected data was done using MS Office software coupled
with manual computation techniques to reach the figures on prevalence percentages,
incidence, and statistical significance.
The survey findings revealed that all types of diseases were prevalent at much
higher levels at Eloor as compared to Pindimana. The lung function tests conducted in

Eloor among those complaining about breathing problems also showed a very high
prevalence of respiratory illnesses. These findings show that the cocktail of poisons in
the air and water of Eloor is exerting synergistic effects to cause poor health and well
being of the local population. The mortality due to pollution-related illness like cancer
(2.5 times), birth defects (2.63 times), asthma (2.23 times) and bronchitis (3.35 times) is
very high in Eloor as compared to the control population. They attribute this to the
presence of polluting industries as it is the main factor that differentiates Eloor from the
control population at Pindimana.

Environmental Audit Report – 2005
This was a report commissioned by the Supreme Court Monitoring Committee
(SCMC) and was conducted by an empowered group called the Local Area
Environment Committee (LAEC).
The SCMC commissioned this study after seeing the dismal state of affairs at
Eloor and Periyar due to the widespread disregard for pollution control
standards and laws.
The committee consisted of representatives from the judicial system, State
Government and civil society.
The committee reviewed the situation in Eloor over a period of almost 2 years
and submitted a huge report to the SCMC.
Each factory was reviewed separately, giving details of the raw materials used,

production process, waste composition and waste treatment facilities. They
mention the steps each factory has to take to ensure proper control of pollution.
Not a single factory was adhering to the existing regulations.
The report exposes the blatant violations by each industry and the ineffectiveness
and the inertia of the Pollution Control Board.
The factories were given time to implement the recommendations of the
committee. Most of them however have not implemented them.
There are many shocking photographs printed in the reports showing the
obnoxious conditions inside and outside the factories, the colours of the river due
to the pollutants and violation of laws.
It is however unfortunate that due to corruption, two separate and opposing
reports were submitted by the SCMC to the Supreme Court which eventually led
to the dissolution of the committee.

STATUS REPORT ON PERIYAR RIVER - 2004
Dr. M. L. Joseph et al made an attempt to review the available literature on
Periyar river ecology. The study is a journey through the geography and history of
Periyar, the demands on Periyar, navigation, fisheries, industries, deforestation in the
Periyar valley, tourism, sand mining, pollution (mainly industrial) and the pollution
status assessment.
For the pollution status assessment, they have made an attempt to review the
different studies which reveal the facts about the various aspects of pollution of the

Periyar. This includes the presence of radioactive elements, heavy metals, nutrients,
nitrate, phosphate, ammonia, nitrite, sulphate, the biological oxygen demand ( B O D),
chemical oxygen demand ( C O D) and so on (see next page).
The study reveals a significant lack of scientific information on various ecological
parameters of the river with reference to its alarming proportion of contamination from
sources like small and large industries, agricultural run-off and sewage cum garbage
pollution from cities, towns and other local bodies.
On the biodiversity aspect, they have found a change in the algal species in
various parts of the river which indicate a change in the chemical composition. The
number of fish species and also the number has decreased drastically around the Eloor
industrial area.
The study concludes by saying that further investigation should be conducted on
unexposed but vital components of the river system which includes significant areas
like rapidly disappearing biodiversity, sand mining and its effects on river ecology,
dangerous level of industrial pollution and its multidimensional impacts on river
system and local inhabited area, large scale destruction of fishery resources and its
socio-economic impacts on society.

Pollution indicators in lower reaches of Periyar River
Polluting agent

Source

Range

Place

KSPCB, 1981

4600kg/day

Industrial area

BOD

Ammonia

NEERI, 1992

0.2mg/l

Eloor

Greenpeace , 2003

2-6 mg/l

Edamalayar

Joseph et al, 1984

Trace-288µg/l

Alupuram to Eloor

Joy, 1989

0.0-65.71µg/l

Edamalayarbackwaters

Nitrate

Inorganic phosphate

Paul & Pillai, 1974

5.5-8.57 ppm

Industrial zone

Joseph et al, 1984

1.85-7.07µg/l

Industrial zone

Joy, 1989

Highest-406µg/l

Industrial area

Greenpeace, 2003

1-100.5mg/l

Industrial zone

Paul & Pillai, 1974

160-910µg/l

Industrial zone

KSPCB, 1981

9500kg/day

Joseph et al, 1984

Trace-148.14µg/l

Joy, 1989

0-64.58µg/l

Edamalayar to
backwaters

NEERI, 1992

0.5-0.7ppm

Alwaye to Eloor ferry

Greenpeace, 2003

1-2.5ppm

Industrial zone

The Egg Report : 2005
This study was conducted by IPEN (International Persistent Organic Pollutants
Elimination Network) to analyze the level of POPs like dioxins from biological samples
from various parts of the world, especially from industrial toxic hot-spots. Dioxins are
among the most toxic chemicals in the world. The levels of this chemical in Eloor are
sky high.

Table showing the levels of Dioxins in Egg samples from various samples from all
over the world:

Health survey report – Thanal, 2005
PMVS and Thanal together conducted a health survey for members of 300
households residing near the Kuzhikkandom creek at Eloor in April, 2005. The objective
of the study was to assess the overall condition of the health of the people and to find
solutions to some of the serious problems faced by the local population.

The Methodology used for the survey was a structured questionnaire prepared
in the local language, Malayalam and the information was collected by educated,
trained local community members through interviews of one member of each family.
The survey was carried out among 326 families who reside on the banks of the

Kuzhikkandom Creek in the Eloor Panchayat. The families covered in the survey were
residing in the area between 2 months and 60 years.
The major findings of the survey were:
The people residing near Kuzhikkandom creek were dependent on Public pipes,
the Kuzhikkandom creek and wells as their main sources of water. But the situation was
that the well water and the Kuzhikkandom creek were not suitable for use at all. It was
found that well water and the creek water appeared colored at time - yellow, red, blue
or black. When asked about the atmosphere there, the people reported that the air in
their area “changes each day”. Even if the air appeared to be clear, the odour of rotten
eggs, human excreta, urine, ammonia, DDT and clay were commonly present. Most
people also reported episodes of bad smells occurring at random times during the
night.

The major health problems identified by the survey were respiratory diseases,
cancer, reproductive problems, cardiac/heart diseases, neurological problems and
muscular/skeletal problems. But asthma, heart attacks and cancer were seen to be the
major cause of deaths in the surveyed area. The survey revealed that at present there
were 6 individuals suffering from cancer, 4 of whom were women. Their diagnosis
include: cancer of the spinal chord, stomach, uterus and breast, respectively.
Reproductive health problems were another major issue in the area. Minor ailments like
stomach ache and back pain were also very common. A table showing the statistics of
the major diseases noted in the survey can be seen on page no. 12. The study thus

highlighted the major health problems in the community, and the only reason appeared
to be the toxic wastes in the environment of Eloor.
.

