Draft Development Strategy, National Water Management Plan
Arsenic in Annex L
3.3 Arsenic Contamination
A detailed assessment of the current situation regarding the incidence of
arsenic in groundwater and the probable causes is presented in Annex C Appendix
8. This
discussion summarizes the situations and focuses on the implications
for drinking water supply.
The current Bangladesh water quality standard permits arsenic up to
0.05mg/1. This is five times higher than the WHO guideline of 0.01mg/l.
Factors affecting susceptibility to arsenic poisoning are not yet
well understood, with different people sharing the same contaminated
source showing different levels of symptoms or none at all. The long -
term trend will probably be to move towards the WHO guideline value. In
the shorter term, use of a higher threshold of contamination will help to
define the areas for priority action.
Arsenic was first found in high concentration in groundwater in random
screenings of HTWs across Bangladesh. Testing for arsenic was initiated
because of awareness of arsenic problems in neighboring West Bengal and
the medical diagnosis of arsenic poisoning in some patients. ‘Hotspots’
were identified as a result and more testing conducted in these acutely
affected regions. The full extent of contamination is not yet known and
will not be known until full screening of all HTWs is carried out using
reliable test kits. However, estimates as a result of continuing broad
based testing suggest that people living 60 of 64 Districts in Bangladesh
may be affected by arsenic contamination to some degree.
As a result of initial investigations, arsenic in extremely high
concentrations was found in groundwater pumped from HTWs and DTWs in parts
of the South West, the extreme North East, in isolated ‘hot spots’
along the Ganges/Padma river, in large swathes of the South
East, and in some areas near Dhaka (Figure 3.1).
In some places, up to 2.4mg/l of arsenic, approximately 250 times the WHO
standard (0.01mg/l) or 50 times the Bangladeshi standard (0.05mg/l)
was identified.
Not all wells are affected: fewer than half the wells tested to date have
contained arsenic above the WHO guidelines. The concentration of arsenic
in groundwater is highest between about 20m and 60m depth and the
risk of it occurring in groundwater below 200m is low.
Since the detection of arsenic and recognition of
the potential hazards to public health of ingesting arsenic contaminated
water, public health engineers and medical experts have realized that a
radical shift will need to take place in the way in which safe and
affordable domestic water supply is provided in rural Bangladesh. To date,
the crisis appears mainly to affect rural communities.
However, shallow tube wells in urban areas are also affected. Urban piped
systems may be affected if the DTWs supplying them draw water from a
contaminated aquifer.
3.3.1 Population at Risk
Estimates vary as to the number of people at risk from arsenic
poisoning, though the situation is critical. One report suggests that
nearly 70 million people are likely to be affected by arsenic
contamination of shallow tube wells. Until comprehensive tests of all STWs
(HTWs and irrigation wells) are completed and entire communities screened,
however, the actual number of people at risk from arsenicosis will remain
uncertain. Detection of arsenic in HTWs and emergency measures have been
the priority to date. The areal extent and degree of contamination of
existing drinking water sources is believed to be
considerable, however, and as resources are limited the impact of these
measures has been low. In an initial study conducted by Dhaka Community
Hospital (DCH), Ministry of Health and Family Welfare (NIPSOM) and
School of Environmental Studies (SES), Calcutta, tube wells in 27of 38 Districts in
Bangladesh were revealed to contain arsenic above the GOB
pemissible limit of 0.05mg/l. The percentage of arsenic - contaminated tube wells in
Nawabganj, Pabna, Faridpur and Laksmipur in that study was found to be
higher than anywhere tested in the previous ten years in West Bengal, a factor
signalling the potential severity of the problem in those Districts.
Figure 3.1: Maps of Arsenic Contamination [Click inside for full view]
Since the detection of arsenic in groundwater, testing of wells has been
complemented by epidemiological surveys. Laboratory analyses of hair, urine
and nail samples taken from people with symptoms of arsenic poisoning (skin
lesions and the thickening of the soles of the feet and palms of the hand)
have revealed very high levels of poisoning. Not all those who drink
contaminated water develop arsenicosis however. Scientists attempting to
determine the factors which affect the susceptibility and resistance of people
to arsenic poisoning have concluded that good nutrition may be a significant
factor. People whose nutritional status is poor will tend to develop skin
lesions while better-fed people will not, an indicator that one strategy to
combat arsenicosis might be increased consumption of nutritional supplements
such as Vitamin A28 or antioxidants such as Vitamin E.
Leafy vegetables upon which many Bangladeshis rely for daily nutrients are
suspected of absorbing arsenic and therefore, are no longer recommended for
arsenic patients. As understanding the degree to which arsenic enters the food
chain is crucial for developing long - term arsenic mitigation and nutritional
improvement strategies in Bangladesh, two types of related research have
recently been undertaken. The Australian Center for Irrigation, Agriculture
and Research (ACIAR) is investigating evidence of arsenic entering the food
chain while FAO is conducting a study in Bangladesh to determine the possible
effects of arsenic on stunting rice stalks and reduced rice yields up to a
possible 20% of total production. However since crops are already being
irrigated with water containing arsenic, such yield reductions would already be occurring and are not likely to cause a drop in
future production.
