For 10 years, Ghanshyam underwent treatment for tuberculosis (TB) as his persistent coughing and chest pain refused to go away. But in 2011, the stone quarry worker was told that he is in the last stages of silicosis - an insidious and incurable lung disease that has claimed the lives of many mine workers across Rajasthan.
Twenty-five years of working in the sandstone mines of Karauli district in Rajasthan and inhaling the silica dust have reduced Ghanshyam, 50, to a skeleton. On a liquid diet for the past many months, the father of two cannot stand and always moans in pain.
"There is no hope for us now. We are in debt as around Rs.4 lakh has been spent on his treatment. Had he been diagnosed with silicosin (silicosis) on time, life wouldn't have come to this," Dayabai, Ghanshyam's wife, told a visiting IANS correspondent.
Dayabai has come to terms with the reality that she will lose him any time.
Karauli is one of the 19 districts in Rajasthan where thousands of mine workers are battling with silicosis caused by inhaling dust containing crystalline silica.
Ghanshyam is not the only botched-up case of misdiagnosis in Aarampur village of Karauli in the eastern belt of Rajasthan where sandstone is found in abundance and has been used in building the historical Red Fort and the palatial Rashtrapati Bhavan.
"Many silicosis-affected patients in this village, in fact in several adjoining districts, have died mistakenly thinking they had TB," Vikas Bhardwaj, secretary at Dang Vikas Sansthan - a non-government organization - told IANS.
Legal mining of stones in this backward district dates back to 1920, but the first official case of this deadly disease was detected only in 2011, said Bhardwaj.
"It was only as late as November 2011 that we realised that the people were in the grip of silicosis," said Bhardwaj.
Sribai, 50, a gaunt-looking silicosis patient, said she lost her husband to the disease a few years ago.
According to locals, Balram, 60, is the eldest male of this village of 3,000 people. The disease has sapped away the lives of several men, mostly in their middle age, leaving behind their widows.
"No one survives here till 60. Despite having silicosis, Balram is still alive," remarked Prabhu Dayal, a silicosis patient himself.
Rajasthan has no accurate data on silicosis, thanks to the poor health infrastructure to diagnose the disease and unchecked mining and quarrying in the state.
Rajasthan has 32,000 mines where over two million labourers work and only seven Pneumoconiosis Board centres to diagnose silicosis. Located in seven state-run medical colleges, each centre has a team of three doctors who examine the cases only on weekends.
At present there are 244 registered silicosis patients in Karauli, but Bhardwaj says their numbers run into thousands.
"At least 13,000 mine workers have got themselves registered with the Dang Vikas Sansthan. All have pain in their chests and want to be diagnosed for silicosis," Bhardwaj said.
The nearest Pneumoconiosis Board centre for patients in Karauli is located in Jaipur, around 200 km away. The other six are situated in far-flung areas of Rajasthan.
For patients like Mishra Lal, whose name figures last in the list of 13,000 suspected patients, their wait to get diagnosed at the Jaipur centre means that they will possibly have to wait for 27 years, according to Varun Sharma, programme coordinator at the Association for Rural Advancement through Voluntary Action and Local Involvement (ARAVALI).
"And by that time he would have died. The Pneumoconiosis board centre in Jaipur can see only 40 people in a week which works out to 480 cases in a year," Sharma told IANS.
Established by the Rajasthan government, ARAVALI is working in collaboration with the Dang Vikas Sansthan in the livelihood sector.
Rajendra Kumar Jenaw, superintendent of the TB hospital in Jaipur, says that staff at Pneumoconiosis board centres is inadequate to examine cases of silicosis.
"We lack the wherewithal to screen silicosis patients all the time. The government must set up a dedicated centre for this disease," Jenaw told IANS.
Another reason why silicosis goes undetected is the illegal operation of thousands of mines.
"The number of stone mines operating in Rajasthan is much more than the official figure of 32,000. The workers in these unlicensed mines are not covered under the Mines Act 1952," Sharma added.
The Mines Act lays down certain safety procedures for mine workers.
Sharma says that since many of these mines lie away from major roads and habitations, the mining officials often don't conduct checks.
Silicosis has pushed the families of mine workers into further poverty, with the breadwinners over time turning into a health burden.
To support Ghanshyam and his family, his 20-year-old son Ravi has inherited the legacy of becoming a mine worker.
"I work for 12 to 13 hours every day in the nearby mine. Sometimes my chest starts paining," Ravi told IANS.
(Gaurav Sharma can be contacted at email@example.com. This story is part of a National Media fellowship supported by the National Foundation of India)