The use of alternative safe water options to mitigate the arsenic problem in Bangladesh: a community perspective

CHAPTER 8.  FOCUS GROUP DISCUSSION

A number of focus group discussions were held in each of the villages with different types of villagers. The following is a brief description of these discussions.

8.1 Focus group discussion at Vhagolpur Village of Sonargaon Upazilla

Vhagolpur is situated in Sonargaon upazilla, which is close to the Dhaka-Chittagong highway. It is very close (about half an hour by car) to Dhaka, the capital city of Bangladesh. Arsenic in the water was first detected in this village by BRAC in late 1999 and they tested each and every tube well for arsenic contamination. According to BRAC’s results all but one of the tube wells were arsenic-contaminated at levels that were higher than the acceptable limit i.e. more than 0.05 mg/l, and the average depth of the tube wells was 75 feet. The majority of the villagers are businessmen. As regards culture, the people of this village were found to be different from typical villages of rural Bangladesh. From BRAC’s long experience in this village it was observed that it was difficult to motivate people to accept innovations that originated outside of their community. Although arsenic in tube well water was first detected in this village more than a year before, villagers still remembered all the messages about arsenic that had been provided them by BRAC at the time of testing. But at the same time the villagers mentioned that although they were concerned about the provided alternative safe water options and at the same time scared about the hazard of arsenic poisoning, the majority of them were still drinking from the arsenic-contaminated tube wells. The present study identifies the following reasons for these perceptions:

• Almost all the respondents of Vhagolpur mentioned that since there were no arsenic patients in the village they were not taking this problem seriously. ­At the same time, its long incubation period made villagers careless about the disease. Many of them anticipated that better options and medication for the disease would be invented by the time symptoms show up. They also mentioned they have been drinking water from the same sources without any difficulties and they thought that this would hold true for the future as well. The irregular pattern of attack of the disease even within the same families also made villagers careless regarding further spread of the disease. At the same time many of the villagers even mentioned that this might be a ploy by the pipe-manufacturing companies to sell more pipes to them.

• Many of the villagers expressed different concerns about the arsenic problem. They mentioned that in the near future there might be a problem i.e. they might get affected with arsenicosis. In principle they would welcome some solution to the problem; in practice, however, the options provided by BRAC were not very popular with the villagers and they expressed their wish for a better solution, preferably the further sinking of the existing tube wells.

• Proximity to urban centers and frequent movement to the capital and other major business towns made people feel superior and that is why they did not want to accept any new idea or information that was coming from outside of the village.

• Many people from this village work outside of Bangladesh in order to earn more money; others, the majority in fact, are businessmen - these two characteristics in particular make the village more affluent in comparison to the other study village. On average the economic condition of the villagers was better and therefore their nutritional status was also comparatively higher than the other village. For this reason (better nutrition), and as the villagers themselves mentioned, they are less vulnerable to this disease.

• Although the majority of the respondents of this village considered arsenic to be a problem in the near future yet the percentage of people still drinking arsenic-contaminated tube well water was higher in this village. Villagers also mentioned that the information provided both by government and NGOs was not enough and according to them door-to-door campaigns as well as a more visual presentation of the consequences of the disease would be more realistic to sensitize people.

• Villagers expect more NGO involvement to solve the problem but they were found willing to pay for better and improved options. Tube well masons of this village provided a different sort of information: they were advocating further sinking of tube wells pipes to get arsenic free water. The masons told the villagers that it was possible to get arsenic free water from about 300 feet depth. The villagers initially accepted this opinion, especially when they observed a couple of success cases; but in most other cases the masons could not get arsenic-free water from the same depth and this made villagers frustrated and caused them to question the viability of investing more money in such an uncertain measure. Villagers were eager to know both from the NGO workers and also from scientists, the depth at which arsenic-free water could be found from the same source, which they were familiar with. However, there is no such evidence available to the scientists that concerns which level of the groundwater would be arsenic free and for how long.