3.3.2 Hot Spots
The composite mapping of findings in June 2000 of village
‘hotspots’ by Thana undertaken by the Emergency Task Force of the local
Consultative Group (and based on the DFID/BGS studies, the UNDP 200 village
survey, the UNDP/WB 500 village survey, BAMWSP, UNICEF, JICA, DANIDA/DPHE, NGO
Forum, DPHE/DFID and the WATSAN partnership data) confirmed that clusters of
highly affected Thanas are found along the western border of the South West,
large areas of the South East, the extreme North East, spots North East of
Dhaka along the Meghna, and at points along the Ganges/Padma.
More specifically, the swathe of most affected Thanas spans some, but not
all, of the western-most Thanas of the South West around Jessore, the riverine
areas near Rajbari and Faidpur, southwards to Nagarkanda and Muksudpur, a
concentration near Santhia, Sujanagar, and Bera on the left bank of the
Ganges/Padma, parts of the South East near Lakshmipur and Chandpur, and a
smattering in the north eastern-most Thanas including Zakianj, plus areas near
Sonargaon and Raipura along the Meghna.
Various agencies conducting surveys using a variety of test
kits have recently published individual findings as well. NGO Forum through
its regional offices has tested a total of 11,279 samples and found arsenic
above 0.05mg/l in 2668 (less than 25%). Of 2882 villages, arsenic was found in
782 wells at a concentration ranging from 0.10 to 1.70mg/l. In one of the
earlier studies, DCH found arsenic above 0.01mg/l (WHO standard) in April 1999
in 142 villages of 24 Districts. UNICEF claims to have found arsenic
contamination in 211/460 Thanas at a concentration of 0.05mg/l,
roughly in 29% of all wells. Grameen Bank members tested 17,902 wells in
Chandpur District by March 2000 and found 98% of wells to be contaminated. (In
one Thana in that District, no green tube wells were found in the 119 villages
surveyed so the proposed strategy of asking women to seek water from neighbors
would not be possible in those areas). Ponds were not deemed an appropriate or
acceptable source so in that case, dug wells were provided. Communities in the
main opted for DTWs.
At the 3rd DTW sponsored conference on arsenic in May 2000,
it was estimated that only 5% of hand pumps in Bangladesh had so far been tested
so the state of knowledge was far from complete.
Agencies who continue to be involved in the testing as of June 2000 include
DANIDA/DPHE, BAMWSP, JICA, the WATSAN partnership, UNICEF, plus
Dhaka Community Hospital, NGO Forum, BRAC and Grameen Bank.
3.3.3 Social and Health Impacts of Arsenic Contamination
Children, in particular, are at
high risk from arsenic exposure, especially if they are poor and malnourished.
In one village, more than 55% of children under ten years of age drinking water
containing 0.84mg/l of arsenic showed arsenic - induced skin lesions. These
children were all poor and ill - nourished. As a large number of women and
children under five suffer from severe or moderate malnutrition, the number of
persons at risk may be underestimated. A random examination during a field
survey in 18 of the 34 Districts where arsenic contamination was suspected found
57% of people to have arsenic lesions. Researchers believed that only 10 - 15%
of those suffering from arsenicosis had come forward at that time and been
formally diagnosed. Many ‘patients’ do not come out to be examined, fearing
isolation if their disease proved to be contagious, and young women in rural
communities do not wish to be examined by male doctors. They are also afraid of
being deemed unmarriageable if found to have skin lesions. Arsenicosis is
connected in local people's minds with HIV/AIDS or leprosy and as a result,
patients are treated as pariahs. Women have been divorced on the basis of having
arsenic lesions and patients are being refused water from arsenic-free wells.
Subsequent surveys are helping to compile a gender - based profile of
patients and ascertain factors contributing to the development of asenicosis.
The UNDP/DCH 497 village survey identified 2327 patients (59% rnale/34% female)
in villages, which were comparatively more affected by arsenic. A survey of
37,239 people in flood-prone, plains and hilly zones in 1999 revealed a
predominance of male patients (the number was not named) and the majority of
tube wells affected by arsenic were in flood prone areas (42% of wells contained arsenic above
0.01mg/l
and 23%>0.05mg/l). This result is supported by another study, which found 54%
of patients to be male and to be in he range of 10 - 40 years old.
That study concludes that 35 million people, mostly in rural areas, are at risk
of arsenic toxicity.
In the course of five years, DCH analyzed 22,003 HTW samples
in which they have found arsenic levels above 0.01mg/l in 54 and over 0.05mg/l
in 47 Districts. Groundwater containing arsenic above the Bangladesh standard
was found in 918 villages. So far DCH has identified a total of 3688 patients in
30 of 32 Districts surveyed. From a total of 11,000 hair and skin
samples, (50% from those with lesions, 50% from those without) researchers have
determined that 90% of people tested have a level of arsenic in their hair,
nails and urine above the normal level. In affected areas, some people suffering
from arsenic lesions have since died from cancer and gangrene.
The World Health Organization estimates that exposure to
arsenic over a period of five to ten years can produce symptoms of keratosis and
over a lifetime, can lead to cancer. Selenium, an element, which can combat the
effects of arsenic and is present in eggs, milk and a few other food stuffs has
been found to be notably missing in post - mortem examinations of the livers of
arsenicosis patients. The absence of selenium can be attributed to the depressed
purchasing power of the rural poor, though not enough is yet known to assess the
impact.
