777The newsletter of the Bhopal Medical Appeal, October 2003

In Union Carbide’s abandoned pesticide factory in Bhopal,deadly chemicals lie exposed in the open air. Eighteenmonsoons have washed the poisons deep into the soil - andinto local drinking wells. Read the full story on page 4.

The killer plantthat keeps on killing

Nightmare without end

page 4

Carbide’s factorystill killing

page 6

What we aredoingpage 8

Successes (and failures)

page 10

This newsletter’s name arose from an attempt to capture the spirit ofthe Bhopal Medical Appeal. Someone suggested, ‘saat, saat, saat’,which in Hindi means ‘together, together, together’, but with a slighttwist of the tongue could also mean ‘seven, seven, seven.’

The Appeal was launched in 1994, when a man from Bhopal came toBritain to tell whoever would listen about the calamitous condition ofthe still suffering victims of the Union Carbide gas disaster. Thosewho met him learned that after ten years, the survivors had receivedno meaningful medical help. (Unless one is prepared to accept thataspirin is a cure-all for the dreadful illnesses visited on them.)

The survivors realised that they must help themselves, because nobodyelse would. They wanted to open their own free clinic for gas victims.They were joined in the UK by a few individuals who put the mechanicsof the Appeal together. They were in turn joined in this effort by you,and other like minded people.

‘We’ means all of us, all together.

Our first appeal, which appeared in The Guardian and The Observer onthe 10th anniversary, produced a response so generous that we wereable to buy a building, recruit doctors and staff and open the clinic.

To date our Sambhavna Clinic has treated more than 12,000 people. Weemploy thirty staff, roughly half of whom are themselves gas survivors.We carry out valuable studies (one of which has just been published inthe Journal of the Americal Medical Association), inform, educate andtrain people in gas affected communities to monitor their health.Working to a principle of ‘first do no harm’ we have pioneered newtreatments combining modern medicine with traditional ayurvedic herbalmedicine and yoga. Our work has won a string of humanitarian awards.

We have bought the land to build a larger clinic, with a garden forthe medicinal plants used in our treatments. Now we need to raise moremoney for the expanded work. We have never accepted funding from companies or corporate trusts. Companies and governments are directlyresponsible for the suffering of the Bhopal survivors. Always, theywant something in return for their money. We will not deal with them.All the funds we have ever collected have come from our own pockets.

In the Bhopal Medical Appeal ‘we’ don’t ask ‘you’ to help ‘us’ help‘them’. The Appeal and the Sambhavna Clinic are shared efforts betweenthose of us who are survivors, those of us who run the Clinic and theAppeal and those of us who support the effort with our money and byvolunteering our skills or just our enthusiasm. This is our vision,that all of us are equal in an unbroken chain between supporters atone end and gas survivors at the other. Thank you for being part ofit. The people in Bhopal have a lot to give back to the rest of us.Please read on, and let’s carry on the good work we’ve begun together.

together together together

SAAT SAAT

FOR MERITORIOUS SERVICE. The Sambhavna Trust was awarded the 1999Tajiri Muneaki prize for ‘meritorious services rendered to the victimsof Bhopal gas disaster’. The award is given in memory of the lateTajiri Muneaki, a Japanese campaigner against industrial pollution andoccupational hazards. Amongst the other co-prize winners that year werethe late Teruo Kawamoto, who fought for the rights of victims of theChisso Corporation in Minamata.

FOR HUMANITARIAN WORK. On September 7, 2001, Sambhavna was presentedthe Inner Flame Award 2001 by the Governor of Madhya Pradesh, Dr. BhaiMahavir, for ‘outstanding humanitarian work and excellence in deed’.

FOR COMPASSIONATE ACTION. The Spring 2002 Mead Award - the final suchAward to be given in conjunction with the Mead Centennial celebration -was awarded tothe SambhavnaClinic. TheAwards honour organisations that reflect Mead’s sense of the relevanceof anthropology to social action: groups that have demonstrated effec-tive, imaginative, compassionate actions on race, gender, culture,environmental justice, child rearing and self-empowerment within commu-nities. The Sambhavna Trust was given this award for exemplifyingMargaret Mead’s famous words: ‘Never doubt that a small group ofthoughtful committed citizens can change the world.’

On October 8th the hugely influential Journal of the American MedicalAssociation published a Sambhavna study which for the first time provedconclusively that even children conceived and born after the disaster

have been affected. It shows thatthere are potentially thousandsof such children who will need

special medical attention and care (possibly all their lives) raisingthe question of compensation. It also adds to scientific knowledge ofmethyl isocyanate, corroborating a 1987 animal study done by Dr. DayaVarma at McGill University, Montreal. In 1985 the Indian Council ofMedical Research had begun a study similar to ours and found differencesin anthropomorphic measurements. That study was wound up incomplete in

1992 despite praise from the Chairman of theScientific Commission on Bhopal in 1988 and thepleas of the principal investigator that it beallowed to continue until the children reachedpuberty. Our study fills this crucial gap anddemonstrates the value of what you and all of ustogether, saat saat saat, are accomplishing.

