In the early 2000s, news reports began to surface of another disturbing phenomenon in rural villages in the cotton belt. The jet-black hair of numerous Punjabi schoolchildren, some as young as 10 years old, had turned gray—a rare condition most often associated with vitamin B12 deficiency or thyroid problems. Moreover, the number of cancers among middle-aged villagers, particularly women, seemed to be on the rise. Ailing patients began traveling from their rural villages to the southern Punjabi city of Bathinda to catch the train to the Acharya Tulsi Regional Cancer Treatment and Research Institute in Bikaner, a city in the neighboring state of Rajasthan. By early 2010, the Hindustan Times, one of the major Punjabi papers, reported that some 70 patients a day were boarding train number 339 for the eight-hour ride to Bikaner. The train
is now widely known as the "Cancer Express."
Many blamed the high volume of pesticides sprayed in Pun jab. Scientists and health officials have long known that pesticides, particularly insecticides that are designed to kill creatures with nervous systems and immune systems not terribly unlike our own, can harm human health. Some of the earliest and most persistent chemical pesticides, organochlorines like DDT and Lindane have been linked to soft-tissue sarcomas, non-Hodgkins lymphoma, and leukemia, as wellm as lung and breast cancers. Somewhat newer organophosphate pesticides, which are more acutely toxic but break down faster in the environment, have also been linked to non-Hodgkins lymphoma and leukemia.
Organophosphates are neurotoxins that kill insects by suppress ing acetylcholinesterase, an enzyme critical to the functioning of bugs' nervous systems—as well as ours. It serves as the stop signal in the nerve's Morse code, and without it the system goes haywire, leading to convulsions, hyperventilation, vomiting, diarrhea, and ultimately death if exposure is left untreated. The sarin nerve gas that killed 12 people and injured more than 5,000 during the 1995 terrorist attack on the Tokyo subway system was one of the first organophosphate pesticides invented, and one of the most lethal, developed in Germany in 1938. Even the newer, less toxic organo phosphate pesticides used in the Punjab and around the world can weaken human immune systems, hampering the T cells that attack tumors, and making people more susceptible to disease.
The link between pesticides and public health is a particular concern in the Punjab, where a number of studies have found high levels of DDT and Lindane in Punjabis' water, food, and blood since the green revolution began. A study conducted as early as 1974 found that of 140 wheat flour samples taken from mills across the state, 124 contained DDT and 116 contained Lindane. In 1980 researchers analyzed the breast milk of 75 new mothers in Punjab and found both pesticides in every sample. The average amount of DDT in the samples amounted to 18 times the safe consumption level recommended by the World Health Organization (WHO), while the Lindane amounts were higher than in any other country besides Japan.
An eight-year-long study in the 1990s found that some 70 per- cent of vegetables tested from markets around the state were con taminated with various insecticides, and 27 percent tested above the maximum residue limits, suggesting that farmers were not waiting the recommended 10 days after spraying to harvest their crops. By 2002, studies showed that the amount of DDT in Pun jabi foods had fallen, but the amounts of organophosphate and carbamate pesticides were on the rise. Nearly all of the rice sam pled (97 percent) and more than half the milk samples (53 percent) from 1996 to 2001 were still contaminated with Lindane, while 85 percent of the tested fruits and 71 percent of vegetables were
contaminated with other insecticides.
Even though several of the pesticides used in Punjab are known or suspected carcinogens, proving that they cause high cancer rates in a specific area is difficult, especially when so many other factors, like smoking, alcohol use, or air pollution, also increase the risks of the disease. But in 2008 the Punjab Pollution Control Board sponsored a large study that surveyed more than 180,000 rural Punjabis to see who had contracted or died of the disease over the previous decade. Roughly half of the villagers lived in a region that grew mostly wheat and cotton, while the other half lived and farmed in an area known for wheat and rice. Those who farmed cotton relied mostly on canal water, while those who grew rice drank groundwater.