3.3.4 Arsenic Mitigation: Strategies and Impacts
Dhaka Community Hospital (DCH) which has sponsored
three international conferences on arsenic in 1997, 1999 and 2000, has
been actively engaged in alerting the public to the wider health implications of
arsenic poisoning. With assistance from UNDP, DCH was involved in testing wells,
detecting arsenicosis patients and raising awareness of the problem in
conjunction with Ministry of Health and Family Welfare (MoH) through the Rapid
Action Testing Programs. As The disease initially was largely unknown to
doctors, DCH was also involved in training medics and health workers to diagnose
symptoms of arsenicosis, with support from OXFAM and other NGOs.
In January 1999, a multi - media communication campaign was
commissioned by DPHE/UNICEF to raise awareness of the arsenic problem. In
February 1999, a Government conference on arsenic, mitigation took place and
UNICEF took up an integrated 'action research' arsenic mitigation program in
four Thanas (500 villages approximately) with associated NGOs, to test and
analyze existing water sources, provide safe alternatives and investigate health
impacts. In August 1999, UNICEF supported DCH to expand the scope of their
program using an integrated and comprehensive community - based strategy. Other
innovations were tested as well. A pilot treatment plant for arsenic
removal was installed in Tungipara (Gopalganj) and the Swiss Development
Corporation (SDC) funded the WATSAN project in Rajshahi and Chapai Nawabganj to
test the efficacy of solar - assisted oxidation and sterilization of
groundwater.
In 1999, DFID in conjunction with the British Geological Survey completed
Phase II of its hydrological study on the origin and extent of arsenic
contamination following its Phase I systematic survey of more than 3000 wells.
DFID with DCH is now developing a health/nutrition/epidemiological study with
arsenic mitigation in six areas, in addition to a water and sanitation field
implementation project with DPHE/UNICEF.
Other donor - sponsored projects implemented to facilitate arsenic mitigation
include the development of treatment technology (CIDA and AusAid), test kit
development (JICA and WHO), further related studies (USAID, GTZ, and FAO)
hydrological investigations (IAEA) and screening, and development of alternative
sources (Rotary International). The Netherlands Government also piloted arsenic
removal techniques for piped water systems and community awareness in
Paurashavas under the 18 DTP.
Testing of HTWs for arsenic to date has then highly localized and targeted
towards known areas of high arsenic contamination. It has also been relatively
time consuming and expensive. A major problem has been that some agencies only
undertake testing of the tube wells they have financed and installed. Because of
the critical situation, many consumers wish to know if their individual, often
privately financed HTWs are contaminated by arsenic.
However, several years after acknowledging the problem of arsenic contamination,
it is still not clear how they will obtain equal access to test kits or arsenic
removal facilities.
Field test kits used since the start of the investigations have not been
entirely reliable. Moreover, they were not able to determine arsenic content at
relatively low levels (i.e. between 0.01 and 0.05mg/l). General
Pharmaceuticals Ltd (GPL) have recently stopped
production in January 2000 due to poor reagent quality. They are now importing
the reagents from MERCK BDH England and have sent the reagents to the National
Science Laboratory for validation. Water Aid will he procuring a small number of
these GPL kits and cross - checking their field results with both the Arsenator
and the laboratory. In some areas, a faster, more sophisticated and more
expensive instrument known as an ‘Arsenator’ is also being tested.
Comprehensive testing of all wells including irrigation wells formed the first
component of the GoB/World - Bank/Swiss Development Corporation funded
Bangladesh Arsenic Mitigation Water Supply Project (BAMWSP). This is proceeding
but results of testing were not available for this report. Under the BAMWSP
project, a three-tier monitoring and testing strategy is also being established
in order to provide support in the long term to quality control of the
monitoring process.
Various mitigation strategies have beat implemented to date on a pilot basis,
but again, often only in areas where the contaminated tube wells have then paid
for and installed by Government and donor agencies. In areas where arsenic was
detected and tube wells marked red, initially people were advised to drink water
from other sources. Field workers encountered resistance to this at local level,
however, and many continue to drink from untested wells. DPHE/UNICEF have
provided pond sand fliers (or DTWs where possible). DPHE/DANIDA arsenic
mitigation projects installed alum based treatment tanks in Noakhali initially
but are now concentrating on installation of DTWs in those peri - urban areas previously provided with
hand pumps under their program. Other donors have set up emergency pilot schemes
to distribute filters and test their efficacy along with other modes of
treatment. The Khan three kolshi method is currently under test by BRAC
and Water Aid. DCH has suggested modifications of this traditional method, which
entail using iron chips, coarse sand, wood charcoal and fine sand.
Initial testing of the locally made Shafi filter indicated that arsenic was
removed from water between 0.5 to 0.05mg/l and made water safe in 97% of cases,
however, field evidence showed that this result could not be sustained. The
filter is now undergoing modification. Various technologies used for arsenic
removal are being subjected to controlled testing by independent authorities
before widespread replication. The Government based Technical Advisory Group
(TAG) has only approved one arsenic removal technology to date, however: the
three kolshi method. They advocate use of ‘alternative sources’ pond
sand filters, rainwater harvesting, DTWs and hand dug wells.
