I. Background
Over the past 2 ½ decades, the pesticide
endosulfan has been aerially sprayed on a cashew nut plantation
covering several villages in Kasargod District, Kerala
State, India. People residing in the villages within the
plantation have been afflicted with different kinds of
illnesses which, according to the villagers, were not
present before the cashew nut plantation started their
operations. People also noticed the death of fishes, honeybees,
frogs, birds, chicken and even cows. In 1979, a farmer
began to suspect that the pesticides being aerially sprayed
in the plantation might have caused the deformities and
stunted growth which he observed in 3 of his calves. A
journalist reported the story warning that endosulfan,
the pesticide used in the aerial spraying, might have
been the cause. The story raised awareness among the people
who started voicing out their complaints about health
problems and environmental damage. The stories, however,
were not given due attention by government authorities
and the pesticide users and the spraying of endosulfan
continued.
In 1997, a medical practitioner in one of the affected
villages called the attention of the Indian Medical Association
about the unusually large number of serious neurological,
developmental, reproductive and other diseases, including
cancer, that he had been seeing among his patients. His
appeal for help and investigation was not given any attention.
Meanwhile, more health complaints surfaced and in 1998
and concerned people started to organize themselves to
address the issue. An appeal to stop the aerial spraying
of endosulfan was lodged in the courts by a coalition
of public interest groups after their initial investigations
confirmed that indeed there was an unusually large number
of diseases occurring in the villages within the cashew
nut plantation where endosulfan was being aerially sprayed.
THANAL, one of the most active environmental organizations
involved, conducted a more in-depth investigation on the
issue and came up with a report which affirmed the people’s
suspicion that endosulfan was the cause of their problems.
In January, 2000, the School Resource Group in Vaninagar
Govt School , the area where most of the complaints were
coming from, also released a report stating that most
students coming from the plantation areas were observed
to be mentally and physically deficient compared to their
schoolmates from other areas and that many of them were
suffering from congenital anomalies, physical deformities,
mental retardation, and were frequently ill. Despite the
growing protests, however, the Plantation Corporation
of Kerala (PCK), the owner of the cashew nut plantation,
continued the aerial spraying of endosulfan, claiming
that endosulfan was “safe” and was not causing
the reported illnesses. The public interest groups then
asked the Center for Science and Environment (CSE) from
New Delhi to conduct laboratory analysis of blood, water,
and other samples from the affected areas to determine
endosulfan contamination. In its study, the CSE found
very high levels of endosulfan residues in all the samples
collected and published their report in February 28, 2001.
By this time, the campaign against the aerial spraying
of endosulfan was getting stronger and the Munsif Court
of Kasargod in February, 2001, issued a stay order on
all endosulfan applications in Kasargod.
The CSE report was strongly criticized by some agricultural
scientists, including the Director of the National Research
Center for Cashew, claiming several deficiencies in the
study, which were responded to later by the CSE. A team
from the Kerala Agricultural University (KAU) conducted
their own study soon after and their results showed no
endosulfan residues detected in water, pepper berries,
and betel leaf but found high levels of endosulfan in
soil and cashew leaf samples from inside the plantation.
The PCK also sponsored their own study, conducted two
months later, and came up with results showing only small
amounts of endosulfan in samples of cashew leaves and
soil, and no residues in samples of water, human blood,
fish and milk.
Subsequently, the government of Kerala formed a committee,
headed by Dr. Achyuthan, to study the problem and suggest
remedial measures. The report of the committee was released
in November, 2001, with the following significant recommendations,
among others:
1. Ban aerial spraying of pesticides in all cashew plantations
of PCK in Kasargod District.
2. Use of endosulfan in the PCK plantation of Kasargod
District should be frozen for 5 years.
3. “…a detailed investigation involving scientists
from all related fields should be conducted to identify
the risk factors for the high morbidity in the Padre village
and other areas. …the health survey should cover
the plantation workers also.”
4. The right to information on the use of pesticides should
be respected.
