Punjab Cancers | Harsha Vadlamani Photography

Harsha Vadlamani Photojournalist, Documentary Photographer and Filmmaker in India

Wheat lit up by the lights of a harvester in Sema in Bathinda, Punjab, India. April 27, 2024. During the Green Revolution, farmers were encouraged to move away from their traditional crops to sow paddy and wheat and were provided with hybrid seeds and easier access to fertilisers, pesticides and technological inputs. Between 1965-66 and 2004-05, wheat production increased by 756% and paddy by 3307%. Accounting for only 1.53% of India’s landmass, Punjab now contributes 51% wheat and 22% rice to the central pool.

Buta Singh, 55, a farm worker, washes his hands after spraying a cocktail of fungicide, insecticide, and nutrient supplements in a desperate attempt to improve paddy yield in Nangal Kalan in Mansa, Punjab, India. September 29, 2023. Mansa received 39% deficit rainfall during the monsoon season, which resulted in the underdevelopment of crops on the 15-acre land and less grain in sheaves.

Farmers unload fertiliser at a farm in Burj Mehma in Bathinda, Punjab, India. January 20, 2024. Punjab accounts for 9% of the country’s total fertiliser consumption. In 2022-23, Punjab had the country’s highest DAP consumption of 91.49 kg/hectare and the second-highest urea consumption of 375.63 kg.

Staff from a privately run Reverse Osmosis-based water plant deliver water to a home in Deon, Bathinda, Punjab, India, on May 01, 2024. Groundwater in most villages in the Malwa region of Punjab is unfit for human consumption owing to the significant presence of heavy metals, compounded by pollution from fertiliser and pesticide runoffs from fields. Villagers now either buy water from private water purification plants or fetch it from plants installed by the government. Deon, which had a population of 7139 in 2011, has three private plants.

At Phulad in Sangrur, Punjab, India, someone added a Google Maps placemark over the Ghaggar, which flows past the village, as the Cancer River. Bimla Devi, 40, is a cancer survivor from the village who believes that it is indeed the water that caused her stomach cancer two years ago. October 04, 2023.

Kartar Singh, 42, grazes his sheep on the bed of a seasonal stream in Chandbhan in Faridkot, Punjab, India. The stream’s water has turned black with effluents from farms and factories, which Singh says has been causing severe health issues among his sheep, such as swollen jaws and kidney and lung ailments. November 07, 2023.

Maluck Singh, a registered medical practitioner (not a qualified doctor but someone with medical experience), has been serving the local community for 23 years and is very well respected, especially for his work during the COVID-19 pandemic in Lalluana in Mansa, Punjab, India. Singh says he is observing a higher prevalence of kidney stones, high blood pressure, diabetes, and cancers among villagers.

Sukhmander Singh, 60, from Bajakhana, Moga, undergoes dialysis at a government-run centre in Bathinda, Punjab, India. January 24, 2024.   Singh had quit farming six years ago after it became tough for him to work the farm owing to his kidney disease. Singh, who owns 5 acres of land, gave it away on lease and currently has a medical debt of about INR 400,000 (USD 4820).  Singh is certain the disease was caused by the huge amounts of pesticides and fertilisers used for farming. Farmers earlier used organic cow manure in their fields but shifted to chemical fertilisers because of the ease and effectiveness, and that has, in turn, led to the water and food being polluted with chemicals, he said.

A cancer screening camp organised by Homi Bhabha Cancer Hospital, Sangrur in Cheema in Sangrur, Punjab, India. October 07, 2023.

Passengers arrive at the railway station in Bhatinda, Punjab, to board a train to a popular cancer hospital in Bikaner, Rajasthan, the neighbouring state. The train, whose passengers mostly include cancer patients, is now popularly called the Cancer Express. November 29, 2016.

A cancer patient from Punjab onboard the train from Bathinda to Bikaner, infamously referred to as the Cancer Express. November 29, 2016.

Farmers from Punjab wait for consultation at the Acharya Tulsi Memorial Cancer Research Center and Hospital in Bikaner, Rajasthan, India, where many of them go for cheap and accessible treatment for cancer. November 30, 2016.

A patient from Punjab at the Acharya Tulsi Memorial Cancer Research Center and Hospital in Bikaner, Rajasthan, India, where many from the state go for affordable and accessible treatment for cancer. November 30, 2016.

Lung X-rays being dried at the Acharya Tulsi Memorial Cancer Research Center and Hospital in Bikaner, Rajasthan, where many from Punjab go for cheap and accessible treatment for cancer. November 30, 2016.

An advertisement for a medical diagnostic centre outside Bathinda, Punjab, India. November 14, 2023.

Dr. Nikhil Garg, 36, performs a mastectomy on a 59-year-old woman from a farming family at the All India Institute of Medical Sciences in Bathinda, Punjab, India. May 06, 2024.
Dr. Garg, who heads surgical oncology at the hospital, said he sees about 250 patients a week. The hospital was one of the two public cancer treatment facilities established by the government to ensure patients do not have to travel far to Rajasthan

Sarabjeet Kaur, 58, a stage-4 lung cancer patient, lies down in the open at her home in Gehri Buttar in Bathinda, Punjab, India. January 28, 2024.  The family, which owns 10 acres of land, spent over INR 500,000 (USD 6000) and has maxed out their credit limit at all available sources, her son said.  Their street in Gehri Buttar in Bathinda, Punjab, India, has about ten houses and has recorded five cases of cancer in the last few years.

One and half years ago, Ram Singh, 76, died of throat cancer after refusing any surgical interventions. His son Jaskaran Singh, 56, had learnt to give morphine injections himself, as he learnt he could rely on the availability of medical professionals at odd hours of the day. The family spent INR 150,000 (USD 1800) on his medicines. January 28, 2024.  Their street in Gehri Buttar in Bathinda, Punjab, India, has about ten houses and has recorded five cases of cancer in the last few years.

Harshdeep Singh, 10, watches TV on the Indian Republic Day holiday at their home in Tamkot in Mansa, Punjab, India. His father, Jagtar Singh, 40, killed himself a year ago, burdened by an INR 13,00,000 (USD 20,300) debt incurred on farming and his grandmother’s cancer treatment. His mother, Gurvinder Kaur, 40, doesn’t want him to be a farmer when he grows up and prefers that he finds a job. “What will he do becoming a farmer?” she asked. January 26, 2017.

Kalwinder Kaur Sidhu,45, lost her husband, Kuldeep Singh, to suicide four years ago after working up a debt of Rs. 600,000 (USD 9400) on their son’s cancer treatment. 13-year-old Karnveer Singh didn’t survive despite the family’s best efforts. Sidhu, who now suffers from debilitating back pain, leased out their 4-acre farm in Talwandi Akhliya in Mansa, Punjab, India. January 28, 2017.

Raj Kumar Bawa, 50, goes through the order register at his flour mill in Sangrur, Punjab, India. He mills flour for people who bring their grains and also sells wheat flour. He says there is a growing preference for wheat from Madhya Pradesh in central India despite it costing 50% more, as there is a lot of awareness about excessive pesticides in local wheat. October 05, 2023.

Wheat flour from Madhya Pradesh is prominently displayed at Raj Kumar Bawa’s flour mill in Sangrur, Punjab, India. October 05, 2023.

Balwant Singh, 35, works with his brother Gurbans Singh, 48, to clear a small patch of land to grow vegetables without chemical inputs for their own consumption, in Dadde in Bathinda, Punjab, India. September 30, 2023. “We use pesticides in such quantities that anything you eat in Punjab is bound to give you acidity, if not some serious ailment.”