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

CHAPTER 10.  CONCLUSION

Bangladesh is one of those countries that are most likely (through the use of tube wells) to achieve their rural water supply target as set by the International Drinking Water Supply and Sanitation Decade. It has achieved one of the highest levels of service in any developing country; 45% based on one hand-pump per 75 people (UNICEF, 1999). A huge effort was needed to transform the behavioral patterns of the rural people in order to change the drinking water source from surface water to groundwater i.e. tube well water. Both government and non-governmental organizations have worked tirelessly for the last 25 - 30 years to achieve this. As a result of this success the number of deaths due to diarrhoeal disease was reduced remarkably. But the value of this achievement is now being undermined by the discovery of arsenic (above the permissible limit) in tube well water. Although there is a long debate over the causes of arsenic contamination in groundwater it is nevertheless true that the achievement of bringing safe drinking water to this huge population is now questionable.

To face this new threat, a number of alternative safe water options are available in Bangladesh. Some of these options are based on treating surface water and some are based on treating the arsenic-contaminated water. It is very important to have different alternative safe water options available not only to be able to evaluate and select the best options for a particular community, but also because of the physio-cultural and socio-economic variations among communities.

It has been observed that communities were not homogeneous in terms of expressing their views and accepting the provided options. Different communities have addressed the problem in different ways. For instance, in Vhagolpur people were found to be reluctant to address the problem, as a result of which the initiative to develop community-based options did not work. On the other hand, in Kamarpara people were initially eager to collect water from the provided options and in that village some of the community-based options worked well.

The concentration of arsenic in tube well water of both the study villages was found to be almost the same but the awareness level about arsenic and the perception of the provided safe water options were different for the people of the two villages. Variables such as age, education, occupation, monthly income, perceptions of the problem, and expectation to solve the problem were analyzed in order to find the reasons for this variation among the community. A statistically significant difference was observed in their use of the safe water options and their perceptions of the problem. For example in Vhagolpur more than 80% of the respondents were still using arsenic-contaminated water. The absence of any practical evidence (arsenic-affected patients) in the village, the long term practice of drinking tube well water without any difficulties, better nutritional conditions, the long incubation period of the disease, the cumbersome process of obtaining water from alternative water sources: these were some of the factors which made the people of this village skeptical about the disease and subsequently reluctant to use alternative options.

On the other hand, more than 85% of the people of Kamarpara were drinking arsenic-free water. The presence of arsenic-affected patients in this village motivated people to drink arsenic-free water. Although initially people were collecting water from the provided safe water options, when government introduced deep tube wells in this village people all but abandoned these options. It was decided initially that deep tube wells would not be included in this project because it is not yet decided scientifically whether they are arsenic-free in the long-term. Therefore, co-ordination among different stakeholders and the development of uniform messages about the problem for the people of the affected areas are considered important to earn community trust as well as community participation. Respondents (14%) from this village who live far away from the deep tube wells were still drinking arsenic-contaminated water but not continuously; they mentioned that sometimes they try to collect water from deep tube wells. An in-depth investigation is needed into why these people were still drinking arsenic-contaminated water, in spite of observing the practical problems of drinking such water.

An interesting distinction was observed between the two villages in terms of solving the arsenic problem; people in Kamarpara expected government involvement in solving the problem. Frequent visits by arsenic experts (from home and abroad) to observe the situation and the presence of a high number of arsenic patients in the village, made them optimistic about getting more free government support in order to solve the problem - this was also reflected in their not being willing to pay for alternative options. On the other hand, people in Vhagolpur were from the very beginning reluctant to address the arsenic problem. But at the same time considering the possibility of future disaster, they wanted to have better alternative options and they showed their interest in financial contribution depending on one’s capacity. Therefore, they wanted more NGO involvement in finding a quick solution and also the proper utilization of their financial contributions. Many of the villagers were aware of the corruption and the long bureaucratic procedure in the government structure.

Using tube well water is a long-term practice of the people of both the study villages because they have found this source to be both cost-effective and convenient in terms of operation and maintenance. On the other hand, cumbersome processes are involved with all the provided options. Physiographic and seasonal variations were also found to be important limiting factors for community acceptance of the options. For instance, people of Kamarpara did not show much interest in the RWHs. In Vhagolpur, people were not very much in favor of the construction of PSFs because they use ponds extensively for culture fishery and for that reason they need to use fertilizers and pesticides to kill predator fish in the ponds. In Kamarpara it was also observed that although some households had one alternative safe water option provided by BRAC, they were reluctant to use the provided option - instead they were even collecting water from deep tube wells that were quite far away. Therefore, alternative options should be provided - although not for free and after proper consultation with local people in order to get their full assurance of co-operation and use.

Despite the dissimilarities, there was a similarity among the villagers in terms of their willingness to have alternative safe water options in order to avoid any possible health hazards. This similarity, combined with the differences in terms of choice of options and willingness to pay for them, has produced a differentiated response-pattern of community participation. In most cases the willingness to pay extended either to a deep tube well or better options for which operation was easier and less maintenance was involved. Further study is needed in order to deepen our understanding of these factors and to find out if other factors also influence this response pattern.

This study has shown that the differences in the response patterns of the villagers to the arsenic problem and the solutions proposed are not as it were random, but are themselves related to variables such as the relative economic condition and mobility of the populations. Which is why research has to take into account these variables and locate the introduction of new options within a wider social context.

Finally, it can be said that the situation of arsenic poisoning in rural areas of Bangladesh is like the ebbs and flows of a river. When villagers get fresh motivation or are faced with newly-affected people in their vicinity, they make an effort to collect or obtain arsenic-free water for a couple of weeks or months. Soon, however, they go back to being reluctant to collect arsenic-free water. In order thoroughly to convince people, a well-structured motivational programme (such as that which was successful in converting 97% of the population to tube well water) that in turn draws upon the prior identification of different community factors, is needed to make arsenic-free, safe drinking water a priority in rural areas of Bangladesh.