Article From News From Bangladesh archives

A two-week survey carried out by DCH/SOES team between December 1998 to January, 1999 covering 10 villages of 8 districts that has turned up more patients than expected is a bad portent for us all. What this means is that, either the situation is worse than we thought, or that we are incapable of keeping pace with its advance.

When we learn that arsenic in the groundwater of one village in Bogra is as high as 1.5 mg/l, we should be worried. This causes us to think that other villages and other districts are similarly afflicted.. This idea is borne out by the information coming out of yet another village, Izrapara, in Sarisabari, which now is identified as the village with the largest number of people affected by arsenic-poisoning as more than half the people doctors examined already have the tell-tale signs of skin lesions. Worse still, out of 48 children below the ages of 11 examined, 16.6% are similarly afflicted. 

With much the same story coming out of almost all the villages now being tested for

arsenic-contamination, it is time to take stock of the situation and measure it against our achievements especially when we hear that people in villages like Chattarpaya of Thana Senbag, are still drinking the water from tubewells which are known to have a high concentration of arsenic. This particular village also has the dubious distinction of being the village with the highest concentration of arsenic (4.7 mg/l) found anywhere in the world. Below is at Table-1 is a report on 10 villages in 8 districts covered by the DCH/SOES team.

Name of the villageNo. of tubewell analysed% of tubewells having arsenic above 0.05 mg/lNo.of people examined for dermatological symptom% of people having arsenical skin lesions% of people having arsenic in hair above toxic level* (average of all villages)% of people having arsenic in nail above normal level** (average of all villages)

BograBogra SadarUlipur47128920

JhinaidhahMahespurKrishna Chandrapur113239126.3

JamalpurSarisa BariIzrapara, Baushipara4940.814550.3

JessoreAbhaynagarPombagh6396.818820.772.584

ComillaChandinaOrain6280.66116.4

BarisalBabugonjDehergati (Uttar)18178.513345.8

NoakhaliSenbagSeladi,

Chaterpaya104993141.9

ChandpurMatalabKaladi67885125.5

*       Normal amount of arsenic in hair is about 0.08-0.25 mg/kg with 1.0 mg/kg being an

indication of arsenic toxicity.

**      Normal arsenic content of nails 0.43-1.08 mg/kg

What is sad about it is that years after the problem was uncovered, villagers in many places are not only drinking water that is contaminated with arsenic but are blissfully unaware that they are being poisoned or that the skin lesions they see have been caused by this poison. This scenario is being constantly repeated around the countryside and smacks of inefficiency on the part of the authorities. Arsenic mitigation programmes in Kushtia and elsewhere in the southwestern region of the country has, according to reports, also suffered a setback due to a similar lack of concern. In fact it may even be correct to say that nobody seems to be responsible for supervising the programmes undertaken either by the government or private NGOs.  That people are still ignorant of what has befallen them is hard to accept as UNICEF appointed a publicity agent to inform and educate the people on all aspects of contamination and arsenic-poisoning.

One major problem being encountered is that people believe that the illnesses and diseases caused by the ingesting of arsenic are the work of evil spirits.  If this is allowed to continue, treating patients becomes almost impossible and gives a chance for charlatans to take over. But there is another problem  many doctors at the health complexes in Upazilas are so divorced from the problem they are unable to recognise arsenic-induced illnesses when they see them. This can be easily remedied by refresher

courses and by diseeminating knowledge on these diseases to all medical personnel. The result of such ignorance is easy to tell as these doctors could prescribe incorrect courses of treatment for the smitten which can be very dangerous. In just one village, seven members of a family are reported to have died because the cause of their illnesses was unknown until a team of doctors from the Rajshahi Medical College came and identified it.

Other difficulties being encountered by the people are related to the sealing or marking in red of contaminated tubewells WITHOUT ENSURING AN ALTERNATIVE SOURCE OF DRINKING WATER. The obvious result of suchs neglect is that the people have no other choice but to drink the water from the tubewells, knowing them to be contaminated. It is quite one thing to drink contaminated water unknowingly but to know one is consuming a known poison must be a nightmare, especially for parents of small children. Another problem being encountered is that many villagers do not comprehend the danger especially when the same tubewell has been used for years without anyone getting sick. This is certainly something difficult to explain to people, so if people believe the tubule is safe and their illnesses are caused by evil spirits, who can blame them?

Although there are reports that the government is pondering digging some covered ring wells with hand pumps to alleviate the problem of a shortage of arsenic-free drinking water, generally it can be seen that little has been done to implement this plan. Although the DPHE has a scheme to install 40 ring wells within the district, still no ring-well has been installed despite the selection of contractors. The officials are not even sure how

many people in their area are suffering from arsenic-poisoning, although an unconfirmed survey report does say that 40 per cent of the people are sick. When asked, these officials are likely to blame the shortage of manpower as the reason for the lack of action but as Arsenic Control Committees have been formed at the grass-root level, (i.e. the ward level to district level) no programme for creating an awareness among the people about arsenic contamination, water management, nutrition or which measures to take to face the arsenic threat appears to have been taken up.

In Chapainawabganj, a project under the auspices of the Watsan Partnership Project (WPP) is now underway in 160 villages of 3 upazilas. The WPP works in partnership with three other organisations, CARE, DASCO and IDEA and 15 local NGOs and their joint programme consists of creating awareness among the people of the harmful effects of consuming arsenic-contaminated water. It also includes the transfer of technology for the removal of arsenic from the water as well as a programme for identifying patients. Such projects are worthy efforts but, although it would seem that removing or reducing

the arsenic in the groundwater is simple, applying such remedies as are available have not always been acceptable to the people. The problem with this is that, though many, if not all of these treatments work, if they are not acceptable to people, or people cannot understand the basic concept, these will all become useless as soon as supervision is removed.

If despite international coverage on the disaster, policy-makers are still unable to comprehend the seriousness of the situation we are in, the nation is in trouble for, if solutions are not in the process of being put in place, they should be. Nowadays, small babies are also showing signs of poisoning. This should have been expected as arsenic is a "teratogen"  meaning it can jump the placenta barrier. That  this problem warrants our undivided attention seems to be missed. First and foremost people must be told what ails them and they must be told what they can expect and taught to recognise the symptoms of arsenic-poisoning for themselves. If they make a mistake in diagnosis, this is not important but arsenic-poisoning is, for when consumed over a long period of time it can be a cause of skin, liver, lung, kidney and bladder cancer.

Already it has become an outsize burden on the country's health services and for this reason alone we must reduce exposure to arsenic-contaminated water to as near to zero as possible. Meanwhile we must intensify the search for reliable alternative sources of  water. But as Bangladesh is a country of approximately 127 million people, this is no easy task, which in itself makes the problem unique. This difficulty is all the more painful

when we know that caught in the early stages, arsenic-poisoning can be reversed by providing people with arsenic-free water.  This means the longer we wait to take put alternative arrangements in place, the worse it will be for us all.

Her E mail: zainah@bdonline.com

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