Mystery illness and unexplained deaths are becoming common in India. Cases such as the litchi-linked child deaths in Muzaffarpur, Bihar, and the pesticide poisoning incidents in Yavatmal, Maharashtra, are just a few examples. Sudden deaths in recent years, often attributed to heart attacks, also fall into this category. How can this be the case when medical science, diagnostics and laboratory capacities have significantly advanced? Yet, rather than solving these mysteries, they seem to be growing. The exact causes remain unknown, largely because no post-mortem examinations are conducted, nor are detailed medical histories compiled to establish patterns or underlying reasons. In India, authorities struggle to establish clear diagnoses for illnesses. Diagnostic approaches are frequently hindered by negligence, corruption and systemic inefficiencies. Moreover, the correlation between environmental factors and illnesses is rarely explored. Shockingly, doctors often present assumptions as scientific facts.
There is also a noticeable disregard for rural populations affected by pesticide poisoning and other chemical exposures, with their ailments being dismissed as results of unhygienic conditions, genetic predispositions or lifestyle choices like tobacco and alcohol consumption. The teratogenic (birth defect-causing) effects of chemical exposure are not thoroughly investigated. Instead, they are dismissed as rare occurrences. India’s medical establishment is ill-equipped to assess the genotoxic, oral toxic and teratotoxic impacts of the increasing chemicalisation of our food, water and air. Recent incidents, such as the unexplained deaths in a village of Rajouri district in Jammu and Kashmir and the rise in Guillain-Barré Syndrome cases in Pune, follow the same pattern of ambiguity. In Rajouri, pesticide poisoning was suspected only through deductive reasoning—survivors showed improvement after being administered atropine, an antidote for certain toxic exposures. The source of contamination remains unidentified.
Pesticide poisoning is emerging as a significant cause of illness and death in rural areas, as pesticide use continues to rise and intensify. Even doctors lack proper knowledge about pesticides, their properties and hazards. Primary health centres in India, especially in regions with intensive pesticide use, are among the least equipped in terms of knowledge, diagnostic tools and treatment protocols.
The ongoing incidents in Rajouri and Pune should serve as a wake-up call. The government must establish a cross-disciplinary consortium of doctors and scientists dedicated to investigating and solving India’s most perplexing medical cases—at no cost to patients. This effort should combine traditional medical expertise with cutting-edge diagnostic tools. Moreover, India must actively encourage epidemiological research to better understand the links between environmental exposures and health outcomes.
(Narasimha Reddy Donthi is a public policy expert and consultant at the Pesticide Action Network India and a visiting faculty (honorary) at Delhi-based Impact and Policy Research Institute)
This was first published in the 16-28 February, 2025 print edition of Down To Earth