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Krishna Kumar Mitra
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Neithalath Mohan Kumar
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A review of the Health impacts and status of remediation.
Dr. Adithya P.
Community Health Cell (Bengaluru)
Thanal (Kerala)
H-3, Jawaharnagar, Kawdiar P.O. Thiruvananthapuram, Keralam 695003
Tel: +91 471 2727150. E-mail: [email protected]
October 2009
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
The endosulfan tragedy which occurred in Kasaragod district of Kerala,
India is now well known. It is considered by many experts in the field of
pesticide toxicity as one of the worst pesticide disasters to happen to a
region and its people. The tragedy occurred for various reasons, starting
with the recommendation to use such a chemical in a populated, waterbody rich area like Kasaragod. It was then continually aerially sprayed by
the Plantation Corporation of Kerala on its cashew plantations for 20 years,
without even once looking into its impacts.
After several studies, court cases, public protest etc, the State of
Kerala banned the sale and use of endosulfan within its boundary in 2003.
The enormity of the health problems in the area was brought to the notice
of the government by the local people as well as various organisations like
Thanal, Endosulfan Spray Protest Action Committee (ESPAC) etc. This moved
the government to start an Endosulfan Relief and Remediation Cell in the
year 2007 and since then it is working under the Kasaragod Jilla Panchayath
(Local government at the District level) to give some relief to the affected
people. Not only the government but some organisations and individuals
are also working for the welfare of the affected communities, however small
it may be.
This report is a preliminary appraisal of the impact of the remedial
and relief efforts among the affected community and has been compiled
primarily with the help of community doctors, government doctors, officers
in charge of the relief cell and activists associated with the relief measures.
Apart from this rehabilitation work, one important result of the ban
of endosulfan is that it has made a lot of changes in the health scenario of
the affected area and this is vouched by many doctors working in the area.
A quick appraisal of these changes in the year 2008 was also carried out.
Local health practitioners had documented increased incidences of
congenital anomalies, delayed puberty, mental retardation, abortions and
cancer during the years of
endosulfan spraying. However these
doctors are now reporting that,
following the ban of endosulfan in
2003, there is a significant decrease
in cases of these diseases, for example
no new cases of cancer, no children
born with congenital anomalies or
neurobehavioural abnormalities.
Cashew Plantations
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
Brief background and timeline of the events at Kasaragod
The aerial spraying of endosulfan over the cashew plantations in
Kasaragod district in Kerala, India was started in 1978. This was done 3
times a year over an area covering 15 Grama Panchayaths (Local Government
at the village level) in Kasaragod3. There were many warning signals about
its impact from the beginning, including the mass deaths of bees, fishes,
frogs, birds, foxes and also congenital deformities in domestic animals like
cows4. Since 1979 there had been local outcry from farmers and media
concerning the health effects of the pesticide spraying.
In 1994, independent health observations by a local doctor,
Dr. Mohankumar revealed that there was a rising incidence of cases of mental
illness and congenital anomalies in Kasaragod. He initially considered the
possibility of heavy metal or radioactive toxicity of the water in the area
(small streams and ponds ) since some of the health disorders were more in
the people staying near these water sources. He had a letter on this issue
published in a journal for doctors published by Indian Medical Association,
asking the experts to conduct a study in the area. He took action by writing
to the media and other doctors1. Later in 1998, Leelakumari Amma, a staff
of the Krishi Bhavan (Agriculture Department’s office at the village level) at
Periya Panchayath witnessed the deterioration of health of her two children
and herself – loss of voice and hormonal problems – after she came to live
in a village inside the spraying area. She then lodged a complaint in the
local court along with two other farmers to stop the aerial spraying in the
interests of the people’s health and the environment.
In 1998 a Sub-court temporarily stopped the spraying of endosulfan
in Periya Panchayath where Leelakumari Amma stays.
Several national and international groups conducted health and
toxicological studies between 1998 and 2002; and arrived at the conclusion
that the abnormal health problems at Kasaragod were due to the spraying
of endosulfan.2,3,4&5
The commonly noted unusual diseases were neurobehavioral disorders,
congenital malformations in girls and abnormalities of reproductive tract in
males3. Another report showed increased rate of cancers and gynecological
abnormalities as well6. Later the Kerala State health department also
conducted medical camps in various regions and subsequently they also
conducted a study. The report reaffirmed the relationship between endosulfan
and the health problems in Kasaragod.
