Harshitha was born at home during the national lockdown against COVID 19, on July 19, 2020. The strict lockdown measures meant that her mother could not even reach a hospital to deliver her. “She was like any other baby at first, but gradually her head began to grow bigger,” recalled her step-sister Susheela over a phone call. After a tragically short life, Harshitha died on February 2, 2022 while she was under treatment in Calicut medical college. “For a year she used to smile at us when we called her name. That smile ended as her head kept growing and became softer and her hands and legs remained stiff,” Susheela explained. Harshitha was suffering from a disorder called Hydrocephalus, a condition that several endosulfan infected children are suffering from.
Kumbadaje, the village Harshitha’s family belongs to, has just one primary health centre (PHC). “It costs us Rs 100 to reach the PHC by auto. Harshitha was not included in the list of endosulfan victims as the medical camps to update the list of newborn victims are no longer being conducted. We were told in Kasargod district hospital that these camps stopped years ago,” Susheela said.
Kasargod district is demanding to be seen. An indefinite hunger strike began on January 13, 2022 demanding a branch of AIIMS in the district as many believe this will improve the health situation of the many endosulfan victims in the district. When the union budget did not announce any AIIMS in Kerala, locals blamed the state government stating that if Kasargod district was pushed as one of the places to set up AIIMS, then it would have been approved.
The rising frustration is understandable. From December 28, 2021 to February 2, 2022 three endosulfan affected children died in the district. The AIIMS for Kasargod People's Collective sees these deaths as facilitated by the government. Two of those, Ameya and Harshitha, under five years of age, were not included in the endosulfan victims’ list. The third, eleven years old Muhammed Ismail was included in the list, but no health camps have been conducted here since 2017.
The demand for AIIMS stems from the fact that there are still undiagnosed conditions children are born into. Five-year old Ameya was taken to Sree Chitra Tirunal Institute for Medical Sciences and Technology where she was prescribed two scans, first for treatment and another to see its impact. On December 27, 2021 with severe vomiting, Ameya was admitted to District Hospital in Kanhangad, but the doctors were clueless, said Fareena Kottappuram a school teacher and general convener of the collective at a press meet held on February 3. Ameya was then shifted to the ICU as there was no time left to take her to another hospital, where she died.
Signature campaign at protest site
Two years of COVID 19 has broken the health logistics that generations of endosulfan victims relied upon. The dependency on both private and government hospitals in neighbouring state Karnataka came to almost an end. The lack of a multispecialty hospital as recommended by the Supreme Court, pushed them to rely upon the next hospital in proximity, within Kerala. Several patients in need of physiotherapy were limited to their beds. Surgeries were either postponed or medicines continued and only painkillers were administered. When the national lockdown was imposed, the state government did not initiate any special rehabilitation project for the endosulfan victims. To make matters worse, their pensions were delayed. This led to another protest.
"There is no other district where people have died on the road gasping, because they did not get treatment. At this point we realised that we have nothing in terms of health infrastructure,” says social activist Ambalathara Kunjikrishnan, who had been in the forefront of anti-endosulfan agitation. “We realised we need to have a research oriented medical facility to find out the problems these children are facing, which is why we demand AIIMS. Three children who died recently belong to Scheduled Caste communities,” Kunjikrishnan notes. In 2014, five MLAs filed a petition with the Oommen Chandy government demanding to add Kasargod to the proposed list for AIIMS. But the government included Kottayam, Ernakulam, Thiruvananthapuram and Kozhikode. In 2017 an all party committee met the chief minister, but were told that only Calicut would be considered. “Kasargod is the most backward district in the state. Interior villages like Bayar, Panathur etc. are denied better medical care and people of these villages have joined this protest” Zubair, a People’s Democratic Party leader said.
“It was Kasargod district that was selected for a large scale cashew production as cashew factories were mushrooming in Kollam district. Cashew trees were extensively planted in both inhabited areas and isolated regions alike and the pesticide use was the easiest way for the state to ramp up cashew production.
This aerial strike has polluted rivers, rivulets, streams, ponds and wells. People who consumed water from these died early of cancerous diseases. It breaks our heart to see the new born babies who are born with diseases. Even after two to three decades, children with endosulfan-caused diseases are born, they die. Isn’t it the government's responsibility to solve this issue permanently? An ordinary medical college that isn’t functional yet is no solution. It is not mercy. For the district, it is a right to have AIIMS, an independent institute where the most modern, free treatments are available,” a pamphlet distributed at the AIIMS People’s Collective reads.
Sumathi, mother of eleven-year old Mithun who is living with six severe conditions, says that there are several cases that go unreported. She belongs to Mavilan, a Scheduled Tribe community. In October 2021, during an interview she told that she feels her pain is less while thinking about mothers who have three to four children who are endosulfan infected.
Mithun has been diagnosed with microcephaly, mixed cerebral palsy, global developmental delay, organic acidemia, grade IV PEM Marasmus, and severe hearing loss. He was not able to sleep till he was four years old. It was only after he started getting physiotherapy that he began to sleep. Sumathi opined the political parties are not unified for the cause due to health infrastructure. “There are many who aren’t included in the list. We were assured that the list will be updated. It looks like the government does not want to accept the fact that many children are affected. If the district collector (Dr Sajith Babu) made a report saying that people who aren’t endosulfan affected are included in the list, it is the fault of the process itself. It takes a lot of process to be on the list, doctors and experts are included” Sumathi said.