The committee, however, concluded that “there
is no evidence to implicate or
exonerate endosulfan as the causative factor of the health
problems.”
In August, 2001, the Government of Kerala ordered that
“the use of the insecticide endosulfan in crops/plantations
in Kerala is suspended until further orders.”
In October, 2001, upon the instance of the National Human
Rights Commission, the Indian Council of Medical Research
and the National Institute of occupational Health conducted
a study on school children and their parents from the
affected areas in Kasargod. The report on the study is
still being awaited.
The public interest groups and the villagers, however,
were not satisfied with the way the studies were being
done and with the apparent bias of government bodies in
favor of the PCK, a government corporation. They observed
that the approach of the government designated investigative
bodies was not participatory, ignoring the community groups
in their decision making and conducting their research
without carefully eliciting information from the people
themselves.
In November, 2001, the THANAL Conservation Action and
Information Network formally requested Dr. Romeo F. Quijano,
Professor at the Department of Pharmacology and Toxicology,
College of Medicine, University of the Philippines Manila,
to visit Kasargod and look into the question of whether
or not endosulfan was the cause of health problems observed
in the cashew nut plantation areas.
II. Objectives of
the Fact –finding Mission
There were two major objectives of the
fact-finding mission:
A. To determine the veracity of reports
that serious health problems and adverse environmental
effects have appeared in Kasargod since the time the cashew
nut plantation started its operations.
B. To determine whether the reported illnesses were largely
due to endosulfan aerial spraying.
III. Conduct of the Fact-finding Mission
The fact-finding mission was conducted
from January 19-22, 2001, through the following activities:
A. Ocular inspection of the physical and topographical
characteristics of the cashew nut plantation areas in
Kasargod.
B. Ocular inspection of village interiors within the plantation
areas covered by the aerial spraying of endosulfan.
C. Household visits to selected families reported to have
been affected by the aerial spraying of endosulfan.
D. Individual interviews and physical examination of selected
persons, and/or their immediate relatives, who had been
afflicted with illnesses attributed to endosulfan.
E. Interviews with key informants, including:
1. One medical practitioner living in the affected villages,
2. One medical practitioner in a nearby primary care facility,
3. One investigative journalist involved in the issue
since ten years ago,
4. Several public interest NGO leaders, and
5. Some village leaders.
F. Focus group discussions, and
G. Review of documents (official reports, scientific articles,
internet documents,
magazine articles and news reports).
IV. Findings
The cashew nut plantation in Kasargod,
estimated to be 2,190 hectares, is located in a slightly
elevated hilly area with patches of grassy open spaces
punctuated by clusters of small trees and shrubs. The
cashew nut trees are mainly in the elevated portions while
the villagers’ houses are located in the valleys
canopied mostly by areca palm and coconut trees. A government
high school is located just at the outskirts of the plantation.
Individual houses are interspersed within the lush vegetation
in the valleys where the village people reside. Streams
vigorously flow with lots of small ponds and tributaries
which eventually drain into a nearby river. Households
get their water, including drinking water, from open wells
or “surangas”, made by excavating a few meters
into the rocky side of the hill to draw constant drips
of water collecting into a small pond. Households appear
to be generally self-sufficient in food, cultivating modestly
sized parcels of land with vegetables, fruit trees, grains
and pulses. The main cash crop is the areca nut. Almost
every household also has a cow or two and other domesticated
animals, including poultry. The houses are modest in size,
bungalow type, and usually made of wood and clay material.
One or more families live in a single house.
The villagers visited were friendly and were quite open
to interview and examination, perhaps due to the fact
that the village doctor was with the fact-finding team.
The team visited nine households, mostly in Padre village
in Enmakaje panchayath which was located within the plantation.
A short description of the families afflicted with serious
ailments follows:
1. Mr. Narayana Shastri told us that his wife, 35 years
old, is a diabetic, asthmatic and is afflicted with skin
disease. She was also diagnosed to have endometriosis.
