Arsenic Contamination: Who Will Be Our Saviour? - 1997
by Sylvia Mortoza
Introduction
Bangladesh is a country of 124 million people, give or take some, of
whom most live out miserable lives in the lap of extreme poverty, a poverty
people who live in the West cannot begin to understand. Poor as they are,
they are also people used to disaster, for they deal with them almost on
a daily basis. These disasters come in different forms and in varying degrees
but all are faced with the same imperturbable determination not found anywhere
else. The latest disaster to come their way may, however, defy even their
fortitude for it is worse in many respect than any other disaster, man-made
or natural.
The recent Conference on Arsenic Contamination has made one thing clear
- there is no easy remedy to this disaster and dealing with it may be beyond
even the capacity of these stoical people for, although arsenic contamination
is not peculiar to Bangladesh alone, for it takes place in many parts of
the world, the difference is in the degree and velocity of this disaster
for the number of people at risk is higher than other places, even in neighbouring
West Bengal where a similar disaster is taking place. In other words, nowhere
is arsenic contamination as severe or as widespread as it is in Bangladesh
and nowhere are the people more helpless in this fight for the killer is
invisible.
The Arsenic Problem
First identified by K. C. Saha, in 1983, this former Professor of Dermatology
of the School for Tropical Medicine estimates the numbers to be at risk
as 50 million but other estimates are more in the region of 65 million.
Although officially, arsenic-related diseases have been identified only
since 1992 when a doctor in West Bengal, puzzled by the appearance of skin
lesions on a woman when no-one else in the family had them, had discovered
the woman had only recently arrived from Satkhira in Bangladesh and alerted
the authorities there. But other sources suggest arsenic-related illnesses
have been around for much longer - only that they were not recognised as
such.
However, little publicity has been given to this even now and, although
the problem has reached a sizeable proportion, it is still largely unknown
to the people of Bangladesh. However it is not possible to conceal a disaster
of this size and magnitude for long, if that is the intent for sooner rather
than later information related to arsenic-contamination and arsenic-poisoning
is bound to surface. With more and more information on arsenic-contamination
and poisoning coming in, one good aspect is, it is now gaining the attention
of the world.
The holding of an International Conference on Arsenic Contamination
in Dhaka recently brought this home to us all. It also carried a hope that
solutions will be found for contamination has already spread and now covers
48 out of the 64 districts that make up Bangladesh. As the matter is more
urgent than most people appear to realise, the question is, can solutions
be found in time to save the people for, as a recent article in the medical
journal Lancet says, this is the world's worst episode of arsenic poisoning.
Although this revelation may have awakened the medical profession working
abroad, for most doctors working in the interior, it is still largely unknown.
This carries serious implications for most of these doctors are not on
the look-out for the signs of arsenic-poisoning.
Although there are several factors that may have been responsible for
triggering off these arsenic-related diseases in Bangladesh, the primary
cause appears to be malnutrition, a state that describes 80 per cent of
Bangladesh's population. But in addition to the nutritional problems, there
are aspects of arsenic-related diseases, which range from melanosis to
skin diseases, that must be addressed immediately for the social effects
of these diseases are such they are having wide-spread repercussions for
the people. Unless something pragmatic is done, women suffering from arsenic-related
diseases will increasingly face ostracization and discrimination for women
with skin lesions are no longer considered acceptable as wives. Married
women succumbing to the disease are quickly divorced, which means we already
have a social problem of sizeable magnitude on our hands, for such women
are rarely taken back into the fold of their families. Worse is the condition
of women married to men who have developed skin lesions, for in addition
to having to care for the sick, they too are ostracized.
More severely affected than their neighbours in West Bengal, researchers
are studying why this is so and believe a daily intake of 5:6 l. of arsenic-contaminated
water by farmers in hot weather may be a key factor. This however does
not explain why the children of Bangladesh are falling sick when children
in West Bengal are not. Whatever the causes maybe, the result of a continuous
consumption of arsenic-contaminated water is that more than 3000 patients
in 28 districts have been identified to be suffering from the arsenic-related
diseases.
Addressing the Problem
Although watershed management and rainwater harvesting is the most pressing
need, it must be emphasised that this is only a short term solution therefore
longer-term solutions are needed. Before any steps in this direction are
taken, the urgency of the situation must be clearly understood because,
from the first day of consuming arsenic-contaminated water on a daily basis,
the period of survival is five to eight years only - less for children.
Therefore only permanent solutions are acceptable. Even knowing that the
source is geological does not help.
With arsenic being found in the shallow tube-well water that is widely
used for drinking and irrigation, SOES and the Indian Council for Scientific
Research have developed a filter-tablet system to remove arsenic. For its
part, the Bangladesh Atomic Energy Centre has produced a "chemical
packet" which it says removes arsenic from water through precipitation.
However, this could create further problems, especially for women, for
the sediment left behind is highly poisonous and is difficult to dispose
of, therefore exposure to this sediment could be dangerous for women whose
job it will be to dispose of this exposing them further to the possibility
of poisoning.