Eloor Health Survey 2008
The Kerala State Government commissioned a health survey at Eloor to
understand the impact of industrial pollution on the health of the people residing in
Eloor grama Panchayat.
The module of the health survey was prepared, discussed and approved by the
committee which included Dr. Indira Murali, Dr. Krishna, Fr. M. K. Joseph, Mr.
Purushan Eloor and Mr. Vijayakumar. The survey was coordinated by Dr. Celine
Sunny, Chief Coordinator, Research Institute, Rajagiri College of Social Sciences.
The interview schedule was administered to 3246 households in 9 wards of Eloor
grama Panchayat and to 360 households in 12 of the wards in the Pindimana grama
Panchayat. A team of 30 surveyors was selected and they were given training for the
data collection which included - a brief introduction about the health survey,
familiarization of objectives and tools, mock interviews and a demonstration on the
verification of data.
It was found that one third of the population was employed in each of the
Panchayats. Most of the employed earned their living as coolie, construction workers,
and daily wage workers formed the major group in both Panchayat.
The findings:

Almost 80% of the respondents perceived that their health problems are caused due to
the pollution.
An overwhelming 92.8% agreed that the atmosphere (air) in Eloor is polluted whereas
in Pindimana a majority (98.6%) felt that the air was very clean. Around 80% of the
people at Eloor suffer from minor acute problems like coughing, breathlessness,
headache everyday when the waste gases are released from the factories early in the
morning and late in the night.
A huge number in Eloor (41.3%) felt that their well water is polluted as compared to just
a few (0.79%) at Pindimana.
The above numbers are themselves enough to show the poor state of the environment at
Eloor, and there can never be good health in a place with such a polluted environment.
The major health problems and also the major causes of death reported in Eloor were
respiratory diseases, cardiac diseases, cancer, reproductive problems, neurological
problems and skeletal problems.
Unusual medical conditions like congenital deformities and mental retardation which
are associated with antenatal exposure to toxic chemicals are also much higher in Eloor
(between 7 – 10%) as compared to the control population (less than 1%).
Though the report shows clear evidence of the pollution-related health problems at
Eloor, they unfortunately remain diplomatically inconclusive at the end of the report.
But they do go on to mention that the health problems are probably due to the
pollution.

We at Thanal have scrutinized the numbers from the tables in the report a bit further to
check for any co-relations that may have been missed and thereby found some
interesting results which were not mentioned in the original report:
Though it was mentioned that the percentage of people with ill health at Eloor and
Pindimana were 61.6% and 56.7% respectively, the disease burden at Eloor is more
than twice that of Pindimana. This can be calculated by adding the prevalence of each
individual disease from the comparison table, and the totals we get are: 120% for Eloor
and 58% for Pindimana. This is because the individuals at Eloor are actually suffering
from two or more conditions at the same time while at Pindimana the individuals do
not commonly suffer from multiple diseases.
As we have mentioned earlier, the pollution related illnesses like congenital
deformities and mental retardation are much higher in Eloor which is a point that has
not been highlighted in the original report. This is a very important point showing the
difference in the environmental conditions of the two places of our interest. There are
several chemicals in the environment of Eloor which are feto-toxic. Pregnant women are
exposed to them through the air, water and the locally grown food.
If we observe the table showing the disease prevalence system-wise, we see that in
Eloor each disease has a prevalence which is at least twice the number in Pindimana.
Such a significant co-relation has also been missed from the original report.
Not enough importance has been given to the daily plight suffered by the people there,
the release of waste gases cause breathlessness and cough for 80% of the people which
affects their activities of daily living.

The report also mentions that the well water and river water in Eloor is coloured and
has bad smell. This is a very significant point because water is the basic necessity for life
and it is a complete violation for such contamination to occur.
To further prove statistical significance, Chi square tests were performed on various
disease prevalence and these were some of the results:
Respiratory diseases

Sample

Affected Unaffected

Total

Eloor

2048

7663

9711

Pindimana

131

1371

1502

Total

2179

9034

11213

Chi squared equals 126.299 with 1 degrees of freedom, The two-tailed P value
is less than 0.0001. The association between rows (groups) and columns
(outcomes) is considered to be extremely statistically significant.
Problems of reproductive system

Sample

Affected Unaffected

Total

Eloor

229

9482

9711

Pindimana

17

1485

1502

Total

246

10967

11213

Chi squared equals 8.554 with 1 degrees of freedom, The two-tailed P value equals
0.0034. The association between rows (groups) and columns (outcomes) is
considered to be statistically very significant.
Allergy

Sample

Affected Unaffected

Total

Eloor

1344

8367

9711

Pindimana

68

1434

1502

Total

1412

9801

11213

Chi squared equals 101.650 with 1 degrees of freedom, The two-tailed P value is
less than 0.0001. The association between rows (groups) and columns (outcomes) is
considered to be extremely statistically significant.
Neurological problems

Sample

Affected Unaffected

Total

Eloor

367

9344

9711

Pindimana

12

1490

1502

Total

379

10834

11213

Chi squared equals 34.472 with 1 degrees of freedom, The two-tailed P value is less
than 0.0001. The association between rows (groups) and columns (outcomes)
is considered to be extremely statistically significant.
Gastro intestinal diseases

Sample

Affected Unaffected

Total

Eloor

307

9404

9711

Pindimana

17

1485

1502

Total

324

10889

11213

Chi squared equals 18.378 with 1 degrees of freedom, The two-tailed P value is less
than 0.0001. The association between rows (groups) and columns (outcomes) is
considered to be extremely statistically significant.
Musculo-skeletal problems

Sample

Affected Unaffected

Total

Eloor

1896

7815

9711

Pindimana

155

1347

1502

Total

2051

9162

11213

Chi squared equals 73.128 with 1 degrees of freedom, The two-tailed P value is less
than 0.0001. The association between rows (groups) and columns (outcomes) is
considered to be extremely statistically significant.

A Comparison between the 2005 and 2008 health surveys
The table below represents the comparison between the health problems of people near
the Kuzhikandam Creek (wards 19 and 20 of Eloor) in two surveys conducted 3 years
apart. It shows a rapid increase in the disease profile of the people residing in the two
wards near Kuzhikandam Creek over the 3 years.

Major Health problems

2005 study

2008 study

Diabetes

87 (2.39%)

163 (4.47%)

Cancer

6 (0.16%)

13 (0.35%)

Respiratory diseases

67 (1.84%)

646 (17.75%)

Allergy

615 (16.90%)

476 (13.08%)

Cardiac/heart problems

70 (1.92%)

370 (10.16%)

Reproductive problems

64 (1.75%)

109 (2.99%)

Muscular problems

60 (1.64%)

694 (19.09%)

Neurological problems

81 (2.22%)

160 (4.39%)

Birth defects

14 (0.38%)

15 (0.41%)

Thyroid gland problems

24 (0.65%)

74 (2.03%)

The data for the above 2 studies has been collected by two different groups using
a slightly different sample population from the same study area. Hence this fact should
be kept in mind while making the correlations.
There is a clear indication that the health of the people of Eloor has worsened
drastically between the years 2005 and 2008. This is especially true for respiratory
diseases which have shown an alarming ten time increase in number. This only goes to
show that the standards and the recommendations the Monitoring Committee had
recommended have not been implemented. The pollution continues as usual.

The next page contains a table comparing the health survey data of Eloor, with
those of Pindimana, Kerala State surveys of 1997 and 2004. These numbers just go to
show that the people at Eloor face a much higher risk of acquiring disease. The only
factor that seems to cause this significant difference in health indicators is the presence
of polluting industries in close proximity to the settlements. Kindly see the table on the
next page.

Comparison between health status of Eloor with health statistics of Kerala state from
various studies : (Numbers indicate prevalence of chronic diseases per 1000 population)

Pindimana

1997 KSSP

2004 CDS

study report

study report

Eloor (2008)

Diseases
(2008)
Asthma

6.3

72.2

14.3

16.20

Cancer

0.2

3.4

2.3

2.38

Diabetes

5.6

71.2

5.5

16.90

Skeletal
15.5

189.6

18.3

-

14.6

109.6

5.98

10.81

1.7

22.9

4.14

-

1.2

36.7

0.92

2.58

0.1

0.4

4.1

2.96

problems
Cardiac/heart
diseases
Problems in
reproductive
system
Neurological
problems
TB

To further look for any co-relation on the factor of proximity to the polluting factories to
the prevalence of disease, we segregated the wards according to their locations with
respect to the industries and the polluted part of the river. We found that wards – 4, 19
and 20 are the wards which are closest to the industries and the polluted part of the
river and hence should be the ones facing the maximum brunt of the toxicants. These
wards are labeled as “high exposure”. We then found that wards – 5, 6 and 8 are the
ones lesser exposed as compared to other wards at Eloor and these have been labeled as
“moderate exposure”. To demonstrate the above statements, we have printed a map of
Eloor below showing the location of the industries, river, factories, wards and direction
of water and wind. Finally, we used the control population at Pindimana as “least

exposure” since they are most distant from the industrial area. The table clearly shows
that there is a dose-dependent response of diseases and wards 4, 19 and 20 are the
ones having the maximum disease prevalence. This is a very clear indication that the
poor health at Eloor is due to nothing else but the presence of the polluting industries
and hence the poor state of the environment there.