She was one of those who provided blood for the CSE study
and it was found the endosulfan level in her blood was
very high (114 ppm). Mr. Shastri’s daughter is an
epileptic and his son also suffers from a skin ailment.
He narrated that their cow and buffalo died recently due
to some liver problem which he suspected was due to the
aerial spraying of endosulfan.
2. Mr. Narayana Bhatt and his family live at the edge
of the plantation. His father died of abdominal cancer
6 years ago and his mother died of uterine cancer. His
sister, 35 years old, is an epileptic and his nephew,
22 years old, is also an epileptic and suffers from severe
mental retardation. Another nephew, Vishnu, 18 years old,
is also an epileptic, has breast enlargement and is also
suffers from severe mental retardation. Vishnu’s
blood showed 108.9 ppm of endosulfan in the CSE study.
3. Sheena Shetty and his family also live at the edge
of the plantation. He narrated that his eldest daughter
became epileptic soon after endosulfan spraying started
in the area and died 6 years later. His son, Kittanna,
whose blood test showed 109.5 ppm endosulfan, suffers
from severe cerebral palsy. Another child, Shridhara,
17 years old, is mentally retarded. Mr. Shetty also revealed
that his cow, which was grazing at the time of endosulfan
spraying, returned home bleeding and vomiting and eventually
died 8 days later.
4. Kumaran, who is about 50 years old, has been diagnosed
with liver cancer and is suffering from severe ascites.
He has no history of alcoholism and had no known exposure
to hepatitis B virus. He is a non-smoker and claimed that
he had been strict on his diet and was very health conscious.
He knows of no other possible cause of his disease except
endosulfan.
5. Udaya is 10 years old with cerebral palsy. He lives
at the edge of the plantation. His mother was exposed
to endosulfan spraying during the early months of her
pregnancy. There was no history of difficult delivery
nor physical trauma and there was also no history of smoking,
drinking alcohol, drug intake, or exposure to other chemicals
except endosulfan during her pregnancy.
6. Shruthi, 8 years old, has congenitally deformed hands
and legs. Each hand is bifid with four fingers. The severely
deformed right lower limb was recently amputated to enable
the fitting of a prostheses. Her mother was exposed to
endosulfan spraying during her pregnancy with Shruthi
and there was no history of drug intake or any other exposure
to other chemicals or pesticides except endosulfan. Shruthi’s
mother died of cancer 6 years ago.
7. Balakrishna, 6 years old, lives also at the edge of
the plantation. He was diagnosed to have brain tumour(neuroblastoma).
He had undergone one round of chemotherapy but his family
could no longer afford the rest of the treatment. His
parents confirm that they had been repeatedly exposed
to the aerial spraying of endosulfan. There is no history
of exposure to any other chemical.
8. Rishana is a 3 year old girl with serious growth retardation
and delayed mental and psychomotor development. She could
hardly speak and started to walk only a few months ago.
Her mother had no history of difficult delivery and was
not taking any medication during her pregnancy with Rishana.
Her family lives within the plantation the only exposure
to potentially toxic chemicals they could recall was exposure
to endosulfan aerial spraying.
9. Subramanian is a 19 year old boy with cerebral palsy
and lives within the plantation area. He has been an epileptic
since birth and has severe physical and mental retardation.
He could not perform simple tasks and could not respond
to questions. His mother had no history of difficult delivery,
trauma, nor any intake of medications during pregnancy.
The source of drinking water for the family is an open
well which is left uncovered during the aerial spraying
of endosulfan.
The cases described above are just few of
the more than a hundred cases that Dr. Mohan Kumar, the
medical practitioner in the area, had documented. Since
1990, in fact, he had noted a large number of diseases
related to the central nervous system in Padre village
where he had his private clinic. He revealed that the
197 cases he had documented came from only 123 households.
He added that those he had recorded was not comprehensive
and did not include those who might have consulted other
doctors. His list also did not include cases of asthma,
hormonal disorders, infertility, miscarriages, skin disorders
and others. Most of the cases in his list are cancer,
cerebral palsy, mental retardation, epilepsy, congenital
anomalies and psychiatric cases, including suicides.
