A woman is traveling with her family of six to be tested for cancer. A husband and wife are taking their teenage daughter for her third chemotherapy session. A man accompanies his wife to learn whether she has suffered a relapse in the past six months.
The patients travel from the fertile farming areas of the northern state of Punjab, a region that reports an alarmingly high use of pesticides. The train has become a magnet for cancer campaigners and groups fighting for laws to restrict the use of pesticides, and has been featured on posters and in promotional videos and publicized at international conferences.
In the past five years, the number of patients on the train has continued to grow, sending a wake-up call to the government.
Last month, Punjab’s government launched its first door-to-door cancer census across the state to determine the number of people who have cancer or cancerlike symptoms. The public hospital to which the train ferries patients — in Bikaner, in the neighboring state of Rajasthan — reports 1,000 more cancer patients a year, on average, according to chief oncologist Ajay Sharma. But officials acknowledge that the reports on cancer in Punjab are mostly anecdotal.
“To tackle this head-on, we now need to get a sense of the scale of the problem,” said Baldev Singh Sahota, the senior medical officer in the health department in Malwa, a cotton-growing region in Punjab where pesticides have been used heavily to battle a bollworm infestation.
India’s Green Revolution of the 1960s and ’70s — introduced with American help to promote modern farming methods using high-yield varieties of seeds, chemical fertilizers and pesticides — was meant to fight hunger and increase productivity. But over the years, that model has become medically and environmentally unsustainable, according to many anti-pesticide campaigners, who advocate organic farming and tougher laws.
A 2008 study found a possible link between pesticide use and reports of high cancer rates in Punjab’s rural agricultural communities. Another big medical study is underway to ascertain the cause of the upsurge.
On the train, almost everyone — patients and regular passengers alike — agrees there is little doubt that pesticides are mainly to blame. But they say they cannot afford to stop using them.
“I spray pesticides 10 times in three months on my cotton crop, every week on the vegetables and a couple of times on the wheat crop,” said Baldev Singh, a 63-year-old turbaned farmer. “I am told there is a link between pesticides and cancer. But it increases productivity.”
Singh’s wife, Jasveer, is a cancer patient.
“It is all because of poisoned water and my destiny,” she said.