Comparison between the disease occurrence between area depending on dose of
exposure to the pollutants/ distance from factories:

Name of disease

High toxic exposure

Moderate exposure

Less exposure

Respiratory diseases

21.2%

16.3%

8.7%

3.3%

1.5%

1.1%

19.4%

15.8%

10.3%

11.4%

11.1%

9.7%

0.4%

0.5%

0.13%

4.8%

2.5%

1.1%

2.8%

1.6%

1.1%

Gastro intestinal
problems
Musculo skeletal
problems
Cardiac/heart
diseases
Cancer
Neurological
problems
Problems in
reproductive system

Allergy

15%

12.5%

4.5%

Conclusion:
With so much evidence available on the presence of toxic chemical in alarming
concentrations, along with the evidence of altered and reduced biodiversity in the
Periyar and also the poor condition of health at Eloor, it is clear that the industries in
Eloor and the Pollution Control Board of Kerala are responsible for the above. In the
light of such a blatant act of human rights violation and right to a clean environment, it
appears that the meaning of ‘development’ has been lost amidst the foreign exchange
and thick smokes that emanate from the chimneys of the industries.
There is no doubt that the cause of ill-health at Eloor is due to the high level of toxic
chemicals there. Immediate action should hence be taken to curb the pollution and
restore the lives and livelihoods of the people of Eloor.

The Situation in Kasargod – 2008
Kasargod had been under the wrath of the poison called Endosulfan and for 30 years they
suffered under its showers. Now it is almost 8 years that the spraying of the pesticide has been
stopped but some of its legacy can be seen among the people of Kasargod.
Being an extremely hazardous chemical, it has caused various health problems like congenital
anomalies, mental retardation, delayed puberty and cancer.
The spraying was stopped due to protests from the local people and also a lot of other support
groups and the media.
Based on the temporal and spatial associations of the spraying and the residence of the
communities, and the toxicological profile it was clear that Endosulphan is the most likely cause
for most of the health problems listed above.At the end of the long struggle, the High Court
banned the use of Endosulfan in Kerala purely on a precautionary principle. Knowing that the

half life of Endosulphan is between 28 and 500 days, one can say that the effects should decrease
over a period of 8 years.
Alongside the ban on the use of endosulphan ( the ban was in 2004,when was the cell set up ?) ,
a remediation cell has been setup for the compensation and relief for the victims of Endosulfan .
This cell has been in operation for a period of one and a half years and has conducted many
activities already. It is a government approved body consisting of members from Zilla
Panchayat, members of Panchayat from the affected villages and the civil society.
During this visit I have interacted with many of the persons involved in the relief process and
also with health professionals and patients. Each had varied perspectives regarding the remedial
measures but the doctors were unanimous that the disease profile is returning to normal. This
document is an account of my experience at Kasargod. Since there are many perspectives about
the issues, the document is a collation of all perspectives. I have not presented my opinions in
this document and will submit the same as soon as possible in a separate document.
I thank Dr. Sripati for his kind hospitality and guidance at Kasargod and the members of Thanal
for the opportunity.

Objectives:

1) To learn about the functioning of the Endosulphan Cell and its activities
2) To meet health professionals in Kasargod and understand the health situation there.
3) To interact with patients and learn if and how the remediation measures have been helpful.

Visit duration:
5 day visit between the 15th and the 19th of October, 2008.

Persons met:
Dr. Sripati Kajampady, General Practitioner, Perla
Dr. Mohan Kumar, General Practitioner, Perla
Mr. Sree Padre, Journalist, Swarga
Mr. Lakshmipriya, Teacher, Sarva Siksha Abhyan (SSA)
Mr. T. Balakrishna, VP, Enmakaje panchayat
Mr. Madhavan Nambiar, Coordinator, Endosulphan cell, Kasargod
Dr. Ravishankar, PHC officer, Vaninagar

Dr. Krishna Kumar, PHC officer, Perla
Ms. Leelakumari, retd. Govt agricultural officer
Several victims of the spraying

The Endosulphan Cell

The Cell is one and a half years old and is located in Kasargod in the Zilla Panchayat building. It
comprises of 34 members – 10 members from Zilla Panchayat, 11 members from the Panchayats
of the affected villages and 13 members from civil society.
The Cell is a government approved body and will not be affected by change in governance. The
functioning of the Cell is not time bound. Meetings have been held almost every 2 or 3 months to
discuss the issues related to the remediation measures and future activities. The main activities so
far have been:
- Conducting health surveys and medical camps to create victim lists at each panchayat level
with the help of the associated PHCs. Following the surveys, 103 patients were sent for further
management to KMC, Mangalore. Of these, 63 received treatment there and the rest needed
rehabilitative measures. The survey had revealed a high rate of physical disability and these
patients have received aids such as wheel chairs, hearing aids and spectacles. A total of
approximately 250 such aids have been distributed, which was completed last month.
- Compensation of Rs. 50,000 has been for the families of the deceased and seriously ill patients.
In the first phase 123 families were given the amount, now in the second phase another 45
families will be receiving the same..
- The recent budget has not allocated any extra amount for the Cell but the functioning continues
as the previously given funds are not exhausted yet. They also plan to raise more money through
the new website that’s coming up. The Cell will then through the meetings decide on how the
funds are to be used. The initial amount that was allocated for the remediation measures was Rs.
50 Lakh, of which Rs. 37 Lakh were for compensation, Rs. 6 Lakh for research work and Rs. 7
Lakh for aids like wheel chairs and spectacles.
If any victim has been left out of the survey, an application letter can be written to the Cell
informing the same. The Cell then instructs the local PHC to confirm that the person is indeed
suffering as a consequence of the spraying. The PHC officer then informs the Cell about his/her
findings. The coordinator of the Cell is still receiving such letters from patients.
There was a vision at the start of the Cell’s operations for initiating community based
rehabilitation, special schools, pensions etc but these things have not taken shape yet because of
the geographic profile of the affected areas.

The Health Situation in Kasargod

As I’ve mentioned earlier, the spraying had caused an increase in a number of unusual diseases
like congenital anomalies, delayed puberty, mental retardation, abortions and cancer. Dr. Mohan
Kumar had documented his observations about these illnesses and was one of the first person to
bring this to media attention. The people of Kasargod were exposed to Endosulphan directly by
the spraying and also by the contaminated water, food and air.
Dr. Mohan Kumar and Dr. Sripati are the only doctors who have been practicing in Kasargod
through the entire fiasco and hence have a better picture of the trends. The medical officers at the
PHCs are here since one year only and give a good account of the current disease trends. The
medical records at the PHCs also give valuable information about the trends.
Most of the unusual diseases mentioned above have not been seen by any of the doctors recently.
All the patients of these conditions are old ones (those who got the disease more than 5 years
ago). Amongst the children who were born the last few years there has been no case of
congenital anomalies or delayed development. One doctor has noticed a high stillbirth rate
among Muslim women in Perla but attributes it to the high birth order among them. The number
of abortions has also dwindled to very few. A majority of the doctors confirmed that the rate of
cancer has decreased but one doctor says that it continues to be the same. Hormonal problems
like delayed puberty, abortions, menstrual abnormalities have all decreased. The doctors go on to
mention that the disease profile has returned to normal except for conditions like chikungunya,
scabies and hypertension which are higher than normal.
I checked PHC registers at the Vaninagar PHC and found that that what the doctors were saying
was true. Patient records have been maintained for separate diseases ( since when ?) and there
has been no new entry in the records for seizures, mental retardation, disability and cancer. The
number of new entries for gynecological problems too has decreased. The cancer patients who
were registered have all died. The pharmacist still has some left over stock of the cancer
chemotherapy which was meant for those patients. No cases have been registered of late.
The various comments on the remedial measures