To assist in the long testing and verification process, Water Aid undertook
preliminary field testing and consumer assessment of household arsenic removal
methods. They concluded that passive sedimentation (i.e. storage of water for 12
hours+) was not a ‘universal’ solution since bacteriological contamination
increased substantially and arsenic content was not reduced below 50mg/l. The
two bucket treatment (as developed by DANIDA/DPHE) and under test by DCH, WATSAN
Partnership, BAMWSP and Water Aid) was shown to reduce arsenic content by 81 -
90% but not below 50mg/l. A variant on this using locally procured phitkiri
or alum was also tested and proved very popular with women. It similarly reduced
arsenic content but not to the standard required in all cases. The Shafi filter,
on the other hand proved to be unpopular with consumers as it
produced only 12 liters of water per day,
(insufficient) for domestic purposes) and was too law to be practicable for
daily needs. At Tk1000, it was also seen to be far too expensive for most
households.
It is clear that even if proven successful and manageable at local level,
arsenic mitigation treatments may be difficult to replicate or sustain beyond
the emergency phase. Most will require monthly purchase of chemicals and regular
testing of the filtered water to ensure quality, so local availability and price
may be crucial. BAMWSP was advocating treatment of contaminated water at
household level using freely distributed buckets, alum and chemicals but
monitoring of household treatment using alum and potassium permanganate revealed
a tendency for women to use an excessive dosage of chemicals, so creating a new
health hazard. Widespread use of this method is now being discouraged.
UNICEF-sponsored VERC/WATERAID pilot projects have also been providing
filters and arsenic removal kits free of cost to test mitigation strategies. In
areas of acute arsenic contamination, DPHE/UNICEF have
installed DTWs, (each costing Tk45,000) free of charge and during the Flood
Rehabilitation Program 1998 - 99, more DTWs have been installed as part of
emergency relief operations. For several years, rainwater harvesting tanks have
been provided in the coastal belt areas by the
World Food Program and other agencies. These actions though justifiable from
a humanitarian point of view, will not engender a desire in communities
to contribute towards the capital investment cost of
pond sand fitters, DTWs or filtration systems in the long term.
The private sector is also
attempting to respond to the demand for affordable and reliable arsenic removal
equipment. Two solutions which might be applicable at the community level are
first a packaged filter unit capable of running at 5m3/hour being developed by
the University of Connecticut. This filter would have to be replaced every nine
to 12 months and the final costs have not yet been estimated. The second is a
filter unit suitable for use with a hand pump. The Stevens Institute of
Technology has also introduced a bucket filtration system using tablets to be
made locally. These technologies along with all the others are subject to formal
approval by TAG before they can be produced and disseminated. The Stevens’
filter is currently undergoing field testing but has not yet been granted
approval.
The National Policy for Safe Water Supply and Sanitation (NPSWSS),
passed in November 1998, requires cost sharing be
introduced as part of a new approach to sustainable water supply provision. This
policy was largely formulated and signed prior to an understanding of the
potentially catastrophic dimensions of the arsenic problem and revised estimates
of the population affected. However, its orientation reflects changing consumers’
perceptions about investment in household infrastructure. Unfortunately, it has
become clear that most communities are nor willing to invest in arsenic
mitigation strategies. Experience from Pakistan, Yemen and Egypt, however,
indicates that communities probably would be interested in investing in
technologies which improves their access to water in the household and
would not be affected by seasonal shortages.
The only known direct treatment for arsenicosis is to drink and consume water
from an arsenic-free source. It is possible that arsenic poisoning may be
reversed, and in West Bengal as well as Bangladesh, many people previously
showing diffuse melanosis or symptoms of earlier pigmentation associated with
arsenic poisoning have returned to normal life after drinking safe water, eating
nutritious food and doing some daily exercise. One option which is under trial
and might be efficacious is the distribution of vitamin-enriched dietary
supplements and anti-oxidants to arsenic patients, though the impact is not yet
known. At the moment, most of the eleven million HTWs have not been tested so
individual households are not sure if their source is contaminated or not. This
is an unsatisfactory situation and one which needs to be tackled in a pro-active
manner.
Safe water sources are available. Current information indicates that
groundwater from depths greater than 200rn is almost always free of arsenic.
While a limited number of deep wells have been shown to be arsenic contaminated,
these may not be drawing water only from a safe depth.
In saline coastal areas, where arsenic may also be present, there is a
concern that the deep aquifer could be contaminated if DTWs were dug which
punctured the sealing layer between the deeper fresh water aquifer and the layer
above which is saline.
Other solutions for providing water supply may need to be found in these
areas for the long-term.
The task of the National Arsenic Mitigation Information Centre (NAMIC)
established under BAMWSP is to
collect, manage, interpret and disseminate all relevant hydro-geological, water
quality health, socio-economic and technical information necessary for the
Project Management Unit so as ‘to devise strategy and priorities, develop an
action plan and monitor progress in arsenic mitigation. BAMWSP is to test a
range of pilot schemes in six Thanas to be replicated in 60. Additionally, in
collaboration with others in the sector the project is to review the results of
mitigation trials and help to co-ordinate a coherent and comprehensive strategy
for dealing with the arsenic problem.