The results were striking: the confirmed cancer cases were almost double among the cotton-farming families, who used far more pesticides. Women in the cotton belt were by far the hard est hit, with the most common cancers attacking the reproductive system—cancers of the breast, cervix, uterus, and ovaries. While the levels of pesticides in drinking water, vegetables, and blood were also higher in the cotton-growing villages, so were other factors, such as heavy metals (arsenic for instance) in the water, alcohol use, and smoking. Residents in the cotton belt were also found to be using empty pesticide containers to store food, and spraying their cotton crop 30-35 times a season, often without using protective clothing, as compared to the 10-12 applications recommended by Punjab Agricultural University.
You don't have to walk far in any Malwa village to see the pain behind the statistics. In Bhuttiwala, a village in the Muktsar disrict, I met with Jagsir Singh, a 44-year-old Sikh with a blue turban and long salt-and-pepper beard who was the former sarpanch, the chairperson of the elected village council. While sarpanch, it had been his responsibility to fix the roads, see to the schools, care for the sanitation facilities and drinking-water sources, and record births, deaths, and marriages in the village register.
"Over the last four years we've had 49 deaths due to cancer," said Singh. "Most of them were young people. The water is not good. It is poisonous, contaminated water. Yet people still drink it." That number amounted to four times the annual cancer death rate found in the Punjab Pollution Control Board study.
"Do you think the green revolution was good or bad?" I asked.
"It was initially a great success for the nation and Punjab," Singh said.
"Punjab still gives great food grains to the country. But the conditions for the farmers are deteriorating. They use more and more fertilizers and pesticides year after year. They have exploited these soils that used to be the most fertile in this country. They really feel a difference in the soil from when we used to use manures as fertilizer. If you tasted the soil earlier it tasted normal. Now it tastes salty."
We walked together down the dirt streets of the village, past gray walls, yellow mud-brick houses, and conical piles of dung used for cooking fires. He entered a gate and introduced me to Amar jid Kaur, a demure woman in bare feet, wearing a blue sari with red flowers embroidered on the hem. She was 40 years old and had been diagnosed with breast cancer 10 months earlier. Doctors had removed her breast, but she was still on medication. She had no family history of the disease, and though she'd been married for 22 years, she had been unable to conceive a child. Her family had already spent 100,000 rupees ($1,900) on her operation and will have to spend another 100,000 rupees on her treatment—each sum about the total average annual household income for a small farmer in the Punjab.
We walked farther down the dusty path until we came to the home of Tej Kaur, a woman of 50, who wore a light-brown scarf that draped low down her sari to cover her chest. Despite Singh's protests, she immediately knelt into the dirt to touch his feet—an ancient ritual of respect. After rising from the dust, she said she had also had a breast removed two years earlier, but that was not what pained her. She had lost her 7-year-old grandson to leukemia six years before, and the family had spent most of its savings on his treatment in Chandigarh.
I asked her husband, 70-year-old Billu Singh, if the family ever drank out of pesticide jars. He nodded. "Generally we wash the pesticide containers and use them to carry water or make drinking glasses," he said. "Nobody has told us not to do this."
Dozens of people in several Malwa villages offered similar tales of woe. Most were middle-aged women suffering from breast or ovarian cancer, but I met a few men as well. Sima Singh was a powerful looking man of 45 in a dirty green turban. A year earlier he had noticed a small growth on the side of his nose. The tumor had grown to the size of a grapefruit and had taken over the entire right side of his face. His right eye peered out from its grotesquely swollen socket as if he were the Indian Elephant Man. I asked him what he did for a living. "I work in the fields and used to spray pesticides on cotton and paddy," he replied.