I interacted with 10 patients at each of their homes. I got their contacts of these patients from the
list of affected victims at the Zilla Panchayat and Perla PHC; and chose all the patients from the
Enmakaje Panchayat who received surgical or medical care. I also spoke to the doctors and the
Govt employees about their opinion on the remedial measures.
While speaking to patients it comes to notice that most of them are receiving some remedial
measures but they are not sure who the provider is. The schemes are being conducted by the
following agencies: the State Government of Kerala, Solidarity (an organization working for
social causes), SSA ( expand here as it appears first here) and the community itself. Most of the
measures have been coordinated through the Cell.

The medical camps that were conducted initially certainly helped in covering the affected
population to screen for victims; but the camps did not help the people medically. Many of them
were referred to higher centres and didn’t have the means to do so.
The medicines for the patients are also being provided for most cases in the closest PHC.
Medicines for seizure and the other psychiatric conditions have been made available at these
PHCs and have helped in symptomatic relief for the patients. Surgical care has been provided for
all the patients who required it; the major surgeries have been conducted at KMC ( expand)
Mangalore. The patients I interviewed underwent some major surgeries and are doing much
better after the surgery. The Cell has borne the costs of the surgery and hospital stay. These
interventions have definitely improved the quality of life of the patients and the families.
The patients who are affected with serious disability, surgical disorders or chronic medical
disorders are getting a monthly pension of Rs. 140 – 200. This is to support the member who
stays back at home to look after the sick relative. This has been in operation since 2 years
according to the affected families and they are happy about the fact that some monthly pension is
being provided. Most of them feel that the amount is adequate.
Some of them have to follow up at KMC and have to buy medications from outside. This is
proving quite expensive for them. Some patients have also been advised scans and are not sure if
the Cell can provide them monetary support for that. The remediation for one patient has been
halted for reasons he does not know.
An organization called Solidarity is providing food and provisions for affected persons on a
monthly basis which the families have found very helpful. This scheme has been in operation for
more than 2 years now. The group has also promised to build houses for some of the families
who lack decent housing facilities.
The SSA has initiated a pilot project in Kasargod in an effort to mainstream 108 physically and
mentally challenged children. This is to be conducted through weekly meetings, parent training
and medical and rehabilitation measures. The children have been assessed for the level of
disability and are being provided with whatever aids that have been prescribed for them. They
are being taught exercises and are given opportunities for social interaction; and the children
with less minor mental disability will be given formal education.
In certain cases, the members of the community have themselves contributed for the relief of
certain victims.
Some of the persons I interviewed felt that not all the people who received compensation are
victims of endosulphan. Many of them are coming forward for the Rs. 50,000 and hence the
meaning is lost. But the doctors do say that it is difficult to differentiate patients who were
affected from those who were not, as the diseases could present in similar ways. There may have
been political contamination in preparing some of these victim lists. Some also feel that the funds
are not being used appropriately; they want the seriously ill victims to get a monthly pension of
Rs. 1000 – 1500 which would prove useful for the families. Some are of the opinion that the Cell

only conducts meetings without any meaning or action; and the functioning is very political and
not for social benefit.
As such it appears that the initial surveys have picked up most of the affected persons and
families. The affected families are aware of the measures but do not have good knowledge about
it. At times they are confused about what to do in cases of referrals. The surgical and medical
interventions have proved very helpful for the affected families. The pension plans are
inadequate to meet some needs. The SSA has definitely come to the aid of disabled children; this
was one missing link in the remedial measures so far.
My impression and comments on the Kasargod relief and remediation efforts

It was truly heartening to see that such an effort has materialized considering the state of affairs
in most other affected places in the country. As Dr. Sripati has said, it seems to be more due to
providence than anything else. The ban has now lasted for almost 6 years and the health and
environmental parameters seem to be improving. Declaring Kasargod as an organic district is a
great preventive measure that has been taken.
During my visit, I had a chance to understand the objectives and the functioning of the
Endosulphan cell, the efforts conducted so far and also about the support from external agencies
for the relief of the people of Kasargod. Some however expressed their concerns and opinions on
the functioning of the cell and the remediation efforts. Here I have presented my understanding
of the remediation efforts.
There is no doubt that even though the spraying has been stopped, the affected victims will suffer
for the rest of their lives and hence will require continued support. The Government has not
allocated any money from this year’s budgets for the Endosulphan Cell; therefore the future
activities may depend totally on donations from external sources. For this reason, the campaign
through the website and other methods will have to be strong. The Sarva Shiksha Abhyan (SSA)
and an organization called Solidarity (NGO) are also conducting relief measures in Kasargod.
There should be meetings conducted where representatives from Solidarity and SSA meet with
the Endosulphan Cell members so that the activities can be discussed and coordinated. The
coordination of activities will save time, effort and money and will prove beneficial in the long
run. It will prevent overlap of services and also encourage optimal utilization of resources. The
discussions should be open and no group should be forced to anything against their will. Such an
event will only hamper the remediation measures.
The families are already receiving a pension of Rs. 140 – 200 per month. This amount can be
increased, especially for those families who have patients with physical or mental disability,
death of earning members and chronic serious conditions; thereby are required to stay at home
all the time.
I feel that no further planned medical surveillance or survey is necessary. Also there is
provision for potentially affected individuals to write to the Cell to inform about their condition.
This is an important link for the patients to file in their complaints and hence it should be kept

intact. The copy of such a letter can also be forwarded to a Cell member of civil society like
Thanal or Mr. Shreepadre just for record keeping and counterchecking.
The medical officers in the PHCs of the affected panchayats and also the local GPs could be
further sensitized about the issue and be told to contact the Cell if such cases are seen. I am not
sure of what the relation is between the age group of the affected patients with the time of
stopping the spraying. A calculated guess will be that the potential cases would have been born
before 2003, as the spraying has been stopped since 2002. This is considering the fact that no
new cases of MR and congenital malformations have been seen in the last 5 years.
Most of the affected patients are receiving their special medications free of cost from the PHCs
and the patients who were to get surgical interventions have received it from KMC Mangalore
and other hospitals nearby. Patients with need for appliances to assist their handicap have also
been provided the same through the Endosulphan cell and the SSA.
So the main area of concern is the rehabilitation work for the affected families
The Sarva Shiksha Abhyan has already started an effort to mainstream the disabled children;
and to give community based rehabilitation for them. Periodic checkups by doctors and
physiotherapists will also be done. The project has just been started two months ago and the
funding for this is from the state and central government. One of the initial visions of the
Endosulphan Cell was to start community based rehabilitation measures; and hence this matter
can be discussed with the teachers in this project of the SSA – Mr. Lakshmpriya is the one incharge in the Vaninagar area. Furthermore, details of community based rehabilitation can be
obtained from groups like CBR Forum and APD (Association for people with disability) in
Bangalore.
Facilities for vocational training for such children and adults can also be discussed with the
SSA teachers so that they can contribute to the income of the family. This can be discussed with
the SSA and the CBRF and APD groups from Bangalore
The organization called Solidarity is already providing provisions on a monthly basis for the
victims; and their activity can also be discussed at the Cell meetings as an adjunct. This is
important to ensure that the remediation activities don’t overlap. The organization is also
planning for some medical rehabilitation according to some of the affected families.
Coming to the referral services, certain patients who are going for follow- ups at the KMC
Mangalore have to bear the expenses of the travel, stay, investigations and the medications. Such
patients who have been registered as Endosulphan victims could be entitled for additional
allowances if the funds allow it.
The above measures are the ones I felt could be performed. Considering the terrain and the
distribution of the houses in Kasargod, any relief measure will be difficult. I therefore applaud
the efforts that have gone in so far for the victims and I hope for their continued success.