Dr. Shripati Kajampady, a medical practitioner and proprietor
of a primary health care facility in the nearby Perla
village, corroborated the observations of Dr. Kumar. Dr.
Shripati had also seen several patients from the nearby
villages within the plantation areas who were suffering
from similar diseases. He had also observed the disappearance
small animals in the areas covered by the aerial spraying
of endosulfan.
Mr. Shree Padre, the farmer-journalist who first wrote
the story about cows giving birth to deformed calves after
exposure to endosulfan spraying also corroborated the
observations of the two medical doctors. He, too, have
seen many villagers with various kinds of “strange”
diseases. The public interest group leaders and other
villagers echo the same observations. Reports from both
non-governmental and governmental organizations also confirm
that an unusually large number of serious illnesses and
developmental disorders have occurred in the villages
where aerial spraying of endosulfan had been regularly
done. The public interest group, THANAL, for example,
has investigated the reports of health problems associated
with the aerial spraying of endosulfan and conducted community
monitoring in the affected areas. THANAL confirms the
observations of the village doctors and the others that
indeed there are a large number of illnesses in the villages
and stated that the most likely culprit was endosulfan.
The official report of the study committee formed by the
government of Kerala tacitly admits that there is a high
incidence of diseases in the plantation, although other
sections of the report cast doubt on the veracity of the
health complaints. Recommendation No. 8 of the report,
for example, stated that “…a detailed investigation…should
be conducted to identify risk factors for the high morbidity
in the Padre village and other affected areas.”
More revealing were the results of the study done by the
Kasargod District Committee of the Kerala Shastra Sahitya
Parishad. A household survey was done to assess the health
and environmental situation in 7 villages within the cashew
plantation where endosulfan was being aerially sprayed.
A total of 747 households with 4102 inhabitants were included
in the study. The respondents were categorized into two
main groups. Those from the Enmakaje area, where most
of the reports of health problems came from, were designated
as Group B and the rest, where such reports were apparently
less, was designated as Group A. Health and environmental
quality indicators were then compared with those of the
entire state of Kerala from the latest available data
(1996). The results showed that disability rate was 73%
higher in Group B compared to that of Kerala state and
that the rate of locomotor disability and mental retardation
taken together was higher by 107%. Likewise, chronic morbidity
was higher in Group B by 70%. Although the rates of total
disability and chronic morbidity in Group A did not seem
to be significantly different from the overall rates in
the state of Kerala, the rates of locomotor and visual
disabilities were significantly higher. In a separate
study done in February, 2001, by the Deputy District Medical
Officer in Kasargod, in a survey of 400 households in
the affected areas, it was also found that the rate of
mental retardation in the endosulfan sprayed areas was
above the state average.
Given the foregoing case descriptions, corroborative testimonies
and observations, and governmental and non-governmental
studies/reports, there seems to be no doubt that indeed
there is an unusually large number of illnesses occurring
in the villages within the cashew plantation where endosulfan
has been aerially sprayed.
The question now remaining is: are these
illnesses mainly due to endosulfan exposure? The answer
is YES, for the following reasons:
1. The illnesses observed are to be expected
from the known intrinsic toxicologic properties of endosulfan.
The preponderance of neurologic and mental
illnesses among the reported health problems is compatible
with the fact that endosulfan is a known neurotoxicant,
belonging to a group of highly toxic organochlorine chemicals.
Endosulfan blocks the inhibitory receptors of the central
nervous system, disrupts the ionic channels, and destroys
the integrity of the of the nerve cells. Acute toxic effects
include dizziness and vomiting, hyperactivity, tremors,
lack of coordination, and convulsions. Chronic exposure
may result to permanent damage to the nervous system which
may manifest in various kinds of neurologic diseases.
Apart from its capacity to directly damage the nervous
system, endosulfan is also an endocrine disruptor. Even
low levels of exposure during pregnancy could result in
various forms of endocrine disrupting effects in the offspring,
including mental retardation, reproductive organ anomalies,
developmental disorders, behavioral disorders later in
life, and many others.