Then there was Jagdeve Singh. The 14-year-old boy lived in Jajjal village in the heart of Malwa, one of the villages included in the study sponsored by the Pollution Control Board. Jagdeve's father invited me into their small mud-brick house as the sun went down, the only light coming from the flickers of a small TV showing SpongeBob SquarePants dubbed in Punjabi. Jagdeve was slumped over at an odd angle in a wheelchair in front of the set, unable to hold himself upright. His father, 35-year-old Bhola Singh, said they had first noticed his condition when he was two years old. He could not walk like the other children his age. He kept falling down. The doctors told Bhola that Jagdeve had spinal deterioration, and that he would not live past 20. But they did not say the cause. Several recent studies, however, have documented chromo somal damage in Indian and Pakistani cotton farmers routinely exposed to pesticides.
Bhola had no history of the disease in his family. He and his uncle Gurdeep Singh farmed 2 acres of cotton. They said no one had warned them of the dangers of pesticides until the previous two or three years. I asked them if they ever wore protective clothing. "No one wears protective clothing. We wear the same clothes we wear now," Gurdeep said, pointing to the loose cotton shirts that fell to their knees, their baggy cotton pants, their bare feet protected only by sandals. "No one has told us to do so. It cannot be done without spraying," he adds, "because of the bollworms."
The pesticides that the Malwa farmers use—monocrotophos, chlorpyrifos, and cypermethrin—are classified as restricted-use pesticides in the United States. Monocrotophos is so toxic that it was actually banned by the EPA in 1988. In North Carolina, no one can buy or apply such chemicals to crops unless they have a pesticide applicator's license issued by the state, or are personally supervised by someone with a license. To get the license, farmers have to take a written 50-question multiple-choice test and get 70 percent of the questions correct. It isn't easy. (Sample question: A sprayer is calibrated to apply 10 gallons per acre at a pressure of 20 psi. What pressure would be required to increase the output to 20 gallons per acre without changing the speed of travel or nozzle size?) I took the test as part of a weed science lab at North Caro lina State and barely passed.
If you're spraying ag chemicals in North Carolina, the regula tions require you to wear long pants, a long-sleeved shirt, chemical- resistant boots, chemical-resistant gloves, a wide-brimmed hard hat, eye goggles, and a chemical-resistant apron. In India, it's a different story. Many of the poorer Punjabi farmers are barely literate. Labels on the pesticide jars are often in other languages.
No farmer or laborer I met in Malwa used any safety equipment; they simply walked through the fields in sandals with cheap, leaky backpack sprayers. When I asked officials at Punjab Agricultural University about this lack of basic pesticide education, they said they run frequent pesticide safety seminars in the villages. If so, the message isn't getting through.
Instead, the Punjabi government simply blamed the cancer out- break on polluted drinking water. But instead of tackling the prob- lem at its source by reducing the chemical runoff from the fields, they began building small municipal reverse-osmosis (RO) water treatment plants in 45 of the worst-hit villages in the Malwa dis- trict to filter the contaminated water. The first was built in Kaouni village in 2008, in no small part because the finance minister hap- pened to be from there. The plant displays an impressive array of stainless steel filters and drums in a small cinder-block building next to an evil-smelling village lagoon, but its source water came from a 500-foot-deep well. The water was then pumped at high pressure through increasingly smaller membranes and activated carbon filters to weed out most contaminants (though certainly not all). Villagers paid 60 rupees a month for 20 liters of filtered water each day, and had the option of buying more. The bottled water was popular with the frightened villagers, who no longer trusted the water from the pumps and canal. Even the poorest villagers I interviewed now got their water from the RO plant.
Jagsir Singh, the former leader of Bhuttiwala village, was proud of their new water system and thought it would help reduce the cancers. But the water in the canals and aquifer remain as con taminated as ever. "Nobody has suggested we use less fertilizer or pesticides," he said, which is not surprising. The fertilizer and pesticide industries are political powerhouses in India, and the soon to be most populous nation in the world is highly dependent on the grain yields and cotton income they help provide.
The third part of the extract will be published online on November 21, 2015.