• Villagers also mentioned that they have little faith in the technical viability of treating surface water and in the quality of the treated water from the provided options. Many of them also mentioned that they do not have confidence in the message provided by the local NGO project staff.

• Community spirit was not strong among residents of this village. Although this was a typical village in terms of rural village definition of Bangladesh, but the characteristics of the people of this village were different from those of other villages. For example, the tendency to communicate with neighbors and community cohesion was not present in this village. Most of the villagers are businessmen and they tend hardly to communicate with other members of the community. For example, many of the respondents mentioned that they do not like to collect water from another person’s house; rather they consider it a measure of prestige not to do so.

• The villagers mentioned that community-based options to alleviate arsenic problem would not be feasible for them; they would prefer home­-based arsenic free treatment units. The Three-Pitcher system, for instance, seems to be popular with many of the villagers.

8.2 Focus group discussion at Kamarpara Village of Jhikargacha Upazilla

Arsenic was first detected in this village by the Department of Public Health Engineering (DPHE) in 1993 through sporadic sampling taken while developing a countrywide arsenic concentration pattern in tube well water. The total number of households in this village was about 210 and the number of arsenicosis patients identified was 40.

About 91% of the tube well water of this village were contaminated with arsenic. Two out of the nine arsenic free tube wells of this village were deep tube wells and were installed by government i.e. by DPHE. It was a combined decision by DPHE, UNICEF and the implementing NGO (BRAC) that deep tube well would not be included as a safe water option for this action research project because it was not yet scientifically-proven whether this option would be arsenic free or not in the long run. The results of the focus group discussion are presented below:

• Although in the beginning all the provided alternative safe water options were widely accepted by the community, after about a month or so the villagers started to use these options hesitatingly - very few people in fact were found currently using them. It has been observed that, except for a few people, villagers who were still using these alternative safe water options were using them for cooking and washing purposes.

• In Kamarpara, arsenicosis has broken out only in the two paras (a small cluster of settlements within a village; a village may have several paras) where the concentration of arsenic in tube well water is comparatively high (BRAC survey 1999) and people generally have very low incomes. People from other areas of the village were alarmed to see these patients but gradually started to believe that their area would not be affected since the disease has not spread during the last 4 to 5 years. At the same time, there is a firm belief among the villagers that there will be no problem in the near future - this is because they have been drinking water from the present sources for generations without any observable effects.

• Except for a very few families living close to these wells, none of the villagers collect water regularly from deep and green tube wells. Almost all the villagers mentioned they do not have enough manpower to collect water from distant places. Women and children are reluctant to fetch water over long distances because of the time and labor involved and also because of bad road conditions particularly during the rainy season. Some of them mentioned that they sometimes fetch water from red tube wells without informing anyone at home.

• There is a traditional practice in this area that men never collect drinking water. They mentioned that they usually do not collect drinking water. Because of religious perceptions and cultural traditions, rural women avoid any sort of contact, including visual contact, with unknown persons and non-relatives - this discourages men from fetching water from places where women usually do, for example deep tube wells in this case. Villagers also mentioned that if some men do fetch water, other men taunt them for ‘obeying the wife’s command’ or for doing ‘a woman’s work’. Therefore, men usually do not participate in collecting water from common places, unless there is no other option.

• A number of social problems were found to occur at the initial stage when arsenicosis was first detected in the village: for example, the arsenic-affected patients were kept aside, their marriages tended to founder, etc. These problems no longer existed when they learnt that the disease was neither contagious nor hereditary.

Initially all the provided alternative safe water options were widely accepted by the community, for the following reasons:

• People were frightened of the possibility of being affected by arsenicosis;

• People thought that the alternative safe water options would be something different and interesting so they used these options continuously for at least for couple of weeks;

• A fresh motivational programme and the presence of arsenic-affected patients particularly in Kamarpara, helped people avoid drinking arsenic-contaminated water;

• Continuous broadcasts on national radio and television explaining the potential effects of this disease also helped people to accept alternative safe water options or to avoid drinking arsenic-contaminated water.