SAATPlanting a herbgarden in Bhopal

page 12

The new clinicpage 12

Ways to help the Clinic page 14

Voluntaryadventurespage 16

Bhopal Medical Appeal

Sambhavna’s awards

JAMA article

A PROJECT OF THE PESTICIDE ACTION NETWORK UK, REGISTED CHARITY 327215. DONATIONS MAY BE MADE DIRECT TO: PESTICIDE ACTION NETWORK/BHOPAL ACCOUNT NUMBER 61752312,

NATWEST BANK BRIXTON BRANCH (SORT CODE 60 03 36); 504 BRIXTON ROAD; LONDON SW2 8EB

credit card hotlinefreefone 0800 316 5577

THE FAMOUS PICTURE ON THE RIGHT was taken on themorning after the disaster by Magnum photographerRaghu Rai. He remembers that the child’s father,unable to bear the thought of never seeing herface again, had brushed away the earth for onelast lingering look.

What he saw that day - heaps of twisted bodieslying in the streets, agony of blinded and choking survivors, the lamentation of a destroyedcity - traumatised Raghu, who has rarely beenback to Bhopal. However last year he returned totake a new set of pictures. Like most people notdirectly involved in the Bhopal campaigns forhealth and justice, he expected that things musthave improved in the nearly two decades sincethe disaster. He was appalled. The pictures hetook on this second visit can be seen onhttp://www.greenpeace.org/features/details?features_id=22086

Today, nineteen years after the disaster, more than 130,000 people in Bhopal are still seriously ill. People are dying at the rate of one a day from injuries sustained on THAT NIGHT.Thousands have lost their livelihoods. Many are now homeless beggars. Their breathless bodies no longer able to push handcarts and lift heavy loads, they have fallen into utter destitution. Many have been reduced to begging and their families have learned the lessons of the abyss, binding rags tightly round their middles to create the illusion of full stomachs,

giving children crying andsleepless from hunger water toswell their empty bellies.

Since the disaster, the cityhas experienced epidemics of cancers, menstrual disorders and‘monstrous births’ but treatmentprotocols have hardly advancedbeyond the state of ignorancethat prevailed immediately afterthe disaster, when doctors didnot know which poisons hadleaked. Subsequent attempts todevise effective treatments havebeen hampered by the company’scontinuing refusal to shareinformation it holds from 60

years of studies on the toxic and mutagenic effects of MIC - the maingas that leaked. Union Carbide and its new owner Dow Chemical claimthe data is a ‘trade secret’, but the damage done by MIC is by nowcatastrophically clear. For more on this, seehttp://www.bhopal.org/achildisborn.html.

For twelve years Carbide’s executives have been ignoring the summonsof a Bhopal court to answer criminal charges of ‘culpable homicide’ fora death-toll that continues to mount and which already exceeds 20,000.

And men shall the

PHOTOGRAPHS: RAGHU RAI

While the case drags on many survivors have not received a single centin compensation for their injuries and years of suffering. Of those whohave, more than 90% got less than $500 – a typical sum being around$280, never enough to buy medicines. Over nineteen years, it works outat around 7 cents a day, which just about buys one cup of tea, even inBhopal. By contrast (as the Times of India complained) Alaskan seaotters harmed in the Exxon Valdez disaster were fed airlifted lobsterat a cost of $500 per day, per otter.

Meanwhile a new generation of Bhopalis is being poisoned by chemicalsabandoned by the company at its now-derelict factory. In December 1999Greenpeace reported that soil and groundwater in and around the plantwere contaminated by cancer- and birth-defect causing heavy metals andorganochlorines. A February 2002study found mercury, lead andorganochlorines in the breastmilk of women living in nearbycommunities. The company says itwill not pay for the clean-up ofthe factory site. (See our storyon p6.) The pain goes on and on.

SUNDER BAI WAS SIX MONTHS PREGNANT when the gas leaked. She alreadyhad two healthy sons. The night of the gas she suffered burning in thelungs and eyes, froth came from her mouth. the baby was born dead

after eight and a half months. It had avery small head, was greenish blue incolour and its flesh had become gelatinous.A year later she had a miscarriage. A yearafter that she had another. Her youngestchild, a baby girl was born six and a halfyears after THAT NIGHT and lived one and ahalf months. The day she died she threw upfroth through her nose and her stool wasdark red. In 1993 Sundar Bai gave birth toa daughter, Guriya, now eight years old. Avery beautiful child when we met her inApril 2002, she was healthy until ninemonths ago. Now she too is showing all toofamiliar symptoms: constant fevers, bodyaches, breathing problems, chest pains andso on. She is now a dull counterfeit of thebright faced gamine we met last year.

Sundar Bai says, ‘Diseases have got stuckto us like insects drinking our blood.’ Herneighbour remarks, ‘There is a prophecy inthe Quran that men will drink the blood ofmen. It is being proven true in Bhopal.’

drinkblood of men

LAST JULY JON SNOW AND HIS CHANNEL 4 FILMCREWvisited Bhopal at our invitation. Jon saw theneighbourhoods where people died in 1984. Hemet women to whom badly damaged children havebeen born. He saw and smelled their poisoneddrinking wells. Finally, we arranged for himto visit Union Carbide’s derelict factory.

It is hard to describe the impact of the place.The huge 66 acre site is reverting to jungle,out of which ruined industrial structures riselike temples to some failed religion. Thefloor of the abandoned control room is strewnwith Carbide papers from nineteen years ago.The dial which read the outlandish pressurein the MIC tank is still jammed on overload.Globs of mercury, spilled long before thedisaster, still gleam on the ground.

