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Sodium thiosulphate, injected intravenously, had started providing relief to those affected by the sudden massive gas leak in the night of December 2-3, 1984 from the pesticide factory of Union Carbide in Bhopal. Just as the victims were showing improvement, the State government ordered the doctors to stop it, because Union Carbide wanted administration of sodium thiosulphate stopped immediately.
This is revealed by Dr N R Bhandari in his book “25 Years of Bhopal Gas Tragedy: Inside Story and Untold Truths”. The 264-page book, priced at Rs 300, has been published by Lalwani Publications, Bhopal. Bad editing does not lessen the importance of this eye-witness account of the tragedy and its aftermath.
Dr Bhandari was the Medical Superintendent of the State-owned Hamidia Hospital (attached to Gandhi Medical College, Bhopal) and Professor and Head of the Department of Paediatrics at the time of the gas leak disaster. He was very closely involved, as he himself says, from minute one of the tragedy, directly as an administrator and clinician. “I witnessed the death of the victims from the midnight of 2-3 December, gasping, collapsing and dying due to respiratory problems and severe eye injury, in front of my very eyes. We did not know what was happening, the impact was so sudden and unexpected”.
Dr Bhandari received the first phone call about some gas having leaked from the pesticide factory of Union Carbide from the Bhopal Commissioner a little before midnight of December 2; soon thereafter the casualty medical officer of the Hospital informed him that some patients had arrived with the complaints of watering, irritation and redness of eyes. He hurriedly got ready and had just emerged on the veranda of his official residence, some 200 metres from the casualty department, when he “suddenly became breathless with severe cough. I could not move. I went inside, put the fan on (in) that wintry night and took some medicines. The medical officer was ringing me again (and again) and I was not in a position even to talk to him. Fortunately within half an hour, I felt better and rushed to the casualty section. I found hundreds of people all around.” The first dead body arrived around 3 am.

Dr N R Bhandari


After the initial confusion about the source and chemical properties of the gas, Dr Bhandari came to know that some 40 tonnes of poisonous gas had leaked out from the Union Carbide pesticide factory and the people who had inhaled it or came in its contact were taken ill. His first information was that it was phosgene, which is a toxic gas. The information either about the effect of the gas on human body or its antidote was not available. Several hours later, the doctors at the Hamidia Hospital were informed that it was Methyl Isocyanate (MiC) “which is highly toxic and can kill a person instantaneously”. Only later it became clear that it was not only MiC but a mixture of about 20 gases. “Immediately after exposure thousands of children and adults died of acute pulmonary oedema, respiratory failure, toxic effects on various systems including CNS (central nervous system), congestive heart failure and other complications”.
While the people were dying in Bhopal, not only the medical officer of Union Carbide but all its officials were telling lies about the gas and its effects. J.Mukund, who was the works manager and the top man in the factory, told reporters that “its effect is like teargas, your eyes start watering; you apply water and you get relief.” A few days later Jackson B Browning, director of health, safety and environment affairs of the Union Carbide, referred to the poisonous chemicals that had till then killed over 8,000 people in Bhopal as “nothing more than potent teargas”.
Dr Bhandari says that while Union Carbide had all along maintained that MiC had nothing to do with cyanide and that the effects of MiC on living organisms were completely different, the very first communication received from UCC on possible medical effects of MiC poisoning stated: if cyanide is suspected, use amyl nitrite; if no effect, use sodium nitrite 0.3 gms and thiosulphate 12.5 gms. This, according to Dr Bhandari, clearly suggested that UCC was aware that MiC could decompose into cyanide once it entered the body.
Dr Bhandari writes: “after studying the literature, I felt the drug (sodium thiosulphate) should not have adverse effect; if it does not do any good, it will not do any harm. It was worthwhile taking the chance and we used the drug in many patients. Ten days after the disaster, Union Carbide Corporation’s medical director first supported mass administration of thiosulphate and, in another telex message three days later, forbade it. Soon after, Union Carbide’s ally in the State bureaucracy, director of health services Dr M.N.Nagu, sent a circular to all doctors in the city warning them that they would be held responsible for any untoward consequences of thiosulphate administration. In the prevailing situation of medical uncertainty, this circular effectively stopped any administration of thiosulphate.”
Dr Bhandari adds: “however, in Medical College (and Hospital), the use of this injection was continued. We did not find side effects. A number of patients felt better after receiving the injection”.
The State government had stopped administration of sodium thiosulphate even though Dr Max Daunderer from Germany and Bhopal’s eminent forensic specialist, Dr Heeresh Chandra, both had found that sodium thiosulphate, when administered intravenously, led to improvement in the patients affected by the gas. Clinical trials carried by the Indian Council of Medical Research (ICMR) from 1985 to 1987 confirmed the efficacy of this drug in relieving exposure induced symptoms.