There is also evidence that endosulfan can
cause cancer, despite contrary claims from the chemical
industry produced data often quoted by international technical
bodies including the WHO/FAO committees. For example,
endosulfan was found to be mutagenic in various assay
systems, including the Ames test, micronucleus test, and
the yeast conversion test. Endosulfan was also found to
cause chromosomal aberrations in hamsters and mice, sex-linked
recessive mutations in Drosophilia, and dominant lethal
mutations in mice. Studies in human cells, both in vitro
and in vivo, also showed that endosulfan caused chromosomal
damage. Other studies indicate that endosulfan may cause
lymphosarcoma and that it is a potential liver-tumour
promoter.
The high incidence of cancer in the endosulfan
sprayed areas is therefore compatible with existing independent
scientific evidence showing the carcinogenic potential
of endosulfan. The fact that endosulfan has not been classified
as a human carcinogen by international bodies is no reason
to exonerate endosulfan as a probable cause. Most carcinogenic
chemicals have not been classified as human carcinogens
because of the unrealistic standards of evidence required
by corporate dominated “sound science” and
the “risk assessment ” paradigm.
The genotoxic and chromosome damaging properties
of endosulfan not only indicate that endosulfan causes
cancer but also explains the high incidence of congenital
abnormalities found in the endosulfan sprayed areas, since
genotoxic and chromosome damaging chemicals are also usually
embryotoxic. In fact, endosulfan has been found to be
embryotoxic in animals. This embryotoxic property of endosulfan
can also explain the high occurrence of abortions, stillbirths,
and other related disorders.
There is also scientific evidence that endosulfan
is immunotoxic. This should not be surprising since endosulfan
belongs to the organochlorine group of chemicals, many
of which have already been demonstrated to destroy the
immune system. This immunotoxic property can also explain
why many of the affected villagers are very susceptible
to practically all kinds of diseases.
2. It is undeniable that the affected villagers
have been chronically exposed to high levels of endosulfan.
There is no dispute about the fact that
the PCK had been aerially spraying endosulfan regularly
in the areas where the affected villagers live. The villagers
have seen the actual spraying and they have actually smelled
the pesticide which lasted several days. PCK admitted
that aerial spraying was being done regularly and the
government study committee reported that “ the PCK
has not been following the rules prescribed for aerial
spraying.” The aerial spraying occurred 2-3 times
a year using 1% solution of the endosulfan commercial
preparation. Exposure was highest in Enmakaje, where the
surangams ( a shallow, open pit carved off the side of
the hill to store water), the source of drinking water,
are mostly located. It is also in Enmakaje where wells
were mostly uncovered during the spraying of endosulfan
and where people have resided the longest compared to
other areas within the plantation. This difference in
extent and length of exposure can explain the observation
that there are more affected people in Enmakaje compared
to the other areas. The very high levels of endosulfan
found by the CSE in blood, water, soil, milk, and other
samples obtained from Enmakaje(Padre village), are therefore
consistent with the above circumstances. With the known
frequency and quantity of endosulfan spraing in the area,
it can be expected that high levels of endosulfan can
accumulate in various environmental biologic media.
While the CSE study on endosulfan levels is being disputed
by the National Research Center for Cashew, PCK, KAU committee,
and the pesticide industry association; the CSE study
gives the most credible results on endosulfan levels in
the area, providing the details of standard methodology
and having no vested interest on endosulfan. The studies
done by the KAU study committee and the pesticide industry(FIPPAT),
on the other hand, have not provided the details of their
methodology and have obvious vested interest in exonerating
endosulfan as the cause of the observed illnesses in the
affected areas. The seemingly contradictory results on
endosulfan levels may be due, however, to methodological
and time differences. The CSE study sampling, with the
highest levels, was done nearest to the time of last endosulfan
spraying while the FIPPAT study (with the lowest levels)
was done about two months later. Nevertheless, the laboratory
results notwithstanding, exposure to endosulfan of the
affected villagers can be concluded unequivocally since
it is an obvious incontrovertible fact.
