On the night of Dec. 2-3, 1984, the inhabitants of the Indian city of Bhopal became victims of the largest industrial disaster in history. Forty-one tons of methyl isocyanate leaked from a pesticide plant run by U.S.-based Union Carbide, agglomerating in a noxious yellow cloud over the shantytowns surrounding the site. Cost-cutting by the corporation had long since rendered dysfunctional all six safety systems specifically placed to prevent such a catastrophe. Only two years earlier, an inspection team found 30 critical safety faults in the factory.

As residents of the surrounding slums woke up choking, the sight of their family members dying around them led to a mass stampede away from the plant. The apocalyptic image of bodies piling up in the streets has been etched in the minds of survivors. People began coughing up blood from nearly instantaneous necrosis of lung tissue. Some drowned as their lungs filled with liquid while others asphyxiated as their airways constricted as if during an asthmatic attack. The average time from exposure to death was three minutes. One man cited by the BBC tried to capture the mayhem: “Everybody was very confused. Mothers didn’t know their children had died, children didn’t know their mothers had died, and men didn’t know their whole families had died.”

Almost instantaneously, half a million people had been exposed to methyl isocyanate. By conservative estimates, around 4,000 people died on the initial night alone, while 10,000 to 20,000 more since then have died from direct complications. Another 100,000 to 200,000 people suffer from disability and ongoing chronic illness from the exposure. The long-term consequences of methyl isocyanate include lung scarring, kidney damage, liver disease, cataracts, anemia and decreased immunity. Gas-induced respiratory damage may explain why Bhopal now has the highest rate of lung cancer in India.

As if this initial calamity were not shameful enough, insult has been added to injury as victims have been forced to engage in incessant legal wrangling over the past two decades for inadequate compensation and failed justice — what many call the second tragedy of Bhopal. Even by Indian standards, the initial $470 million settlement between Union Carbide and the Indian government has been woefully inadequate to cover the ongoing disability and health costs of the affected population. Union Carbide (and now Dow Chemical, which bought Union Carbide in 2001) has refused to appear in Indian court on criminal charges since 1992, and all attempts to seek further compensation for victims in U.S. courts have failed. Victims have long been pressing to get Warren Anderson, Union Carbide’s former chairman, to appear in Indian court, but the U.S. Department of Justice refused to extradite him earlier this year on charges of culpable homicide.

It is also now clear that the poisoning of Bhopalis that began 20 years ago never really ended. After 1984, Union Carbide abandoned the plant, including 5,000 tons of toxic waste, which have slowly been seeping into the nearby water supply. Research by nongovernmental organizations has revealed contamination of water, soil and even the breast milk of local residents with carcinogenic levels of organochlorines, chloroform and mercury. Just last month, the BBC independently sampled a well and found levels of chemical contamination 500 times the limits set by the World Health Organization. Union Carbide refuses to even acknowledge this crisis; its official Bhopal Web site only states, “We are not aware of any evidence to support such claims [of continuing contamination].”

What does the Bhopal tragedy symbolize today, two decades later? From a medical perspective, Bhopal dramatizes the way multinational corporations compromise the health of poor folks in developing countries, especially through environmental degradation. Indeed, to the list of the global plagues of our time — HIV, tuberculosis, and malaria — we should add predatory globalization as a fourth epidemic. Whether through oil contamination of land by Shell in Nigeria or depletion of villagers’ groundwater by Coca Cola in India or use of the sterilizing pesticide DBCP by Chiquita throughout Central America, these corporations show notorious disregard for the well-being of local populations. After all, their basic logic is to zero in on places where human lives are cheap and environmental standards nonexistent. And Bhopal has taught them that their “mistakes” in these situations have few repercussions.

Yet, the actions of multinationals are but one instance of rich nations’ general devaluation of poor black and brown lives in developing countries. A study published last month in the medical journal Lancet that suggested the Iraq invasion has resulted in 100,000 excess civilian deaths (more than half women and children), mostly from violence due to air strikes, hardly made a splash in the U.S. media. Even as Americans cling to these dogmas of “economic development” (in the case of Bhopal) or “liberation and democracy” (in the case of Iraq), unshakable faith in our benevolence blinds us to the true human costs of these interventions. Whether the “beneficiaries” are asphyxiated Bhopalis or bombarded Iraqis, they remain faceless and voiceless to the CEOs and Pentagon officials who determine how they live and die. The gaseous yellow mist that took the lives of thousands of Indian slum dwellers two decades ago is less distant than we would like. Even as the devaluation of Third World lives remains unquestioned, the cloud of this ethical nightmare continues today to hang over our own heads.

Ramnath Subbaraman is a third-year student at the School of Medicine.