It's been 18 years since a gas leak from a Union Carbide plant in Bhopal, India, killed 16,000 people. But the disaster continues to claim lives every day. According to official reports, half a million local people exposed to the toxic gases have poison still circulating in their bloodstreams. And many of them have come to rely upon a small, holistic clinic not far from the shuttered Union Carbide plant for help and hope.
The Sambhavna Clinic sees as many as 110 people a day suffering from internal organ damage, vision problems, shortness of breath, persistent coughs, menstrual irregularities, fatigue, depression, anxiety, and a host of other painful disorders. "Right from the beginning it was very obvious that modern medicine wasn't working for all the health problems [of the Bhopal disaster]," says Sathyu Sarangi, an engineer turned activist who helped found the clinic six years ago and currently serves as its managing trustee.
He launched the clinic with the belief that Indian officials, anxious to downplay the disaster out of fear of "jeopardizing the investment climate," were not paying attention to side effects of the gas leak-tuberculosis, cancer, reproductive problems-showing up in survivors.
Sambhavna, which means "possibility" in Hindi, is housed in a two-story building that doesn't look like a hospital or a clinic. Potted flowering plants decorate the rooftop terraces. Fruit trees with benches underneath surround the grounds. Patients practice yoga on a terrace with walls decorated by the paintings of children. Inside, the clinic bears even less resemblance to conventional medical centers. The familiar odor of biocidal synthetic cleansers is absent; the clinic uses only plain water for cleaning. There are two rooms for ayurvedic massage and a library where information related to the gas accident is readily available.
In another room, staff members prepare more than 60 ayurvedic medicines, using herbal ingredients formulated according to this ancient Indian healing tradition. There are three cubicles for doctors, a computer room, a pathology laboratory, and a facility for regular cervical screening, Pap smears, and treatments for cervical cancer. Sambhavna is the only facility in the city to conduct regular Pap smears.
The clinic has survived mainly through appeals for donations in national and international newspapers. An international advisory group provides professional support to the clinic and serves as a link for fund-raising in other countries. Many of the staff also donate their services. After finishing her residency in community and family practice, Dr. Jaysi Chander spent six months volunteering at the clinic. "One of the most memorable and poignant moments for me," she says, "was when an elderly Muslim widow living in a slum in Bhopal offered a garland of flowers to me as a sign of her appreciation for the medical care I had offered her. She prayed for my good health and I for hers."
In addition to alternative therapies, the clinic practices an alternative form of organization. Instead of a traditional staff hierarchy, the clinic functions on a collective-management model. Each of the 25 staff members has equal input regarding decisions and equal responsibility for implementing them. The ratio of the maximum salary ($185 per month) to the minimum salary ($57) is barely more than three to one. Almost half of the staff are survivors of the accident.
Gary Cohen, co-coordinator of the U.S.-based Health Care Without Harm, a group that works to reform environmental practices in the health care industry, finds inspiration in Sambhavna. Cohen, who has worked with Union Carbide gas leak victims for years, says, "This clinic really represents the triumph of memory over forgetfulness. There's a profound way that both Union Carbide and the Indian government want to erase the memory of Bhopal, because it's an uncomfortable embodiment of the worst abuses of globalization. The clinic is a powerful symbol of people being empowered to defend and heal themselves."
The clinic conducts health surveys and continues to monitor deaths related to the gas exposure. Researchers use a questionnaire to conduct "verbal autopsies," interviewing a family member of the deceased to determine whether he or she died as a result of the Union Carbide leak.
"By all accounts, the poisoned night of December '84 is far from over in Bhopal," Sarangi says. "I am happy that, along with the survivors, we at Sambhavna refuse to go silently into this night. We have lit a lamp and continue to curse the darkness."
Emily Polk is associate editor of Whole Earth magazine. Reprinted from Whole Earth (Spring 2002). Subscriptions: $24/yr. (4 issues) from Box 3000, Denville, NJ 07834. Sambhavna Clinic, 44 Sant Kanwar Ram Nagar, Berasia Road, Bhopal, India 462018;