Desperate for cash, Indian volunteers are often ignorant of the possible side effects.
Unemployed turn to drug trials
KOLKATA // When Sameer Karmakar, a school dropout, landed a job as a diamond polisher in India's diamond capital, Surat, in the western state of Gujarat, he thought all his dreams had been answered. Within two years, he was earning 10,000 rupees (Dh740) a month and sending most of it back home to his family, 2,000km away, in a village just outside Kolkata. "With six years of earnings, I married off my two sisters [with dowry] and built a house in my village," he said. But then the economic downturn began to bite and many of the cutting and polishing factories where Mr Karmakar, 30, and thousands of others worked, closed because of a lack of demand for their services. "When my factory closed down the grocer knew about the crisis and stopped offering provisions on credit. The landlord, too, asked me to vacate the room as soon as possible. I could not tell my wife back home that I had lost my job. "I was desperate for some money, but I could not find a suitable job. Then a colleague introduced me to a [clinical research lab] agent. He took me to a lab and I agreed to take part in a [medical] trial last month." Over the next month, Mr Karmakar made four trips to the laboratory near Vadodara city. The first time he was given the trial drug and the three other times his blood was collected and monitored. He received 20,000 rupees. "My agent suggested taking me to another lab after two weeks for another trial. He said I would not disclose to the second lab that I had gone through a trial before. I thought perhaps it was not good for my health and so I did not go for the [second] trial," Mr Karmakar said. "The money I got from the lab helped to see me through for some days. But finally I could not see hope for a return of my job and so decided to return to West Bengal. At this point of life, I cannot figure out what I can do except pull a rickshaw and bring 50 or 60 rupees at the end of the day here. My wife married me when I was a skilled diamond polisher who earned up to 12,000 rupees a month in Gujarat." Although he has returned to his village, he has not told his wife that he lost his job, saying instead that his factory has shut for a holiday. According to an Indian labour ministry report last week, at least half of Gujarat's half a million diamond workers have lost their jobs since September. With no sign of an immediate recovery, about 75 per cent of the workers who migrated to the city have returned home. With no job and no money, 71 diamond workers have committed suicide in the same period, the People's Democracy reported. Kinjal Patel, 35, worked as a diamond polisher for 10 years in Surat. When he lost his job in October, he agreed to take part in a two-month-long medical trial for which he and a colleague were paid 25,000 rupees each by Lambda, Asia's largest clinical research unit. "At Lambda we had to stay several days at their boarding facility inside the campus and there we found many unemployed diamond industry workers participating in trials just to support their families, as is my case," said Mr Patel, who is planning to work as a day labourer at a mango orchard in Valsdad. The stories of Mr Karmakar and Mr Patel highlight the desperation of Gujarat's laid-off diamond workers. According to The Telegraph, a daily newspaper in Kolkata, at least 4,000 diamond workers have offered their bodies for medical experiments in Gujarat in the past three months. The newspaper cited medical and industry sources. Although recruiting humans for medical trials is not illegal in India, there are ethical concerns since most of those volunteering are usually poor and illiterate, with little knowledge of the possible side effects. "At least in some cases the risks could be life threatening. There is also the possibility of side effects - many of which, with varying levels of physical and neurological disorders, could persist throughout life," said Pinagapani Manorama, a Chennai-based doctor and rights activist. Dr Manorama warned that some drugs could damage the liver and kidney and even the bone marrow, and called for insurance coverage for people participating in such trials. A senior executive of Accutest Research Laboratories, a clinical research facility in Ahmedabad, said that "a good number" of former diamond workers had approached his lab to take part in trials. "We have our own staff co-ordinating with needy people in cities and villages and these days unemployed diamond industry workers are taking part in our clinical studies. However, being unhealthy or underweight, many of them have been rejected," said the executive who did not want to be named because he was not authorised to speak to the media. Some former diamond workers are even taking part in two or three trials a month, contrary to Indian Medical Association guidelines that say one cannot participate in more than one drug trial a month. Medical sources said many of the volunteers were not aware of the possible side effects. "A lady executive [at the lab] tried to inform me of the possible side effects. I could not understand what she explained, but I signed the [consent] papers," Mr Karmakar said. "I was desperately trying to get some money to clear the outstanding house rent [in Gujarat], to buy some provisions and to bring some money home [West Bengal]. I was not in a mood to worry about any side effects." firstname.lastname@example.org