Nature seems desperate to erase all traces ofUnion Carbide. Lantanas choke the pipework ofthe fatal MIC unit. Woody finger-thick vineshave swarmed to the top, more than a hundredfeet above ground, wrapping themselves roundladders and safety rails, as if to strangleand rip down the hated plant. No birds sing.On the highest platform, you can reach outand touch the stack of the vent-scrubber fromwhich the poisons escaped, its paintworkstill blistered black from the heat of thegases that roared through it on THAT NIGHT.

Up by the stack, there is a fine view overthe city. You can see all the neighbourhoodswhere the gases worked their slaughter.Directly ahead, across the boundary wall isan unplanned chaos of shacks: JayaprakashNagar, in whose narrow unlit lanes thousandsperished. It’s where our friend Sunil used tolive, who lost his mother and father and fiveof his eight brothers and sisters on THATNIGHT. Bhoora Khan the rickshaw-driver whohangs around outside our clinic also livedthere, in a tiny house he built himself, neara well whose water now stinks of chemicals.

Look beyond Jayaprakash Nagar and you can seeBapna Colony, with Kabadkhana and Ibrahimganjfurther to the south. Chhola Naka and PhutaMaqbara lie to the east, Qazi Camp to thewest, killing grounds all. On the right,heading straight for Chowk in a haze of busand truck exhausts is Berasia Road. On THATNIGHT it was a river of people, some in theirunderclothes, struggling as if in the laststage of a marathon, falling, not getting up.Aziza Sultan, who works at our clinic, wastwo months pregnant. She lost her baby as sheran. Her womb simply opened and the foetusfell out. (You can read Aziza’s story athttp://www.bhopal.org/aziza.html) She losther child at the Bhopal Talkies crossroad.It’s over there, by the dome of the nearbyShi’a mosque where the followers of ImamHussain firewalk on the eve of Muharram.

The MIC plant is now lost in jungle

E-610, the fatal MIC storage tank

The ‘rocks’ that could release MIC again

The vent scrubber still black and blistered

PHOTOGRAPHS:

DAN

SINHA

Tank E-610’s thick sides are buckled. Theexplosions that took place in its steel gutwere so violent that they broke the tank outof its underground concrete bunker. The tankis empty now, but something was beginning toirritate the skins of the camera crew. Jonput his finger to his lips and said, ‘I’mtasting chemicals, but this plant closedeighteen years ago.’ In his report fromBhopal he at one point stands in front of a large heap of reddish rocks. They are actually chunks of carbaryl, a potent poisonand potential carcinogen marketed by UnionCarbide under the brand name Sevin. Jon toldhis audience, ‘Twice in the last twelvemonths, I have stood at the seat of greatdevastation - Manhattan, and here in Bhopal.Yet Ground Zero was cleared within eightshort months. Here, eighteen long years on,where three times as many people perished, theplace is still uncleared.’

The shocking, unforgivable fact is that UnionCarbide has never bothered to clean up itsfactory. Warehouses and open-air sheds holdhundreds of tons of toxic chemicals in rottingdrums and sacks. The ‘rocks’ are weeping athick, deadly tar. Each monsoon chemicalsfrom the factory, among them heavy metals andorganochlorines, wash down into the earth.They have polluted the acquifer which feedslocal drinking wells. A 1999 Greenpeace studyfound cancer- and birth-defect causing toxinsin well water. 20,000 people are drinking andwashing in dilute poison. Even people whocame to Bhopal since 1984 have been sufferingillnesses similar to those of the victims ofthe 1984 disaster. Deaths and horror birthscontinue. In January 2002 women in JayaprakashNagar learned that they have been feedingpoison to their babies via their breast milk.(http://www.bhopal.org/ganesh.html for medicaltestimony on birth defects.)

Union Carbide and its 100% owner Dow Chemicalsay that the factory poses no threat todrinking water. But they know it does. In abox beside me as I write this are over 1,000pages of private Carbide documents. Among themis a report, never meant to be seen by anyoneoutside the company, which reveals that inJune/July 1989, five years after the disasterand a full decade before Greenpeace’s study,Union Carbide already knew that soil andwater in its factory site were lethal.Carbide said nothing, warned no one, and didnothing to clean up. Instead its bosses,knowing all along that local people ran therisk of being slowly poisoned, went ontelling them their drinking water was safe.

What sort of men do this, knowing that thecommunities being poisoned are those whose livesthe 1984 gas leak has already devastated?

Local people say the factory is haunted. Insome places not even grass will grow. In otherswild sandalwood has seeded and turned intotrees. The site is crawling with cobras. lastyear two rabid dogs were livingthere. (Pics onhttp://www.bhopal.org/factory.html)

Lost in undergrowth is a rusting tank, big asa steam locomotive. On THAT NIGHT this tank -E-610 - blew, smothering Bhopal in methyl-isocyanate, a gas 500 times more toxic thancyanide. The factory in West Virginia usedtanks a fraction of the size. The company’ssafety rules required that the tank be keptno more than 40% full and at no more than 5degrees above zero. But on THAT NIGHT tank E-610 was 70% full and local managers, toldby their US bosses to cut costs, had somemonths earlier shut down the refrigerationunit to save on freon gas. Survivors alwayswondered how much was saved, to make it worthrisking the lives of a city. Last November,private Carbide papers came into our handsand we had the answer. $37.68 a day.

