MFCM047: Press Release by medico friend circle on Bhopal study.pdf

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extracted text
press
release

medico friend circle
organization & bulletin office
326 V Main I Block Koramangala
Bangalore 560034
30.3.1985

The medico friend circle (mfc)z an All India group of socially
conscious.doctors and health workers has just completed a
systematic study of the continued effects of toxic gas in two
bastis in Bhopal.

The observations of the study conducted between March 18-25
in the highly affected Jayaprakash Nagar and the less affected
Anna Nagar are yet to be fully analysed. However, the initial
findings definitely indicate that : (i) the affected population
is already showing signs of reduced breathing and working capacity
which is likely to be permanent unless remedial measures are

urgently introduced; (ii) pregnant women who had been exposed to

the gas in the first three months of pregnancy or have become

pregnant since the disaster have still not been informed about
the possible dangers to the foetus. Moreover, detoxification
measures recommended by the ICMR over a month ago—the administra­
tion of sodium thiosulphate has not been implemented. The mfc

is deeply concerned and agitated about the situation.
Reduced breathing and working capacity among the affected
population
The mfcfs study team has observed that men are not able

to go back to work because of breathlessness on accustomed
exertion (exertional dyspnoea). Those who have returned to work

report definitely reduced working capacities. Most women find it
difficult to carry on their usual household chores. The team
has noted with particular concern that very few of the children

can even play or participate in normal physicial activity in
the affected bastis.

It is well known that a large proportion of the MIC affected
population is likely to develop fibrosis of the lungs (develop­
ment of scars) following inflammation of the lungs due -to
irritation. This condition permanently affects, breathing and
hence working capacity. Such a condition is already in evidence
in the population covered by the mfc study.

Simple breathing exercises are known to help, to reduce
this disability. Information abo^it these exercises must be
widely known and their importance stressed.

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Mass detoxification by sodium thiosulphate

More than a month ago the ICMR had recommended the administra­

tion of sodium thiosulphate for detoxification of all patients
suffering from symptoms of MIC poisoning. This recommendation
was based on conclusions drawn from a double-blind clinical

study. But as yet, there appears to be no strategy in action
with regard to administration of sodium thiosulphate to the
vast majority of affected people. Only a tiny fraction, consisting of the seriously ill are receiving the injection.

mfc emphatically feels that as suggested by the ICMR, all
patients suffering from symptoms of *mid poisoning should be
urgently administered'sodium thiosulphate so that their
suffering is reduced and they may go back to work. This service
and other medical facilities should be urgently provided in

a decentralised way, close to the bastic in affected areas.
The insight that sodium thiosulphate may well be

effective was known even in the first week after the disaster.
It is extremely disturbing and deplorable that decisions on
vital issues like this which affect the lives of thousands of

people should have been so long delayed. Even more shocking is
the fact that even now, a month after the recommendation was

publicised, mass detoxification of MIC victims has not begun.

Possible risks to the foetus

Another disturbing feature is that pregnant women who have been
exposed to MIC have not been given any advice regarding the
possible risks to the foetus. Given the fact that the first
three months of pregnancy is the most sensitive period/ it is
likely that these women as well those who became pregnant
immediately after the disaster are likely to giye birth to

deformed babies, since MIC or,its breakdown products are

very reactive chemicals. Moreover many of these.women have

received several types of drugs when as a rule in the first
three months no drug should be given for fear of drug induced

deformations. Somce of these drugs, especially steroids are
known to cause deformities.

There is an urgent need to inform peopla, especially
women about these dangers and to advise them to undergo
medical termination of pregnancy. Adequate and free facilities
should be made available to those women who opt for it without

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coercing them to undergo sterilisation. Further, those couples

who have lost children and want reversal of ‘sterilisation must

be offered these facilities free of charge. .
Doctors belonging to mfc had pointed out these dangers
in anearlieri. note ~ sent to the concerned authorities a

month ago. But to date nothing seems to have been done.

Many of these women have by now crossed the five month limit
of pregnancy beyond which MTP is unsafe. But there are some
who can still terminate their pregnancy although the risks
are greater than in the first weeks. Facilities for ultra­

sonographic examination should be made available to these
women immediately to - detect gross abnormalities in their foetuses.
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That thisxis not being done is a reflection of the indifference
of health authorities towards the health problems of poor women.

Moreover mfc feeLs that the ICMR study designed to follow

up these women on a long term to assess the percentage of
deformities without informing women about the possible risks
or the advisability of MTP is unethical. The dangers to pregnancy
are well known and poor 'women should not be used as guinea pigs

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in medical research.

Contraceptive advice to affected -couples

Most of the MIC affected population is still suffering
from symptoms of cyanide like poisoning indicating, therefore,
the persistence of the biochemical changes which have occured

due to MIC poisoning. It is safer tp avoid pregnancies till
complete detoxification has
taken place. Since a large
proportion.of the women are suffering from menstrual disorders

and other gynaecological problems, male contraceptives (Nirodh)
should bez recommended rather than Copper T or oral contrace­
ptive pills by the women.
We demand that the health authorities should give serious
and urgent consideration!to the issues raised here.

released by the convenor'of mfc
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