Chemicals in the
Periyar – Analysis and
interpretation
Thanal, Trivandrum, India
Dr. Romeo Quijano, Professor, University of the Philippines Manila, and President of PAN
Philippines
Dr. Adithya P, Community Health Cell, Bangalore, India

Background:
We received data from the Pollution Control Board (PCB) of Kerala on the levels of various
chemicals that were being “monitored” in the Periyar. This River is called the Lifeline of Kerala,
but has been receiving effluents from the Eloor indusrial complex since 1946. There are many
people living around this area and had been using the river for livelihood and nutrition before
1946. Due to the unregulated high level of pollution there, the people and fauna have faced
severe problems. The number of fish has become very low and also the bird population has
decreased. The people face a variety of pollution related illnesses. Due to sustained public
pressure, the PCB has been monitoring the river for the levels of various problem chemicals
since 2004.
However, we feel that their methodology and rationale for the sampling; and timing of sample
collection are very unclear and disorganized; details for which will be available in this document.
We have tried to get the maximum out of the data available to us.
The data available:
The data given to us was in the form of date-wise tabular columns containing values of the
chemicals that have been tested and the location of the sampling. We have not received any
information on the methodologies followed by the Pollution Control Board.
From them, we came to the conclusion that there are 6 problem chemicals at Eloor which are:
Benzene hexa-chloride (BHC)
Endosulphan

Dichloro diphenyl trichloroethane (DDT)
Cadmium
Lead
Mercury
The tests have been conducted between 20.11.2004 and 7.8.2008 for the above mentioned
chemicals. Various locations on the Periyar within Eloor have been tested during this timeframe.

The problems with the sampling methodology of the PCB:
For a visual proof of the problems of the sampling methodology, the datasheets may be viewed.
The total number of samples that have been collected over the 4 year period and the number of
locations from which they have been tested:

Chemical

Number of samples
tested

Number of locations
tested

Fro
m
BHC
105
54
the
DDT
68
27
abo
Endosulphan
92
49
ve
Cadmium
112
108
tabl
Lead
113
106
e,
Mercury
20
20
we
can see that the samples have not been tested repeatedly from the same location but from a new
location each time which leaves little room for temporal comparisons. It is hence very difficult to
comment on any improvement or deterioration in the pollution status over the years. If all the
sampling were done from one or a few sites repeatedly then some conclusions could have been
drawn from them.
Secondly, the timing of the sampling is very irregular. This too can be confirmed from the data
spreadsheets available. Many samples have been collected but there is no consistency in the
timing. If the samples had been collected on a particular date of every month over the 5 years, it
would have proven far more valuable and would have served as a monitoring tool.
Therefore, the best way to use the available information, which of course is in the form of
scattered data, will be to assess each data point individually. This itself has been helpful enough
to prove a point.
Each chemical has been assessed separately using various accepted standards from India, other
countries and from respectable organizations like the WHO.

Each chemical has been compared with standards for effluent water, river water, river sediment,
drinking water, accepted levels for freshwater life. List of references:
CPCB – Central Pollution Control Board of India
http://www.cpcb.nic.in/Industry-Specific-Standards/Effluent/PesticideIndustry.pdf
EPA – Environment Protection Agency, USA
http://www.epa.gov/ogwdw/contaminants/index.html#1
Levels for aquatic life – SEPA, National Centre for Environmental Toxicology, Scotland
ATSDR - Agency for Toxic Substances and Disease Registry
http://www.atsdr.cdc.gov/toxprofiles
EU Standards – http://balwois.com/balwois/administration/full_paper/ffp-541.pdf
Mg – milligram
Mcg – microgram
Ng - nanogram
L - litre
Ppb – parts per billion

Diseases associated with high concentrations of heavy metals:
Disease
Chemical
Minamata
Methyl mercury
Shortened life
Lead
Itai-itai
Cadmium
(From ‘Water Pollution’, S K Aggarwal)

Concentration
1 to 10 mcg/l
50 mcg/l
1 to 10 mcg/l

Drinking water standards:
Metal

WHO

WHO

Ministry of
Works and
Housing 1975

(highest
(maximum
desirable)
permissible)
Lead
0.1
Cadmium
0.01
Mercury
0.001
(From ‘Water Pollution’, S K Aggarwal)

(Acceptable)
0.1
0.01
0.001

Ministry of
Works and
Housing 1975
(Cause of
rejection)
0.1
0.01
0.001

CPCB standards for effluents, 1995:
Parameter

Inland surface water

Land for irrigation

Marine coastal

Mercury Max.
0.01
(mg/l)
Lead Max. (mg/l)
0.01
Cadmium Max
2.0
(mg/l)
(From ‘Water Pollution’, S K Aggarwal)

-

water
0.01

-

1.0
2.0

Endosulphan
Health effects associated with endosuphan: damage to kidney, developing foetus, and liver.
Immuno-suppression, decrease in the quality of semen, increase in testicular and prostate cancer,
increase in defects in male sex organs, and increased incidence of breast cancer. It is also
carcinogen.
A growing body of evidence suggests that endosulphan has estrogenic activity and can disrupt
hormonally mediated processes. The U.S. EPA considers it to be a potential human endocrine
disruptor, and in 2000 Agency for Toxics and Disease Registry (ATSDR) concluded that
“endosulfan may potentially cause reproductive toxicity in humans.” Since then, studies of
populations exposed to endosulphan have been published suggesting that endosulphan can
increase the risk of autism, delay puberty in boys, and cause birth defects of the male
reproductive system.

Accepted standards:
CPCB effluent standard (max): 100 mcg/l
EPA value for rivers (max): 74 ppb
Accepted levels for freshwater organisms (max): 0.003 mcg/l or 3 ppb

The analysis:
A total of 49 locations have been tested between 12/3/2005 and 23/6/2008. Most of the locations
have been tested only once hence trends will be difficult to study (see page 12 for a comparison
graph). The total number of values are 92.
None of the values are higher than that prescribed for the effluent levels by the CPCB.
All the values recorded are much higher than the accepted levels according to the EPA. All the
values are also much higher than those recommended for freshwater life forms.
The highest values were: (alphabet represents the column in the respective excel sheet)

B: 62.4 mcg/l
D: 30.9 mcg/l
H: 25 mcg/l
P: 23 mcg/l
AA: 64.61 mcg/l
AC: 31 mcg/l
AM: 27.89 mcg/l
AN: 47.75 mcg/l
AP: 64.5 mcg/l
One spot alpha-endosulphan value was 147 mcg/l.