Still killingafteralltheseyears

IN A SHADY COURTYARD under a spreading mangotree people wait to be seen by our doctors.Some glance through newspapers, others chat,or read through the medical materials we haveprepared for them. People are relaxed. Thereis laughter. Upstairs on the flat roof, is aherb garden and an airy room where Nivrittais teaching yoga breathing, which has provedso effective in relieving the breathlessnessthat afflicts so many of Carbide’s victims.Next door is the small room where Biju givespanchakarma therapy and massage to ease theiraches. Biju has been trained in chiropractictoo, by Steve Doctor, a volunteer who comesevery year.

On this typical day at Sambhavna, everyone iseasy, the atmosphere is tranquil. Hard toimagine that the nearby streets once rang withscreams and the cries of choking, dying people.But just half a mile away, in a site heavilysalted with dangerous chemicals and fastreturning to jungle, stand the gaunt remainsof Union Carbide’s pesticide plant, the causeof two separate medical disasters.

Some of those who come to us carry in theirbodies the legacy of that night of poisonnineteen years ago. Others weren’t in Bhopal,or weren’t even born, at the time, but havebecome ill by drinking water poisonedby chemicals leaking from the abandoned plant. Sambhavna accepts and treats free of charge, people who have been injuredby drinking contaminated water. Governmenthospitals and the hospital built from thesale of Union Carbide’s confiscated sharesrefuse to treat the ‘water-victims’.

Our community health workers recently did asurvey among the 1528 residents of AnnuNagar, a shantytown just across the railwaytrack from the factory. 91% were drawing waterfrom contaminated hand pumps. Half suffered aplethora of symptoms - the commonest beingabdominal pain followed by giddiness, chestpain, headaches and fevers - that we haveseen over and over again among gas-victims.Nearly half of teenage girls aged 13 to 15had not yet begun their periods. This was animportant finding because there is menstrualchaos in Bhopal. Girls who were toddlers, orin the womb, on THAT NIGHT come to see Aziza,our gynaecological health worker, complainingof no periods for four months, or three in amonth. Now the water-victims are experiencingthe same thing. Aziza, herself a gas-victim,regularly hears their stories at the healthcamps she organises in local communities,where women come and talk to her about theirproblems.

On this typiecal day here comes Ramesh-bhaion his bicycle, back from Annu Nagar, wherehe has been checking up on TB patients. He

Ramesh, whose favourite word is ‘lekin’ (but)

A day at Volunteer chiropractor Steve Doctor at work

and others have also been busy rallyinganother local community, in Atal-Ayub Nagarto demand clean drinking water from the coun-cil. They stuck up posters everywhere toalert people about the danger of drinkingpoisoned water and organised three anaemiascreening camps (hardly anyone had normalhaemoglobin levels). Six 1000 litre freshwater tanks have now been installed and arekept filled by water tankers.

Meanwhile downstairs in the pathology lab,Mahindra is taking a blood sample. Sathyu is onthe phone trying to arrange free surgery fora woman whose biopsy has revealed a malignantlump on one breast. In his dispensary nearbyKamal is making up prescriptions of modern(allopathic) drugs and herbal (ayurvedic)medicines. Our doctors Qaiser and Deshpande(allopathic and ayurvedic respectively) copeevery day with incredible caseloads. Theycross-refer cases and consult together inwhat must be a unique collaboration betweenconvention and alternative medicine.

Outside, in the mango shade, Sunil is hummingas he clips news stories relevant to ourwork. Sambhavna’s Documentation Centre holdswhat is probably the world’s most complete collection of original source material about

the Union Carbide gas disaster. Athis desk in the centre, surroundedby dusty files, our administrator

Mr Chowdhry is keeping track of monies spent- so much this month on allopathic drugs, somuch on herbal treatments.

One can’t mention all our staff in this shortspace which is a pity because they are heroesevery one. All decisions are taken communallyat a weekly meeting where people speak theirmind. We eat together at lunchtime, al frescoon the roof under the mango branches. Thefood is simple vegetarian and a chai-wallahbrings Bhopali tea (spiced with cardamom andginger, sugar and a pinch of salt). BhooraKhan the auto-rickshaw driver is usually aboutnearby if you (speaking now to potentialvolunteers) need to get around Bhopal.

This summer the clinic lost a great friend andBhopal one of its great characters. UstadAbdul Latif Khan (the word ustad signifies‘maestro’) was probably India’s most famoussarangi player. A sweet man of unfailingcourtesy and great honesty, he was patriachof a fifty-strong clan of sons, daughters,grandchildren and great grandchildren. On thenight of gas, Ustad and his family were intheir house in the Old City. Outside, thedeadly panic was beginning. He refused to run,saying, ‘If we have to die then let us dietogether, with dignity.’ He told them to sealdoors and windows, thus saving their lives,as those who ran out into the gas perished.

Ustad Abdul Latif Khan, who died this summer

SambhavnaMahindra is this month’s clinic co-ordinator

Sathyu Sarangi, ManagingTrustee of Sambhavnaexplains why we place sucha high emphasis on findingnatural ways to treatillness, using herbaltherapies in conjunctionwith modern medicine.

