Pyari Bai was 16 when she got married, just a year before the December 3, 1984 Bhopal gas disaster. She was in the first trimester of her first pregnancy when the highly toxic MIC (methyl isocyanate) gas leaked into the city's air on that fateful night. She miscarried as she fled from the exposed areas with her husband. Since then, her menstruation has stopped and she has been unable to conceive. In addition, she suffers from other symptoms of gas exposure such as breathlessness on slight exertion, diminished vision and panic attacks. Today she is 37. In medical terms, Payari's condition is called premature menopause.
Noorjahan Begum, a resident of Annu Nagar, used to live in Kazi Camp, one of the worst affected areas. She was 13 when she got married; and for many years after gas exposure, she could not conceive. Noorjahan finally conceived and gave birth to a baby girl in 1998. "The girl was born after so many years, even though we did not take any precautions," she says. However, ever since 1984, she has had an irregular menstrual cycle and the problem of white discharge.
Twenty years after the gas disaster, menstrual abnormalities, vaginal discharge and premature menopause have emerged as common problems among gas-hit women and their children. Besides affecting the reproductive health of the women, these conditions are also leading to social problems in conservative communities.
The Indian Council of Medical Research (ICMR), in its final technical report published in November 2004 on medical studies in Bhopal from 1984 to 1994, has reported high abortion rates in the initial years after the disaster. The ICMR studies (in the initial years) identified elevated menstrual irregularities and excessive bleeding among gas exposed residents. This pattern has been attributed to "post-disaster trauma", a fairly normal occurrence in the aftermath of any natural or man-made disaster. But as it turned out, several of these women had episodes of abortions later on, and many could not conceive at all.
Since 1994, when ICMR stopped its research, there has been no scientific follow-up nor any study on the long-term impact of MIC on the reproductive tracts of women and men. Gynecological disorders are not even listed among effects of MIC exposure in official records. The Bhopal Memorial Hospital and Research Centre (BMHRC) does not have a gynecology department at all, because, it says there is a separate government hospital for women.
Information gleaned from a clinic run by a local NGO, Sambhavna Trust, tells an alarming story. Data collected from patients attending this clinic shows that girls who were exposed to the gas as tiny tots are today facing menstrual problems. "When my periods started, they were regular for three to four months but then they stopped for four months. So I took some pills and got my periods. But over the last year, my problem is getting worse. I had my periods once in five months. For the last seven months I have not had my periods at all. I have been taking medicines but there is no improvement," said an 18-year old girl in a testimony recorded by health workers of the clinic. The girl had begun menstruating at 12.
Dr Devender Kaur is the gynecologist in charge at the Sambhavna clinic. She says that although adolescent girls are reaching menarche at the right age, they soon come with problems like delayed periods, excessive bleeding, secondary menarche (re-start of period), and even leucorrhea.
"They don't want to get tested. But they get relief with symptomatic treatment. They have constipation also, which is another cause for leucorrhea. Among married women, premature menopause (before 35) is seen in large number of cases," says Dr Kaur. "This is very early. There are some who have not had periods for 10-12 years. And then they have irregular periods."
While damages caused to the respiratory, ocular, gastro-intestinal, neurological and musculo-skeletal systems have been documented in studies by ICMR and others, the reproductive health consequences of the disaster have been paid no official attention at all, says Satinath Sarangi, of the Bhopal Group for Information and Action. "Generations of women were affected by the gas (MIC). Among women who were pregnant at the time of the disaster, 43 per cent aborted. For several years, spontaneous abortion rates remained very high. And now girls who were exposed in infancy and in their mother's wombs are experiencing 'menstrual chaos'."
In response to the demands of several organizations which are working with the survivors of the disaster, the Supreme Court has appointed an advisory committee, to be headed by the director general of ICMR, to recommend appropriate follow-up research. The panel will also recommend the structure and content of the research on long-term health consequences of toxic exposure including its effect on children born to exposed parents after the disaster.
Meanwhile, many of the MIC-affected women are facing social problems within their communities. Rehana of JP Nagar, for instance, has three daughters and a son. She says her 18-year-old daughter has menses problems. "Men prefer not to marry a girl from a gas-hit family, because they feel that these girls can not produce children. Even if they marry such girls, they leave them after some time."
As a pattern, marriages are being arranged within the MIC affected families. And women don't want to talk about this problem, because if they do, they are likely to face bigger problems. Says Aziza, a health worker attached to the Sambhavana Clinic, "There are cases of such girls getting married, and of being divorced soon after. One girl was divorced after she gave birth to two children, because of irregular menses. So now, the girls are more cautious."