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Arsenic Contamination:  Who Will Be Our Saviour? - 1997

by Sylvia Mortoza


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

The Lancet
The Disaster Forum


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