In Punjab, Crowding Onto The Cancer Train The use of chemical fertilizers, pesticides and high-yield seeds to increase production transformed India from a country dependent on food aid and imports to one that sometimes exports grains. But did it also fuel a dramatic rise in cancer among the farm families of India's Punjab state?

In Punjab, Crowding Onto The Cancer Train

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From NPR News, this is ALL THINGS CONSIDERED. I'm Robert Siegel.


And I'm Michele Norris.

Every night, Train Number 339 pulls into a farm town in the state of Punjab in northern India. The passengers who crowd onto the train reflect a medical mystery: is the modern system of farming making people sick? Locals call Train 339 the cancer train because a lot of the passengers have cancer. They board the train for an overnight journey to a town called Bikaner - a town which has a large cancer hospital.

These days, Train 339 is packed, and we asked NPR's Daniel Zwerdling to find out why.

DANIEL ZWERDLING: The cancer train is supposed to leave the town of Bathinda every night at 9:30 p.m. By 8:30, passengers jam the platform.

(Soundbite of a crowd)

ZWERDLING: The tea man keeps trying to hawk his tea, another vendor keeps slapping dough into discs; he's making chapattis. Most passengers don't seem to notice. There are hardly any ventures in this station, so most people are sitting on the bare pavement, some are lying on it asleep.

My interpreter and I start asking people at random...

Excuse me, may I interrupt? Are any of you going to the Bikaner cancer hospital?

Unidentified Man #1: (Speaking foreign language)

ZWERDLING: The first few people say, no, we're going someplace else. But then, we meet this farmer.

Unidentified Man #2: (Speaking foreign language)

Ms. SOOK MANIKOLI(ph) (Translator): This gentleman says that this young boy traveling with him has cancer.


Ms. MANIKOLI: He's in Class 12.

ZWERDLING: The next man we ask is also a farmer. He's going to the hospital, too.

Unidentified Man #3: (Speaking foreign language)

Ms. MANIKOLI: This man's mother has cancer.

ZWERDLING: This is the woman in the stall just behind him?

Ms. MANIKOLI: Yes. They don't know what kind cancer is this. They're going to go now and find out.

ZWERDLING: People say you never use to see so many cancer patients in this farm region. But now, some of the most respected medical researchers in India have found that villages that used a lot of pesticides have higher rates of cancer than villages that don't. Nobody knows for sure if pesticides are the culprit, but they're concerned that these cancers might be a side-effect of the Green Revolution.

Remember the Green Revolution? Back in the 1960s and '70s, scientists and world leaders got together and they got farmers in countries like India to switch to the American way of farming: pesticides, fertilizers, high-yield seeds. Today, farmers in Punjab produce way more food than they used to, but they're wondering if they're paying the price. For instance, there's a family with a little kid over by the tea stall. They're farmers.

Unidentified Man #4: (Speaking foreign language)

Ms. MANIKOLI: The kid's got hip cancer. Oh, yeah. It was very small, but now, since three months, it's been hurting.

ZWERDLING: And there's another passenger who's wearing a bright yellow turban. He's gaunt. He's wrapped in a shawl. He points to his throat.

Unidentified Man #5: (Speaking foreign language)

ZWERDLING: He has throat cancer. He speaks through a plastic box.

Unidentified Man #5: (Speaking foreign language)

Ms. MANIKOLI: It's difficult for him to talk. He has to press it to talk.


Unidentified Man #5: (Speaking foreign language)

ZWERDLING: Did the man get cancer from smoking or did the Green Revolution make him sick? In any case, my interpreter, Sook Manikoli, says please stop asking him questions. She can't handle it.

Ms. MANIKOLI: I don't want to make him talk any more.

(Soundbite of train)

ZWERDLING: And now, the cancer train is coming into the station.

This is crazy. Everybody is rushing towards the edge of the platform. People were pushing so hard, I was almost shoved through the opening of the car. This is ours?


ZWERDLING: Uh-oh, right near the toilets.

We squeeze into a compartment with six benches, which are stacked like bunk beds. And it turns out, two of our bunkmates have cancer, too. And, yes, they're farmers.

Unidentified Man #6: (Speaking foreign language)

Ms. MANIKOLI: The gentleman in the blue turban says that the thing is that production is good, but everyone is getting ill health, is degenerating of people around us. Their health is degenerating.

ZWERDLING: Now, it's lights out. Everybody lies down. Eight hours to go till Bikaner.

(Soundbite of snoring)

A few days before we took the cancer train, we visited a village called Jajjal. We'll get back to the train in a few minutes.

But first, we're going to spend some time in the village, because one of the farmers here played a role in getting researchers to tackle the mystery: is the Green Revolution hurting people's health?

