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FOR eight years now, SA Azad, a former school teacher, has been fighting for the rights of the dying victims of silicosis, cast away in Lal Kuan on the southern fringes of Delhi. He went to court, appealed to the state government, ran after doctors and talked to the media. No stone was left unturned. Finally, Azad has achieved significant victories for India’s mine-workers. On May 27, the Supreme Court issued an order to the ministries of labour, health, company and law and state governments to form a central committee and lay down guidelines to prevent dust exposure in stone crushing units and quarries all over India.

On 24 October last, Delhi’s chief minister, Sheila Dikshit called a meeting to discuss the demands of the silicosis victims. Present with her were the health minister and senior bureaucrats, representatives from Azad’s NGO, Prasar and some people from Lal Kuan.It was decided to conduct a survey at Lal Kuan and provide victims with health facilities, livelihood skills, Antodaya ration cards and pension schemes for widows and the disabled. It was also agreed that a multipurpose community centre would be set up.The survey to identify victims was done under the guidance of Dr TK Joshi, Centre for Occupational Environment and Health. Out of 98 people, 41 had silicosis.

Then on January 24, a health centre was inaugurated by the state health minister at Tajpur, two km from Lal Kuan. It has two floors, with the first yet to be completed. On the ground floor there are five rooms for a pharmacy, consultation and so on. A radiological unit is yet to be installed. There are three doctors, three pharmacists, a dresser and two nurses. Livelihood programmes are underway.

“We would like other state governments to follow the good example of the Delhi government and set up victim rehabilitation villages where alternative livelihood, education, health, an anganwadi, mid-day meal scheme, pensions and all government schemes are implemented,” says Azad.However, he soon realised that getting officials to carry out their own programmes is like trying to push an elephant uphill. Implementation has been patchy. Success here, defeat there. The government’s humungous departments, like that of social welfare, have become addicted to fobbing off their work to NGOs.

It remains to be seen whether the newly inaugurated health centre will be able to alleviate the suffering of silicosis victims or merely function as another government facility.The opening of a dispensary in Lal Kuan was dropped on the grounds that it is an illegal colony. The Directorate of Health Services (DHS) dumped the responsibility on Azad’s small NGO Prasar to find suitable land for it. A mobile health clinic does come four days a week for two hours. “At first the mobile team was very irregular,” says Azad. “People would wait for hours. Their behavior towards the people also left much to be desired. That changed once the deputy director of the DHS came over to check.”

Silicosis survivors are now into sheep rearing, stitching, welding, computers and STD booths. Some victims have got ration cards and widow pension.Time and again Azad has been given ‘friendly’ advice that he should draw up a project and do the government’s work. But Azad is clear. He will not do so. “We want direct involvement of the people through cooperatives. There are 20 NGOS working in Lal Kuan on diverse issues. How much change have they made? Bringing in an NGO will only muck up the issue.”

Open drains, festering garbage and broken roads are what you will find in Lal Kuan. However, silicosis is an even bigger problem. There are hardly any men left. Their frail, emaciated wives may well die too, leaving behind sad faced malnourished children. “I lost my husband and six sons. Will anything change?” asks Gulab Devi, who worked in the quarry for almost 30 years.

The Lal Kuan quarries were closed in 1992. The Supreme Court ordered their closure after environment lawyer MC Mehta argued that such industries were polluting Delhi’s environment. The quarries shifted to Pali in Haryana. But workers lost their work and health.Silicosis is an incurable lung disease caused by inhaling silica dust which is released when rock, sand, concrete and ores are crushed. It leads to lung fibrosis and emphysema. The disease has no cure.In 1999, Azad was working with Pratham, the education NGO, when he came across innumerable cases of people falling ill and dying in spite of taking medicines. “I realised that something was not right and decided to do something about it..” Azad says: “We went to many doctors but none could help us. They (the doctors) would tell the workers to have honey or bananas. Imagine! Then we started writing letters to the government, in kilos. We wanted to establish the presence of silicosis at AIIMS but even there the doctors did not have the know-how or the facilities for diagnosis.”

Eventually, Dr Anand Jaiswal, chest surgeon at the Lala Ram Swarup Institute of Tuberculosis and Respiratory Diseases came to their aid, and with the guidance of a team of Israeli doctors did the first positive confirmation of silicosis in 2002.It is difficult to distinguish between TB and silicosis. On X-ray, it is easily mistaken for TB. When Narayani Devi, a quarry worker, first started vomiting blood the doctors diagnosed her ailment as tuberculosis. For 20 years she took TB medicine till it was finally discovered that she had silicosis.

“Once we had four or five confirmed cases we started to challenge the government. Then the media also began to pay attention,” says Azad. He wrote endless letters to the labour department. It wrote back saying silicosis was ‘outside its purview’. A committed activist, Azad put together the demands of the quarry workers. These were: proper measures to detect and prevent silicosis, adequate compensation and rehabilitation facilities, alternative employment and a local dispensary. With this they filed a Public Interest Litigation in the Delhi High Court in May 2004.

“If the labour and pollution departments of the government had insisted safety laws and guidelines be followed in quarries, workers would not have died like this,” says Azad. “Why did they allow so much dust to be emitted? Why were there no facilities for water sprinkling?“Almost all these hazards can be prevented with the right approach,” says Dr Joshi. “But in our country this responsibility has been delegated to the labour ministry. Why? In the entire health policy of the health ministry, there is just one paragraph on occupational hazard.”“It is the responsibility of the employer to take care of his employees. Now if a worker gets sick he is fired. For his treatment he goes to a government hospital which in turn is funded by the taxpayer. It means that the employer profits in every way.”While MC Mehta won the Magsaysay for his activism it has been left to people like Azad to pick up the pieces.