October 2009
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
In 2002 the Kerala High Court banned the sale and use of endosulfan
in Kerala, and following this the State Government also issued a ban order
in 2003. Local efforts for relief and rehabilitation started at Kasaragod with
the help of the local panchayath, local organisations and the Calicut Medical
College in 2003. In 2005 the Central Government issued an order that the
labels on the pesticide bottles must carry a message that this pesticide is not
for sale in Kerala.8 This order does not seem to have been implemented by
the Central Government effectively.
Facilitated by Thanal and the Kasaragod Jilla Panchayath, a consultative
workshop was conducted in August 2005, which was attended by various
health experts and social workers to formulate a plan to bring the relief and
remuneration package to reality. The Special Purpose Cell for Implementing
Relief, Remediation and Rehabilitation was set up by 2007 with the support
of the State Government of Kerala. It is an independent and transparent
body which is looking into all aspects of the relief work – health, social,
environmental, policy and financial.
The Endosulfan Victims Relief and Remediation Cell9&15
The Endosulfan Victims R&R Cell is the outcome of the consultative
workshop held in 2005 between the Kasaragod Jilla Panchayath, Grama
Panchayaths of the affected villages, health, social and agriculture departments
of the Government of Kerala and civil society groups like Thanal and ESPAC.
The Cell was initiated formally in 2007 and is located in the district
headquarters of the Kasaragod Jilla Panchayath. It is a government-approved
body and has 34 members – 10 members from the government including
the Jilla Panchayat, 11 members from the Grama Panchayaths of the affected
villages and 13 members from civil society.
Meetings are held almost every 2 or 3 months to discuss the issues
related to the remediation measures for the victims and the future activities
of the Cell. The initial amount that was allocated by the state government
for the relief and remediation
measures was Rs. 50 Lakh. It
was decided by the Cell that the
given amount can be used as
follows: Rs. 37 Lakh for
compensation (medical and
other) of affected families, Rs. 6
Lakh for research work in the
affected area and Rs. 7 Lakh for
aids like wheel chairs and
Meeting at Vani Nagar
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
The main activities so far have been:
1) Conducting health surveys and medical camps to create ‘victim lists’ at
the level of each Panchayat with the help of the associated Primary Health
Centre (PHC).
The initial surveys revealed 103 people who required tertiary medical and
surgical care and were sent for treatment to Kasturba Medical College,
Mangalore (KMC). Of these, 63 received treatment there and the rest needed
rehabilitative measures. Surgical care has been provided for all the patients
who required it; the major surgeries have been conducted at KMC Mangalore.
The Cell has borne the costs of the surgery and hospital stay.
2) 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 and the project
continues as the need arises.
3) A Solatium of Rs. 50,000 has been given for the families of the deceased
victims. In the first phase 123 families were given the amount; and now in
the second phase another 45 families have received the amount. Presently
about 300 more families of the deceased have been cleared for payment of
solatium, making the total approved list of deceased endosulfan victims to
nearly 500.
4) The medicines are also being provided for most of the patients at the
closest Public Health Centre (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. These medicines are usually
not available in PHCs in India.
5) The recent state budget has not allocated any extra amount for the
activities of the Cell. They plan to raise money through a new website
dedicated to the victims of the
endosulfan spraying.15
Victim’s House
October 2009
If any victim has been left
out of the “victims list”, an
application letter can be written
by him/her 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.
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
The PHC officer then informs the Cell about his/her findings. The coordinator
of the Cell is still receiving such requisition letters from patients. The Cell is
finding it difficult to compensate more victims due to the shortage of funds14.
There was a vision when the Cell began its function for initiating
community-based rehabilitation, special schools and pensions but these things
have not taken shape yet because of the geographic profile and scattered
distribution of people in the affected areas, as well as lack of trained specialcare personnel and expertise in the area. The lifespan of the Cell has not
been decided and it may continue to function as per the need of the people.