(Soundbite of machinery)

ZWERDLING: We met Jarnail Singh out in his fields. The weed was brilliant green. His mustard crop was exploding. It was all bright yellow flowers. Singh and some hired hands were mixing fertilizer.

Mr. JARNAIL SINGH (Mustard Farmer): (Speaking foreign language)

ZWERDLING: Singh says when the Green Revolution came to this village, it was a miracle. Farmers grew three or four times as much crops per acre as they used to. But then, Singh started to sense that something was wrong. For instance, the peacocks disappeared; they're the national bird of India. You used to see them all over the fields.

Mr. SINGH: (Speaking foreign language)

Ms. MANIKOLI: Definitely, you would have seen a lot of peacocks and peahens, and even the eggs, and a lot of cranes, and many more animals also. Then now, we don't see any more.

ZWERDLING: Then, it seemed like too many people in the village were getting sick. Singh says seven people in his own family got cancer, including his brother and sister-in-law.

Mr. SINGH: Three members died with cancer. (Speaking foreign language)

ZWERDLING: Singh says the more he watched other farmers, the more he saw that they don't use toxic chemicals the way they're supposed to. And that raises one of the biggest potential problems with the Green Revolution in developing countries. Government leaders pushed it before they had many safeguards to protect the population.

For instance, the chemical industry says, look, we put instructions and warnings on the pesticide bottles and the farmers ignore them. It's their own fault. But a lot of farmers in countries like India can't read much. So they don't spray their crops only a couple times the way the pesticide label says, they spray a dozen times or more.

Mr. SINGH: (Speaking foreign language)

Ms. MANIKOLI: I used to see that the farmers, when they were spraying pesticides and fertilizers, they actually used to get totally covered by it: in their hair, on their body, in their eyes. And that got me thinking about why aren't we really looking at that; how that may affects the farmers?

ZWERDLING: And Jarnail Singh asked the same question to politicians. He went to conferences and asked scientists. And a few years ago, it paid off.

(Soundbite of knocking)

Medical researchers decided to study whether this area really does have more cancer.

Rajesh Kumar is head of the School of Public Health in Punjab's capital city, Chandigarh. Kumar recruited a small army of researchers.

Dr. RAJESH KUMAR (School of Public Health): From health department of Punjab, State Pollution Control Board, experts on cancer...

ZWERDLING: They met with thousands of families in farming villages and they found there was more cancer in villages like Jajjal, which used a lot of pesticides than in villages that didn't.

Dr. KUMAR: The cancer rates were higher, significantly higher.

ZWERDLING: But Kumar says before you blame pesticides, it's important to remember something about health studies in general: they're incredibly hard to do and they're super hard in developing countries.

Now, think about this. The United States keeps better medical records than most countries around the world, yet even in the U.S., it takes years of research to link a certain chemical in the environment to cancer or other health problems in people. And even when scientists do show a link they usually can't prove it conclusively.

As for India, India didn't even start collecting extensive health statistics until a few years ago. So Kumar says, yes, their study shows that cancer rates in the target area were higher. But they do not know if pesticides made the cancer rates higher. Maybe it was industrial pollution or smoking or different diets. Or maybe all those factors caused cancer.

Dr. KUMAR: So, as a scientist, my submission to everyone would be that there should be more investigation into this to find out the cause of it.

ZWERDLING: Meanwhile, other studies suggest that pesticides might be linked to other health issues in Punjab, such as subtle effects on memory and coordination in children. Again, the scientists caution this research is not conclusive. But it's potentially troubling because the world's population keeps booming; leaders are calling for a new Green Revolution so they can feed everyone, yet scientists have only just begun studying the potential side effects of the last one.

(Soundbite of train)

When we were last on the cancer train, everybody was going to sleep. Now, they're waking up. It's about 6 a.m. and the train is just pulling into Bikaner. The passengers almost sleepwalk down the platform. And soon, dozens of passengers are crowding the hallways of the Bikaner Cancer Hospital.

(Soundbite of passengers)

ZWERDLING: We run into the 16-year-old who has blood cancer. His name is Jassa Singh. He's pale and skinny, and he and his family look anxious.

How are you feeling today after that long train ride?

Mr. JASSA SINGH: (Speaking foreign language)

Ms. MANIKOLI: He's feeling well now.

Mr. SINGH: (Speaking foreign language).

Ms. MANIKOLI: They're going in for a blood test, and then they'll give the results to the doctor, and then they'll know.

ZWERDLING: And when they get the results, they'll head right back to the station, and they'll ride eight hours toward home on the cancer train.

Daniel Zwerdling, NPR News.

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