Kunjikrshnan says that endosulfan is just a representative of pesticide companies. Post the pesticide tragedy and ban, Kasaragod district was declared as bio district. “The companies are afraid that the district will reach a phase that says an absolute no to the pesticides. The district collector Dr Sajith Babu gave an interview that endosulfan can be consumed like water and he said nothing happened because of the pesticide. The collector said there are non deserving individuals in the list. He claims that there are cases in which diseases are cured. He is an agriculturalist and cannot claim to be an expert about diseases. He was aiming to find individuals whose medical conditions are cured, to claim that the rest are invalid. There is a conspiracy behind this to bring back the pesticide” he stated. When asked about the remaining endosulfan stock that is still in the district, he said, “The endosulfan stock is kept in Plantation Corporation’s three godowns at Periya, Cheemeni and Rajapuram since the pesticide was banned in 2000. In 2012, the barrels broke and there was a leakage in the Cheemeni warehouse. We demanded that it be neutralised. Around 1,600 litres of endosulfan had an expiry date in 2017. The then district collector Jithendran had assured us that this will be shifted to new barrels. But five years have passed. We demanded the pesticide be taken back to the company and the neutralisation done in a scientific manner. But in 2021 October they made a move to secretly bury the pesticide in a pit, spending Rs 43 lakhs. We protested again. The present collector is aware of things and assured that they would conduct studies. The people of Kasargod can’t stand another experiment.”
Dr YS Mohan Kumar, while working in Swarga village, found out that there was an increase in diseases in the 1990s and realised the dangers of endosulfan. While working as a doctor, he published research findings about this in medical journals. Speaking of the present conditions in Kasargod’s health infrastructure, he says that Kerala being number one model is an unreal claim.
“A new medical college is being built at Ukkinadka. It has been four years since construction began and no attempt is being made to speed up the work. The service of good specialists and doctors must be made useful here. Without developing the infrastructure can we say Kerala is Number one?” Dr Mohan Kumar asked.
“Kerala model is a media propaganda. Rural health infrastructure must be developed, urban dwellers are not the only ones who deserve health facilities. I stay forty kilometres interior from the main road. We don’t have a good road. Last year, a child who got an electric shock died without getting any medical aid. In the hilly areas of Kasargod’s interior, we only have primary health centres. We have one in Badiadka. It is not functioning full time. In Karnataka, there are CHCs that function round the clock. In number one Kerala the service is available only till 2 pm. Where should we go after 2 pm?” he questioned.
Muneesa, who has visual disability and gynaecological issues due to endosulfan, is a front leader running a rehabilitation centre named ‘Sneha Veedu’ for children with disabilities.
“For a majority of people, going to the hospital is a huge task. Going to Trivandrum and returning takes twenty six hours for us by train. They make us run from hospital to hospital. If the government has the will to facilitate our demands it wouldn’t take much of a time. Each life is valuable. For the mother, the child is as important with or without disabilities. Doctors are frustrated because they do not have enough facilities to treat us. The TATA sponsored COVID hospital was built in three months. Why is there a delay of ten years in the medical college construction?” Muneesa asks.
In 2016, Thiruvananthapuram based NGO Satya Sai Trust proposed a two hundred bed specialty hospital in Kasargod. The project was launched in 2018. The trust has also built 45 houses in five acres of land in Eriya near Periya, but the allocation of these houses to the beneficiary families are yet to be fulfilled. The procedure has to be done through the Special Cell for Rehabilitation of endosulfan victims, which has not met for more than a year.
Muneesa thinks that the Kerala legislative assembly’s recent decision to appoint two more neurologists in Kasargod district is a result of the ongoing protest for AIIMS. She keeps receiving calls from mothers of endosulfan affected children when there is a medical emergency. A mother couldn’t find a facility even in Kannur for an MRI scan for her son and had to contact a hospital in Mangaluru, but it could be done only with an RT PCR test result. “It requires staying there for a day and getting the tests done. The parents are not financially well off to do it. After I discussed it in a state committee group for welfare, a person arranged the facility at a hospital in Kannur. But this is just for a child. How long and how many children can survive like this? A Supreme Court verdict exists that says medical facilities should be facilitated by the state government” she said.
The Kasargod Government medical college under construction
Kasargod medical college now has a neurosurgeon who is available thrice a week. “Now facilities are available for the endosulfan affected community in the medical college like seizure management, epilepsy, and treatment for infections. The medical college is functioning as a temporary outpatient department. Rest of the facilities will be hopefully brought in near future,” Dr Adarsh, medical superintendent of Kasargod Government medical college told TNM. Construction work on the hospital had been halted again due to non-payment of wages to workers and resumed only after an assurance of payment was given.
Mrudula Bhavani is a freelance journalist based in Kerala. She reports on state policies with a focus on gender spectrum, law, public health, caste, and environment.
Pics by Mrudula Bhavani