Every Sunday afternoon, Nandalal Tanti and his 40-year old wife, Belmoti Tanti would leave their home on the Doyang Tea Estate in Assam’s Golaghat district, to pick up supplies from the local weekly haat, or market.

Nandalal Tanti has been employed as a labourer in the tea garden, administered by the Kolkata-based Grob Tea Private Limited, for over 10 years now. The family lives in one of the garden “lines” – as workers’ quarters in the tea gardens are called.

One such Sunday, February 11, while trekking to the market, Belmoti told her husband that she was feeling unwell. The couple decided to head back home. As they reached, Belmoti complained of a dull headache. A couple of hours later, as darkness fell, she threw up in the courtyard of their two-room house. She skipped dinner and retired to her bed soon after.

Around 3 am, Belmoti suddenly woke Nandalal up, asking for a glass of cold water. As he returned with the water, Nandalal recalled, Belmoti held him in an embrace. He could feel her body turning cold, he said.

A couple of minutes later, Belmoti died in his arms.

The next day, hours after Belmoti was cremated, Nandalal’s mother, Durpadi Tanti, who lived in the same house, complained of dizziness. As one of her neighbours attended to her, Durpadi broke into a cold sweat and lost consciousness.

A panicky Nandalal rushed her to the tea garden’s hospital. The medical facility has no full-time doctor and is manned by a pharmacist and a solitary nurse. The pharmacist, Jaan Bora, referred her to the district government hospital in Golaghat.

Durpadi died almost immediately after reaching the hospital, her family says.

Two of the Tanti’s neighbours from Chamasia Line, Mohon Tossa and Anjana Tangla, had died barely a few hours earlier in the same room, the emergency ward at the Kushal Konwar Civil Hospital in Golaghat. Both Tossa and Tangla had displayed similar symptoms, complaining of weakness and throwing up a couple of times.

Four people from the same line – all of whom were fairly healthy, according to their families – had died in less than 48 hours.

Many more people were to suddenly die over the next few weeks in Doyang Tea Estate’s labour lines. According to government records, as many as 19 people, including a two-year-old girl, died between February 3 and March 6. Twelve of these deaths took place in the period between February 12 and 24.

A labour line in Doyang Tea Estate.

Nandalal’s younger brother, Gaurav Tanti, died on March 2. Now, the Tanti household is left with only one adult and Nandalal and Belmoti’s three children.

Residents insist that the number of deaths is even higher, and the official records do not reflect at least two other deaths in the same period. It is not clear what caused the deaths.

Doctors at the Golaghat hospital who attended to most of the deceased claimed “all possible symptomatic treatments” were given. Mukul Sarma, a doctor who treated the patients, said they received “antibiotic cover” in addition to topical steroids such as hydrocortisone. Patients who complained of respiratory troubles were also administered medicines through a nebuliser, said Sarmah.

The hospital’s records show that most patients died within hours of being admitted.

‘Illicit alcohol’

Officials of the Golaghat district health department say most of the deaths were caused by toxic alcohol. A report filed by the department on March 6 speaks of “illicit alcohol which has worsened their existing diseases like tuberculosis, hypertension, etc. causing damage to organs of deceased leading to death”.

“There appears to have been a manufacturing defect in the local alcohol the people consumed,” said Ratul Chandra Bordoloi, who heads the district’s directorate of health services. “When we inspected the local alcohol manufacturing facility, we found all kinds of toxic substances such as batteries and polythene.”

Bordoloi claimed the number of casualties drastically dropped after that particular manufacturing unit was shut down. He conceded, however, that “some cases are not because of alcohol”. There were “some TB defaulters”, he said, referring to people suffering from tuberculosis who had not completed their courses of medication.

According to medical records kept at the Doyang Tea Estate Hospital and seen by Scroll.in, six of the 19 people who died had suffered from tuberculosis at some point.

Questions over health department’s report

In the lines on the Doyang tea estate, families of the deceased reject the health department’s report. They claim that if spurious alcohol was indeed the cause, more people would have been affected in other labour lines in Doyang and neighbouring tea gardens. Also, the fact that more women have died – 13, compared to six men – pointed towards a different cause, locals contended.

Of the 19 deaths, 16 have been from two colonies in the garden: the Chamasia Line and the Tongi Line. The garden has seven labour lines. There are several other tea plantations nearby. So far, none of the other gardens has reported any death in the same period.

Said Kartik, whose father Mohon Tossa, is among the dead, : “They are saying it’s the alcohol, but tell me who doesn’t drink in the bagan [garden]? So how is it that only a few people died? People from the neighbouring gardens also drink from the same bhaati [distillery], why did nothing happen to them? In fact, only people from a few specific lines from our garden have died.”

Mohon Tossa's family claimed that he did not suffer from any ailments.

Others insisted that not everyone who died drank alcohol. Nandalal Tanti, for instance, claimed that his wife Belmoti did not drink at all. His mother, he said, only had an occasional night cap but had not had a drink the night before her death.

