Cancer Express

Passenger Express 339 enters Bathinda railway station around 9 pm, as if blindfolded by the dark winter night.
The sight of it brings a glint to the lifeless eyes of Balwinder Singh (42) waiting on platform number two. He is too
weak and turns to his brother who will be his crutches.
There are many like him battling cancer, frail and fragile, waiting to board. But all the commotion and noise is on
the other platforms. Here, silence hangs in the air heavily.
By 5 am, after travelling for 326 km, they will reach their destination across the state border: Acharya Tulsi
Regional Cancer Treatment and Research Centre in Bikaner, Rajasthan. They come all over from Punjabs
Malwa region, which comprises nine of the states 20 districts and 60 per cent of the population. Its an arduous
but unavoidable journey Acharya Tulsi is the closest government cancer hospital that is affordable. Ive spent
Rs 1 lakh in a private hospital in Bathinda. Couldnt afford it anymore and went to Bikaner, says Balwinder Singh
who has cancer in the oesophagus. Bathinda is at the heart of Malwa. The poor of the most prosperous state go
to another state to save themselves.

As many as 70 patients per day on an average travel on this train from Bathinda that it has come to be known as
the cancer express, and the region as cancer belt. An epidemiological study done by the Post Graduate
Institute of Medical Education and Research (PGIMER), Chandigarh, concluded the incidence of cancer is higher
in this area than elsewhere in the state. Cancer death rate was 51 per lakh per year in Talwandi Sabo of
Bathinda as compared to 30 in Chamkaur Sahib, outside Malwa.
Those onboard Express 339 are taken hostage by different types of cancers. But doctors advise all of them to
switch to clean packaged drinking water. The Green Revolution that started in the mid 1960s has turned Punjab
into the breadbasket of India contributing more than 95 per cent of the food grains that feed deficit areas in
other states but it has also turned the water table into a poisonous aquifer.
Malwa consumes 75 per cent of the pesticides used in Punjab, according to a 2007 State of Environment Report.
It is the excessive usage of fertilisers, pesticides and extensive irrigation that has caused the problems, not the
Green Revolution methods, says Rattan Lal, a soil scientist at Ohio University, USA. Lal studied in Punjab
Agricultural University in the early Sixties.
Punjabs land is so addicted to fertilisers consumption in the state is at 177 kg per hectare as compared to 90
kg at the national level and pesticides that even cattle fodder cant be grown without their application.
Children are more susceptible to the nitrate pollution caused by the fertilisers, says Reyes Tirado of University
of Exter, UK, who published a study on the area in November 2009 for Green Peace.
In Jhajjal village, Sarabjeet Kaurs baby was born in the sixth month. He is nine now, but still experiences
weakness neck down. A few houses away, Paramjeet Kaur has three children with the same ailment. There are
20 such children in the village of 3,500. Reproductive health has taken a beating, number of sterile couples is
increasing. Since the female foetuses are more susceptible, it will add to the dwindling sex ratio, says G.P.I.
Singh, community health expert, Aadesh Medical College, Bathinda.
But there is no proof these pesticides triggered cancer. Chronic diseases like cancer cant be linked to one
factor. But what we know is about chronic toxins present in these pesticides and fertilisers. There are some
strong epidemiological correlations, says Singh.
Hospital records in Bathinda show 61 people have died between 2004 and 2008 by inhaling pesticides while
spraying, an RTI enquiry. These pesticides have entered the food chain. Studies detected pesticides
carcinogens like heptachlor and ethion in the farmers blood here. And also in fodder, vegetables, bovine and
human milk. Nothing had come of the expert committee constituted by the state government in 2007. After the
first meeting nothing has happened, says Sateesh Jain of Oswal Cancer Hospital, Ludhiana, a committee
member.
The number of patients boarding the cancer express is rising, so is the usage of pesticides and fertilisers. But
there is something that is on the decline: productivity. Finance Minister Pranab Mukherjee admitted in the latest
Budget speech: The declining response of agricultural productivity to increased fertiliser usage is a matter of
concern.
Balwinder Singh, 42, Bhagawanpura, Bathinda
Balwinder Singh used to grow cotton and wheat in his two-acre land and kept his family happy. He was shocked
to learn that his son Jaspreet Singh (14 now) is mentally retarded. Several studies have concluded that
pesticides affected mental growth of the kids. Bigger shock awaited Balwinder in March, 2009. His severe pain in
the stomach was diagnosed as cancer of the oesophagus. Now hes given out his farm on lease.
After trying out the expensive treatment at a private hospital, having lost Rs 1 lakh, he took the cancer express
to Bikaner. Somebody in my village told me that the treatment is cheaper there. Hes stopped drinking water
from the tube well and started spending Rs 20 on bottled water on medical advice. When they tested drinking
water, only three out of 250 houses in our village had drinkable water.
Nirmal Singh, 54, Jagraon, Ludhiana
Nirmal Singh had been a government schoolteacher for thirty years. He had also been farming,along with his
brother Malkit Singh (42), for at least twenty years. He had to extend his summer vacation in 2006, as he was
diagnosed with the cancer of the gall bladder. He has been visiting Bikaner ever since. The doctor had said that
fertilisers have gone down to the water, he says.

Like most whove come to catch the cancer express, he had also heard about it from fellow cancer patients in
and around his village. He had spent Rs 3 lakh for treatment in a private hospital in Ludhiana in vain before going
to Bikaner. I have submitted the bills to the government, and I have been waiting forever now.
For three years, hes been on chemotherapy. Every trip costs me around Rs 20,000. And my brother has to put
farming on hold and take me to Bikaner.
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