“WHAT SOME OF US FEEL is that modern medicinepropagates and perpetuates a very violentworld view which is absent from traditionalsystems of therapy. Modern medicine says,there’s an infection, we’ll go in hard, we’llblitz it and kill it. Chemical agriculturehas the same mindset. In Carbide’s factorythey used to make systemic pesticides whichwould joyride in the blood and damage everyorgan and thus kill insects. Only 1% of sucha pesticide does what it’s supposed to do.The other 99% kills everything else: insects,fishes, birds and animals all down the line,through a process of bio-magnification andaccumulation in the bodies of the animals.

Take an antibiotic for a stomach infectionand it will wipe out the healthy bacteria, so there are none left to maintain the body’sinternal ecology. This kind of tunnel visionutterly loses sight of the interconnectednesswithin the body and of the body’s connectionswith nature and the universe. It doesn't seeall the other possibilities. It’s moderntechnology providing non-working solutions toproblems created by modern technology itself.

If you look at the other systems, Aryuveda,yoga, acupuncture, the Chinese traditionalsystems, they don’t look at a health problemin isolation, but realise that it is theresult of many factors. It’s a different wayof looking at health, disease and life.” At Sambhavna we do not underestimate thepower and capabilities of modern medicine fordoing good, neither do we want to be over-reliant on it. We realised early in our workthat many drugs used to treat gas victimswere actually doing harm. So we introducedyoga as a drug-free therapy and ayurveda as atherapy based on medicinal herbs. When some-one comes to Sambhavna, they can choose forthemselves whether they wish to be treatedwith modern allopathic medicine, ayurveda(traditional Indian herbal medicine) and oryoga. We are constantly looking for safe,effective and inexpensive ways to solve thehealth problems of the gas victims, and in sodoing have pioneered treatments that combinethe best of modern and herbal medicine, yogabreathing and exercises. The results are veryencouraging.

First do no harmWe hold to the principle of ‘first do no harm’and do our utmost to avoid unnecessary andharmful drugs. We monitor the effects of ourtherapies and develop treatment protocols forspecific complexes of symptoms.

Records, monitoringWe have developed a good working system forrecording and processing survivors’ medicaldata. It confirms their history of exposure,helps us monitor their health and the efficacy

of the treatment they arereceiving. Because we see a lotof chronically ill people, thismethod has significance in thesearch for long-term answers totheir health problems.

Demonstrating the value ofayurveda and yogaWe have shown the efficacy ofayurveda and yoga in treatinggas-induced health problems andhave succeeded in providinglong-term and sustained reliefwith these therapies. We havedone research studies and presented objective data to showthe benefits of yoga therapy forexposure related problems. A1997 research study documentedimprovements in lung functionamong survivors with chronic

Our successes

Regular health camps encourage people to formtheir own community health committees

respiratory problems who hadopted to use yoga therapy. Thestudy showed significant benefitsand a reduction in the use ofdrugs. This paper was presentedat the 16th World Asthma Congress,Buenos Aires, in October 1999.

Collecting medical dataWe have generated a wealth ofmedical data that could help indeveloping a long-term strategyto address the health problems ofgas-exposed persons.

Airing unmentionable issuesIn the traditional society ofBhopal some health issues areneglected or shunted into thebackground, our community workersbegan interviewing gas-affected teenage girlsabout their menstrual problems and prepared areport based on the data and drew widespreadattention to the problem.

Showing effects on the second generationWe gathered data on the physical developmentof children born in Bhopal between 1982 and1986. The study shows that male offspring ofexposed parents are shorter, lighter, thinnerand have smaller heads than sons born tounexposed parents in the same period. Sons ofexposed parents showed abnormal growth, their

upper bodies being disproportionately smallerthan their lower bodies. The results of thisimportant study were published on 8th October2003, by JAMA, the influential Journal of theAmerican Medical Association.

Community control of tuberculosisWe have created a working model for communitycontrol of tuberculosis, a disease which is a double problem because it stigmatises thevictim. Our health workers identify peoplewith TB, persuade them to undergo treatment,supervise and monitor their progress. Much ofthe work is shared by ‘health leaders’ whoare recovered TB patients.

Encouraging and empowering local peopleOur education campaigns and meetings haveencouraged gas-affected communities to formlocal health committees. In four areas localvolunteers now identify people in need ofmedical help, counsel them about treatments,organise meetings and hold health camps.

Pioneering the use of verbal autopsyWhen someone dies at home without access to

medical care, the cause of death can be hardto determine. Dr Daniel Chandramohan of theSchool of Hygiene and Tropical Medicine,London, helped us develop the technique ofverbal autopsy to track exposure-relateddeaths and to establish its legitimacy as ascientific tool for helping families seekredress and compensation for the loss ofloved ones killed by Carbide’s chemicals.

Limitations and failureThe number of people offered care is only a fraction of the survivors in need. The distance of the clinic from badly-affectedcommunities is a real problem for many people.

A substantial number of people treated havenot received sustained relief and the problemof relapse of symptoms remains.

The patient-load on individual doctors isincreasingly difficult to manage.

As yet we have not managed more than two epidemiological and clinical research studieson the long-term health consequences.

We have yet to start regular treatment ofcervical cancer.

While the new larger clinic will help us toremedy many of these failings, it will mean abigger budget. We need to raise significantlymore funds than at present. Anything you cando or help directly or to help us fundraisewill be gratefully welcomed.

