Silent victims of silicosis
Published by MAC on 2001-05-01
A large number of Indian quarry workers die a slow death from silicosis, without any compensation from their employers, as the workers are unable to prove the link between illnesses and their conditions of work.
Silent victims of silicosis
Frontline, October 22 - November 4 2005
ANNIE ZAIDI, in Shankargarh, Uttar Pradesh
RAM JIYAWAN crawls to the door of his hovel in Quarry No.5 to meet this correspondent.
After 30 years of breaking silica stone, crushing it, breathing it in as dust and coughing it out as disease, Jiyawan has been left too ill even to walk upright, and too breathless to tell his story.
He has been taking treatment for tuberculosis (TB) for the last year and a half, but the medicines do not work. His wife Mundi grazes the goats, and ignores her own fevers and coughs. She refuses to get her lungs tested. "He gave up working two years ago. Where's the money for two people to be treated?"
Quarry No.5 is a village of about 150 families, where each man, woman and many of the children work in silica or stone quarries. The Frontline team spoke to a small group for a few minutes, learning of as many cases: Asha has TB. Lilavati and Gulab-kali have TB. Biraj Prasad and his wife Kamla have TB. Old Vijay Raj and young Nankau have TB.
Nankau's wife Meera is learning to shrug it off. "We're broken; just like the stone we break. Medicine keeps you alive. But there's a fine choice to be made between food and medicine. A week's dose costs Rs.130-150; our daily wages are Rs.40-45."
The wages, though, are much better than they used to be. Vijay Raj, who has given up breaking stones but continues to load trucks, says that had the halla bol not happened, they would still have been working at Rs.15-20 a day. He explains that halla bol refers to a rebellion by local workers in Shankargarh, with support from a non-governmental organisation (NGO), Sankalp. Most of the land was leased out by the government, for 99 years, to the erstwhile Raja of Shankargarh, who in turn leased it out to contractors. For a long time, the workers toiled for a pittance at the stone quarries, almost like bonded labourers, until some of them rebelled and started quarrying independently. That was in the late 1980s and early 1990s.
Neither Jiyawan nor Meera, nor any of the estimated 25,000 quarry workers in Shankargarh block in Allahabad district has heard of silicosis. All they know is that every third person among them is diagnosed with TB, and that the average life span of a worker is 40 years. People have begun to refer to the disease as `Shankargarh-wali TB' (the TB of Shankargarh).
By all indications, `Shankargarh-wali TB' is probably silicosis, an incurable disease that develops over a period of time, mostly among workers in silica-related industries. Many of its symptoms are similar to those of tuberculosis. In fact, TB is often a direct result of silicosis.
Dr. T.K. Joshi, a consultant at the Department of Occupational and Environmental Medicine at the Maulana Azad Medical College, Delhi, explained that silica is perhaps the most toxic particulate matter that can destroy human life. He said: "Crystalline silica dust causes a fibrogenic reaction in the lungs. The ability to breathe is compromised. Blood vessels get obstructed and you could have heart failure. It also has the unique ability to destroy macrophages in the lungs. Therefore, immunity is compromised. Think of it as having a home without a guard and a scavenger. In crowded places like India, it is impossible not to be exposed to tubercule bacilli. Those who have silicosis will also get TB, but the difference is that TB can be cured whereas silicosis is irreversible. In fact, in the United Kingdom, TB is officially considered an occupational disease for miners. Here, doctors are not even taught to take note of occupational history. In fact, there's a certain technique of doctors to be able to read X-rays for diagnosing silicosis. We need specially trained doctors to be posted in industrial and mining belts."
SINCE no one is taking occupational history into account while diagnosing TB among silica-stone quarry workers, there is clearly no question of compensation. Jiyawan, for instance, has not received any. For years, he was paid a below-minimum daily wage of Rs.20. When he stopped working, the contractor stopped paying him. After the halla bol, the mitr mandal (local union) arranged for him medication worth Rs.6,000, but it was not enough.
Since the workers of Shankargarh have taken over the land, they no longer have an employer to whom they can turn for compensation. The extent of damage is so widespread that the cooperatives cannot possibly compensate themselves.
