Every year, 2.78 million people die because of diseases or accidents incurred in the workplace. In India, where eighty percent of labour occurs in unsafe environments, one of the major occupational hazards is silicosis. Nationwide, between three and ten million workers are at risk of developing the disease. For workers in Rajasthan, the toll is acutely being felt.
For many labourers, the opportunities to earn a living are limited. Many turn to sandstone quarries and mines where they are vulnerable to long-term exposure to respirable crystalline silica (RCS), a fine dust which can penetrate deep into the lungs and lead to health complications including silicosis. The disease is a form of pneumoconiosis, a type of lung disease hallmarked by fibrosis. It is irreversible – as workers who are affected and their relatives are painfully aware.
“The combination of illegal mines and cases going under the radar means that comprehensive data as to Rajasthan’s silicosis burden is far from forthcoming.”
In the village of Roundhpura, 52-year-old quarry worker Ramashai Meena told National Geographic earlier this year that “almost every house here has lost someone to silicosis.” He himself developed the disease, which killed his two brothers. To survive, the report says he depends on the contents of “a large plastic bag….[containing] hundreds of pills and several inhalators that keep his dust-scarred lungs working.” The village itself, National Geographic notes, is known as a silicosis ‘widows’ village’ given the sheer number of women who have lost husbands to the affliction.
A report by the Comptroller and Auditor General (CAG) of Rajasthan detected 7,959 cases of silicosis between January 2015 and February 2017, with 449 deaths across five districts. The CAG additionally noted 2,548 mining sites where workers were silicosis-prone. However, this does not give a full picture of the total number of mining sites in the state given the sheer number of illegal facilities in operation. Meanwhile, the disease can go undetected because of misdiagnosis. Many cases of silicosis are mistakenly attributed to tuberculosis.
The combination of illegal mines and cases going under the radar means that comprehensive data as to Rajasthan’s silicosis burden is far from forthcoming. When considering the Silicosis Grant Rebursement – a compensatory payment to those afflicted with the disease – the sheer number of applications are staggering. As of March 2019, the scheme registered 35,517 applications of which it rejected 10,284 and approved 8,255. 5,864 cases are pending. Of the 8,255 approved applications, just 1,959 have received the funds.
“Efforts are weak in ensuring doctors are properly trained to diagnose silicosis. Workers themselves, according to one study, show low awareness of the occupational hazard of silicosis and so may not realise the risk to their health until it is too late.”
The crisis is one which sparked a protest in Rajasthan state capital Jaipur in August last year, bringing together 1,000 silicosis-afflicted workers. Lawmakers do seem to be waking up to the issue. Chief Minister Ashok Gehlot has committed the state government to taking action against the disease. Following a high-level meeting which included the State Health Minister Raghu Sharma and the State Mines Minister Pramod Jain Bhaya, Gehlot affirmed that “the government is serious about the issue of silicosis in mining areas. We would surely make efforts to free the state from the disease.”
To do so, major reforms to workplace safety will be needed. Cracking down on illegal mining sites and ensuring workers are provided with protective equipment are steps which could be taken. In addition, as Health Issues India has previously reported, “measures must also be put in place to allow for the use of occupational history in medical diagnosis to allow doctors a means to more easily diagnose silicosis and differentiate it from potential cases of TB.”
Meanwhile, there are inadequacies in the state’s handling of silicosis. A body – the Rajasthan State Pneumoconiosis Board – was established in January 2004 but has been struggling to make a meaningful impact in workers’ lives. Much of this is related to underfunding, in part thanks to the Board itself. Of the Rs 25.8 crore it was allocated by the state health department in the 2011-12 fiscal year, a mere Rs 12.77 crore was spent. Meanwhile, efforts are weak in ensuring doctors are properly trained to diagnose silicosis. Workers themselves, according to one study, show low awareness of the occupational hazard of silicosis and so may not realise the risk to their health until it is too late.
It is good news that Chief Minister Gehlot is speaking up about silicosis. However, action is urgently needed to resolve a healthcare crisis many are grappling with because they simply have no choice. Other lines of work are lacking, so hazardous professions are often the only option to put food on the table. Meanwhile, the regulatory system which should be in place to protect workers is simply not there.