3.3.5 The Socioeconomic Context of Arsenic Mitigation
Although the dimensions of the arsenic problem in Bangladesh are enormous,
public awareness of the overall extent of arsenic contamination has been
limited. It has also been difficult for arsenic mitigation projects to reverse
the consumer trend towards urbanization and self-sufficiency epitomized by
shallow tube well technology. Low cost piped water supply would constitute the
next progressive service tier, in that it would supply running water in the
bari and so supplant the use of hand pumps.
From field studies of attempts to persuade consumers at risk from arsenic
poisoning to adjust to new technologies, several behavioral trends have so far
been identified. If a safe source is distant or situated in a site of potential
conflict (a neighbor’s house, for example), women tend to revert to collecting
and drinking water from the contaminated source, despite all warnings. Women are
also noticeably reluctant to abandon their private source and adopt a
community-based resource that will be difficult to maintain and may not provide
safe water throughout the year. Arsenic contamination of drinking water supply
has been discovered at a time when many low-income households have invested
extensively in private hand operated tube wells (HTW's), which pump from the
shallow aquifer. A safe domestic filter may prove acceptable to consumers in the
short term as a means of redeeming the investment but probably only as a
short-term mitigation option.
Women are responsible for undertaking arsenic treatment in the household as
part of their domestic tasks. Field studies conducted by DANIDA/DPHE indicate
that even in affected areas, they need to be specifically encouraged to pursue
this task through interpersonal communication and house- to- house visits.
Findings from 18 DTP indicate that women do not understand the tube well color
markings, as the notion of green=positive, red=negative is not familiar to them.
Iron content in tube well water (which is bothersome but not lethal) is also
being confused with arsenic poisoning. Having been weaned away from surface
water sources, which were deemed to be the source of water-home disease, women
associate dangers arising from consumption of unsafe water with diarrhea. Field
workers have found that it was very difficult for women to accept or
conceptualize the problem of arsenic poisoning for that reason.
In addition to the relative absence of information on the dangers of arsenic
and the risk of arsenicosis, a credibility gap has developed amongst consumes.
In many communities including those in which arsenic has been detected, people
do not believe that arsenic (since it is colorless and odorless) has poisoned
the water source and will induce life-threatening illness. There is also a
common perception that arsenic ingested in small quantities will not hurt anyone
(especially if no lesions are visible) and therefore, drinking the contaminated
water will not have a negative effect on health in the short term. Evidence from
some screenings indicates that people in arsenic affected areas have a higher
percentage of arsenic in the body than normal so this perception will need to be
vigorously reversed through media campaigns and information dissemination.
New investment in alternative sources may also prove difficult for rural
consumers. The 1998 flood created a crisis of indebtedness in many parts of
the country from which many people may not have
recovered. Affected people may be unwilling or unable to take on further loans
at this juncture unless more lower-cost, long term credit is made available for
housing improvements which would include upgrading of water and sanitation
facilities. There has been a mixed response to cost-sharing from GoB and NGO
water sector providers. Consumers say that this ‘plague’ or ‘poison’ in
the drinking water is not of their own making. They argue that since the
government advocated drinking from wells, the Government should take full
responsibility for the cost of arsenic mitigation.
Communities will welcome access to arsenic-free supplies through improved
sources such as piped supply and be more likely to contribute to investment in
these than in others, if it is afordable. In the meantime, it is that that
several factors will increase the risk to the public of arsenicosis. No
comprehensive and extensive media campaign directed at rural users has been
undertaken by the GoB to acquaint the public with the range of issues
surrounding arsenic contamination. Recent experience shows, however, that media
campaigns alone may not he sufficient to prompt behavioral change Pre-testing
conducted by UNICEF of proposed TV spots on arsenic contamination, indicated
that non-literate respondents had different understandings of the spots advising
them not to drink from tube wells marked red and in the instances where
B&W TVs were used, misunderstood one of the important messages. The
difficulty of designing messages to broach the comprehension gap between
literate and illiterate, and enlighten rural people as to the risks involved in
drinking tube well water, will
require extensive field study and community consultation (prior to materials’
preparation) if these television campaigns are to be successful.
Several factors are already known to influence the
acceptability of the arsenic mitigating option to rural communities. For
outside sources, perceptions of the quality and taste of water from antiquated
surface water sources, their physical ability to carry sufficient quantities
from source to home and their safety in moving back and forth to the water
source daily are among the reasons women are reluctant to adopt these sources.
Household filtration techniques rated positively by rural women include those
which resemble traditional filtration and water purification techniques (used
during flood), are low cost, easy to use, the additives are easily available,
and the temperature of the filtered water remains acceptably cool. Provided these
remove arsenic and have no ill effects, these low cost solutions could be
encouraged over the short term. To ensure acceptance of these methods over the
longer term, however, is difficult. Programs will need to involve women in
discussions of the merits of alternative water sources, interim household
arsenic mitigation treatments and the planning, operation, management and
monitoring of new and better systems concurrently. To date, NGO workers
have been predominantly male and therefore unable to make contact with village
women. To ensure that information reaches women and women's views are taken into
account, more women will clearly need to be employed by NGOs, Government
agencies and water supply providers to spur on development of more progressive
water supply systems and the arsenic mitigation efforts.
