Workers of Gujarat’s agate industry continue to inhale silica dust – and dying painful deaths. But there has been little action from the government to assess their health or working environments.

Crafted agate stonework is often Prime Minister Narendra Modi’s first choice for gifts to visiting dignitaries. The craft has received geographical indication tag. But there is little attention to the workers who make these. More precisely, their working conditions and occupational health risks.

Workers say that chipping, grinding and polishing agate and other stones to carve out ornaments and craft-work leaves their bodies scathed. There are several studies referring to deaths due to Silicosis, SilicoTB and tuberculosis among people engaged in the craft.

For instance, a study by the Lucknow-based Industrial Toxicology Research Centre in the eighties points to the high prevalence of chronic lung diseases among agate workers. The study pointed out that health problems start with the workers are still young. But nothing was done. The study even documented that young people and children working near the agate units were suffering from silicosis and Silico-TB.

A series of epidemiological and environmental studies done by the National Institute of Occupational Health (NIOH) in the following years too pointed to the high prevalence of lung diseases.

Stonehearted

But there is little action on the ground and the bureaucratic ways of the government only consider agate good to gift – never looking at the lives of the people behind an artwork.

A 2007 analysis by the Peoples Training and Research Centre (PRTC), a Gujarat-based NGO working among workers in the agate industry showed that every extra year of exposure the odds of getting silicosis increased by about 12 per cent.

The government’s own studies over a decade ago, nor the studies on-ground organisations like PRTC have moved planners to act. Business and industry claim that the lung diseases are a thing of the past because, they say, the process of wet grinding introduced a decade ago has ensured that silica is not available to inhale.

This argument proffered by business has found buyers among those framing policies – not bothering to enquire why silicosis, tuberculosis and silico-tuberculosis remain rampant, with even young children who have interacted with the environment in recent years.

Officials in Gujarat have sided with business, insisting that the problem has been resolved, without even studying to document the status of the problem after the introduction of the wet grinding process.

“Little is done to study and address the high prevalence of tuberculosis and silicosis among agate polishers in Khambhat, Gujarat. Silicosis, particularly, is a matter of concern say experts, because the particles of silica dust that causes it, slowly and painfully suffocates its host to death,” says Jagdish Patel, who founded of PRTC to work among silicosis-afflicted craftspersons in the agate industry, pointing to the stonehearted apathy in corridors of power.

“It is double-whammy when silicosis combines with tuberculosis, because the individual’s health is too weak to resist an infection,” Patel says on the apathy towards the health needs of the workers.

Unanswered letters

Efforts by NIOH and NGOs to reduce silica levels at work in last decade has reached the National Human Rights Commission (NHRC) that even published recommendations on preventive, remedial, rehabilitative and compensation aspect of Silicosis over a decade ago. In 2017, the NHRC had recommended the government of Gujarat to frame a policy for rehabilitation of silicosis patients. It is five years now, but no action has yet to be taken.

But little has come to fruition – except for the revised National TB Control Programme (RNTCP) recognising silicosis as risk factor for TB and the health and labour ministries developing a framework to address TB and related co-morbidities in the world of work in India in April 2019.

These too has not been followed up.

Patel’s own letters on the matter, written to authorities in the Indian Council of Medical Research (ICMR) remain unanswered. “There is clear link between TB and silica exposure. Universal screening for TB in this community on a regular basis has not been done by anyone,” Patel wrote in his letter in February 2021, impressing on the need for systematic surveillance study.

“it will be prudent to take up a silicosis and TB prevalence study in Khambhat through NIOH in collaboration with the RNTCP to assess the current situation and help plan for further improvement,” he wrote.

Eighteen years since the last NIOH study, the organisation has not followed up on the situation of occupational health in the agate industry. Experts and activists say a study will help make an informed decision and guide strategies not only to end TB but also to achieve UN SDG 8.8.