Fractured/Earth

Reportage on a planet without equitable or sustainable development.

Cancer has exploded in Bihar as lakhs of people drink water poisoned with arsenic

It is a day like any other at Mahavir Cancer Sansthan.

The driveway is lined with people who have travelled a long way to get to this charitable hospital in Patna. Families sit huddled, holding their bags close. The lobby is even more crowded, rather like the ticket buying hall of a train station.  The hospital gets between 60 and 100 patients every day – a substantial number for a 400-bed hospital. Ashok Ghosh, who heads research at the hospital, said that the load is such that “surgery has a two-month waiting list even though the disease might become inoperable by then”.

On the morning this reporter met him, Ghosh made a wry comment about the rush, asking: “When you entered this hospital, did this look like a cancer hospital or a general hospital?”

One reason this hospital is receiving so many patients is the dismal state of public healthcare in Bihar. Government hospitals are understaffed and poorly equipped. While the state has seen a jump in the number of private hospitals, most of them are too expensive for middle income and poor families in the state. Most of them, Ghosh said, end up coming to Mahavir Cancer Sansthan.

But lack of affordable care is not the only reason. Tata Memorial Hospital in Mumbai, one of the best cancer treatment facilities in India, gets about 25,000 patients every year from around the country. In contrast, Mahavir Cancer Sansthan gets nearly as many at about 22,000 patients last year despite drawing patients from just Bihar, Uttar Pradesh and Nepal. Many of these patients suffer from cancers of the gall bladder or liver, both which are associated with arsenic toxicity.

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m rajshekhar

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I am an Indian journalist with interests in energy, environment, climate and India’s ongoing slide into right-wing authoritarianism. My book, Despite the State, an examination of pervasive state failure and democratic decay in India, was published by Westland Publications, India, in January 2021. My work has won the Bala Kailasam Memorial Award; the Ramnath Goenka Excellence in Journalism Award; five Shriram Awards for Excellence in Financial Journalism; and, more recently, been a finalist at the True Story Award and GIJN’s Global Shining Light Awards. Write to me at despitethestate@protonmail.com.

Reviews

“…une plongée dans les failles béantes de la démocratie indienne, un compte rendu implacable du dysfonctionnement des Etats fédérés, minés par la corruption, le clientélisme, le culte de la personnalité des élus et le capitalisme de connivence. (…a dive into the gaping holes in Indian democracy, a relentless account of the dysfunction of the federated states, undermined by corruption, clientelism, the cult of the personality of elected officials and crony capitalism).” Le Monde

“…a critical enquiry into why representative government in India is flagging.” Biblio

“…strives for an understanding of the factors that enable governments and political parties to function in a way that is seemingly hostile to the interests of the very public they have been elected to serve, a gross anomaly in an electoral democracy.” Scroll.in

“M. Rajshekhar’s deeply researched book… holds a mirror to Indian democracy, and finds several cracks.” The Hindu

“…excels at connecting the local to the national.” Open

“…refreshingly new writing on the play between India’s dysfunctional democracy and its development challenges…” Seminar

“A patient mapping and thorough analysis of the Indian system’s horrific flaws…” Business Standard (Image here)

“33 മാസം, 6 സംസ്ഥാനങ്ങൾ, 120 റിപ്പോർട്ടുകൾ: ജനാധിപത്യം തേടി മഹത്തായ ഇന്ത്യൻ യാത്ര… (33 months, 6 states, 120 reports: Great Indian journey in search of democracy…)” Malayala Manorama

“Hindustan ki maujooda siyasi wa maaashi soorat e hal.” QindeelOnline

“What emerges is the image of a state that is extractive, dominant, casteist and clientelist.” Tribune

“…reporting at its best. The picture that emerges is of a democracy that has been hijacked by vested interests, interested only in power and pelf.” Moneycontrol.com

Book lists

“Ten best non-fiction books of the year“, The Hindu.

“Twenty-One Notable Books From 2021“, The Wire.

“What has South Asia been reading: 2021 edition“, Himal Southasian

Interviews

“Journalism is a social enterprise…,” Booksfirst.in.

“Democratic decay at state level: Journalist M Rajshekhar on book ‘Despite the State’,” The News Minute.

“Covid-19 en Inde : “des décès de masse” dont un “État obscurantiste est responsable,” Asialyst.

Allusions/Mentions

“JP to BJP: The Unanswered Questions“.
Mahtab Alam’s review of “JP to BJP: Bihar After Lalu and Nitish”.

“Urban History of Atmospheric Modernity in Colonial India“. Mohammad Sajjad’s review of “Dust and Smoke: Air Pollution and Colonial Urbanism, India, c1860-c1940”.

“Westland closure: Titles that are selling fast and a few personal recommendations,” by Chetana Divya Vasudev, Moneycontrol. (Because this happened too. In February, a year after DtS was released, Amazon decided to shutter Westland, which published the book. The announcement saw folks rushing to buy copies of Westland books before stocks run out.)

“Time to change tack on counterinsurgency” by TK Arun, The Federal.

“All Things Policy: The Challenges of Governing States” by Suman Joshi and Sarthak Pradhan, Takshashila Institute (podcast).

“The Future of Entertainment“, Kaveree Bamzai in Open.

“On What India’s Watching“, Prathyush Parasuraman on Substack.

“The puppeteers around us“, Karthik Venkatesh in Deccan Herald.

“Will TN election manifestos continue ‘populist’ welfare schemes?“, Anna Isaac for The News Minute.

“Why wages-for-housework won’t help women“, V Geetha in Indian Express.

“The poor state of the Indian state“, Arun Maira in The Hindu.

Book discussions

14 April, 2024: The costs of political corruption, Bangalore International Centre.

27 May, 2023: Safe Spaces/Why Indians live despite the state. TEDx Bangalore.

12 November, 2022: Stop Loss: Overcoming the systemic failures of the Indian State. Tata Literature Festival, Mumbai.

26 December, 2021: Rangashankara, Bangalore, a discussion with Dhanya Rajendran.

16 November: Rachna Books, Gangtok, a discussion with Pema Wangchuk.

29 August: Books In The Time of Chaos, with Ujwal Kumar.

21 May: Hyderabad Lit Fest with Kaveree Bamzai and Aniruddha Bahal.

28 March: Paalam Books, Salem, Tamil Nadu.

19 March: The News Minute, “Citizens, the State, and the idea of India“

6 March: Pen@Prithvi, with Suhit Kelkar

20 February: A discussion between scholars Usha Ramanathan, Tridip Suhrud, MS Sriram and me to formally launch Despite the State.

6 February: DogEars Bookshop, Margoa.

5 February: The Polis Project, Dispatches with Suchitra Vijayan.

30 January: Founding Fuel, “Systems Thinking, State Capacity and Grassroots Development“.

25 January: Miranda House Literary Society

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