4. Rural Water Supply
4.2 Issues for Rural Water Supply
4.2.3Overview of Current Arsenic Mitigation Emergency Options
International agencies introduced tube well technology to Bangladesh and
created a huge consumer demand for hand pumps. If as predicted, 11 million hand
pumps have been procured the consumers who have purchased those hand pumps are
at risk as are those who have received subsidized tube wells from donor or
Government agencies. Consequently, information on emergency mitigation and
supply of safe drinking water needs to be provided to all those affected, or at
risk. Donors have responded to date with pilot mitigation projects in selected
areas. Techniques tried out include physical coagulation, addition of resins and
use of solar energy. The options tested to date include DPHE/DANIDA supported
small arsenic removal units in Noakhali and Lalkshmipur involving use of alum (phitkiri) (and potassium permanganate) in small (2m3) closed box community
tanks (cost of tank: Tk15, 000 and O&M cost, Tk 10/family/month), the
domestic Shafi filter (UNICEF sponsored VERC and Water Aid project in Sitakunda
(Chittagong); the use of precipitated ferric oxyhydroxide in well-head
treatment tanks under a three-year New Zealand funded pilot project in
Chapai-Nawabganj (Rajshahi) and an Australian funded project to test
sunlight-enhanced removal of arsenic from tube well water.
For surface water purification in areas of arsenic contamination, BRAC,
Grameen Bank and OXFAM have approved the ‘five kolshi’ filter
and tested the use of ring wells. The ‘three kolshi’ filter has also
been approved for domestic removal of arsenic. These techniques are however,
emergency measures and by their very nature will not deal with the long-term
problem of supplying safe water to the rural population.
Research and development of pond sand
filters for coastal areas of Bangladesh was undertaken in
1984 by DPH/UNICEF. In areas of severe shortage of portable water,
they have been successful but the main O&M limitation is that the top layer
of sand must be cleaned extremely frequently by community members for the water
to be potable. Feasibility studies have been undertaken to investigate the
acceptability of pond sand filters in arsenic contaminated areas by LGED and
MoH. If tube well water is used to fill the pond, disposal of the
arsenic-bearing sand poses a long-term environment hazard. Current disposal
techniques include burying the sand in dung and disposing of sand in latrines.
Initial evaluation of pilot pond sand filters have indicated a public
reticence to adopt such alternatives wholeheartedly. Community managed systems
which encourage public access to drinking water are not normally preferred to
privately managed sources such as HTWs but may become more acceptable in
emergency situations. In recent field studies of options, rural consumers
indicated that a shift to surface water sources would represent a step backwards
in the progression towards urbanization of infrastructure. In resource terms,
pond systems require considerable land acquisition, the purchase of expensive
plastic linings and fences to ward off live stocks (though as been proposed,
suitable public or khas land could be donated from school yards in every
village. Water collectors are also required to pump water into the filter before
filling their container (so that the next user does not have to wait for the
water to filter through the system) and this would be expected to create
bottlenecks in densely populated rural areas.
In arsenic contaminated areas, there is also considerable resistance
to abandonment of HTWs on the grounds that they contain arsenic. To some
consumers in those areas, the fact that the water which appears clear and pure
may contain carcinogens is not credible. From field studies it appears that
there is considerable reluctance to revert to surface water systems. If ponds
are to be selected as the favored option, information campaigns will need to be
launched to persuade consumers that they must switch from HTWs to ponds (the
former source of diarrheal disease) and stop using tube well water for a variety
of domestic tasks. This has proven difficult to date.
Cost recovery of the capital cost of pond sand filters is also likely to be
limited since the public would need to be convinced of the
value of this system. Precedents have been created by DPHE/UNICEF 1998
and NAMIC 1999 who provided new community ponds free of charge.
(In some cases, land is to be donated by the community but in the NAMIC case,
land acquisition comprised a major cost of the invention). Willingness to
pay would depend on the ability of the local elite to mobilize support for this
option. Women could be preferentially employed in managing these systems at
community level (as elsewhere) especially if these schemes were adopted. Since
they are the main users, this would constitute a managerial and O&M
advantage.
A pond of 0.5ha and 2m deep would be sufficient to provide 12.5 litres/day
for 2000 people, when allowance is made for evaporation. On this basis 50, 000ha
of ponds would be needed for the total rural population of 100M, although
not all regions would need such a solution. One constraint is that ponds have to
refilled during the monsoon season is unlikely to be sufficient to
refill a deep pond. If monsoon season rainfall is
2000mm and dry season evaporation is 1, 000 then the
available water in the pond is effectively only 1000mm
unless other surface water is used to fill the pond,
with associated risks of pollution. A pond of 0.5ha
would need at least six sand filtration units to serve
the target population. Smaller ponds, each with one
sand filter, are an alternative which would be more
convenient for the community but less feasible because
of total land take. Furthermore, 12.5 liters/day meets very basic needs for drinking and cooking. Other
sources would still have to be maintained and used to supply water for other
uses. In sum, pond sand filters are a short term mitigation strategy requiring
considerable subsidy, and one which is to gain much currency amongst rural women
who are the main users.
4.3.3 Rainwater Harvesting
Rainwater harvesting has also been advocated and developed
by DPHE/UNICEF for use in the coastal Districts since 1994.
