Teja Rohilla, India — In a dimly lit room in a small village at the western edge of India’s Punjab state, a slight, sinewy man named Govinda sat close to his wife, Usha Rani, as he flipped through a stack of medical records. The couple, in their early 20s, were trying to understand why they still couldn’t conceive a child after four years of marriage. “We get mad sometimes,” Govinda, who goes by one name, said on a warm afternoon in April. “We’ve had lots of tests and spent almost one lakh” — roughly $1,577, an amount higher than their annual income — trying to figure out what went wrong.
In their village of Teja Rohila, a dusty cluster of mud houses and unkempt roads where some 1,600 people live, dozens claim that something strange is plaguing their families. Conceiving and raising healthy children has become more difficult than ever. Many women suffer multiple miscarriages or remain infertile. Others give birth to weak, sick children with physical or mental abnormalities. The source of all this, they allege, is the sour, rust-colored water that began flowing from their hand pumps in recent years.
This problem isn’t exclusive to Teja Rohila. Across Punjab, families are desperately seeking answers to this poorly understood epidemic. Many in Teja Rohila blame the very thing that has made Punjab indispensable to India: its farms, along with the waters that feed them. Long the breadbasket of India, the state and its agricultural economy depend on fresh water. But those same imperatives have pushed farmers to drown the soil in excessive chemicals and pack it with fertilizers to boost crop production. Water from Punjab’s farms and factories, contaminated by chemicals, seeps into the groundwater and rivers and, ultimately, onto the dinner plates of Punjab’s nearly 28 million citizens. Now, a growing body of research supports the link between heavy metals and chemicals in the groundwater and the deteriorating health of some women and children in Punjab.
Across the state, there is ample evidence of health issues — including reproductive health problems, bone disease, cancer, and autism — says J.S. Thakur and his colleagues at the Postgraduate Institute of Medical Education and Research, a public teaching and training facility in the state’s capital, Chandigarh. Drawing on data from the past decade, Thakur’s studies reveal a chain of acute and chronic diseases caused by poor water quality and pollution. In a 2014 report, he found that 65 percent of his sample population of 5,567 people in Punjab living close to five major wastewater drains — areas of major chemical concentration — showed varying degrees of high genetic toxicity, which can make people more vulnerable to certain types of cancer and genetic disorders. The study also found that a high concentration of heavy metals, such as mercury, lead, and arsenic, in contaminated waterways have made people more susceptible to such health hazards. Lead, especially, is linked directly to poor reproductive health in both women and men, as well as developmental issues in infants and children. Arsenic increases the risk of cancer and leads to skin and circulatory system problems.
When we tested water from the hand pumps in Teja Rohila at Sigma Test & Research Centre, an accredited laboratory in New Delhi, it found that the water contained lead, arsenic, and chloride levels above the World Health Organization (WHO)’s permissible standards, with chloride and arsenic levels at more than double the WHO’s maximum permissible limits.
There are multiple potential sources of contamination. For one, farmers often pour three times the necessary amount of pesticides and fertilizers into their soil to boost production, according to a report by Greenpeace. Another source: the unregulated impact of industrial waste from large corporations in Punjab, like Hindustan Unilever and PepsiCo. While companies like PepsiCo have publicizedtheir commitment to replenishing safe water in the area, activists like Umendra Dutt of Kheti Virasat Mission, an environmental nonprofit, said they continue to harm Punjab’s ecosystem. (In response to a request for comment, a PepsiCo spokesperson emailed us a statement that said, “We’ve made significant progress but also recognize this is a journey, and that there’s always more to do,” adding that the company has introduced several measures to replenish water in India and support farmers.)
Researchers say Punjab’s waters are poisoned on a larger scale.
“What we have found is that there is a cocktail of chemicals, which includes heavy metals and pesticides,” said Thakur. That cocktail can damage blood vessels, cause organ failure, and obstruct mental development, according to the WHO. And the outcomes are even worse for women in the affected areas. Why, Thakur wonders, has the Punjabi government failed to recognize the magnitude of the crisis?
Yes, the state government and the World Bank implemented the Punjab Rural Water Supply and Sanitation Project to provide easy access to clean drinking water in 2006. And just this year, the World Bank announced another $248 million project to help the state improve water sanitation and curb open defecation, a widespread problem in India.
But officials say they still lack sufficient evidence to definitively link water contamination and health issues, including those impacting women and their children. “Where there is development, there are diseases,” said Surjit Kumar Jayani, Punjab’s health and family welfare minister, surrounded by his assistants at his home in Chandigarh. While he acknowledged the existence of pollution caused by the state’s industrial growth, he dismissed claims that infertility and development problems are caused by environmental issues, instead choosing to blame lifestyle choices. “How can you get pregnant eating burgers and pizza?” he asked, referencing the pregnancy problems facing women in places like Teja Rohila. “Life is fast and everything is artificial.”
