Has the World Forgotten Bhopal?
Editorial, The Lancet
(online at http://www.thelancet.com) Vol.356, No.9245, 2 Dec 2000

During the night of Dec 2-3, 1984, what still has the dubious accolade of the world's worst industrial accident took place in the Indian city of Bhopal, at a pesticide- manufacturing factory owned by the US-based multinational Union Carbide. Tonnes of toxic gas leaked from the plant into the surrounding densely populated area.

The exact nature of the gas is disputed but it is believed to have been mainly methyl- isocyanate. Estimates of the mortality and morbidity in the aftermath vary. The environmental pressure group, Greenpeace, puts these figures at 16,000 and half a million, respectively. More conservative estimates have put the mortality at 3,800 and morbidity at 350,000, with ocular, respiratory, and systemic symptoms predominating, the former now being known as "Bhopal eye syndrome". What no-one disputes is the sheer scale of the tragedy that hit the capital of Madhya Pradesh state 16 years ago this weekend. As Rosaline and Ramana Dhara wrote in 1995: "There is a growing list of chemical contamination episodes in the world today, but in terms of injury, morbidity, and death none can compare with the world's worst industrial cataclysm that occurred on the night of December 2-3, at the Union Carbide plant in Bhopal, India."

Most of the information on the clinical sequelae of the gas leak was generated by the Indian Council of Medical Research, but several of these studies were prematurely terminated and release of certain results was, and according to local activists continues to be, delayed or suppressed. Critics argue that there has been no systematic effort to document the medical and social impacts of the disaster. When the Permanent People's Tribunal was held in Bhopal in 1993, it recommended bringing in a group of outside experts to assess and report on the effects of the disaster and the adequacy of the response.

Thus, more than a decade after the disaster, the International Medical Commission on Bhopal produced a report that roundly criticised the medical care being offered to survivors, recommending that facilities and treatment appropriate for chronic illness be provided. The neglect of those exposed as children was deemed "appalling", since they had been neither registered nor compensated for their disabilities. The IMCB estimated in 1996 that as many as 50,000 survivors still had partial or total disability as a consequence of the disaster. A study published by members of the IMCB in 1997 had found persistent small-airways obstruction in survivors consistent with gas exposure. Clinical research seems to have petered out since then, as one pressure group, Gas Peedit Nirashrit Morcha Bhopal, claimed last week: "A matter of serious concern is the discontinuation of research and monitoring activities in Bhopal".

More recent interest has turned towards the longer-term environmental effects of the gas leak. A study by Greenpeace published last year drew attention to the general contamination of the factory site and the hazards to which the local population are exposed. Greenpeace reported that they found severe contamination of land and drinking-water supplies with heavy metals and persistent organic chemical pollutants. And, 16 years on, legal processes continue to try to establish liability and compensation for the disaster, but these efforts are so slow that most people seem to have forgotten about this tragedy. According to official records, only 8,394 personal-injury cases and 570 death cases remain to be decided. However of the 459 969 cases rejected, activists claim, at least 100,000 have been wrongfully denied compensation for reasons such as inaccurate registration of address.

A class-action lawsuit against Union Carbide was filed by victims of the disaster in a US court on the 15th anniversary of the disaster last year, but the case was dismissed this summer on the grounds that further claims are barred by the settlement the Indian government hastily agreed with Union Carbide in 1989. At some points, the legal twists and turns have seemed almost farcical, with former head of Union Carbide, Warren Anderson, remaining a "proclaimed absconder" due to his failure to appear at hearings for a criminal case filed in India.

Given the amount of time that has lapsed, the prospects of all those afflicted being afforded reasonable compensation and care seem gloomy. Has the world forgotten its worst industrial accident and the victims? The answer, it would seem, is Yes.

The Lancet