(and failures)

The gynae education camp held in a severelygas-affected community attracted hundreds

AT THE SITE OF THE NEW CLINIC, we are plantingan organic Ayurvedic herbal medicine garden.It will produce fresh herbs for making theAyurvedic medicines used in the clinic, teachpeople organic gardening methods, about using medicinal herbs and demonstrate a home grownalternative to expensive, drug store varietyhealth care.

Garden Journal: March 2003Challenges. The garden’s site used to be abrickworks and the red clay subsoil will needa lot of enriching. We have planted a ‘greenmanure’ cover crop to begin the process.

Bordering the land is an open ‘nala’, chokedwith plastic bags and garbage. During themonsoons, this overflows onto the land,depositing all of the garbage. We spent twoweeks cleaning upbefore we couldplant our covercrop. We will haveto pick plasticbags out of thesoil for years tocome. It will takea strong stonewall to preventthis flooding.

The largest treeon the property isa lovely oldtamarind, stillstanding tallalthough the soilaround its rootshas been severelyeroded. We will build a protective wallaround the base, and fill it with soil andgood compost to help protect this tree, whichis our favorite place to sit in the shade andcool off while working here.

Garden Journal: August 2003The dampness has set in now, as we reach themiddle of the rainy season here in Bhopal.The early rains came as dramatic afternoonthunderstorms blowing fast across the land-scape. I stand on the roof of my apartmentbuilding and watch the lightning displaysuntil they are too close and I run inside.The afternoon and evening rains cool thingsdown and make nights pleasant for sleeping.Some days the sun glares down through thethick air enough to dry the laundry on theline. And in the open space across the way,boys splash and play in the seasonal pools,and muddy themselves in rowdy soccer games.Compared to the parching dryness and dust ofthe winter and summer seasons, the moisturein the air is welcomed by my skin and nos-trils. The thirsty earth bursts forth in alush green, luminous against the dark skies.

And in my garden the soil is transformed fromhard dry bricks into thick sticky clay thatclings to my sandals, adding inches to myheight. Worms have come, and the cover crop Iplanted in March/April that I thought hadbeen completely destroyed by heat and grazing has reemerged and is jumping toward the sky, along with a healthy crop of weeds. The wallis completed, keeping the overflowing nallaat bay and the ever hungry goats and cows awayfrom the plantings. Jean Baptiste and Aude,

two organicfarmers fromFrance, came to volunteer. We built thefirst compostpile, weeded,and plantedtrees donated by a local shrubnursery.

The biggestproject was digging the pondbefore it becametoo rainy towork. The pondwill store rainwater for

irrigating during the dry season. The workwas done by hand by about 15 local men andwomen who completed the whole thing in aweek. Now it is filling up, and I am anxiousto see if the water will stay without havingto put in a liner.

My attempts at seed sowing in my nascentplant nursery have all met with disastrousresults, with everything succumbing to ‘damping-off’, a soil fungus that attacks andkills young seedlings, and obviously thrivesunder these monsoon conditions. With nothingresembling a ‘sterile soil mix’ availablehereabouts, I think I’ll try sowing into puresand next. My other idea is to water theseeds with neem leaf tea. I'll let you knowif it works.

Garden Journal: October 2003As quickly as they came, the rains haveended. And the overabundance of water hasjust as quickly dried up. But I am impressedby our mulching. The soil is still moist anddamp, even on the surface, in the areas wherewe have mulched.

Terry’

Our pond has filled up with water and nowsupports cypress grass and lotus. The lotusflowers look beautiful in early mornings,thrusting their deep rose flowers, crisp,clean and new, toward the sky. Lots of frogsleap into the water as you walk around theedge, and red-orange dragonflies dance theirdance above the surface. Mohan says there isalso a turtle, but I haven't seen it. I didsee a big black water snake swimming swiftlyaround one day, but it slid into the grasswhen it saw mewatching.

All around theboundary we haveplanted dozens oftrees and hundredsof cuttings. A short list:Nirgundi a lovelyshrub used forrelief of headache,rheumatism, andfever, with anti-cancer activity;Giloy, a climbergood for fevers;bougainvilleawhose thornybranches willbecome a crucial part of the live fence, andwhose hot pink flowers will provide cheerfulcolor even during the droughts. And this isjust the beginning! We plan to add Shikakai,a thorny vine good for the hair, fragrantIndian roses, Karonda, a thorny fruitingshrub whose berries are good for pickles andjams, and Henna shrubs. (Email me if you wantLatin names.)

Our plant nursery is now doing well. Westarted more than 120 varieties of medicinalplants and trees, and those that germinatedand survived ‘damping off’ are now ready togo into the ground. We should be able tostart planting in the next few days. We willdirectly sow many more varieties.

We used our first cover crop of Sorgham tomake a nice pile of compost. And down on thelow lying portion of the field near the nalawe have planted a new set of nitrogen fixing,soil improving cover crops like alfalfa, redclover, and indigo. It is essential that wegrow our own biomass for compost and mulchingmaterial, as there is no other local source.

The cover crops are planted between the treesin rows separated by newspaper and straw mulchto suppress weeds and conserve moisture. Itis time consuming to plant this way, but I amsure it will pay off.

Trees we have planted so far include leguminousnitrogen fixers, good for biomass, plus lotsof delicious vegetables, medicinal fruits,and trees with medicinal leaves and barks,such as Arjuna, Palash, Ashok, Neem, Cassia

spp., Gulmohar,Babul, Amla,Amaltas, Bel,Ber, Peepul,Banyan,tamarind, lemon,banana andpapaya.

