The most apt description of Bhopal on the early morning of 3rd December 1984 came from one by Dr. Ivor Doney who likened the tragedy to “Pompeii suddenly engulfed in the dust of Vesuvius, or Hiroshima when the atom bomb was dropped”.

Had Union Carbide Company (UCC) taken the usual precaution of storing MIC in small batches or lots and not in huge 400 ton tanks, the tragedy would have been far less and easier handled. Alas, this was not to be. Cost-cutting led to people –cutting. In very little time poisonous gases killed hundreds of people and maimed thousand in the coming months.

It was during these conditions that a team of scientist and engineers, led by Dr. S. Varadarajan, determined what all could have happened during the leak, and cleared the second tank of MIC safely, thus avoiding Bhopal 2. A heroic achievement indeed!

What was happening to the people whom MIC and its resultant chemicals poisoned? What treatment, if any, could be given to them? It in this other part, a wrenchingly human part, of the tragedy that we found two other heroes in dedicated action, the late Drs. Samavedam Sriramachari and Heeresh Chandra.

How well they handled the patients under these tragic conditions, against the disinformation and obfuscation perpetrated by Union Carbide, is best described again by Dr. Doney: “The story should be told at some future international forensic meeting, again, again and again”.

It is this story that we briefly recount here. I urge the readers to access Dr. Sriramachari’s paper on this in the 10 April 2004 issue of Current Science, and his interview by Sujata Varadarajan in the March 2008 issue of Resonance, both available free on the web.

Dr. Heeresh Chandra and associates did over 200 autopsies on the bodies of the dead, in a matter of days, in order to determine what actually caused the death. The lungs, food pipe and upper respiratory track were “cherry red discoloured”. The eyes too were affected, but in a while, they cleared with no damage.

It was these eyes that led UCC to declare that MIC is broken down upon contact with wet surfaces into harmless chemicals, and that MIC does not cross the lung capillary barrier to the bloodstream. False! Then why the cherry red colour?

One theory was that perhaps it was due to poisoning by cyanide, a product of MIC decomposition. Dr. Max Daunderer of Germany, who thought so too, came over with the suggestion of administering sodium thiosulfate (NaTS) as antidote. But here again, UCC seems to have had him bundled out of India. But Heeresh Chandra persisted with the treatment with mixed results.

It was at this stage that Sriramachari rushed into Bhopal on behalf of the Indian Council of Medical Research (ICMR). He decided to check the levels of thiocyanate (product of cyanide and NaTS) in the urines of patients, and autopsy bodies. This required contracting and working with people in Delhi. How does one do so from Bhopal?

Recall 1984 was the pre-cell phone, pre- broadband, pre-laptop era. Bur the ever-enterprising Dr. Varadarajan had set up a ‘wireless station’ near UCC for quick information exchange. Professor A. Ramaiah and Roman Reddy of AIIMS in Delhi did the test and confirmed thiocyanates. So, giving NaTS was not a bad idea, it at least helped many people and caused no harm to others.

Sriramachari persisted with the pathological analysis of blood, lungs, kidneys, liver, and heart of the patients and deduced what all could have happened when MIC affected the human body. Animal experiments involving rats were done to help in the matter. He found elevated levels of the compound called 2,3–DPG, indicative of the body reaching to less than required levels of oxygen.

That meant the haemoglobin was affected. Experiments then showed molecular changes in haemoglobin upon reaction with various products of MIC. In addition to haemoglobin, they appear to disable the enzyme cytochrome oxidase (which helps in producing ATP, the energy currency in cells) and the molecule glutathione (which helps cells running smoothly).

Reading his interview in Resonance and article in Current Science, one is struck by Sriramachari’s thoroughness of approach, logical argument and the fact that he was open to alternate ideas, and willing to test them in dispassionate, unbiased manner. A gentleman to the core, I had never seen him angry. He was the very best contemporary pathologist we have had. As the Sanskrit saying goes “Vidya Dadati Vinayam, Vinayam Dadati Patratam”.

Until his passing away earlier this year, he was still sifting through the records and data. He has suggested that the story is not yet over and that we should study the survivors and next of kin for two generations, and look for any genetic abnormalities. Did MIC affect the genes? An important suggestion, and we hope that this project is taken up.

Sadly though, efforts by Drs Anil Sadgopal and Sujit Das of the Drug Action Forum, a public-spirited NGO, appointed by the Supreme Court in 1989 to make recommendations regarding medical relief and rehabilitation of the gas victims, are being slowed down by inaction (The Times of India, 21-7-2010). UCC adopted the policy of suppressio vary, suggestio falsi (suppress the truth, suggest falsehood), but why should the government dilly- dally? One hopes it will help, at least now after a quarter century.

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