Under their system collection is made from tin rooftops or a
sheet of plastic into large cement tanks where it can be
stored for use in drinking and cooking throughout the dry
season.
In areas where groundwater is saline, WFP and several other
NGOs have distributed rainwater catchments tanks free of charge. This precedent
will create difficulties for future cost recovery. In social terms the
management of the system is home based and so widely
are relatively low and the water is of suitable
quality. Such boreholes would be cheaper since they are within the capability of
hand drilling. In many areas of arsenic contamination, however, boreholes to a
depth of a least 200m will have to be sunk. Theses can be within the capability
of hand drilling provided the diameter is small. Otherwise they will require
different and more expensive technology. The water level in the deep aquifer is
effectively controlled by the water in the aquifer above, so it would not be
necessary to pump water from the full depth.
In non-arsenic areas, the same pump technology could be used where seasonal
draw down of groundwater renders suction mode hand pumps unusable and would
provide a cheaper and more acceptable alternative to the versions of Tara pump
now provided in such circumstances. Either the mini-Tara (or improved
equivalent) pump can be used in conjunction with existing wells or, if new wells
are constructed, these would only need to be dug deep enough to ensure
sufficient supply of water. The output from a force mode hand pump would be
lower than for a suction mode pump, because of the increased effort required to
raise water through a greater distance and could cause hardship to women
operators.
There are some parts of Bangladesh, particularly the South East, where
groundwater irrigation is limited and the static water level in the deep aquifer
remains within the suction limit. Consequently it is feasible, in these areas,
to use the No 6 hand pump with a DTW instead of a force mode pump. However,
given the high cost of a DTW and the low yield of a No 6 pump, this solution has
very high per capita costs.
4.3.5 Piped Water Supply from DTWs
Piped water supplies from DTWs fitted with electric pumps are a solution
which would vary in scale and cost, depending on the size of the community to be
served. Larger systems would save borehole and pump configurations similar to
those used for urban water supply. Distribution systems could be more expensive
because of the larger areas to be served for a given population. However, the
cost of a conventional system using a 10/s pump to serve a community of
2000-3000 people would be in excess of Tk 1.5M or about Tk 750 per capita. The
boreholes are also relatively expensive because they have to be drilled
mechanically.
An alternative approach would be to use much smaller pumps: A l/s pump would
need a smaller, and therefore cheaper, borehole and could provide a community of
about 1000 people with an average of 50 /c-d. This would be much easier to
organize for operation and maintenance, compared with a larger system. Piped
water systems, if well-managed and funded by public subscription, would
guarantee a more constant supply of domestic water than any other. In the 18
DTP, customers found that they could economize on water wastage under a metered
supply and so pay a cheaper flat rate so metering would be advised under this
system to ensure coverage to low-income households.
There are several choices for borehole based pipe systems to be used by
communities. One is to distribute the water to storage tank/standpipe units (the
4.3.7 Domestic Filtration or Treatment
Several different approaches have been developed for household filtration and
treatment of surface water to remove faecal pollutants. Oxfam and
Disaster Management Unit have introduced the three kolshi and five kolshi
domestic filter system to remove pathogens and iron to make water more palatable
and safe for drinking. However, these filters do not remove arsenic.
The Shafi filter and arsenic removal tanks are being tested
by various government and non-government agencies including Water Aid, UNICEF,
and Dhaka Community Hospital. These filters are reputed to be about 95%
effective in removing arsenic using alum (phitkiri) using the one (or
two) large plastic bucket
The problems of environmental pollution arising from the disposal of
arsenic sludge in areas of contamination and long term sustainability of the
option remain unresolved, however and are under investigation. Treatment using
alum requires time consuming stirring as part of the process and is unlikely
to be sustained over long periods though the pilot treatment involving
potassium permanganate requires only three minutes stirring. Another hindrance
to take up is the time required for filtration (eight hours for nine liters of
safe water) although the alum (aluminium sulphate) treatment is faster.
Results show that efficacy and safety of the treatments advocated depend to
a large extent on the increased awareness of householders, first, in how to
operate and
4.3.8 Community Based Arsenic Treatment Plants
In 1998-99, various types of small-scale arsenic removal plants were
introduced in pilot projects where severe arsenic contamination of HTWs was
detected. In Noakhali one small scale, community - managed tank system with tap
enjoyed a high degree of social acceptability. Field reports show that consumers
preferred the taste of be filtered water since the aluminum sulphate based
purification process removed the iron and other impurities at the same time so
improving water quality.
This fining presents a vital clue as to the potential for acceptability and
cost recovery of similar options. The cost of treatment and the additives in
this treatment system (mainly alum) were low and thus affordable. There have
since been health concerns, however, arising from the continual ingestion over
time of traces of aluminum sulphate. Additionally, the long-term problem arising
from any treatment plant remains the safe disposal of contaminated sludge. Much
more research will be needed to ascertain how this can best be done, if domestic
treatment continues to be advocated.
4.3.9 Ring Wells and Other Local Solutions
Ring wells are used in the EH regions where geological
conditions make it difficult to drill wells. Special wells such as shrouded
tube wells are used in the coastal areas, but are difficult to drill and often
fail. They are unlikely to be a sustainable solution as demands increase,
though they may be fitted with pumps and concrete seals to make them more
attractive to consumers.