With the funds from the World Bank, Bangladesh is searching for alternative
water sources for those at risk but with so many people drinking arsenic-contaminated
water on a regular basis, this has now become a matter of great urgency.
But tapping alternative sources of water may require a return to the old
water sources that are polluted with bacteria and faecal pathogens and
the cause of the widespread diarrhoea which claims so many lives and the
reason why the tube-wells were provided in the first place.
Complexities of the Disaster
As arsenical skin lesions have been found in 57.1% of the people during
random examinations in the affected areas, the people of Bangladesh have
only one of two choices - to die from arsenic poisoning or from diarrhoea
and though people normally depend on past experience to get them through
a disaster, this is one disaster of which they have none which means they
do not know which measures to take. In fact as arsenic-contamination of
ground water promises to be a disaster as bad if not worse than a cyclone,
there may not be enough time in hand to sort out all the issues for the
major problem is there are no tailor-made solutions any more than there
are alternative water sources other than surface water. This means that
Bangladesh is now finding herself between the rock and the brick wall.
However, this is a problem likely to "turn nasty" very soon
therefore it warrants all our attention. The first step to be taken is
to tell the people what to expect and how best to handle the situation
for if consumed over a long period of time, arsenic can be deadly in the
true sense of the term. The Disaster Forum of Bangladesh, an amalgamation
of several NGOs has been looking at arsenic-contamination of the ground
water as a full-scale disaster for some time, and have apprised the World
Bank and ODA of their findings and fears. This Forum has been consistent
in warning the people of large-scale poisoning for some time now and have
extended their support to Dhaka Community Hospital and other institutions
for undertaking studies to determine the full extent of the problem. With
a life or death issue like this, it is important to give accurate information
to the people for a disaster of this kind also threatens the basic structure
of society.
Although inorganic arsenic has been recognised as a human poison since
ancient times and large amounts, if ingested, can result in death it must
also be recognised that small amounts, consumed over a long period of time,
can also result in death and with the experts saying it takes only five
to eight years for a person ingesting arsenic on a regular basis, the fear
is real. As arsenic content in soil and underground water is at higher
levels than formerly believed there is no time for either procrastination
or complacency. The problem is made more complex by the fact that the contamination
is occurring below ground where it cannot be seen and "out of sight
often means out of mind" in this land beset with problems. The result
is that, until the damage has been done, the effect of drinking arsenic-contaminated
water is not apparent.
Experts from the Bangladesh Council for Scientific and Industrial Research
(BCSIR) have found the highest level of contamination (14 mg/l of shallow
tube-well water) in Pabna, and 220mg/kg of soil, in Sylhet. (World Health
Organisation standard for arsenic is between 0.01 and 0.05 mg/l). Considering
this, the available evidence points to arsenic-contamination in Bangladesh
as not only widespread but may be considered a "slow onset disaster."
Attacking the problem is still being hampered by the strong denial syndrome
that often happens in such cases - a denial syndrome similar to that found
in countries hit by the AIDS/HIV pandemic.
Although this is not at all unusual for a country whose basic structure
of society is threatened, it could be very damaging for it prevents us
from reacting in a positive manner. This denial syndrome may be aggravated
by the fact that, given our limitations, managing new sources of water
for so many people may be too much for the government even to contemplate.
This makes it much easier for the government to deny that any problem exists,
but such a state of denial must be resisted if the government is to be
able to mobilise all national resources.
Actions Urgently Needed
In a situation of this kind it is believed important to map the stratigraphic
occurrence of arsenic in sub-surface water and try to install new wells
in a manner that the contaminated areas are avoided. Alternatively, essential
measures must be taken prior to drinking tube-well water, for the denial
of life support resources like water, even in the short term, could cause
a panic, especially if alternative sources are not readily available or
cost-effective. One suggestion that is worth considering is to introduce
solar radiation technology which can be put to use for purifying surface
water, for finding alternative sources may not prove easy and will most
certainly be very expensive.
If we choose to take on this problem, one expert has suggested filtering
the arsenic contaminated water through a filter of iron filings. However,
whatever may be the answer, Bangladesh has little choice but to internationalise
the issue by encouraging foreign countries to take an interest in the plight
of the people of Bangladesh. The World Bank is already looking at possible
solutions and Japan also has taken up a research project on arsenic-contamination
in Bangladesh by utilising geographic information systems. Gratifying as
this is, the easiest solution may be to seal all tube-wells in the effected
areas but this also is not as easy as it sounds for a return to surface
water sources will have an adverse effect on the achievements made so far
to control diarrhoea.
One possibility is to adopt the trend gaining ground - studying what
local villagers do when left to find water sources for themselves and helping
them to upgrade these efforts. The major value of this is that the old
methods tend to outlast their modern counterparts for they have stood the
test of time for one reason and one only - they are the result of a long
evolutionary process which has proven practical and effective. In other
words, they work - and they survive down the generations. Maybe our solution
is also in the past.
No. of words: 2144
- Acknowledgements
- The Lancet
- The Disaster Forum
- ITDG UK
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