VIDYA KRISHNAN11 April 2020
The Bhopal Memorial Hospital and Research Centre was set up after the Supreme Court’s intervention in October 1991. The apex court had directed the Union Carbide Corporation, the company that owned the pesticide plant which caused the Bhopal Gas Tragedy, to build a 500-bed hospital for the treatment of the survivors, as part of the settlement. BMHRC.GOV.IN
A decision by the government of Madhya Pradesh to convert the state capital’s Bhopal Memorial Hospital and Research Centre into a COVID19-designated facility has had a devastating effect on one of India’s most vulnerable communities. The BMHRC is a 500-bed super-speciality hospital, which was set up to care exclusively for the first-, second- and third-generation survivors of a chemical disaster that is commonly known as the Bhopal Gas Tragedy of 1984. However, following a directive from the state’s public health and family welfare department on 23 March, the BMHRC stopped all health care for existing patients. All the patients were shunted out of the hospital, barring four, who could not be moved due to their critical condition—three were on ventilators and one was in the critical-care unit. One of these patients, a 68-year-old woman named Munni Bi, died on 9 April due to lack of medical care.
Around midnight on 3 December 1984, over forty tons of methyl isocyanate, a toxic gas, leaked from a pesticide plant and caused mass poisoning in Bhopal. Thousands died in the immediate aftermath of the leak; thousands more have died in the years since, from the after-effects of the poisonous gas. The Bhopal Gas Tragedy is still the world’s deadliest industrial disaster. Generations later, survivors of the leak continue to have increased rates of cancer and birth defects.
Over the last three weeks, Madhya Pradesh’s response to COVID-19 has shown that the state was utterly unprepared to deal with the pandemic. The state’s callous decision to shut the BMHRC is in line with this pattern. It has left the survivors without any avenues for health care even as, till date, not a single COVID-19 case—suspected or confirmed positive—has been treated at the BMHRC, according to activists. The survivors already suffer from a compromised immunity system, and most of them subsist in unhygienic living conditions—factors that puts them at a high risk to contract the novel coronavirus. In this scenario, Munni Bi’s story captures the limitless heartbreak that is being inflicted on the survivors.
Rachna Dhingra, an activist with the Bhopal Group of Information and Action, a group that works with the survivors, told me that when the order to convert the BMHRC was issued, “Almost immediately, my phone started blowing up.” She said that panicked families called her and said that “patients were being forcibly discharged.” She added, “When I made phone calls, I realised that they were trying to discharge people on ventilator support as well. We decided to challenge this in court.” Dhingra told me, “Right to health, to being treated equally, and right to life are fairly closely linked for survivors of the gas tragedy.”
On 7 April, Dhingra and Munni Bi approached the Supreme Court asking for an intervention. According to the plea, the hospital had “forcibly discharged 86 patients.” The plea challenged the state government’s orders, and stated that the hospital was in violation of Articles 14 and 21 of the Constitution—which guarantee the right to equality and the right to life, respectively. The Supreme Court asked the petitioners to approach the Jabalpur bench of the Madhya Pradesh High Court instead. The case has not come up for hearing yet.
Munni Bi died waiting for a court date. She had undergone a surgery on 11 March and had been in the general intensive-care unit, under critical medical care. Her son is a daily-wage labourer who lives in Qazi Camp, one of the worst-affected slum-clusters near the factory responsible for the leak. He could not visit Munni Bi even once while she was admitted, because he lives far away from BMHRC. Once the lockdown began, on 25 March, like the millions of daily-wagers across the country, his financial situation, too, became even more precarious. “The family was fast running out of food,” Dhingra said. “At this point, BMHRC doctors told her son to arrange for a nephrologist, a kidney specialist. The family did not even know what that word meant, how were they expected to arrange a doctor? They can barely arrange their own food.”
The day after Munni Bi died, Dhingra told me, “We wanted immediate relief for in-patient care, and casualty services to be restarted and the 23 March order to be set aside.” She said Munni Bi died because “medical attention was withheld from her.”
Dhingra told me that following Munni Bi’s death, and the slow pace of the case, she alerted a Supreme Court-appointed monitoring committee for medical rehabilitation of Bhopal gas victims. The committee was appointed by the apex court to oversee functioning of six hospitals that had been designated for survivors in Bhopal, after repeated accounts of denial of health care to the victims were brought before the court.
Purnendu Shukla, one of the members of the monitoring committee, told me that he was concerned about the lack of care for the Bhopal-gas victims. “For the last ten days, we have been trying to get the hospital to open casualty and in-patient services.” He said it was only after they intervened that the four patients who were critical were allowed to stay. “When there are other hospitals in the city, I wonder why BMHRC was picked for COVID care,” Shukla said.
Shukla was referring to several hospitals in the city that have been identified for COVID-19 care. This includes the All India Institute Medical Sciences, the Gandhi Medical College and Chirayu, a plush private medical-college. Shukla’s contention becomes more pertinent in light of the fact that while the BMHRC threw out all existing patients, since then the hospital has been lying completely vacant.
Notably, Madhya Pradesh has reported 443 positive cases of COVID-19 and 33 deaths, according to the health ministry, and Bhopal has reportedly seen 112 confirmed cases as of 10 April. A significant number of cases come from a cluster of government officials, police officials, officers of the Indian administrative services and the health department. All of the state government officials are currently admitted at Chirayu. Amulya Nidhi, a co-convenor of Swasthya Adhikar Manch, an NGO that works on health-rights, questioned this preference for a private hospital over a government hospital by government officials. “Both medical institutions, AIIMS and GMC, have publicly stated that they are prepared to treat COVID cases. Why are government employees admitted to private hospitals, when our COVID hospitals are empty?” Nidhi added, “The people who responsible for promoting public health are undermining it by opting for private hospitals, when it comes to themselves.”
The insult to injury is that the BMHRC was shut for the benefit of no one. “For the last 18 days, they have placed bouncers at the gates; they have tried every trick to get the patients in ICU to leave,” Dhingra said. “One of them is dead, others are critical, and the entire thing was done for COVID but it is not being used for it. They are killing the people who have already suffered so much.”
Questions emailed to the principal secretary of the health department, the chief minister’s office and the office of the Indian Council for Medical Research—the BMHRC comes under the ICMR—have gone unanswered. This story will be updated as and when they respond.
Abdul Jabbar, a legend among activists in Bhopal, who spent his life campaigning for survivors of the gas tragedy once, told me that the city had a “limitless capacity for heartbreak.” He died in November 2019. Jabbar and Munni Bi were among the last of the generation who survived untold miseries, first from the poisoning, and then from government apathy. In the coming weeks, activists and families in Bhopal are worried that if the BMHRC is not immediately re-opened for the survivors, the pandemic will cause considerable damage to those who survived the gas leak.
courtesy The Caravan