IN THE HIGH COURT OF PUNJAB AND HARYANA
AT CHANDIGARH
Civil Writ Petition No.11425 of 2005
Date of decision: 31st July, 2009
Cancer Peerat Kissan Committee
... Petitioner
Versus
State of Punjab and others
... Respondents
CORAM: HON'BLE MR. JUSTICE T.S. THAKUR
HOB'BLE MR. JUSTICE KANWALJIT SINGH AHLUWALIA
Present: Mr. Amit Jhanjhi, Amicus Curiae for the petitioner.
Mr. Rupinder Khosla, Additional Advocate General Punjab,
for respondents No.1 and 2.
Mr. Chander Mohan Sharma, Central Govt. Standing Counsel
for respondent No.4.
Notes: 1. Whether reporters of local newspapers may be allowed to
see the judgment?
2. To be referred to the reporters or not?
3. Whether the judgment should be reported in the Digest?
KANWALJIT SINGH AHLUWALIA, J.
Cancer Peerat Kissan (farmers) Committee has filed present
writ petition projecting misery, which has befallen upon farmers of
Mukatsar and Bathinda Districts of Punjab.
With science and technology having become an inseparable
part of the daily life, the creation of scientific awareness among the
masses has become all the more important now than ever before.
Civil Writ Petition No. 11425 of 2005 2
Therefore, present writ petition raises an important question of human
concern regarding excessive use of pesticides. There is no doubt that
pesticides have hazardous health effects and though beneficial to the
agriculture sector and in vector bone disease control, pesticides can be
source of many diseases and deterioration of human health.
By way of present writ petition, in the form of public interest
litigation, we have been called upon to issue directions to the State of
Punjab to take effective preventive steps to save the ruralities of Bathinda
and Muktsar districts from affliction of deadly disease of cancer and
provide necessary medical treatment, amenities and care to the suffering
families. Petitioner, Cancer Peerat Kissan Committee has urged that
residents of various villages of Muktsar and Bathinda Divisions are
suffering from deadly disease of cancer, which has taken a heavy toll of
human lives. It is stated that the ground water in the area is having high
fluoride and selenium contents and has contributed to rise of cancer
disease and has caused agony and trauma. A grievance has been made
that State of Punjab has not taken effective steps to alleviate the suffering
of farmers and there is lack of necessary medical expertise and facilities to
cope up with effects of the dreaded disease. It is depicted in the writ
petition that there are no facilities available in the area for treatment of
cancer.
In the written statement filed by the Additional Director, Health
and Family Welfare Department, Punjab on behalf of the Govt. of Punjab,
it has been stated that in order to curb and check the growing incidents of
incurable disease like cancer, a High Powered Committee was constituted
for implementation of necessary measures and to review and monitor the
grave situation from time to time. In the reply, it is averred that a special
campaign was launched to impart knowledge to people about the early
Civil Writ Petition No. 11425 of 2005 3
symptoms, preventive measures and treatment of cancer disease by
holding rallies with the participation of school children at Block, Tehsil and
District level. A study was also undertaken by expert group under the
Chairmanship of eminent agriculture scientist and medical specialist, Dr.
S.S.Johl, Vice Chairman, Punjab State Planning Board and Dr.
K.K.Talwar, Director PGIMER, Chandigarh. Punjab Agricultural University
carried investigative study on contamination of drinking water, soil and
plants with poisonous heavy metals and pesticides as a potential cause of
abnormally high incidence of cancer in south-western Punjab.
Furthermore, an epidemiological study of cancer cases reported from the
villages of Talwandi Sabo Block in District Bathinda and Chamkaur Sahib
Block of District Ropar was conducted by Department of Community
Medicine, PGIMER, Chandigarh. Centre for Science and Environment,
New Delhi undertook analysis of pesticide residues in blood samples in
State of Punjab. Directorate of Health Services and Family Welfare
launched a study regarding pesticides prevalence in human blood and
urine in Punjab. Furthermore, a survey of cancer patients was also
conducted by the Department in four districts of Punjab, Mansa, Muktsar,
Bathinda and Faridkot. Some of the findings of these committees can be
summed up as under:
(a) Excessive use of pesticides in the area of cotton crop was
considered as one possibility but the study concluded that the
sample size of the study was too small to make any definite
conclusion.
(b) In the shallow hand pumps, contents of arsenic was found more
than the permissible limit, a possible cause, due to disposal of
industrial waste was not ruled out.
Civil Writ Petition No. 11425 of 2005 4
(c) The study taken by PGIMER, Chandigarh revealed that higher
prevalence of cancer was due to residues of pesticides found in
the drinking water.