DDT
Common health effects associated with DDT: reproductive effects: pre term births, decreased
lactation period, early pregnancy loss, decreased psychomotor development, affects neurobehavioral function, liver cancer, chronic liver damage, cirrhosis and chronic hepatitis, endocrine
and reproductive disorders, immunosuppression, cytogenic effects, breast cancer, Non Hodgkins
lymphoma, polyneuritis. (www.atsdr.cdc.gov)

Accepted Standards:
CPCB effluent standard : 10 mcg/l
EPA drinking water standard: 40 ppb
Accepted level for freshwater organisms: 0.025 mcg/l or 25 ppb
Mean concentration (ng/l) of pesticides in river basins (Water Pollution – S K Aggarwal)

DDT
Lindane

USA (ng/l)
8.2 to 10.3
2.8 to 28

UK (ng/l)
1.6 to 64.6
18.7 to 38.6

DDT levels in Jamuna river: Mittal et al 1976 – 1978: (Water Pollution – S K Aggarwal)
Site
Wazirabad upstream
Wairabad downstream
Okhla upstream
Okhla downstream

DDT residue in
river water (in ppb)
0.249
0.558
0.36
0.294

DDT in bottom
sediments (in ppm)
0.108
0.254
0.205
0.353

The analysis:
The tests were conducted in 27 locations in Eloor between 12/3/2005 and 16/2/2008. The total
number of values are 68. Only one test was done in most of the locations.
Out of the 68 values, 16 of them are higher than the level prescribed for effluents by the CPCB.
All the values are much higher than that of the drinking water standards and the accepted levels
for freshwater life.
The values which were high: (alphabet represents column number from the respective excel
sheet):
B: 29.3 mcg/l
C: (7 values), 28.4 mcg/l
D: 10.5 mcg/l
E: 10.9 mcg/l
J: 266.6 mcg/l
P: 17.1 mcg/l
Q: 354 mcg/l
S: 52 mcg/l
W: 12.8 mcg/l
Y: 242 mcg/l
The highest value was 354 mcg/l and all the high values are from around the vicinity of HIL.
(Spot and sediment values available in the supplementary table).

Benxene hexachloride:
Lindane is a neurotoxin that interferes with GABA neurotransmitter function by interacting with
the GABAA receptor-chloride channel complex at the picrotoxin binding site. In humans, lindane
primarily affects the nervous system, liver and kidneys, and may be a carcinogen and/or
endocrine disruptor. (www.atsdr.cdc.gov)
Common diseases associated with BHC: Chronic liver damage-cirrhosis and chronic hepatitis,
endocrine and reproductive disorders, allergic dermatitis, breast cancer, Non Hodgkins
lymphoma, polyneuritis.

Accepted standards:
EPA drinking water guidelines: 1 part per billion
Central PCB standard for effluent from pesticide industry: 10 mcg/l
Accepted levels for freshwater organisms (Scottish guidelines): 0.03 mcg/l

The analysis:
A total of 54 locations at Eloor have been tested. The testing was done between 12/3/2005 and
21/10/2007. Most of them have been tested just once. A total of 105 tests were conducted.
The values of the chemical in each of the samples are much higher than the EPA standards for
drinking water and hence the water in Eloor is not suited for drinking.
Every value was also much higher than the accepted levels for freshwater organisms which is
the reason for the decrease in the availability of fish and the frequent fish kills.
If the CPCB value of 10 mcg/l is kept as the reference value, 37 readings are higher than it:
B: (5 values), 16.22 mcg/l
D: (13 values), 19 mcg/l
F: 14.4 mcg/l
I: 21.65 mcg/l
M: 32.8 mcg/l
N: 11 mcg/l
O: 56 mcg/l
Q: (2 values), 19.4 mcg/l
R: (2 values), 15.7 mcg/l
W: 10.15 mcg/l
Y: 15.17 mcg/l
Z: 14.8 mcg/l
AB: 19.8 mcg/l
AN: 21.8 mcg/l
AP: 11.9 mcg/l
AQ: 62.64 mcg/l
AR: 14.4 mcg/l
AS: 140.5 mg/l
AV: 24 mcg/l
Highest values were near the HIL factory outlets and the maximum concentration was: 140.5
mcg/l which is 14 times higher than the prescribed levels

Cadmium
Health effects associated with cadmium: Prolonged exposure to cadmium has been associated
with gastrointestinal symptoms, kidney malfunction with excretion of low molecular weight
protein (β-2-microglobulin). Chronic exposures may cause loss of smell, occasional ulceration of
nasal passages, cough, shortness of breath, sleeplessness, irritability, loss of appetite, and
cadmium-yellow fringe on teeth. It can lead to kidney stones and osteomalacia.
The disease “Itai-Itai”, was characterized by osteomalacia with pain in the back and extreme,
difficulty in walking and pseudo fractures. It was induced by environmental cadmium exposure

primarily in post-menopausal women. Cadmium toxicity includes suppression of testicular
function and also acts as developmental toxin.

Accepted standards:
EU standard for river water: 1.6 mcg/l
EU standard for river sediment: 40 mg/kg
CPCB standard for river water: 10 mcg/l
Standard for sediment: not available yet.
Accepted standard for freshwater organisms: 5 mcg/l
EPA standard for drinking water: 5 ppb
Concentration of trace metals in various water sources near Bagpur, India around Kodari thermal
station, in mcg/ml (Fender and Kharat, 1992) (Water Pollution, S K Aggarwal)
Site
Upstream water
Cooling effluent water
Machine washing water
Downstream water
Water from unexposed area

Lead
0.85 to 1.30
21.75 to 25.25
18.0 to 25.0
1.43 to 1.82
0.55 to 0.66

Cadmium
0.20 to 0.45
1.2 to 1.5
1.25 to 1.35
0.25 to 0.72
0.15 to 0.20

The analysis:
A total of 108 locations along the factories have been tested from 2004. Most of the locations
have been tested just once; therefore it is not possible to comment on any trend associated with
cadmium levels in the Periyar.
The total number of values available are 112.
All values in the available data are higher than the standard followed by the EPA, most of them
being alarmingly higher than the accepted standards. The values are also higher than the safe
level for freshwater organisms.
2 drinking water samples have been tested: (AA, AB) - 0.01 mg/ l

Highest values (all which are higher than the EU standards):
Sediment:
G 27 – 285 mg/kg,
I 27 – 339 mg/kg,
J 27 – 139 mg/kg,
K 27 – 78 mg/kg,
Y 12 – 98 mg/kg,
AJ 24 – 108 mg/kg,
AK 24 – 568 mg/kg,
BL 11 – 70 mg/kg,
BQ 19 – 405 mg/kg,
BU 11 – 355 mg/kg,
CY 9 – 51 mg/kg,
CZ 11 – 323 mg/kg,
DA 11 – 662 mg/kg,
DB 11 – 723 mg/kg
Water:
Highest values:
F 5 - 4.3 mg/l,
V 22 – 2.26 mg/l
Lowest value: BY 39 - 0.007 mg/l, therefore except for 1 value, all the values are higher than
the CPCB standard also. All values are higher than the accepted EU standard

Lead
Health effects associated with lead exposure:
Infants and children: Delays in physical or mental development; children could show slight
deficits in attention span and learning abilities
Adults: Kidney problems; high blood pressure
Anaemia is common and damage to the nervous system may cause impaired mental function.
Other symptoms are appetite loss, abdominal pain, constipation, fatigue, sleeplessness,
irritability and headache. Continued excessive exposure, as in an industrial setting, can affect the
kidneys.
During pregnancy, especially in the last trimester, lead can cross the placenta and affect the
unborn child. Female workers exposed to high levels of lead have more miscarriages and
stillbirths.

Accepted standards:
EU standards for river water: 2.58 mg/l
EU standards for river sediment: 1078 mg/kg
CPCB standard for river water: 0.01 mg/l
EPA standard for drinking water: 15 mcg/l
Accepted levels for freshwater organisms: 4 mcg/l

The analysis:
106 locations have been tested in Eloor. A total number of 113 measurements were made
including those of water and sediment.
All the values are higher than the EPA standard and hence the water is unsuitable for drinking.
The values are also higher than that accepted for freshwater organisms.
High values:
Water:
AH 5 – 83 mg/l, AP 18 - 4.29 mg/l, N 31 – 2.2 mg/l, O 32 – 2.92 mg/l, AG 5 – 1.6 mg/l, AM 8 –
1.14 mg/l, BV 26 – 1.78 mg/l
Sediment:
BS 22 - 256500mg/kg , CN 11 – 2950 mg/kg, CQ 48 – 788 mg/kg, BI 35 – 640 mg/kg, BK 27 –
1500 mg/kg, CJ 20 – 1063 mg/kg
2 drinking water samples have been tested and contain: 0.1 mg/l

Mercury
Health effects: Organic mercury can cause multi system damage, especially to the central
nervous system. Inorganic mercury causes kidney damage.

