BATHINDA: Jasbir Kaur waits with her husband at the railway station’s dimly-lit platform number one. The station, like the city, is unremarkable. Like dozens others here, they will catch the passenger train to Bikaner at 9.15 pm, from Abohar to Jodhpur.

Jasbir does not find it eerie that her train is called the ‘ Cancer Train ’, a name it earned over the last decade as it has daily ferried people with cancer from Bathinda to Bikaner for cheap treatment of the deadly disease. On any given night, there are about 70 to 100 cancer patients on this platform, says a station attendant. “Everyone knows it’s the train for those with cancer,” shrugs Jasbir, the cancer in her mouth slurring her speech.

The cancer-affected on this train are small farmers from the southern districts of Punjab: Bathinda, Faridkot, Moga, Muktsar, Ferozepur, Sangrur and Mansa. Known together as the Malwa region, farmers and families here are grappling with cancer and health problems that have crept into their homes through the backdoor as the farmers of India’s grain bowl fed the nation.

Dr Manjeet S Jaura, senior oncologist at Faridkot Medical College says he receives a staggering 30 to 35 new cancer cases daily at the yearold cancer facility in Faridkot, set up as part of the National Cancer Control Programme. “There is definitely an increased prevalence of cancer in the region,” he says.

The lush fields hide a scary tale. Farmers live in a disturbing cesspool of toxicity, a result of excessive and unregulated use of pesticides and chemical fertilizers. For one, Punjab farmers’ use of pesticides is 923 g/ha, way above the national average of 570 g/ha (grams per hectare).

Malwa is also Punjab’s cotton belt; cotton crops are prone to pests. Farmers here use at least 15 different pesticide sprays. Of the top 15 pesticides used, the US’s Environmental Protection Agency considers seven used on cotton in the US as ‘possible’, ‘likely’, ‘probable,’ or ‘known’ human carcinogens (acephate, dichloropropene, diuron, fluometuron, pendimethalin, tribufos, and trifluralin).

Worse, “farmers use the empty pesticide cans to store water and food,” says Dr Jaura. Fertilizer use is also sky high: at 380 kg/ha (kilo per hectare), it is the highest in India, almost three times the national average of 131 kg/ ha, as per the National Centre for Agricultural Economics and Policy Research.

Add to that the contaminated water with high heavy-metal toxicity and you have a lethal cocktail. “Every village with a population of 3,000 to 5,000 has at least 30 cancer cases in a period of 8 to 10 years. It’s a grim situation,” says Umendra Dutt, of advocacy group Kheti Virasat Mission (KVM). That’s way higher than the national average.

Consider this. The government’s cancer registry programme for 2004-2005 found a cancer prevalence rate of 68 to 115 per 100,000 for males and 92 to 116.5 for females. So, in the whole Malwa region of a population of about 1.5 crore, there ought to be about 12,000 cancer patients. In Bathinda district itself, with a population of about 14 lakh, there should be about 1500 patients.

KVM’s surveys have revealed that women are more vulnerable to cancer and among cancers, uterine and breast are the more prevalent. Dr Jaura says cancer of the oesophagus, lymphoma and leukemia are the other types prevalent.

Not just cancer, there are scary reports of a reproductive health crisis, from spontaneous abortions to premature deliveries, reduced sperm counts and neural canal birth defects in infants. “Declare Malwa an ecological and environmental health emergency”, says Dutt, who promotes organic farming.

Farmers believe they may be paying a price for the success of the 1970s’ Green Revolution. That was when farmers in Punjab switched from traditional farming methods to a combo formula of high yieldseeds-fertilizer-pesticide-water. The small but wealthy state on an average now accounts for 19% of wheat and 13% of India’s rice production. The Green Revolution, and Punjab’s contribution, ensured that from begging for food and aid, India went on to export food grains.

Despite repeated warnings from doctors and activists, governments are still dragging their feet. “Health is private business in Punjab and the rich farmers go to Delhi and Mumbai for treatment. Where can we go?” says Jasbir. Chandigarh’s PGI and Faridkot’s medical college are the only two state set-ups and even those are too expensive for the poor farmers. Jasbir should know. The 64-yearold has made the trip to Bikaner every fortnight for three years now.

The ‘cancer dabbas’ are at one end. It’s a squeeze but families jostle to allow patients to lie down, the rest squat. Patients can travel free, and attendants get a concession. Jasbir’s train will reach Bikaner early morning around six.

SUCCOUR CENTRE

Cancer patients from Punjab head straight to the Acharya Tulsi Regional Cancer Trust & Research Institute in Bikaner, one of India’s 19 regional cancer research centres, the nearest place where treatment is free and medicines cheap.

POISON IN THE SOIL TOXIC BELT

Punjab’s Malwa region (the state’s cotton belt), south of the Sutlej river, has 10 districts. Bathinda, Faridkot, Moga, Muktsar, Ferozepur, Sangrur & Mansa are fighting battles against hydraheaded health issues: cancer to neural canal defects in infants.

The cancer train at Platform no 1 is the Abohar-Jodhpur passenger train, number 58703. It moves at 44km/hr, and has 26 halts between Bathinda and Bikaner. It leaves Bathinda around 9.25 p.m., reaches Bikaner at 6 a.m covering a distance of about 324 km from Bathinda.

IN CANCER’S CLUTCHES

The first alarm was raised in the late 1980s when farmers in Jajjal noticed that peacocks had disappeared from fields Studies have pointed to a link between unprotected and overuse of pesticides with onset of cancer Of top 15 pesticides used for pest-intensive cotton crop in Punjab, the US’s EPA considers seven as ‘possible’, ‘likely’, ‘probable,’ or ‘known’ human carcinogens There’s heavy metal toxicity in groundwater & rivers Uterine, breast among women & cancer of oesophagus, lymphoma and leukemia prevalent No government-led initiative to survey the region 70 to 100 cancer patients travel to Bikaner every night Doctors at Faridkot Medical College receive 30 to 35 new cancer cases daily.

-- With additional reporting by Subodh Varma/TIG