Even in those mines and washing units where there are contractors, there is no talk of compensation. Pushpraj Singh, one of the contractors for the silica-sand washing units in Garha Katra, admitted that nobody had ever been compensated. "Why should we compensate? We pay them as long as they work. That is enough."
When Frontline questioned him about occupational hazards, he claimed that the workers never had to put in long hours. "We don't want them staying too long, either. We don't keep any records of employment either." Later, he claimed that he was not a contractor, but a wage-earner himself. He said that he did not know the name, address or contact details of the contractor.
This cover-up is symptomatic of the whole quarrying-mining industry, whereby responsibility for workers' health is shrugged off simply by denying them tenure and proof of employment. Unlike other industries such as coal mining, silica quarries are small units with unorganised workers, most of whom do not even have pay-slips to prove that they were exposed to hazardous materials. Where occupational diseases are concerned, proof of damage lies in proof of exposure, assuming that adequate measures are not in place.
There is substantial research that proves the links between occupation and silicosis. The National Institute of Occupational Health, Ahmedabad, had compiled reports which revealed a pattern in the incidence of silicosis: 54.5 per cent in units making slate pencils, 21 per cent in stone quarries, 38 per cent in agate-polishing units and 12 per cent in stone crushing units.
There is little doubt that silicosis is a killer, and the responsibility of warning workers against the risk of disease should lie with quarryowners and contractors. They must ensure that workers get respiratory protection and that silica dust is suppressed at source, through the sprinkling of water, or with vaccum/negative-suction pumps. And workers exposed over long periods of time must be adequately compensated.
Some State governments have passed legislation to tackle silicosis as an occupational disease. Silica is now mentioned in the Factories Act as a hazardous material that workers can be exposed to. The Rajasthan Silicosis Rules, 1955, and the Rajasthan Workmen's Compensation (occupational diseases) Rules, 1965, are in place (under Section 32 of the Workmen Compensation Act, 1923). Occupational diseases have now been classified under various categories, with pneumoconiosis covering silicosis as well as asbestosis or any disease accompanied by pulmonary tuberculosis.
However, compensation is hard to come by, unless local doctors cooperate. Silicosis is often mis-diagnosed as TB, which carries no compensatory liability.
Sister Sheeba Josh, a lawyer with Sahyog, a collective in Allahabad, recalls her first experience when confronted with `Shankargarh-wali TB'. "We confronted the Superintendent of the Community Health Centre (CHC). He denied that there was even a TB problem! We asked the District Magistrate to intervene, and he sent medical equipment to facilitate testing. The superintendent refused to test these people. We had to throw stones and break down the CHC's doors. Later, we filed a PIL [public interest litigation] petition in the Allahabad High Court; as a result, several doctors were transferred and an anti-TB programme was introduced."
She said that Sahyog was willing to take on the silicosis challenge in court and that surveys needed to be conducted.
Currently, there are no surveys under way in Shankargarh. But elsewhere, attempts are being made. The demand for compensation is being raised now in Delhi's Lal Kuan area, where there were several silica-stone quarries until 1992, when a Supreme Court judgment ordered the quarries to shift out of Delhi. The workers were left behind, sick with silicosis and without any compensation.
Groups such as Prasar, Delhi Forum, Toxics Link and Centre for Education and Communication have joined hands to form the Khaan Mazdoor Adhikaar Manch. One of the first things this group did was to petition the National Human Rights Commission (NHRC) and demand compensation from the Labour Ministry for those affected by silicosis, starting with the workers from Delhi.
S.A. Azad, a Prasar activist, said: "At Lal Kuan, we estimate 3,000 quarry workers have already died of `TB'. The national average risk of TB infection is 1.5 per cent. Here, every second person was affected. We've done surveys; at least 11 of those still alive at the Lal Ram Swaroop TB and Allied Diseases Hospital in Mehrauli have been confirmed to be silicosis victims. Now, we're asking Labour Commissioners for records of that era, to get the names of the employers and the contractors."
The Khaan Mazdoor Adhikaar Manch intends to lobby for more stringent occupational safety laws, which could cover even unorganised and casual labourers. It is preparing a model Occupational Safety Bill and lobbying to get it introduced in Parliament. The collective also plans to petition the Supreme Court, demanding occupational health centres across the country.