Environmental Sciences

Punjab’s ‘cancer train’ runs on hope

Punjab’s ‘cancer train’ runs on hope

Cases of cancer are widespread in Punjab and Haryana where groundwater is contaminated by high pesticide use.

Author

Abhiroop Chowdhury, Professor, Jindal School of Environment and Sustainability, O.P. Jindal Global University, Sonipat, Haryana, India.

Summary

At 9.30pm every night, a poorly-lit, 12-coach train pulls out of Bathinda station in the Indian state of Punjab with passengers of all ages and genders.

With their meagre belongings and plastic packets containing sheafs of papers and documents, most talk among themselves in hushed tones.

The destination for an average one-third of the 300 passengers of this train is the Acharya Tulsi Regional Cancer Hospital and Research Centre in the Bikaner district of Rajasthan state.

The train covers about 325km before it reaches Bikaner around 6am. Sometimes the train is delayed by one to two hours. But the passengers do not lose hope.

Over the years, the Bathinda-Bikaner train has earned itself a grim tag as “Punjab’s cancer train” as it ferries hundreds of thousands of cancer patients from this northern Indian state for treatment for this dreaded affliction.

The reason for this interstate migration is the cost of cancer treatment.

The cost of a train ticket is free for any cancer patient while for attendants there is a 75 percent discount on the fare.

Most of the hospitals in the city of Bikaner are covered under Mukh Mantri Punjab Cancer Raahat Kosh Scheme through which patients can get financial assistance up to Rs 1,500,000 ($US1,787). Whereas the scheme is much harder for patients to access in Punjab.

Cancer Capital

The widespread prevalence of cancer in Punjab — and more recently the adjoining state of Haryana — has helped earn India the unenviable title of the world’s cancer capital.

There are many reasons for poor health among Punjab’s population but environmental degradation and water, soil and air pollution are known to be the most common causes of cancer in India.

Cancer cases in the country are at an all-time high, after public officials shared in Parliament earlier this year that there were 1,496,972 cases in 2023 up from 1,461,427 in 2022. There was a record 300 percent rise in cases between 2017 and 2018.

Studies indicated that 1.4 million people had cancer in India in 2020 and the case numbers may rise to 1.57 million by 2025. The reason for this spike may be due to changes in food consumption patterns, increased genetic predisposition to the disease as well as negligence in seeking medical attention at the onset of cancer.

Another report indicates that Punjab saw a four-time rise in cervical, oral and breast cancer cases among people over 30 in 2022.

A Forbes India report indicates that Haryana and Punjab have shown moderate economic growth, notching up per capita net state domestic products of Rs 325,000 ($US3,879 ) and Rs 195,000 ($US2,327) respectively in the financial year 2022-2023.

So rising cancer cases may not be directly linked with economic hardship.

Green revolution’s hidden dark side

Beginning in the 1960s, Haryana and Punjab were two of the prime beneficiaries of the “Green Revolution“ that solved India’s food security problem.

The primary outcome of this scientific and agricultural reform was improvement in crop yields. But this transformation relied extensively on increased use of fertilisers and pesticides.

This excess use of pesticides is known to be the major cause of cancer cases in Haryana and Punjab.

Cancer occurs when a cell keeps on growing and dividing uncontrollably, unlike normal cells which ultimately die. Biochemically, humans have natural protection against cancer through tumour-suppressor genes.

Exposure to certain chemicals can mutate tumour-suppressor genes, switching them off.

Chronic exposure to pesticides can thereby increase people’s risk of developing cancer.

Consuming a staggering 5,270 metric tonnes of pesticides annually, Punjab is the third largest user and has the highest per capita consumption of such chemicals in India.

This high usage results in the accumulation of pesticides in groundwater, drinking water and food. Such contaminants then end up in the human body.

Recent research found pesticide traces in the breastmilk of lactating mothers in Haryana.

Another study showed that in 6.9 percent of cow’s milk samples from Ludhiana in Punjab, the concentration of harmful pesticides such as hexachlorocyclohexane, dichloro-diphenyl trichloroethane or DDT, endosulfan, cypermethrin, cyhalothrin, permethrin, chlorpyrifos, ethion and profenophos were higher than acceptable limits.

Other research indicates the presence of metal pollutants such as arsenic, lead and uranium in the groundwater of Punjab’s Malwa, may also have played a role in the high incidence of cases in the region.

Published in: 360info.

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