Accepted standards:
EPA standard for drinking water is 0.002 mg/l
EU standards:
Water: 0.18mg/l

Sediment: 7.2 mg/kg
CPCB levels for river water: 0.01 mg/l
Accepted levels for freshwater organisms: 1 mcg/l

The analysis:
20 locations have been tested in Eloor and the total number of values available are 20. Each site
has been tested once only. The time of testing is between – 22/11/2004 to 2/2/2005
All are sediment samples
Highest values: B 13 – 0.1 mg/kg, F 11 – 0.102 mg/kg, U 12 – 0.16 mg/kg
Therefore all these values were lower than the accepted standards.

An attempt to study the trends of the values:
During the months from December 2006 to March 2007 several samples were tested in the same
location and hence an effort to study the trends during that phase has been made here:
The time interval between each row is that of one month

2006
Dec
2007
Jan
2007
Feb
2007
Mar

BHC

DDT

ENDO

8.968

2.622

2.984

15.957

10.159

13.513

5.527

28.398

13.15

1.28

13.16

12.35

Comparison between levels of various pesticides
30

Level (mcg/l)

25
20

BHC

15

DDT

10

ENDO

5
0
2006 dec

2007 jan

2007 feb

2007 mar

Time

As I have mentioned above, frequent sampling was performed during the months of December
2006 and March 2007 from the same location and all them have been collated below:

29.12.06
12.01.07
23.01.07
25.01.07
28.01.07
29.01.07
29.01.07
31.01.07
31.01.07
01.02.07
05.02.07
07.02.07
08.02.07
09.02.07
13.02.07
15.02.07
18.02.07
22.02.07
25.02.07
27.02.07
27.02.07
01.03.07
22.03.07

DDT

BHC

ENDO

2.622
2.134
2.67
1.48
10.9
8.017
10.159
2.89
3.22
4.34
6.16
0.41
3.8
10.9
3.923
5.8
8.7
24.157
1.243
28.398
8.77
3.22
2.55

8.968
18.794
na
10.51
14.4
15.957
6.214
11.65
9.89
5.63
5.08
3.6
0.74
14
11.619
19.4
5.5
16.957
4.836
8.097
5.527
5.48
4.26

2.984
10.216
5.66
2.5
5.629
6.275
13.513
5.32
6.23
1.287
11.28
3.01
3.4
5.6
5.726
20.2
9.8
22.218
1.793
13.15
9.824
4.07
2.73

23.03.07
24.03.07
26.03.07
27.03.07

15.79
7.29
2.15
1.28

13.39
13.5
10.97
12.35

10.26
1.45
7.52
13.16

(graph on next page)
Comparison of all values between Dec 2006 and Mar 2007

Level ( mcg)

30
25
20
15
10

DDT
BHC
ENDO

5
0

6
7
7
7
7
7
7
7
7
7
7
7
7
7
.0
.0
.0
.0
.0
.0
.0
.0
.0
.0
.0
.0
.0
.0
12
01
01
01
01
02
02
02
02
02
02
03
03
03
.
.
.
.
.
.
.
.
.
.
.
.
.
.
29
23
28
29
31
05
08
13
18
25
27
22
24
27
Date of test

The above graph shows that there is definitely no improvement in the values with respect to time
and the monitoring has not been used for actual implementation of safety regulations. These high
values show the reasons for the ill health at Eloor and the destruction of other life forms in the
river and at Eloor.

Conclusion:
From the above analysis, it becomes clear that the water of the Periyar which flows through the
Eloor area is rendered poisonous by the industrial effluents. The water is unfit for sustaining
aquatic life, for drinking and for domestic use. The high levels of the chemicals are responsible
for the ill health at Eloor. The authorities should buckle up and improve the testing procedures,
documentation and in enforcing regulation. It is already clear that most of the values are higher
than the CPCB effluent standards and hence immediate action should be taken to improve on
them.
-A few things can be done from now on to ensure better sampling and hence better regulation:
-Establish the regulations that are to be followed at the Eloor complex for further monitoring.
-Choose a few spots (not more than 10 in total) which are upstream, downstream and near the
effluent pipes of the major polluting industries. These should be the only sites from which
samples will be collected.

-Collect samples at fixed intervals – weekly on a particular day would be most suitable, or once
in 2 weeks – one day sample and one night sample on each of the sampling days.
-Use the above data for monitoring the trends of the problem chemicals. Any upward trend
should probe an investigation into the matter. The aim should be to maintain the levels of the
problem chemicals below the maximum permissible limits.
-Documentation should be done regularly, and all the reports should be updated on the PCB
website.

Interview with Jeeva, Chitradurga
Date: 20th November, 2008
Interviewers: Adithya and Obalesh, Community health cell, Bangalore
Persons interviewed: Suresh, Yogaraj and Chauhan
Jeeva started as a spinoff from a Dalit reform organization called Manjunatha Vidya
Samithi, and was registered in the year 2000. The operations began in the year 2004 with
the efforts of Mr. Tippeswamy and Mr. Suresh. Now there are 9 active members at
Jeeva. Over the years they have made an impact on the issues of manual scavengers in
Chitradurga and have received recognition from the municipal officials and the
workers. The main objectives of the organization are to improve the lot of manual
scavengers in Chitradurga. For this they intend to do the following:
- Educate and change mindsets of the manual scavengers
- Ensure formal education for the children of the scavenger to break the vicious
cycle
- Help the families to come out of the profession by taking up alternate
professions
- Bring issues pertaining the manual scavengers to the forefront
Chitradurga like many other places in Karnataka does not have good drainage and
sewer facilities and hence each locality has an open blind drain called “charandi”. This
holds good for over 90 percent of the areas in Chitradurga. All these areas depend on
the manual scavengers for the cleaning of those drains. The people doing this job belong
to the ‘Madiga’ community which is the lowest caste in the social order. Not all madigas
do this job, and those who do it are looked down upon even by others from the same
community.

The workers involved in this work are either government employees or contracted
through some private firm. There are 116 government or permanent workers and 140
temporary or contract workers in Chitradurga spread out over 35 blocks. Most of these
people live in the 32 recognized slums of Chitradurga. Jeeva’s work area has 40 contract
workers. The difference in pay scale is such that the government employees get Rs. 150
per day whereas the contract workers get Rs. 80. This is the biggest difference,
otherwise there is not much difference in the standard of living. There are almost equal
number of men and women workers. Only the government manual scavengers have
unions. Most of the problems are for the contract labourers who don’t have any kind of
security.
According to the government records there are no manual scavengers in Karnataka but
this is very clearly far from the truth. The ditches they clean contain wastes from toilets
and kitchens from homes and also wastes from establishments like hospitals. The
content of the wastes include human excreta (95 percent of the waste) and hospital
wastes including contaminated instruments like blades and needles. The work includes
using a long stick to take out the contents of the gutter and place it on the side of it to
allow more waste to collect there. Once the waste dries up they put it into baskets, carry
it on their heads and load it into a lorry which takes all this waste 8 km from the
location and dumps it. The gutters are usually of the dimension of 2ft width and 2 feet
deep. In some locations they are deeper than that.
The workers have accepted it as their fate. They don’t see their work as a problem.
They don’t maintain accounts of their income and tend to over spend. There is a
practice of spending all the money they earn on the same day itself and not save
anything for future use. Nearly 70 percent of them take small loans regularly from petty
money lenders who’ve taken all these people for a ride and have become rich
themselves. This phenomenon of keeping the scavengers under debt has resulted in
their continued impoverishment.
There are clear regulations for the provision of certain safety measures for these
workers which are prescribed by the government even to the contractors. The
provisions are for masks, gloves, boots, and uniform. But the common understanding is
that the workers feel very uncomfortable in them and hence refuse to wear it during the
long working hours. They feel hot under the boots, masks and gloves. The only things
they use are the uniforms and chappals. They enter the gutters with just chappals.
There is also a practice of taking some alcohol before entering the drains which helps to
tolerate the terrible smell. But according to the documents all the workers have been
provided with the safety devices.
There is just no healthcare facility for these workers. A total of 70 to 75 percent of the
workers suffer from some kind of illness. The common ones are – skin disease, liver
disease and lung problems. On inquiring about why they consume alcohol, there seem