Activists have also contest the health department’s statements. Pranab Doley of Jeepal Krishak Shramik Sangha, a group that works for the rights of indigenous communities living in Golaghat, accused the health department of ascribing the deaths to alcohol without conducting any pathological procedures in most cases. “They have not conducted any postmortem in spite of our repeated requests,” he said. “Many people didn’t even reach the hospital, so how did they know it was because of alcohol without even checking on them?”

He cited the examples of Belmoti and Durpadi who, according to the district’s health department, died of a “cerebrovascular accident” triggered by “hypertension”. In other words, a brain stroke brought about by high blood pressure. According to a study conducted by the Dibrugarh-based Regional Medical Research Centre in 2002, 60% of tea garden workers in Assam suffers from hypertension.

However, according to Nandalal, Belmoti’s dead body was never attended to by a doctor before it was cremated. In Durpadi’s case, even though she died in the hospital, no “cadaver report” was issued. A cadaver report specifies the cause of death and certifies condition the deceased was suffering from.

So far, 11 people have been issued cadaver certificates. These are people who died in a medical facility. Of these 11, the cause of death is mentioned in only seven cases. No autopsy was conducted on any of the 19 deceased.

Critics of the health department ask how it concluded the cause of death in the rest of the 12 cases in the absence of a postmortem report or a cadaver report. “They have basically just made up a report to cover up for their inadequacies,” alleged Jagdish Barik, the president of the All Assam Tea Tribe Students’ Association’s Golaghat unit.

Bordoloi, from the district’s directorate of health services, contended that a post mortem was not necessary as the deaths were “natural”. “Only in cases of accidental death are we duty-bound to carry out postmortem.,” said Bordoloi. “Here, the history is suggestive.”

The department’s report on the deaths states it reached its conclusions “through epidemiological investigation regarding death and interaction with the attendants of the deceased persons”.

Failing healthcare

Barik alleged that the Doyang Tea Estate’s systemic failure to provide healthcare and sanitation was responsible for the current crisis. “Even as we talk now, people are falling sick in the garden, but there have been no attempts by anyone to investigate what exactly went wrong and dispel people’s fears,” alleged Barik. “There is a tacit understanding between the garden management, the health department and the district administration to bury the matter.”

The absence of a full-time doctor in the garden, Barik said, was in contravention of rules.

The Doyang Tea Estate's hospital is manned by a pharmacist and a nurse.

According to the Assam Plantation Labour Rules of 1956, every garden hospital must have “at least one whole time qualified medical practitioner readily available during all hours”. The rules state that the recommended size of population per doctor is 1,750 – and the number of doctors per garden should be calculated keeping that scale as the standard.

Doyang Tea Estate houses at least 3,000 people. Most of them depend on a doctor who visits the garden for two days a week for two hours each. The nearest medical government facility is a mini-primary health centre located around 2.5 kilometres away.

Assam’s tea gardens are known for their abysmal health standards. For instance, the maternal mortality rate in the tea garden-dotted Upper Assam districts of Tinsukia, Dibrugarh, Sibsagar, Jorhat, Golaghat – 404 deaths per 10,000 live births, according to the Annual Health Survey of 2012-’13 – is one of the worst in the country and comparable to sub-Saharan nations. Data on maternal mortality rate was not captured in the last government-commissioned National Family and Health Survey released in 2017.

The Annual Health Survey of 2012-’13 also threw extensive light on the broken health infrastructure in the gardens. According to its findings, only 57% of tea gardens in Assam had functional hospitals and less than 50% had a qualified doctor.

The nearest mini primary health centre in the area is more than two kilometres from the labour quarters

Doyang Tea Estate’s manager, Rajat Das said that he had issued advertisements seeking a full-time doctor several times, but they had failed to elicit a response. “No doctor wants to work in a tea garden anymore, because doctors earn much more in private hospitals for much less effort,” he said.

However, Das insisted that that the lack of skilled manpower in the garden hospital was not a reason for any of the deaths. He said that since the garden was close to Golaghat town, it was standard practice to refer critical patients to the district government hospital there after administering basic first-aid. “Not one person has died in my garden hospital,” he pointed out. “They had all been referred to hospitals in Jorhat and Golaghat where they died.”

Das said it was bad luck that so many people had died in such a short period of time. “There were a lot of old people too who have died, so these are just bad times,” Das said. “The problem is the lack of awareness among our workers. Many of them are TB patients, but they won’t complete their medicines.”

Silent government

The All Assam Tea Tribes Students’ Association, for their part, has threatened to intensify its protests. “The Assam government must acknowledge and intervene,” said Barik. “The labourers who have died, their families should be compensated. After all, they died during their working period and inside the garden’s premises.” On March 14, the association organised a sit-in protest in Golaghat town.

Both the state’s health minister, Himanta Biswa Sarma, and labour minister, Pallab Lochan Das, are yet to make a public statement on the matter. The Golaghat district administration, however, has ordered a magisterial inquiry to probe the deaths.

Meanwhile, workers in Doyang Tea Estate hope that the worst is behind them.