Birbhum has 3 sub-divisions and 19 blocks.

Srl No	Name of the Sub-Division	No of Blocks	Name of Blocks
1	Sadar-Suri	7	1) Suri-I	2) Suri-II	3) Sainthia	4) Rajnagar
			5) Khoyrasole	6) Dubrajpur	7) Md. Bazar	-
2	Bolpur	4	1) Bolpur-Sriniketan	2) Illambazar	3) Nanoor	4) Labpur
3	Rampurhat	8	1) Rampurhat-I	2) Rampurhat-II	3) Nalhati-I	4) Nalhati-II
			5) Mayureswar-I	6) Mayureswar-II	7) Murarai-I	8) Murarai-II

According to an unofficial source there are ‘over 180 illegal stone quarries and 2000 stone crushers are operational in Mohammedbazar, Rampurhat I, Nalhati I and II and Murari blocks that have forced silent displacement of villagers in 142 villages because of excessive pollution, health ailments and the shortage of water.’

A source working for welfare of workers identifies the blocks of Rampurhat I, Mohammadbazar, Nalhati I and Murarai I as the blocks, where most of the quarries and crushers are situated.

Serial	Block	Approximate number of workers engaged in stone quarries and crushers	Approximate number of workers with respiratory symptoms
1	Rampurhat I	14,000	3,000
2	Mohammad bazar	12,000	3,000
3	Nalhati I	5,000	500
4	Murarai I	6,000	400

These numbers include resident as well as migrant workers.

SWASTHYA SHIKSHA NIRMAN proposes:--

1. To undertake the project in Rampurhat I, one of the four blocks. If successful, other agencies governmental or non-governmental can replicate it in other areas.


2. To screen the resident worker-population using BOLD (Burden of Obstructive Lung Disease) Occupational Questionnaire to look for the prevalence of silicosis and other similar lung diseases. It will be a house to house survey. The surveyors will be selected from among the educated youth of the localities.


3. The migrant workers who are usually illegally housed at the crushing plants or in houses near the mines, will be screened at their workplace. These screening will be conducted as surprise visits so that the employers will not be able to hide the workers or replace them with healthy non-workers. The survey team will comprise of outsider volunteers, who could not be influenced by the employers. Labour department officials will accompany and there should be adequate police protection.


4. The screened workers with pneumoconiosis symptoms will undergo radiological chest examination for diagnosis of silicosis or other occupational dust diseases at government diagnostic facilities, preferably Rampurhat Medical College. As there are incidences of private diagnostic centres replacing radiographs of silicosis victims with radiographs of healthy persons, radiographic examination will not be done at private set ups.


5. SNN pulmonologists and radiologists will compare the x-ray films with ILO standard for diagnosis.


6. The list of the diagnosed silicosis victims will be provided to the government for compensation and other benefits.


7. Silicosis patients have very low lung capacity and are unable to do even a little strenuous work. SNN will arrange for their training in various handicrafts. Their products will marketed through government chains.


8. The local youth, initially utilised for survey work, will be trained as health workers, who will look after the needs of the silicosis patients—food, oxygen, OPD treatment, hospitalisation, palliative care etc. and will coordinate with various government departments to meet the needs.

FURTHER PROPOSAL ON DETECTING AND HANDLING SILICOSIS-RELATED ISSUES IN NORTH AND SOUTH 24 PARGANAS

The situation in Birbhum can be considered as a very special one where the crushing units and the overwhelming presence of silica dust are parts of an everyday reality for the temporary labors, working there, as well as the common inhabitants of the area. However, it is likely that the labour force working in these industries are all migrated labours, arriving from different parts of the state and even outside, working for a limited time and then going back to their respective native places with complicated health ailments. Thus, this process must have been going on with an ever changing labour force for decades because none of the workers could spend their whole working lives in these work places. Therefore, it is highly probable that large groups of population have worked in these industries in last couple of decades, went back to their respective homes after losing their identity as industrial labour, but invariably carrying the curse of dust in their bodies. As a result,

1. Doing surveys of the current workforce in these industries will provide only a slice of the total affected population, present there at that very time, and therefore,


2. The survey will invariably have the problem of missing out on thousands of victims (ex-workers) spread over the state.

It can be safely anticipated that neither these forgotten workers nor the available doctors in their respective areas will be able to correlate the health issues and their work history. Moreover, stone industry is not the only source of this deadly disease, as has been clearly presented by your office in the meeting dated September 27, 2019 and consequently shared by Dr. Roy. Brick kilns, construction sector, cement factories, all such industries can potentially give rise to this disease and any comprehensive attempt to fight this disease must include labour forces working in these sectors too.

Therefore, we also propose to carry out surveys in areas where the stone crushing units do not exist in large numbers but the local villagers might have migrated to work in those industries sometime in the past and now having health problems after returning from such places. It will be even more useful if one can survey the population working in the other potential sectors too. Considering these, we also propose to carry out surveys in some blocks of north and south 24 parganas where silicosis has been identified in quite a few cases already and also where a large part of the labor force is involved in brick kilns, cement factories and construction sectors.

While it is difficult to get a realistic measure of the workers working in brick kilns or in construction, an unofficial source indicates a rough number of ex-workers of the stone industries, 35-40% of whom might be suffering from silicosis-related issues while nearly 50 people have already died. A rough estimate is given below on 3 blocks of these two districts.

Serial	District	Block	Approximate number of workers exposed to silica	Approximate number of workers with respiratory symptoms	Number of people died
1	North 24 parganas	Minakhan	250	100	26
2	North 24 parganas	Deganga	70	35	4
3	North 24 parganas	Sandeshkhali I & II	200	30	8
4	North 24 parganas	Canning I & II	100	30	3

SWASTHYA SHIKSHA NIRMAN proposes:--

1. To undertake the project in Deganga, Sandeshkhali I & II, Canning I & II, as part of Minakhan has already been covered by your office and DHS.


2. To screen the resident worker-population using BOLD (Burden of Obstructive Lung Disease) Occupational Questionnaire to look for the prevalence of silicosis and other similar lung diseases. It will be a house to house survey. The surveyors will be selected from among the educated youth of the localities.


3. The screened workers with pneumoconiosis symptoms will undergo radiological chest examination for diagnosis of silicosis or other occupational dust diseases at government diagnostic facilities. As there are incidences of private diagnostic centres replacing radiographs of silicosis victims with radiographs of healthy persons, radiographic examination will not be done at private set ups.


4. SNN pulmonologists and radiologists will compare the x-ray films with ILO standard for diagnosis.


5. The list of the diagnosed silicosis victims will be provided to the government for compensation and other benefits.


6. Silicosis patients have very low lung capacity and are unable to do even a little strenuous work. SNN will arrange for their training in various handicrafts. Their products will marketed through government chains.


7. The local youth, initially utilised for survey work, will be trained as health workers, who will look after the needs of the silicosis patients—food, oxygen, OPD treatment, hospitalisation, palliative care etc. and will coordinate with various government departments to meet the needs.