(d) The study conducted by Centre for Science and Environment,
New Delhi showed that the level of pesticides in the blood of
people from rural Punjab was very high and was further
contaminated with newer OP pesticides. It was noted by one of
the committees that the prevalence of cancer in the Districts of
Muktsar and Bathinda is higher than national average.
Following recommendations were made by the committee:
(i) In depth study to know the exact causes and incidents
of cancer, specifically in relation to the use of pesticides
be undertaken.
(ii) Subsidized Medi-claim Policy to the extent of 50% of
the premium should be made available for the cancer
patients below poverty line and other poor people.
(iii) Educational and informative campaigns should be
initiated to make people aware for taking necessary
precautions and protective measures, i.e. use of Mask
and Gloves etc. while spraying the pesticides.
Arguments of this case were heard at length on December
12, 2008. Taking into consideration the arguments advanced by counsel
for the parties, this Court formulated a view that in order to provide
immediate relief and to ameliorate the cause of sufferers, to provide care
to the cancer patients, following preventive and remedial measures ought
Civil Writ Petition No. 11425 of 2005 5to be taken by the State Govt. Thus, the order dated December 12, 2008
read as under:
“Mr. Amol Rattan Singh has filed an additional affidavit
sworn by the Joint Director (Health), Government of Punjab,
Chandigarh. A reading of the said affidavit shows that a
number of steps are being taken to grapple with the problem
arising out of wide spread of cancer presumably on account of
underground pollution caused by use of pesticides. Details of
the steps allegedly taken however need to be verified as the
same have not been set out in the affidavit. We, therefore,
direct the Government of Punjab to place on record:-(i) the steps that have been taken by Punjab
Infrastructure Development Board (PIDB) so far in
regard to the setting up of Super Specialty
Cancer Centre at Bhatinda under the proposed
public private partnership and the time frame
within which the proposed Super Specialty
Hospital will come up at Bhatinda;(ii) the government shall also indicate the reasons
why the supply of the machine meant for the
proposed Mammography Unit in the Mobile
Medical Unit at Bhatinda District Hospital is being
delayed and what action has been taken to
expedite the said supply;(iii) the government shall indicate as to what norms
have been framed for declaring the patients
below the poverty line to be able to take financial
assistance under the State Illness Fund
established by it;(iv) The State Public Health Laboratory, Chandigarh
shall file a report as to the number of tests
conducted in respect of Water Quality to detect
poisons like Arsenic, Copper, Cyanide and
Chromium in different regions of the State and the
results of such tests;(v) report of the team of experts constituted by the
Government of India for setting up of a Regional
Civil Writ Petition No. 11425 of 2005 6Cancer Centre at Government Medical College,
Amritsar shall be placed on the record;(vi) The Principal, Government Medical College,
Amritsar shall submit a status report as regards
the construction of the Regional Cancer Centre
Building at Amritsar and the process undertaken
for purchase of equipment which according to the
affidavit was started in May/June, 2008. The
delay if any in the purchase of equipment shall
also be indicated together with the time frame
within which the equipment shall be installed;(vii) The Principal, Government Medical College,
Patiala shall report whether the Brachy Therapy
Machine has been installed and is functional. If it
is not the reason why the machine has not been
made functional shall be indicated. The process
for the purchase of Simulator and Mammography
Unit is said to have been started. The reasons for
the delay if any in the completion of that process
shall also be indicated; and(viii) The Principal, Government Medical College,
Faridkot shall report whether the construction of
the building and purchase of equipment has
started? If the same has not been started, the
reasons for the same shall also be indicated.(ix) Similarly, the Principal of Shri Guru Ram Dass
Institute of Medical Sciences and Research,
Amritsar shall report whether Cobalt Radioactive
Source has been delivered by the supplier? If not,
the reasons for the delay together with the time
frame within which the machine shall be received
and installed, shall be given;(x) Director, PGI, Chandigarh shall report whether
the regional cancer centre for Punjab in the PGI,
is functioning satisfactorily and if there are any
deficiencies, the nature of such deficiencies and
Civil Writ Petition No. 11425 of 2005 7the need if any for augmentation of the man
power and machinery required shall be identified.The needful shall be done in terms of the above
expeditiously but not later than six weeks from today.”In compliance with the order dated December 12, 2008,
additional affidavit has been filed by the Joint Director, Office of Health
Services, Punjab on behalf of State of Punjab and the Director, Health
Services, Punjab, Chandigarh. It enumerates following steps taken by the
Department to combat the menace of cancer:
1) Govt. has taken effective steps and has signed an
agreement with M/s Max Lifecare for establishing
Greenfield Super Specialty Hospitals at Bathinda and
Mohali. To facilitate setting up of such hospitals,
necessary paper work has been executed and
concessions have been also granted to the operator of
the hospitals, besides appointment of M/s IL&FS IDC
as Project Developers.
