‘I inhaled the dust even in my sleep’

“My lungs feel like stone. I can barely walk,” says Manik Sardar.

In November, 2022, the 55-year-old was diagnosed with silicosis – an incurable pulmonary disease. “I have no interest in the upcoming elections,” he continues, “I am only worried about my family’s condition.”

Naba Kumar Mandal is also a patient of silicosis. He adds, “elections are about false promises. For us, voting is a routine task. No matter who comes to power, things will not change for us.”

Manik and Naba both live in the village of Jhupkhali in Minakhan block of West Bengal which goes to polls on June 1, in the last phase of the General Elections 2024.

Both men are grappling with failing health and loss of wages caused by their exposure to silica dust in the factories where they worked intermittently for one or one and a half years. Compensation eludes them as most of the ramming mass factories are not registered with the Directorate of Factories and even those which are, do not issue appointment letters or ID cards. Many of the factories are, in fact, illegal or semi-legal, and their workers are not registered.

Despite the clear and present danger of such work, for almost a decade, between 2000 and 2009, many residents of the North 24 Parganas like Manik and Naba Kumar, had migrated to work in these factories in search of a better livelihood. Climate change and falling crop prices meant agriculture, their traditional source of income, was no longer profitable.

“We went there in search of jobs,” says Hara Paik, another resident of Jhupkhali village, “little did we know we were going to the death zone.”

Workers at ramming mass units are exposed to fine particles of silica which they constantly inhale.

Ramming mass is the main component in the lining of induction furnaces for melting metal scraps, non-metallic minerals, ladle and cradle transfer cars and in steel production. It is also used in manufacturing refractory items like fire bricks.

Here, in these factories, workers are constantly exposed to silica dust. “I used to sleep in an area near the site. I inhaled the dust even in my sleep,” says Hara, who spent around 15 months labouring there. The complete absence of protective gear means that it is only a matter of time before silicosis sets in.

Since 2009-10, 34 workers from different villages in the Minakhan-Sandeshkhali block have died prematurely of silicosis after working for nine months to three years in the ramming mass industry.

As workers breathe, the silica dust is deposited in the alveolar sacs of the lungs, gradually stiffening the organ. The first symptoms of silicosis are coughing and shortness of breath followed by weight loss and a darkening of the skin. Gradually, chest pain and physical weakness sets in. In later stages, patients require constant oxygen support. The cause of death among silicosis patients is usually cardiac arrest due to a lack of oxygen.

Silicosis is an irreversible, incurable, and progressive occupational disease, representing a specific form of pneumoconiosis. Occupational disease expert Dr. Kunal Kumar Dutta says, “patients with silicosis are 15 times more likely to contract tuberculosis.” This is known as silico-tuberculosis or silicotic TB.

But such is the need for work that over the last two decades, there has been a steady stream of men migrating there in search of work. In 2000, 30-35 labourers from Goaldaha village went to work in a Kulti-based ramming mass production unit, almost 300 kilometres away. A couple of years later, farmers living below the poverty line in villages such as Goaldaha, Debitala, Kharibiaria, and Jaygram of Minakhan Block went to work in a unit in Duttapukur, Barasat. As did the farmers of Sundarikhali, Sarbaria, Batidaha, Agarhati, Jeliakhali, Rajbari and Jhupkhali villages Sandeshkhali Block 1 and 2, in 2005-2006. In that same period, labourers of these blocks went to a ramming mass production unit in Jamuria.

“We manufactured fine powder from quartzite stone using a ball mill [a type of grinder] and grains like semolina and sugar using a crusher machine,” says Amoy Sardar, another resident of Jhupkhali. “There was so much dust that you couldn’t see an arm’s length in front of you. The dust would fall all over me,” he adds. Amoy was diagnosed with silicosis in November, 2022 after working for almost two years. He can no longer perform tasks that involve heavy lifting. “I sought employment to support my family. But the disease got me,” he says.

Migrations were further fuelled by the 2009 severe cyclonic storm Aila that  devastated agricultural land in the Sunderbans. Youth were especially keen to move out for jobs, to other parts of the state as well as the country.

Mahananda Sardar wanted to be a singer, but after cyclone Aila, he went to work in Jamuria at a ramming mass factory where he developed silicosis. “I still sing kirtans , but I cannot perform at a stretch because I have breathing issues,” this resident of Jhupkhali says. After being diagnosed with silicosis, Mahandanda went to Chennai to work at a construction site. But he was involved in an accident and had to return in May 2023.

Many patients from Sandeshkhali and Minakhan block might shift out but continue to work as daily wage earners in other parts of the state and outside it while struggling with their health.