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The Bhopal Gas Peedit Mahila Udyog Sangathan (BGPMUS) and the Bhopal Gas Peedit Sangharsh Sahayog Samiti (BGPSSS), the two major non-government organisations working for the Bhopal gas leak disaster survivors, have described as “reckless” the decision of the Indian Council of Medical Research (ICMR) to discontinue all gas-related medical research way back in 1994. The research was taken up soon after the December 1984 disaster.
The fact that the ICMR was left with no option but to restart gas-related medical research in 2010 is a testimony to the gravity of the problem that was sought to be surreptitiously buried sixteen years ago, despite the enormity of the problem. As per the affidavit submitted by the Office of the Welfare Commissioner before the Supreme Court on November 16, 2010 [in SLP(C) No.12893 of 2010 filed by BGPMUS and BGPSSS] only 4944 gas-victims have been categorized as suffering from “permanent disability”. In addition, merely 35,455 gas-victims have been categorized as suffering from “temporary disability”. It has also been acknowledged that there are about 2000 cancer cases and about 1000 renal failure cases. In all, the official toll of higher injury cases is just about 43,399.
On the contrary, the ICMR’s own preliminary assessment was: “Out of the total population, nearly 160,000 people present within a radius of 3 km from the factory were exposed presumably to a higher concentration of gas and also perhaps for a longer period of time.” (Source: “Technical Report on Population Based Long Term Epidemiological Studies (1985-1994)”, page 48, which the ICMR submitted to the Supreme Court on 20.11.2007).
The ICMR Report further points out: “It is also a safe assumption that higher the concentration of the toxic gases inhaled, the more severe would be the mortality and greater the morbidity.” Under the circumstances, the two organisations aver, the tall claim made by the Office of the Welfare Commissioner that out of the total 574,376 awarded cases (as adjudicated by the Claims Courts) only 48,694 gas-victims had suffered more than temporary injury (including 5295 dead) is preposterous. The mismatch between ICMR’s preliminary assessment and that of the Claims Courts regarding the degree of injury suffered by the gas-victims is a matter that requires to be thoroughly re-examined by a competent body in the light of the available morbidity data from the various gas-relief hospitals/clinics and from the ongoing epidemiological survey. The problem of second and third generation gas-victims too has neither been assessed nor addressed.
A memorandum submitted by BGPMUS and BGPSSS to Rajya Sabha chairman Hamid Ansari says: “Even 26 years after the disaster, every day on an average over 6000 gas-victims are forced to visit OPDs of seven hospitals and 17 polyclinics (especially set-up for gas-victims in Bhopal) seeking medical treatment for various gas-related ailments. However, there is no proper medical protocol for treating them and they are merely provided symptomatic relief. Moreover, the bulk of them not only continue to be classified as temporarily injured but also have not been provided with health booklets that record details of the diagnoses that are made by the doctors and the treatments that are provided to them. In short, there is no mechanism in place to monitor the health history of the gas-victims”.


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Only one side of picture!

“It cannot be doubted that each of us can only see part of the picture. The doctor sees one, the patient another, the engineer a third, the economist a fourth, the pearl diver a fifth, the alcoholic a sixth, the cable guy a seventh, the sheep farmer an eighth, the Indian beggar a ninth, the pastor a tenth. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still it is never complete.” —- PAUL KALANITHI

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