2) It was stated that Mobile Medical Unit having
Mammography Unit at Bathinda was not feasible but a
Mammography Unit has been set up at Civil Hospital,
Bathinda and same is currently operational.
3) Through the aegis of Punjab Health System
Corporation, the State Illness Fund Scheme has been
implemented to provide assistance to the below
poverty line families. The beneficiaries also include
persons who, on the basis of survey conducted by the
Department of Panchayati Raj and Rural Development
Civil Writ Petition No. 11425 of 2005 8and State Urban Development Authority under Local
Govt., have been issued Yellow Cards.
4) The State Laboratory has been performing qualitative
testing of potable water and testing kits for the
quantitative testing, of water samples regarding
presence of Arsenic, Copper, Cyanide and Chromium,
were issued. Some of the samples of potable water
had failed and efforts are being made that the potable
water available is within the permissible limits as per IS
– 10500: Drinking Water Specifications 1991.
5) For establishing Regional Cancer Centre at Govt.
Medical College, Amritsar, Govt. of India had
constituted a team of expert Doctors, which opined that
establishment of Regional Cancer Centre at Govt.
Medical College, Amritsar is technically and realistically
possible.
6) That the building for Regional Cancer Centre is under
construction at Guru Nanak Hospital, Amritsar.
Machinery and equipment for the treatment of cancer
patients is in the process of being purchased.
7) That the Brachy Therapy Machine has been installed at
Govt. Medical College, Patiala on 14th December,
2007 and same is functioning properly and
satisfactorily. Furthermore, Govt. of India has released
central assistance to the tune of Rs.2.00 crores for
purchase of simulator and treatment planning system.
Process is on to purchase simulator and treatment
planning system. Furthermore, active steps have been
Civil Writ Petition No. 11425 of 2005 9taken for purchase of Mammography Unit for Medical
College, Patiala.
8) A sum of Rs.47.00 lakhs has been released by PWD
authorities at Faridkot for construction of building of
Radiotherapy Block at Govt. Medical College, Faridkot
and purchase order for procuring Cobalt Unit has been
placed with the supplier.
9) Sri Guru Ram Das Rotary Cancer Hospital, Amritsar
has placed an order for purchase of Cobalt Source to
BRIT (Board of Radiation and Isotope Technology) and
an advance amount has been also sent to the
manufacturer.
10) PGIMER, Chandigarh was recognized as Regional
Cancer Centre in March 2005 by Ministry of Health and
Family Welfare, Govt. of India to cater to UT,
Chandigarh and the State of Punjab.
In the affidavit so filed, it has been further stated that the
Department is conscious of certain deficiencies and requirements for
achieving an ideal set up. It further states that subject to availability of
funds from the Govt. or from National Cancer Control Programme,
necessary facilities will be upgraded and augmented from time to time and
the Department shall continue to work to overcome the deficiencies or
cure the shortcomings for providing service to the cancer patients.
Since, nobody had appeared for the petitioner, Mr.Amit
Jhanjhi was appointed as Amicus Curiae. Mr. Amit Jhanjhi has expressed
satisfaction over the steps taken by the State Government to improve the
necessary medical care to the patients of cancer.
Civil Writ Petition No. 11425 of 2005 10
Mr. Rupinder Khosla appearing for the State has also assured
that the State Govt. is concerned regarding the growing incidents of
incurable disease like cancer and its effects, therefore, from time to time
future action plan and strategies shall be drawn to check the incidents of
cancer disease and provide better medical care to the sufferers of the
disease.
Taking into consideration the steps taken by the Govt. of
Punjab, satisfaction expressed by the Amicus Curiae and assurance given
by the State Counsel, we are of the view that further monitoring by this
Court is not required and the present writ petition can be disposed of with
the direction to the State Govt. to continue with its endeavour to take
preventive measures to contain re-occurrence of cancer disease and
educate and make people at large aware regarding ill effects of over-use
of pesticides. We are conscious of the fact that prevention and remedial
measures are an on-going process. Therefore, as and when the need
arises, this Court can be approached for further directions by filing a
separate writ petition detailing ground realities. The petition is accordingly
disposed of with the above observation leaving the parties to bear their
own costs.
[T. S. THAKUR] [KANWALJIT SINGH AHLUWALIA]
CHIEF JUSTICE JUDGE
July 31, 2009
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