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Man who supervised early autopsies dying of after-effects

Man who supervised early autopsies dying of after-effects
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First Published: Wed, Dec 02 2009. 01 15 AM IST

Updated: Wed, Dec 02 2009. 10 49 AM IST
New Delhi: It was once a tenacious and singular voice, of a man who directed several of the early autopsies at Bhopal after the gas leak, insisting that hydrogen cyanide—and not methyl isocyanite alone—contributed to the mass poisoning. Now, it is, at best, a faint concatenation of intelligible gasps.
S. Sriramachari’s condition, his doctors and family say, was brought about by constant exposure—via the autopsies he performed—to thechemical cocktail of over 21 as-yet-unidentified compounds from the plant, and to the polluted air of Bhopal over the years. He suffers from chronic obstructive pulmonary disease, an incurable lung condition that is characterized by deformed air sacs and thickened air walls that makes breathing strenuous. In extreme cases, patients are dependent on oxygen cylinders to survive.
Click here to watch a slideshow depicting current day Bhopal
Sriramachari, 84, former director at the Institute of Pathology, an Indian Council of Medical Research (ICMR) laboratory, was part of the Centrally deputed ICMR team to study the health effects—short and long term—of the leakage of noxious gases from Union Carbide India Ltd’s factory on the early morning of 3 December 1984 that, according to official records, claimed around 3,000 lives.
Sriramachari, currently admitted to the Vallabhbhai Patel Chest Institute (VPCI) in the Capital, is in the intensive care unit. On his bedside table is a blue folder that contains several research papers connected to the Bhopal gas leak.
They outline Sriramachari’s case histories of the first patients who immediately died of the poisoning, and diagrams and pictures of a variety of cell tissue to support his hydrogen cyanide hypothesis.
Union Carbide had said there was no evidence of cyanide poisoning and ICMR itself is divided on the issue. Unlike methyl isocynate, whose toxic effects weren’t well understood, hydrogen cyanide’s were relatively better known. Proving it’s existence could have increased Union Carbide’s legal liability.
“Cyanide poisoning would have invited multi-million dollar suits to the company. That’s because poisoning that way has established legal precedent and puts further questions on the safety arrangements at the plant,” said Mayur Nanavati, a Madras high court lawyer.
“The cherry coloured organs...pink blood...the successful sodium thiosulphate intervention...was all key proof,” said Sriramachari. Sodium thiosulphate was the antidote administered to critically ill patients.
“That most of the patients responded well to the antidote was clinching proof of cyanide poisoning. But most of the reports as well as the medical evidence was largely suppressed,” said S. Sandhyamani, a senior doctor at the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, and Sriramachari’s daughter.
Paying a price: Sriramachari at the Vallabhbhai Patel Chest Institute. Ramesh Pathania/Mint
None of the ICMR study reports were made public until 1994, after which most of the studies on the long-term effects came to a close.
To date, it hasn’t been conclusively established if the gases released have had long-term health as well as environmental impacts.
“There was an opportunity to study long-term damage, but it was wasted,” said V.K. Vijayan, director of VPCI, who was also part of the ICMR team that studied pulmonary changes in the victims as well as residents in the vicinity.
Follow-up studies by Vijayan, five years after the leak, showed there was consistent damage characterized by unusually large quantities of white blood cells such as macrophages and neutrophils. Heightened presence of these cells points to long-term cell damage within the lungs and signs of respiratory problems.
“Typically, these are conditions seen in smokers...those who smoke a pack a day over many years,” said Vijayan. “Not only did we find these in non-smokers in Bhopal, but tragically, Sriramachari’s lungs are just like those of a long-term, heavy smoker.”
His daughter says he was a casual smoker in the early 70s, but quit at least 30 years ago.
Heeresh Chandra, a professor and colleague of Sriramachari at Bhopal, was in charge of most of the autopsies that came to the medical colleges. “731 of them”, reminisces Sriramachari. Chandra, too, contracted severe respiratory problems and died in 2002.
“The autopsies were conducted with doctors wearing little more than surgeon’s masks. These were highly toxic chemicals and I’ve heard gases simply spewed out of them during autopsies,” said Vijayan.
Sriramachari doesn’t begrudge the cost, though, because he is convinced he has done enough. “It’s been proved (the presence of cyanide),” he said.
“I just did my duty.”
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First Published: Wed, Dec 02 2009. 01 15 AM IST