3. There is no other probable cause that might reasonably
explain the observed health
problems except endosulfan.
There is no evidence that other environmental
toxicants that might possibly explain the observed health
problems are present in the affected areas. There has
been no other pesticide, not even household pesticides,
that has been used except endosulfan. There are no industrial
activities at or near the areas affected which might indicate
possible contamination by industrial pollutants, like
lead, mercury, cadmium, polyaromatic hydrocarbons, etc.;
that might confound the causation of the health problems
in the affected areas. Furthermore, the villages affected
were too far away from the nearest city where pollution
by other toxicants might possibly occur. Ionizing radiation
is also an unlikely cause since there is no identifiable
source. Detailed interviews also did not reveal intake
of medications or other substances that might have caused
some of the observed illnesses like congenital abnormalities.
While there is a possibility that areca nut chewing might
explain some of the health problems, there was no history
of areca nut chewing by the mothers of the affected children
before or during pregnancy. Some of the cancers, particularly
oral cancer and cancer of the throat, can be caused by
areca nut chewing, but the overall incidence of diseases
in the affected areas cannot be explained by this possible
confounding causative factor. There is also no history
of smoking among the affected households, nor any history
of habitual alcohol drinking. In addition, the family
history of those interviewed did not reveal any confounding
factor referable to hereditary causes, infectious agents,
or other biological or physical factors. In all cases
of congenital abnormalities seen, there was no history
of similar cases in either the mother’s or the father’s
relatives. There was also no indication of any infectious
episode during pregnancy of the mothers of the affected
children, nor was there any history of difficult delivery
that might explain some cases of cerebral palsy, epilepsy
or severe mental retardation. Malnutrition is also not
a causative factor since most households are relatively
self-sufficient in food and are, in fact, relatively better
off economically compared to other areas. There is also
no evidence that other dietary factors such as food additives
and other food contaminants might be present. Intermarriage
among close relatives, a possible factor in some developmental
disorders, is relatively uncommon and and would not explain
the observed health problems. The two medical doctors
who personally knew the patients and their families also
affirm that there are no other likely cause of the observed
health problems except endosulfan.
4. There is clear time and geographic association
between the occurrence of the health problems and the
aerial spraying of endosulfan.
The people’s claim that the health
problems occurred and gradually accumulated during the
period of aerial spraying of endosulfan has not been disputed.
Cases of cancer, developmental anomalies, reproductive
disorders, neurologic diseases, and the other serios illnesses
were practically non-existent before the advent of endosulfan
aerial spraying. Drs. Kumar and Sripathy also assert that
they noticed the increased incidence of various diseases
only after the aerial spraying of pesticide in the plantation
was started. The teachers in the school near the plantation
also noticed that children from the villages within the
cashew plantation were often sick and perform significantly
less in school compared to children from other areas outside
the plantation. It was also observed that health problems
were more numerous and were more serious in the villages
inside the plantation compared to those farther away from
the plantation.
5.There is corroborating evidence of adverse
effects on animals and the environment which are attributable
to endosulfan.
The reports on fish kills and dwindling
population of honeybees, frogs, birds, and other animals
soon after the aerial spraying of endosulfan started have
not been disputed. Cows and chicken were also observed
to die of mysterious causes. People were also complaining
that their domestic animals had suffered miscarriages,
bleeding, infertility, stunting of growth and deformities.
These effects can be expected as a result of exposure
to endosulfan. Endosulfan is highly toxic to fish, honeybees
and birds, and can also result in the diminution of the
population of various species of animals and wildlife.
Existing scientific data reveal that the above mentioned
adverse effects observed in the endosulfan sprayed villages
in Kasargod have also been observed in many areas around
the world as a result of endosulfan contamination.
6.There is credible testimonial and clinical
record evidence of the various illnesses from competent
medical practitioners who had been directly consulted
by the affected villagers.
