Silicosis killing thousands in quarries across India - Indian Express - Asia Times

Afflicted with an incurable disease, miners in Madhya Pradesh continue to work in hazardous environments, often dying before receiving help

Demand from India’s booming construction industry for granite, sandstone and other minerals has seen the commissioning of more and more stone quarries in mineral-rich states like Madhya Pradesh.

For the people employed by the quarries, however, the work is not only dangerous but potentially lethal. Thousands of workers toiling in hundreds of quarries in Madhya Pradesh inhale air filled with silica and other particulate matters that cause respiratory diseases like tuberculosis, asthma, and, more worryingly, silicosis.

A day in the life of Ramu Mahavir, 35, worker at a stone crushing factory in Godhra. Here, Mahavir spreads the stones on the conveyor belt with his hand.

At Hindustan Mineral Products, one of 20 quartz crushing factories in Godhra, every breath comes at a price.

Ramu Mahavir, all of 5 feet tall, knows this only too well. So he has his gear in place — a cotton face-mask and a multi-coloured synthetic handkerchief.

The white dust produced from quartz crushing, also referred to as the “powder of death” in these parts, is known to cause the incurable and irreversible respiratory disease silicosis. Earlier this month, the Supreme Court directed the Gujarat government to release over Rs 70 million (US $950,000) as compensation to the families of 238 workers who have died of silicosis after working in Godhra’s quartz and stone-crushing units.

Securing the handkerchief around his mask, Mahavir says, “It’s very dusty. Without this mask (a yellow pad), it is difficult to stand here. Although there is no way to stop breathing dust, the mask helps me to a great extent. I am fit and fine, so far.”

While Mahavir, the only worker at the factory besides two maintenance staff, is well aware of the risks, the work at the factory “is a good way to provide for his family”, he says. “I have managed to build a house in my village, buy two motorcycles — one for my parents in the village — and have also paid off all my debts,” says Mahavir, 35, who belongs to Ramsagar village in Dhar district of Madhya Pradesh.

Mahavir reports to work by 10 am. His wife Poona, daughter Maya, 6, and son Rohit, 3, stay with him in his one-room quarter on the factory compound.

“Since my family is here, I feel more at home and do my work better. My wife takes care of the meals and I can see my children grow up, unlike the other migrant workers who have left their families behind,” he says. “My parents and two siblings look after our fields in the village.”

Around noon, two trucks filled with white quartz stones, all mined from the Dahod-Santrampur belt in the eastern part of the state, arrive at the Godhra factory. Mahavir’s job involves overseeing the entire process from here on — unloading the stones to crushing and finally packing the white dust.

Mahavir begins by supervising the offloading of the stones into large conical iron units, where they are stored before being fed into a mechanised unit for processing. After ensuring the transfer of all the stones, Mahavir proceeds to the next step: switching on the conveyor belt connected to the conical units. The stones slide onto the narrow belts, which are surrounded by muddy white mounds of quartz dust.

The conveyor belt is connected to a motor-operated crusher, which has a large iron wheel that breaks down the stones into smaller pieces. As the stones return to the conveyor belt after their first stint inside the crusher, Mahavir checks their size with his hands — he has no gloves on. The cycle continues till the quartz blocks are reduced to a fine glistening white powder. At times, he climbs onto a stool to get to the conical unit and spread out the stones.

It is 3.30 pm, and Mahavir continues with his rounds between the conveyor belt and the crusher, leaving footprints on the thick layer of white powder slathered on the factory floor.

It is this fine dust that contains the deadly silica, which has caused silicosis to many workers in these factories, including several from Mahavir’s district in Madhya Pradesh. It’s from these very residents of his village with silicosis that he first heard about this job opportunity at the “Godhra wali factory”.

“The others from my village came here, worked for a few months, earned money and returned,” he says. “I earn Rs 15,000 a month (US $205 / $9 per day). No job in my village can help me earn this much,” he explains.

But what about the health risks? “I am a poor farmer. We own about 4 bighas (one acre) in the village where we grow soyabean. But when the crops fail, we have to look for other avenues to provide for the family. What other option do I have?” he says.

By now, the dust from the crusher has collected in gunny bags and Mahavir has to seal them. This is considered the most hazardous of the processes. At this factory, while the gunny bags are filled automatically, the sealing is done manually. Today, Mahavir’s wife Poona is helping him out.

Dressed in a printed sari with a handkerchief tied around her face, Poona helps Mahavir check each sack before sealing them

They then arrange the gunny bags in neat stacks in a corner of the factory. The gunny bags are later dispatched to glass companies and silicate industries that provide raw material for manufacture of steel, cast iron, aluminum alloys, ceramics, cosmetics and pharmaceuticals, among other things.

“Unlike the other tribal members of my village, I did not have to pay dowry to my wife’s father. Many of my friends are forced to take up jobs in the city to pay back the money they borrowed for their dowry, sometimes as high as Rs 1.5 lakh. Since my father-in-law didn’t take any money, Poona and I can save whatever we make here,” Mahavir says. He has been working at the factory for a year-and-a-half, with half-yearly breaks in between to return to his village for farming.

Over the past few months, he has learnt a smattering of Gujarati. “Everyone here speaks Hindi. I don’t have too many interactions with people outside the factory, except for the truck drivers. I manage that,” he smiles.

However, he hasn’t struck up many friendships, “just two other workers who take care of the maintenance of the plant”. “I talk to my employers often,” he adds.

At 2 pm, after a quick lunch, Mahavir prepares to return to the factory to oversee another round of crushing and packaging.

The talk returning to labourers who have fallen to the deadly disease, he says, “So far, I have not faced any health problems. The owner gets my health checked routinely.”