Early detection is key to managing the disease. Dr. Kamalesh Sarkar, Director of the Indian Council of Medical Research–National Institute of Occupational Health says, “to successfully manage and arrest the disease, it needs to be identified early. Clara Cell Protein 16 [CC 16], which can be traced from a drop of blood collected from our fingertips, is a biomarker for various lung diseases including silicosis.” In a healthy human body, the value of CC16 is 16 nanograms per millilitre (ng/ml), however in silicosis patients, the value decreases as the disease progresses, eventually reaching zero.

“The government should ensure a suitable legislation, making periodic screening with CC16 test mandatory for the workers of hazardous industries with continuous or intermittent silica-dust exposure. This will help early detection of silicosis,” Dr. Sarkar adds.

“There are no hospitals nearby,” says Rabindra Haldar, who was diagnosed with silicosis in 2019. The closest block hospital is in Khulna. To get there, Rabindra, a resident of Jhupkhali, has to take two boat rides. “There is a Sramajibi Hospital in Sarbaria, but it does not have enough facilities, he says and adds, “for any serious issue, we have to go to Kolkata. An ambulance charges between 1,500-2,000 [rupees].”

In his home in Goaldaha, 50-year-old Md Safiq Molla has been confined to his bed for almost two years now with severe breathing trouble. “I have lost 20 kgs, I need constant oxygen support. I am unable to keep roja ,” he says. “I am worried about my family. What will happen to them when I am gone?”

In February 2021, the family received a compensation of Rs. 2 lakhs from the state government. “Mr. Samit Kumar Carr filed a case on our behalf,” says Taslima Bibi, Safiq’s wife. But the money soon ran out. “We spent it on maintaining this house and our eldest daughter’s wedding,” Taslima explains.

Samit Kumar Carr of Occupational Safety & Health Association of Jharkhand (OSHAJ India), has been fighting for the rights of silicosis affected workers in Jharkhand and West Bengal for over two decades, filing complaints on their behalf for social security and monetary compensation.

OSHAJ India has helped the families of 23 workers who died of silicosis in West Bengal between 2019–2023 in receiving compensation of Rs. 4 lakhs each as well as 30 silicosis-affected workers receiving Rs. 2 lakhs each. In addition, Rs. 10 crore has been sanctioned by the state government for pension and welfare schemes.

“According to the Factory Act, 1948, factories that produce ramming mass and silica powder are classified as an organised industry since more than 10 workers work with electricity. So, all factory-related labour rules and regulations apply,” says Samit. The factories also fall under the Employee’s State Insurance Act 1948, and the Workmen (Employees) Compensation Act 1923. Being a notifiable disease mentioned in the Factories Act means that if a doctor diagnoses a patient with silicosis, they have to inform the Chief Inspector of Factories.

At a workshop organised by OSHAJ India in Kolkata on March 31, 2024, a panel of experts crucially identified that as opposed to the general belief that silicosis occurs only through long-term exposure, short-term inhalation can lead to the disease as well. This is evident in the silicosis patients of the North 24 parganas who worked in ramming mass industries. Any duration of exposure, the panel said, could lead to the formation of fibrous tissues around the dust particles, impeding the exchange of oxygen and carbon dioxide and causing breathing problems.

Silicosis, Carr goes on to explain, is also an occupational disease for which workers are entitled to compensation. But most of the workers are not registered. The responsibility of identifying factories where workers are afflicted with silicosis lies with the government. In its Relief and Rehabilitation policy (Clause 11.4), the West Bengal government has said that workers may seek compensation from employers irrespective of the statute.

But the reality is somewhat different, Carr says. “I’ve observed on multiple occasions that the administration refuses to put silicosis as a cause of death on the death certificate,” he adds. And before that, factories fire the workers when they fall sick.

When Anita Mandal’s husband Subarna died from silicosis in May 2017, the death certificate issued by Nil Ratan Sircar Hospital in Kolkata mentioned “liver cirrhosis and infectious peritonitis” as the cause of death. Subarna used to work at the ramming mass factory in Jamuria.

“My husband never had liver disease,” Anita says, “he was diagnosed with silicosis.” Anita, a resident of Jhupkhali, works as an agricultural labourer and her son has become a migrant labourer, working mostly at construction sites in Kolkata and Diamond Harbour. “I had no idea what they had written in the death certificate. I was devastated at the time. And how can I understand legal terms? I am a simple village housewife,” Anita says.

With their combined income, Anita and her son are supporting her daughter’s higher education. She too is apathetic about the elections. “Two elections have happened in the last seven years. But I still live in misery. Tell me, why should I be interested?” she asks.