On an April morning in the newest wing of the civil hospital in Kotkapura, a small city in southwest Punjab, a cluster of women crowded into physician Karamjit Kaur’s examination room. Kaur, a gynecologist, treats about 1,000 patients a month. She said more women in the region visit her because of infertility, miscarriages, and menstrual irregularities than when she first started practicing 14 years ago. A host of factors, including diet, lifestyle, and increased access to doctors, could explain this spike in the number of patients and issues diagnosed, Kaur explained. But she also suspected that it is the toxins and chemicals in the environment that are taking the heaviest toll on Punjab’s women. Uterine fibroids — small, sometimes cancerous growths in the uterus — have grown common, Kaur said, increasingly requiring her to prescribe hormonal therapy and perform hysterectomies, a procedure that removes the uterus.
Manpreet Kaur, 23, is one of the afflicted women. Sitting in her courtyard in the lush, sleepy village of Karirwali, about 12 miles from Kotkapura, she recounted how the joy of her first pregnancy turned into despair three years ago when the baby emerged from her womb stillborn, the top of his head missing.
Like most of the roughly 20 affected women in the village with whom we spoke, Kaur blamed the water and listed other families and neighbors grappling with similar struggles. “There are a
Pritpal Singh, a naturopathic physician and director of the Baba Farid Center for Special Children, a children’s hospital in the city of Faridkot in southwest Punjab, agreed. He opened the center in 2003 for families like Kaur’s and says that he has treated more than 1,000 children afflicted by a range of mental and physical disorders. Singh said that fertilizers are clearly leaching heavy metals into the groundwater, but because the government doesn’t want to pick a fight with industries in Punjab, it doesn’t take the problem seriously.
In 2010, the Baba Farid Center collected hair and urine samples from 149 children for a study that, for the first time, verified claims that long-term exposure to toxic heavy metals in Punjab could damage blood vessels or cause cancer or lung damage, depending on the metal. In almost every subject tested, Singh’s team discovered traces of barium, cadmium, manganese, lead, and uranium — all of which can cause serious illness and organ damage when ingested — at high levels.
To analyze its samples, the Baba Farid Center sends them to Micro Trace Minerals, a German laboratory specializing in heavy-metal diagnostics; a compilation of medical reports provided to us from the lab supports Singh’s findings. According to analyses by Micro Trace Minerals conducted between 2008 and 2009, the traces of some metals among a few children were more than five times the acceptable range.
Despite the evidence compiled by Singh, Thakur, and others, not everyone agrees on the source or scale of the problem. Devinder Mehta, chair of Panjab University’s physics department, harshly criticized claims that Punjab’s water is dangerously contaminated. He insisted that industrial runoff and pesticides hardly contribute to groundwater contamination. Instead, he cited waterlogging — the natural trapping of water flow — as the main cause. In a collaborative draft report, Mehta and his team ruled out the possibility that certain chemicals in the water, including uranium, were at the root of the problem. He said bacterial contamination and sanitation pose far greater threats. “The hype is beyond imagination,” Mehta said. “Everyone is [talking] about heavy metals. Why not bacteria?”
And Chander Aggarwal, an engineer with the state’s Water Supply and Sanitation Department in Faridkot, agreed with Mehta and Jayani, the health minister, that the problem is not man-made. Walking through a water-treatment facility — a small, grassy field dotted with large water wells — he demonstrated the process of purifying canal water. State officials use on-site bacteriological kits to regularly check for any impurities and send water samples to a government laboratory every two months to test for chemical contamination. “During the course of life, rivers change their direction, and the impurities are coming from underground layers,” he said. He argued that the contamination is just a natural phenomenon and pointed out that the state is using its resources to provide clean drinking water to its people. “Contamination from industries is not so much. The government is … careful. People should also be careful to use this precious water.”
But these denials ignore a growing body of evidence from around the world that supports the link between the chemical content of water and poor maternal and child health outcomes. A 2014 study by researchers from the University of California, Davis, found that a pregnant woman’s exposure to agricultural pesticides disrupts childhood neurodevelopment and increases the risk of autism. Additional reproductive health research has repeatedly shown that many chemicals in pesticides and fertilizers cause miscarriages, reduce fertility, and lead to premature birth. A 2009 study by Greenpeace also suggested a strong link between groundwater contamination and excessive use of chemical fertilizers in India.
For now, the people of Teja Rohila and others across Punjab are stuck. They don’t feel protected against the deteriorating environment around them. And couples like Govinda and Usha Rani are still seeking a solution, as they desperately clutch to their dream of starting a family.
“We don’t know why it happened [to us],” Govinda said. Added Usha Rani: “Right now, we are only hoping for a miracle from God.”
Reporting for this story was supported by a South Asian Journalists Association fellowship.