Suman M, the owner of the factory, claims he has taken all the precautions for his workers.

• “There is no risk of silicosis in my factory. I have done all this work myself in my early days. Workers usually develop silicosis because of their other vices.”

As he walks back, dragging his feet on the thick white dust, Mahavir doesn’t take any chance. Fixing the mask and handkerchief around his face, he says, “I make it a point to not leave it uncovered inside the factory.”

Silicosis is a terminal disease that occurs when a person’s lungs are exposed to silica dust particles over an extended period of time. Doctors have trouble accurately diagnosing silicosis as its symptoms, and the X-ray images of silicosis sufferers’ lungs, are easily confused with those of tuberculosis victims. This often results in the administration of incorrect medicines which can cause further physical complications.

A 17-year-old victim of silicosis in India’s Madhya Pradesh State. Photo: Inder Bisht

In a 2014-15 survey by Indore-based non-governmental organization Nai Shuruwat, 1,721 people were found to be suffering from silicosis in the Alirajpur, Dhar and Jhabua districts of Madhya Pradesh. In the Mandsaur district alone, 674 people had died of silicosis.

“Out of the 1,721, at least 589 are now dead… and the number would have increased now,” Nai Shuruwat member Rakesh Chandore said. He added that silicosis patients should be given medicines based on their symptoms as the disease is incurable.

According to the International Labor Organization, one million people are exposed to silica dust in India every year. Among workers employed at mines across the country, 230,000 people are estimated to be at risk of contracting silicosis, according to the Directorate General of Mines Safety.

Misdiagnosis

Former stone mine worker Keshu, 39, of Panna’s Mazha village has taken anti-tuberculosis medicines for the last 10 years, without much relief. He is bed-ridden for the most part of the day and hasn’t gone to work in the last seven years. Keshu was diagnosed with silicosis in 2011 by Delhi-based NGO Environics Trust.

Silicosis patient Keshu at his village in Panna district, in India’s Madhya Pradesh state. Photo: Inder Bisht

In 2011, the organization diagnosed 78 people as silicotic at a medical camp in Panna district. According to Panna district hospital, however, the number of silicosis patients in the district by 2018 was 41, out of which 14 cases were only detected in 2017.

Former director of the National Institute of Occupational Health, Dr Habibullah Saiyed, said most doctors do not take into account the occupational history of a patient, which is pertinent for making a silicosis diagnosis.

“The diagnosis of silicosis is based on occupational history, [as well as] X-ray images and supportive laboratory data on the significant presence of silica in the patient’s work environment. Under the Factories Act, the permissible levels for silica in factories are laid down, but to the best of my knowledge none of the industrial hygiene laboratories run by the factory inspectorate has the facility to measure silica levels,” Dr Saiyed said.

Environics Trust’s occupational health expert Mohit Gupta said there is no trained and experienced doctor at the Panna district hospital who can read X-ray plates and connect them to other symptoms to make a correct diagnosis. “It’s very difficult for a doctor to pick up on silicosis by looking at the X-ray result of a patient as it looks very similar to that of a tuberculosis patient,” Gupta said.

In Jhabua district’s Jaunsar Matavada village, 38- year-old Khirji mostly stays at his home, performing only light household chores like cutting vegetables and helping in cooking. He recounted how 12 years ago he left his work in Godhra, Gujarat and rushed home following the death of two of his fellow miners. Prior to their deaths, they had symptoms similar to silicosis.

“I got scared and returned home. I thought I had survived the disease and started working in the fields. But three years after returning from Godhra, I started experiencing breathlessness, coughing, and chest pain. Gradually I stopped going to the fields and realized that I too would die eventually,” Khirji said.

Khirji no longer attends the government hospital because the doctors there invariably give him anti-tuberculosis medicines. “I prefer taking tablets from a private medical store even though I have to shell out money from my pocket,” he said. Doctors at the government hospital conducted an X-ray test of his chest but never disclosed the results. “They just told me that the report had been forwarded to the district magistrate’s office,” he said.

Doctors are also usually reluctant to diagnose a patient as silicotic so they can avoid lengthy court proceedings. “You can claim compensation from your employer if you are diagnosed with silicosis. But there is a legal process to fulfill, and in such cases the doctors could be called into court to give evidence. So it’s far more convenient for the doctor to put the patient on a tuberculosis course and the patient won’t return for another six months,” Gupta said.

Continued exposure

Silicosis is an irreversible disease, and its only possible solution is a lung transplant, which can be extremely costly as well as not being uncertain of success.

At earlier stages of the disease, when it has minimal impact on a victim’s lungs, silicosis is also difficult to detect. In the absence of an accurate diagnosis, a patient continues to work in a silica-infested environment and exposes his lungs to yet more deadly silica dust. “Because there is no other work opportunity in the area people continue to work in mines until they become incapable of working. So their exposure doesn’t stop,” Gupta said.

“Secondly, they don’t take nutritious food. When they go to a doctor, he puts them on a strong antibiotic for tuberculosis which puts immense pressure on their body. In the absence of nutritious food the medicines do more harm than good to patients,” he said.

Amid general lack of awareness and the government’s inefficiency and apathy, thousands of undiagnosed cases of silicosis in the region are suspected, according to Panna-based activist Yousuf Beg. In 2011, the National Human Rights Commission ordered a medical team of government doctors to check suspected cases, and when the team visited the district that year, 18 people were diagnosed as silicotic.

“In our second camp in 2012, 78 people were diagnosed as silicotic but the government hasn’t acknowledged it yet. Out of those who have been diagnosed with the disease, only four have posthumously received an ex-gratia amount of Rs 300,000 (US$4,100). The promise of a monthly pension by the state government is not yet realized,” Beg said.