The Health Situation in Kasaragod as of October 2008
Since the late 1970s there had been a rise in the incidence of unusual
diseases like congenital anomalies, delayed puberty, mental retardation,
abortions and cancer.6
Dr. Mohan Kumar, a local practitioner in the affected areas had documented
his observations about these illnesses and was one of the first persons to
bring this to media attention during the mid 1990’s. Another doctor
Dr. Sripathi Kajampady who is running a clinic in this area has also noted
several health disorders, especially among women and children. The people
of Kasaragod were exposed to endosulfan directly by the spraying and also
by the contaminated water, food and air.2&3 Several studies conducted later
did reveal the links between the diseases and the endosulfan spraying.2,3,4&5
Dr. Mohan Kumar and Dr. Sripathi Kajampady have a better picture of
the disease trends there because of their long association with people in the
area. They comment that there has been a change in the disease profile of
the villages over the last few years, after the spray has stopped, as compared
to the previous years. They could not recollect any child who had been
born, under their supervision, with congenital anomaly during the last few
years. 10 There has been no new case of children presenting with
neurobehavioral abnormalities10. The number of abortions has also reduced
to a very few10.
The PHC medical officers who are new here mention that they have
not encountered any new cases of neurobehavioral problems or congenital
anomalies. Three of the four doctors mentioned that the incidence of cancer
has decreased but one doctor says that it continues to be the same10.
Endocrine problems like delayed puberty, abortions, menstrual abnormalities
have all decreased10. The patients with these conditions are all old cases
(those who got the disease more than 5 years ago).
The medical records at the PHCs also give valuable information about
the trends.
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
The PHC disease registers at the Vaninagar PHC at Kasaragod have been
maintained for separate diseases and there has been no new entry in the
records for seizures, mental retardation, disability and cancer since the year
2000.11 . The number of new entries for cases with gynecological problems
too has decreased11. The cancer patients who were registered have all expired
and no new cases have been registered in the last 8 years.
Other Relief measures:
Apart from the measures initiated by the Endosulfan Cell, relief
activities are also being conducted by a non-profit organization called Solidarity
Youth Movement (SYM) and an educational program by the Central
Government called Sarva Shiksha Abhiyan (SSA).
SYM is providing food and other basic provisions for affected persons
on a monthly basis since 2007. They are also constructing houses for affected
families lacking decent housing facilities. Medical support through camps
and paramedical care is also being provided. Some of the children and
youth are also being supported for higher education.12
The SSA has initiated a pilot project in Kasaragod in an effort to
mainstream 108 physically and mentally challenged children. This is being
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 mild mental disability will be given
formal education.13
SSA Meeting
October 2009
India’s Endosulfan Disaster – A review of the Health impacts and status of remediation
Report reprinted in Vol. 9, No. 19, Down to Earth Magazine, 28 February 2001.
A Centre for Science and Environment report on the contamination of Endosulfan in the villages,
Volume 9, No. 19, February 28th, 2001, Down to Earth Magazine
Final report of the investigation of unusual illnesses allegedly produced by endosulphan exposure in
Padre Village of Kasargod district, National institute of Occupational Health, October, 2001
Dr. Romeo Quijano, Report of fact finding mission, PANAP, 2002.
Health hazards of aerial spraying of endosulfan in Kasaragod district, Kerala A Comprehensive
report of the Expert Committee appointed by the Government of Kerala, 2003.
Dr. Mohan Kumar, Interview by PANAP fact finding team, Padre village, Enmakaje, Kasargod,
Juanuary 2002.
Case in the High Court of Kerala: India — Thiruvamkulam Nature Lovers Movement v. Plantation
Corporation of Kerala (2002.08.12) (banning aerial spray of endosulfan) 08/12/2002, O.P. Nos.
20716/2002, 17026/2002, 16300/2002 & 29371 of 2001.
Central government notification: Notification No.: S.O. 1533(E) dated 25.10.2005 and Corrigendum
No. S.O. 1707(E) dated 05.12.2005 regarding the restriction of use of Endosulphan in the cashew
plantations of Kerala.
Interview with Mr. Madhavan Nambiar, Coordinator, Endosulphan Victims Relief and Remediation
Cell, Kasaragod Jilla Panchayat, October, 2008
Interview with Dr. Sreepati Kajampady (private practitioner), Dr. Mohan Kumar (private
practitioner), Dr. Ravishankar, PHC medical officer, Vaninagar and Dr. Krishna Kumar, PHC medical
officer, Perla, Kasargod, October, 2008
Review of disease records at Vaninagar PHC, October, 2008
Interview with victims of Endosulphan, October, 2008
Interview with teachers of SSA at the Vaninagar PHC during Physiotherapy Clinic for the Victims,
October, 2008
Endosulfan victims still suffer in India, Article by P.N. Venugopal, 15 February 2008 .
Website of the Endosulfan Victims Relief and Remediation Cell

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