Compilation and Comparison of Medical camp data in the Endosulfan Issue of Kasaragod,

Kerala

K.M.Sreekumar and Prathapan K.D.

Kerala Agricultural University

Twenty six comprehensive medical camps were conducted in eleven grama panchayaths
affected by the aerial spraying (Badiyadka, Bellur, Enmakaje, Kumbadaje, Karadka, Muliyar,
Ajanur, Kallar, Panathady, Pullur-Periye and Kayyur -Cheemeni) during 2010-2011, to
identify the victims of the endosulphan poisoning. In the 2010 state budget, well before the
commencement of the camps, a substantial allocation was earmarked for the financial
assistance and further treatment of the victims to be identified. The campaigning and the offer
of financial assistance, motivated large number of people to attend the camps. Hence, in
general, participation in these camps could be considered equivalent to a house to house survey.

From these medical camps, expert doctors identified 4273 persons with 300 types of diseases
as victims of endosulphan poisoning (Government of Kerala, 2011: 37). No tests were
conducted in these camps to establish a cause-effect relationship between endosulphan
application and the disease or disability. An examination of the list would reveal that diseases
which are very common in any village in Kerala alone are present in the enlisted patients.
Hypertension, diabetes, skin diseases, back pain, tooth ache, piles, dementia, polio, lung cancer
(common among smokers), liver diseases (common among alcoholics) etc. were adjudged as
endosulphan generated by the expert doctors. This is the first case in the medical history that
all the diseases prevalent in an area were adjudged as induced by a pesticide, which was sprayed
in that area ten years ago, that too at a concentration which is far below the NOAEL (No
Observable Adverse Effect Level). In Table 1, prevalence of the disease affecting the central
nervous system (CNS) in the sprayed areas as per the medical camps, is compiled and
compared with the national average prevalence. The total population of the eleven sprayed
panchayaths as per 2011 census was 2,97,726.

Table 1. Prevalence of the central nervous system insults in the endosulphan sprayed
panchayaths in comparison with the national average
Diseases Total number Prevalence National average Remarks Reference
/disability of cases in (per 1000) prevalence
sprayed area
Mentally 748 2.5 4 out of 1000 Low Ghai, 2011
Challenged individuals
Cerebral Palsy 300 1.06 2 out of 1000 Low Anish et al (2013)
individuals
Epilepsy 108 0.38 3 – 5 out of 1000 Low Harrisons Textbook
individuals of Medicine (2008)

Congenital 18 (1-14 age 1 0.2-0.5 out of equal Venkataramana,

Hydrocephalus group) 1000 deliveries (2011)
Congenital 1 1 1 out of 4000 equal Unnikrishnan et al,
Hypothyroidis deliveries 2011
m
Remarks. Mental challenges, cerebral palsy, hydrocephalus and congenital hypothyroidism
are projected as endosulphan induced by the media. Photographs of such patients were shown
in the official publications of the Govt. of Kerala (Govt. of Kerala, 2011: page 63 and 64)
however, from Table 1 it is very clear that the incidence of these CNS insults are below or
equal to the national average in the sprayed grama panchayaths.

It is argued that endosulphan is mutagenic and cause chromosomal aberrations resulting in

higher incidence of various syndromes. Different types of syndromes present in the study area
are examined in Table 2.

Table 2. Incidence of syndromes in the sprayed areas, based on the compiled medical camp data

Major Syndromes Total National Remarks Reference

(Total population-2,97,726, prevalence Average
no. of live births per year prevalence
estimated 4000 in the last 10
years)
Down syndrome (1-36 years 62 1 in 1000 Low Gadhia Pankaj et
old patients) deliveries al (2015)
Multinodular goitre 19 8.5 in 100 Low Unnikrishnan
AG et al (2011)
Marfan syndrome 1 1 in one equal Vinaykumar RK
lakh et al (2011 )
Klinefelter syndrome 1 1 in 650 Low Adlyne RA et al
newborn (2019)
boys
 Turner syndrome 4 1 in 2000 low Abhishek et al
newborn (2014)
girls
Crouzon syndrome 5 1 in 3500- low Candice AJ et
5000 al (2018)
deliveries

From the above data, it is clear that the prevalence of the diseases and disabilities examined
are either equal to or less than the national average in the endosulphan affected areas. We know
well that the medical camp data is not an alternative to the data generated by house-to-house
survey in epidemiological studies. Since scientifically designed epidemiological studies are yet
to be conducted, the available data from medical camps were used here for any possible pattern
in the health profile of the affected areas. Even if only fifty percent of the patients have attended
the camps, it turns out that the disabilities or diseases are not higher than the national or state
averages.
Abhishek M. and Sudip C.(2014) Turner Syndrome: Fifteen Years’ Experience in India. J. Obstet.
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