to be a few reasons – to bear the smell of the gutters for a long time and also to feel
better in case of illness. Alcohol also helps as a sedative. IPD ( explain !) Salappa had
conducted a health survey among scavengers in Bangalore 2 years ago and submitted
his recommendations to the BBMP but they have not been implemented as of yet.
Seventy percent 70 percent of the families are not providing their children with formal
education. Most of the time the children accompany their parents and help them in
cleaning. Some of them finish primary schooling and then come for this job. Some of
them take over from their parents when the parents fall sick or get disabled.
Jeeva has accomplished the following activities:
-

-

-

-

In an attempt to organize them, they’ve been able to make a group of manual
scavengers. This has been more successful among the women workers as
compared to the men.
They’re providing training and awareness raising classes for them to change
their mindsets about their jobs and lives
Providing alternative livelihoods like chappal making whenever possible – In
2005, 35 workers were given provisions and loans for starting alternate
profession of chappal making and repair.
Teaching them and assisting them in managing their finances when they receive
their salaries. A Self help group has been created for weekly savings of the
workers, through which some women have been able to take loans also.
Reducing the level of alcohol consumption through continuous education.

They are very keen on educating the children of the manual scavengers as they feel that
it is the most important tool available to break the chain of bondage. For this, they will
be submitting a report to the Sarva Shiksha Abhyan on the number of children in the
area by March.
Case studies:
Muthu, a 50 year old man who worked in KB extension, Chitradurga lost one limb to
gangrene. The wound started after he stepped on a needle while cleaning a gutter and
this infection spread to the entire limb for which emergency amputation of limb was
necessary. Now his son works in his place.
Chandrappa is a 40 year old man who is suffering from chronic liver disease (CLD).
When he developed jaundice he was admitted to a hospital and stayed there for 2
months. The total bill amount was Rs. 1 lakh. Now he’s back to work but continues to
drink. On approaching the government, they’ve agreed to pay 50% of the amount.
There is little knowledge on the government schemes available for such situations
among the workers or the members of Jeeva.

Nagendrappa is a middle aged man who also works in KB extension, Chitradurga and
lost both lower limbs to gangrene. Now someone else from his family is working in his
place.
Mental illness contrary to expectation ( whose expectation ? isn’t alcohol dependence a
mental illness – look up ICD -10 disease classification . I understand that most are
drunkards – not necessarily diagnosed as alcohol dependence !) is less because the
community has apparently accepted it as fate and don’t mind doing the job. This is one
of the main reasons Jeeva is finding it tough to educate, mobilize and organize them.
They plan to do the following with regards to occupational health in the near future:
-

conduct a health survey amongst the workers which they will use for awareness
raising and campaigning
further organize them
health camps and checkups
learn about the available government schemes like the ESI scheme.

There is a central government scheme ( can you explain the scheme ) for the
rehabilitation of manual scavengers but the authorities are not implementing it and the
workers are not aware about it.
If all the available government programs are implemented then it will be sufficient for
the betterment of the scavengers and most of their problems would be solved.
The basic problem is that Chitradurga and many other places in Karnataka don’t have a
drainage system. The officials are too lazy to consider improvement of drainage
facilities and prefer to use the system of manual scavenging. Without adequate pressure
there will not be a change in this system.
An article from my blog, through the learning I got at CHC:

The ‘Special’ dilemma:
When I was studying my final year at medical college a professor made a joke "Soon we
will reach such a high level of specialization that there will be a 'Left index finger'
surgeon". Of course we all laughed at the idea of such a thought.
Through ever increasing number of 'experiments' and 'research' there is now so much
literature and technique that each subject needs so many sub-divisions which further
need more sub-divisions. Many sub-divisions have now become subjects on their own.
How does this affect the environment (when I say 'environment' I mean 'everything')?

The physiology lecturer needs a kind of frog which breeds only in a lake from a village
which borders of Western Ghats Sanctuary. Medical students can learn about muscle
and heart functioning from experimenting on the frog. Therefore there is a demand for
the frogs. The tribal have been displaced from the forest by the government officers in
the name of 'conservation'. For a living they have few options, therefore they catch the
frogs for the medical college lab. Due to relentless catching of the frogs (coupled with
chemical run-offs of pesticides and fertilizers from farms and also climate change) the
numbers decrease to such an extent that the lab get fewer by the month. The
conservationist blames the tribals for the threatening the species of frogs. Alongside all
this, a malaria epidemic occurs in the village after a long time. The local medical officers
order DDT to be sprayed in the area and give drugs to all the susceptible people. This
decreases the frog population even further.
The doctors do not know about (or are not concerned about) the fact that the frogs are
the keystone and indicator species in the ecosystem which keep insect populations
under control. They just want the frogs for the experiments. The conservationists donot
know that the doctors are the ones creating the demand for the frogs. The tribals just
need some money to get some food to stay alive. The frogs disappear and hence the
mosquitoes increase creating a situation for malaria. The local medical officers are
taught that DDT is the only solution for malaria producing mosquitoes. They're only
worried about malaria. The tribals have to move on to other jobs. The above situation is
just a small example I've given to show the blindfolds within which each of us are
probably working.
This specialization business is not just in the academic circle. In every area of enterprise,
anywhere from production to consumption there is now a highly 'evolved' division of
labour. There are so many things to take care of that people are needed for so many
jobs. Since the job becomes very specific, the only thing the person becomes concerned
about are the inputs and the output of her/his job. They are not very concerned about
where the raw materials come from, how they've come and who brought them. They
have the raw materials and are expected to make something out of them. Once
something has been made from the raw materials, the first level products are taken to
the next level of assembly and so on and so forth. After the chain of events, the products
reach the level of consumers.
People want cars. The car manufacturer wants the iron and steel, the iron smelter needs
the ore. Iron ore is found usually in thickly forested areas and hence is a major threat to
them. The person who is getting the ore mined wants to minimize his costs to give the
best price to the smelter and hence he orders open-caste mining to be done. This
destroys the forest. But he gets good customers as the price for his ore is the cheapest.
The Smelter uses inadequate pollution control mechanisms to minimize his costs and
hence releases lots of chemicals in the air and heat into the rivers. The car manufacturer

gets all this and produces a hybrid car and calls it 'eco-friendly' and the seemingly
'conscious consumer' buys the car to show that he is concerned about the environment.
What are inter-disciplinary sciences? In the realization that people are losing
perspective of the inter-relatedness of everything, some forums and academies have
opened where people look at subjects from more than one perspective. This ensures
more responsible science and also it has become a necessity to take research further.
Holistic perspective. The key ingredient missing in today's world. Everyone is so busy
playing their 'parts' that the 'whole' becomes irrelevant. It has hence led to a situation
where each one does not consider the other's problem to be his or her own. Each person
has his own way of dealing with each problem and feels that there's no need for a
holistic approach. Only with the advent of such a perspective can one hope for the
environmental situation to get better.

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