INTERNATIONAL MEDICAL COMMISSION
Health care fails Bhopal victims
(Whin - Winter 1996/97)

  The Report consists of two documents:
1. A reprint of the background paper and of the Epidemiological Study, New Delhi, containing a background paper and the Epidemiological Study.
2. A special issue of "International Perspectives in Public Health", containing reports on the medical delivery system, drug usage, impacts on women and children, neurotoxicological effects of the exposure and compensation of the Bhopal victims.
  The IMBC would like to highlight the following main findings related to each of determinants of health, namely medical care, social conditions and economic status as found in Bhopal in 1994:

Medical care: In addition to the widely recognized damage that the Union Carbide gases did to lungs and eyes, the IMCB has identified likely neurotoxicological damage, and evident post traumatic stress syndrome.
  The IMCB calls on the Government of India to recognise all of these problems as part of partial or total disabilities, very likely due to the Union Carbide gas exposure. It is likely permanent, having persisted for more than ten years.
  The IMCB estimates that as many as 50,000 survivors may be still suffering from partial or total disability as a consequence of the Bhopal disaster Medical care oriented towards managing chronic pain and disability could assist survivors on maximizing their remaining health and renewing their will to live.
  The IMCB calls on the Government of India to adopt Bhopal as a priority for the implementation of its stated policy of community based health service.
  This is urgently needed by the chronically ill survivors and would contribute to doctor-patient communication, treatment continuity, relevance and effective care. Community participation in management of these Community Health Centres would aid in restoring a sense of control and provide survivors with effective feedback opportunities.
  These Community Health Centres should keep complete patient records, and be charged with the development of rational treatment and rehabilitation protocols for the various gas related disabilities.
  Continued monitoring of reproductive effects, cancers and other adverse outcomes which may have long latency periods is essential.

In conclusion: Although the immediate disaster response of the medical community in Bhopal was heroic, the chronic medical, economic and social needs of survivors are not now adequately addressed. The IMCB urges the Government of India to establish an Indian Medical Commission - Bhopal to oversee ongoing needs and care of the survivors, and to recommend appropriate interventions on behalf of the survivors and their offspring.

(Bhopal, a Tragic Model of an Industrially Induced Epidemic MCB Summari Sratement, December 1996)