The Endosulfan Tragedy of Kasaragod: Health and Ethics in Non-health Sector Programs

It is now over 15 years since the aerial spraying of endosulfan over cashew plantations was stopped (and subsequently banned) in Kasaragod, Kerala. Thousands of individuals have been affected in permanent ways in the exposed villages. As there are potentially several important lessons to be learned from this experience, it would be useful to reflect on the decision-making that led to the design of the spraying programme and examine the efforts that are being made towards managing these health impacts. Through the lens of public health ethics, this chapter seeks to explore the design and implementation of the relief and remediation programme at Kasaragod, the identification of and support provided to victims and the role played by actors including experts, local community and local government. The chapter concludes with a discussion on approaches to predict and avoid such occurrences through Health Impact Assessment and the involvement of local people and the challenges that might prevent the adoption of such approaches.