There is no reason to doubt the veracity
of the depositions of Dr. Kumar and Dr. Sripathy pertaining
to the occurrence of the health problems reported. These
depositions are backed-up by clinical records of patient
consultations. Their professional evaluation of the cases
seen leads them to conclude that endosulfan is the most
likely cause of the diseases they were seeing.
7.Endosulfan have been demonstrated by laboratory
analysis to be present in high concentrations in biological
and environmental samples taken from the most affected
village inside the endosulfan sprayed area.
The CSE study, which published its results
and described in detail the standard methodology used,
revealed very high levels of endosulfan in all samples,
including human blood, milk, water, soil, plants, and
several others, taken from Padre village. While the study
had been criticized, the criticisms had been answered
by the CSE scientists. Another study, the KAU study, did
not show endosulfan levels in samples of water, pepper
and betel leaves but showed low to high levels of endosulfan
in soil and cashew leaves. This study, which was not openly
published and which has not described its methodology
in detail, concluded that there was no conclusive evidence
that endosulfan was the cause of the problem. A study
was also done two months later by the PCK and the pesticide
manufacturers themselves and came up with results showing
no endosulfan residues found in samples of fish, water,
milk, and blood; while there were low levels in soil and
low to moderate levels in cashew leaves. This study was
also not openly published and no details of the methodology
were provided.
8.People’s experiences and testimonies
from the affected villages had indicated that endosulfan
was causing health and environmental problems.
The people in the affected villages had
been seeing the increased incidence of diseases and environmental
problems only since the plantation started its operations.
Many other villages in Kasargod have also reported such
health problems at various times during the years of endosulfan
aerial spraying.
People’s experiences and testimonies provide important
information and evidence on the causation of certain illnesses.
Medical practitioners often rely on the oral narrations
of patients or their close relatives and friends to determine
the nature and causation of diseases. The clinical impression
often overrules laboratory analysis since very often,
unquantifiable uncertainty factors, including intuition
based on clinical experience, prove to be very useful
in the total appraisal of the situation. Clinical decisions
are often based mainly on patient’s personal account
of signs and symptoms of ill health and its cause. In
the particular case of the health problems in Kasargod,
the people’s testimonies and experiences implicating
endosulfan as the cause of their health problems, carry
a lot of weight.
Taken together, the foregoing reasons establish beyond
reasonable doubt that endosulfan is primarily the causative
factor of the health problems in the villages within the
cashew plantation in Kasargod, Kerala, India.
V. Conclusions
Based on the foregoing findings and analysis,
it is concluded that:
1. There is an unusually large number of
illnesses occurring among the people in the villages of
Kasargod within the cashew plantation where aerial spraying
of endosulfan has been going on since the past 26 years.
2. The occurrence of these illnesses is due mainly to
endosulfan.
VI. Recommendations
1. The use of endosulfan should be permanently
banned.
2. A comprehensive health and environmental survey of
the villages which were likely exposed to endosulfan should
be undertaken to determine the extent of adverse health
and environmental damage.
3. Remediation measures should be undertaken immediately
on the affected villages . Immediate medical assistance
should be provided to the victims and economic compensation
paid for by the polluters should be awarded to the affected
families. Clean-up of the soil and water at the expense
of the polluters should be immediately undertaken in areas
where endosulfan levels are determined to be high.
4. Community health and environmental monitoring for at
least 10 years should be instituted to determine the occurrence
of latent and delayed effects and to determine the effectiveness
of remediation measures.
5. Policy reforms should be initiated to ensure adequate
protection of health and environment from pesticides.
6. Steps should be taken to include endosulfan among the
list of persistent organic pollutants (POPs) targetted
for global elimination.
March 2, 2002
Romeo F. Quijano, M.D.
Professor
Dept. of Pharmacology and Toxicology
College of Medicine, University of the Philippines Manila
547 Pedro Gil St., Ermita, Manila
Tel/Fax:63-2-5218251, Email: romyquij@yahoo.com