We hired twogardeners inmid-August, Mr.Amar Singh andMs. Ratna Soni,and recentlySunil Lodi, agas survivorwith severe psy-chological prob-lems, has joined

us for some horticultural therapy. In addi-tion, several local volunteers have helpedout regularly. They have learned a lot aboutcompost making, seed sowing, cuttings, andtransplanting. We all share our knowledge ofdifferent herbs, and bring in plants andseeds that we find in the villages.

Nivritta, the clinic's yoga instructor, hastaught us several yoga exercises to help usstrengthen and protect our backs. So thingsare off to a good start, and we are allexcited to see what the place will look likein a few months. If you’d like to come andhelp, let me know.

Terry AllanC/o Sambhavna Clinic44, Sant Kanwar Ram NagarBerasia RoadBhopal, M.P. 462018INDIAterrykisan@yahoo.com

s garden diary

PHOTOGRAPHS:

TERRY

ALLAN

SITE WORK HAS AT LAST BEGUN on Sambhavna’sdream of a new clinic to improve and expandour services in the heart of the mostseverely gas-affected communities. Based onthe vision and requirements articulated bySambhavna staff and trustees, the new clinicis being designed as a model setting forintegrated, holistic health care with community involvement, it will be a placewhere survivors receive their choice of allopathic or Ayurvedic health care in atranquil, beautiful setting surrounded byherb gardens and natural vegetation. Locatedon a two-acre plot in Bapna Colony, lessthan half a kilometer to the south of theUnion Carbide factory, the new clinic willbe easily accessible to residents in themost severely affected communities ofJaiprakash Nagar in the North, Chhola andPhuta Maqbara in the east, Kabadkhana andIbrahimgang in the south, and Qazi Camp inthe west. The preliminary site work andorganisational planning is complete. Thisincludes obtaining official permits and permissions, drilling for water, installingan electricity supply, and fencing theperimeter. Nearing completion is a functionalsite building that includes a constructionoffice, a garden office and workshop, astoreroom for cement and building materialsand housing for the site’s watchman. Theexpansion of Sambhavna’s work with the creation of the new facility is expected tolead to a threefold increase in the trust’sexpenditure. We expect these additional fundsto come from the same sources that we haverelied upon over the past six years – smalldonations from over 5,000 people from allwalks of life in India, the UK, US, andJapan. Authors Dominique Lapierre and JavierMoro have pledged a substantial portion ofthe royalties from their book Five PastMidnight in Bhopal, towards supporting thecontinuation and expansion of our work.

In addition to monetary contributions, we arehoping people will donate their expertise tothe project. Specifically, we need help withthe design of a solar electric system, abiological wastewater treatment system, and arainwater harvesting/aquifer recharging system. Please contact us if you can helpout in these areas.

New Clinic

WE TAKE CREDIT CARD DONATIONS VIA FREEFONE 0800 316 5577OR ELSE PLEASE USE THE ENCLOSED DONATION FORM

Help fund the work of the clinic.Sambhavna costs about £2,600 per month

to run including medicines, salaries, medicalinvestigations, publications and all othercosts. You could contribute to this corecost, or if you prefer, specify that yourdonation be used to fund specific activities.These include:- Establishing a demonstration and productionunit for herbal medicines. Cost £260 a month. - Buying equipment. Currently we badly needan Ultra-sonograph machine for our generaland gynaecology clinic. We’ve raised all but£2000 of the cost. Also three computers, oneeach for data entry, community research andpathology laboratory. A computer costs £460. - Special projects. Panchakarma (traditionalherbal detoxification treatment) providessustained relief of many chronic conditionssuffered by the gas-affected, like jointpain, breathlessness, backache, insomnia andanxiety. We want to employ a full time panchakarma doctor (cost £130 a month) andbuy additional equipment (cost £800).

- Reseach projects. Recent studies show thatmethyl-isocyanate is a potential carcinogenfor humans. We would like to do a survey ofcancer incidence in gas- and water-exposedcommunities. We would further like to findbetter ways to screen, diagnose, prevent andtreat cancers in Bhopal. Such a study wouldcost £10,500. - Staff training, seminars and workshops.A two week training course costs £150 perperson. Taking part in a seminar or workshopcosts about £66 a person.- Public education. Help publish a manualfor survivors on preventing, treating andmanaging common exposure related diseases.Cost £1500 for 5000 copies. Community healtheducation material costs us £500 a year.- Public seminars, workshops and camps toeducate local communities. Seminar/workshopscost £400 and a training camp £40.- Help our volunteers. Our volunteers comefrom among the survivors and from all overIndia and the world. While they pay for theirtravel to Bhopal, Sambhavna offers freeaccommodation and meals to the volunteers.You could help by contributing towards theseexpenses which come to about £200 per month.CREDIT CARD HOTLINE FREEFONE 0800 316 5577

Volunteer at SambhavnaMany of our volunteers from abroad

have medical backgrounds, but non-medicalvolunteers also make valuable contributionsand are welcome. The main thing is enthusiasmbut the scope of work expands tremendously ifyou can speak Hindi. Volunteers come for aminimum of two weeks, often fitting in a stayat Sambhavna during a longer tour of India.Some of the things you may find yourself doing:- the work of a physician, gynaecologist,cytologist, herbalist, or massage therapist- video/audio documentation, cataloguing,drawings for health education material- operate computer, update web site, organisedocumentation, write pamphlets, press releases,devise public education posters- work with Terry in the organic garden,teach gardening and use of herbs to localpeople, accompany our community workers ontheir rounds (Volunteer comments on page 16)

Be an online medical advisorPeople with medical skills can help

with research studies and medical contacts

Help us fundraise in the UKYou can help by organising fundraisingevents, forming support groups, giving

talks, holding exhibitions. We are trying toarrange for the Raghu Rai exhibition (see p4)pictures to be available and there are alwayspeople willing to give you more informationand facts about the Bhopal disaster and itsaftermath. Above all, the Bhopal MedicalAppeal is about being a community of peoplestriving to do something unique and valuablein the world, you could put us in touch withindividuals and groups who are likely toenjoy being part of it.

Volunteer in London at PAN-UK’s officesThere are about 5,000 of us in the UK

(hooray) and newsletters like this one take agreat deal of envelope stuffing and stamp-licking. This stuff-fest often takes place inLondon or Brighton. Be part of it! You couldalso come in to deal with the response, whichis generally overwhelming.

Help prepare for the 20th anniversaryin December 2004. In particular we

want to organise a benefit rock concert. Canyou play a guitar? Know someone who can? GiveRadiohead a ring? We need to move on this now!

1. 2.

6.

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Ways to help 4.

THE DONATION FORM ALSO HAS ESSENTIAL CONTACT INFORMATION FOR VOLUNTEERING IN THE UK AND BHOPAL

5.

Steve Doctor, ChiropractorOut of the mysterious webof human friendships andthe medium of coinci-dance,I found myself volunteeringmy chiropractic skill tothe gas survivors of Bhopalat the Sambhavna Clinic.That was four years ago and

to this day I remain deeply touched by, notonly survivors’ plight but also their spirit.Having trained a chiropractor at the clinic,I now help in the Bhopal justice campaign. Icontinue to visit Sambhavna and the dearfriends I’ve made there. Sambhavna continuesto inspire me. It’s a sort of light in thedarkness left behind by the Union Carbidechemical company. Sambhavna is an affirmationof human goodness: I feel honoured to havemet so many good people through Sambhavna.

Rachna Patel: Surrey, UK. Researcher.July-August 2003. No words do justice to thisplace, the people and the work being done?What I have seen, heard, and participated inhas opened my eyes to what this world isreally like and how making a difference tojust one person can be so uplifting. If onlythere were more like Sambhavna, the worldwould be, without a doubt, a better place!

Sean Zager: Michigan, USA. Medical Student.July 2003 Such incredible minds comingtogether to build a beacon of light in theworld of medicine, politics, and humanrights. I have never been part of a grouplike this, and it has taught me the power and possibility of change. How refreshing tosee so many giving themselves to somethingbigger. May justice be served!

Patti Kodish: Florida USA. Research Assistant Feb 2003. All of the dedicated staff atSambhavna have made a vision come true for

me. Everyone is so warm and friendly, there’s a collective spirit and genuine concern for the survivors of Bhopal. Keepfighting for what youbelieve in, for today’schildren and for thosestill to come.

Aude Penet: Toulouse, France. Organic Farmer.June-July 2003. It was a great pleasure tohelp Sambhavna. Such a good team, such agreat organization, such a beautiful projectwith the new clinic and garden. I can’t waitto see the pond full, the trees grown, andall of the plants, flowers and birds. I’msure its going to be a wonderful, peacefulplace. It’s nice to see such big energy evenafter 20 years. We are with you in thisfight. NO MORE BHOPALS! PLUS JAMAIS ÇA, NI

ICI NI AILLEURS!

Jean-Baptiste:Lot, France.Organic Farmer.June-July 2003.We will be happywhen the last bossis hung with theintestines of thelast politician.

Maude Dorr: Rhode Island, USA. Photographer.November-December 2002. Volunteers come andgo, but I admire those who have stuck to thecause for so many years – that is the greatchallenge. The people at Sambhavna continue in good humor and great spirit. I admire the

freedom everyone has tohave their say. Thanks

for letting me be part of it.

Catherine Welch: Connecticut, USA. CollegeStudent. July-August 2003. A farmer namedTerry came to my class one day to tell us ofa tragedy which had begun when I was a year

old. I said to myself, Ihave been ignorant too long- I must go, I must see, Imust shout from therooftops ‘thousands of people have died here, don’tturn your back on them.’Now I have come, and I haveseen, and I have a newspeech for these ancientrooftops: it was not deaththat ignited a passion in

me here but life. More than anything I’llremember the sense of possibility, and hope,and love like I’ve never before known.

Do you want to volunteer?Everyone is welcome to come and live and workwith us. Great if you have medical skills butmore important is yourself and your enthusiasm.You could work in the Clinic, in the herbgarden with Terry or out in the community.You’ll stay in our guest flat, which is basicbut clean. As a first step, please contactSathyu Sarangi, Sambhavna Clinic,44 Sant Kanwar Ram Nagar, Berasia Road,Bhopal, Madhya Pradesh 462018, India.Telephone: +91 (755) 273 0914

Friends Volunteers