4.3.10 Compatibility with NWPo and NPSWSS
All of these options are compatible with the NWPo in that they fulfill
primary human needs. However, to be in conformity with the 1998 NPSWSS, a
proportion of the cost would need to be met by beneficiary contribution. In
areas of arsenic contamination
where many consumers have invested in HTWs at the instigation of government
health bulletins and media campaigns, the proposal that people abandon their
independent water source (paid for at individual expense, in many cases) in
favor of shared, surface water sources, supplying water outside the bari
is unlikely to be acceptable.
4.3.11 Other Environmental Impacts
Risks to flood-proofed piped systems and cost of
rehabilitation from flooding, drought and cyclone are less than to individual
HTWs though leakage in pipes laid in flood-prone or water logged areas may
lead to contamination of the water supply. Pond sand filters may be more
vulnerable to contamination if strong bunds are not built up and maintained to
protect them from flood impacts. Treatment plants may also produce adverse
environmental impacts if contaminated arsenic sludge becomes inunundated by
floodwaters. Options for water supply respond to one of the most basic of
human needs. In terms of coverage and potential contribution to national need,
it is presumed that benefits to health and quality of life will accrue to all
recipients of piped water supply in a hydrological region at all service
levels (village, Union, Thana and District) and therefore, the coverage and
benefits would be greater than in many other options.
4.3.12 Community Based Water Supply Management Options
The NPSWSS advocates the future development of water supply
and sanitation through local bodies, private-public sector partnerships, NGOs,
CBOs and women’s groups (WATSAN committees among others). As part of the trend
to devolve planning and management to community 1evel pilot schemes such as the
Rajshahi SDC/CARE/WATSAN project have been put in place to test possible models.
The UNDP funded Sustainable Environmental Management Plan (which is implementing
26 projects through MOEF) is also supporting the development of other models in
WSS and related sectors such as the community-based ‘Rural Water and
Sanitation Schemes’ (with DPHE), the urban solid waste management projects in
Dhaka (with the NGO, Waste Concern), the urban waste water treatment in Khulna
City (with the NGO, PRISM), and the community based rural industrial waste
management scheme for small-scale textile dying. These are important since they
are entirely demand driven and locally managed, and as such, represent a new
private sector paradigm for Bangladesh. Economic incentives will probably need
to be provided in the future to attract private investors to provide rural water
supply systems, based on these or other models while, at the same time, to set
up and institute privately monitored but community-managed systems of cost
recovery.
4.3.13 Mass Media and Awareness Raising
The use of mass media (particularly television) for
disseminating public interest messages has been particularly successful in
Bangladesh over the last decade. The visual stimulus of television provides an
excellent conduit for ideas to be conveyed to the public in a way, which is both
informative and engaging. In recognition of the fact that behavioral change will
only come about through increased public education, it is proposed to use the
medium of television to create awareness of the NWPo, and to give the public
access to essential information on new safe water systems, best sanitation and
hygiene practice, and environmental conservation and protection.
The campaign is to be entitled ‘Water is Life’. The first part will
consist of a series of four programs on water and sanitation and the second, two
programs on water resource management. The public awareness campaigns will
target rural men and women though women as collectors of water and managers of
the domestic environment will form the major focus.
These programs will be developed in collaboration with the rural communities.
To attract interest in the ‘Water is Life’ campaign, the programs should be
based on field research and broadcast with the help of rural women, in a range
of regional dialects. Location shooting will provide the most authentic
environment for these programs and attract the most interest. For the programs
aimed at men, rural men, not actors, should also be involved in broadcast and
production. The programs should target low to middle - income users and address
the range of ethnic and religious minorities across Bangladesh including the
Chittagong Hill Tracts. Optimal timing of the broadcasts should be determined by
field studies of peak television watching hours of men and women. In areas like
the CHT where television access is constrained, radio programs in indigenous
languages should also be recorded and broadcast with the same messages.
4.3.14 Review of Rural Water Supply options
Subsidized water supplies only meet a small proportion of
need and in the future, private sector capital will probably need to be
sought to provide additional resources. Involvement of the private sector
also offers the most potential for stimulating innovations in technology and
improving equity of access to all consumers. The following development
strategies are worthy of consideration:
(a) In the few areas where the shallow aquifer is
proven safe from arsenic, then suction or force mode hand pumps can
continue to be used and water resources shared within the community However, such
communities would be expected to migrate to more convenient piped
supplies over time.
(b) Where there are the twin problems of arsenic contamination and
seasonal
draw down, systems could be developed to pump from the safe deep
aquifer,
using small electric pumps. This option offers considerable
potential for
mobilizing household and private sector funds, with moderate
financial
support from GoB. Such systems need to be given high priority in the
development program.
(c) Where existing water supplies suffer arsenic contamination but not
seasonal
draw down, ‘short term’ emphasis could be on treatment at either
household or community level in the short term, followed by the progressive
phasing in of alternative supplies, particularly small DTW based pipe
systems.
(d) Where existing water supplies suffer seasonal draw down but testing shows
that there is no risk of arsenic, initial emphasis could be on the installation
of a greater number of force mode hand pumps if the consumers were willing to
invest in this facility. (They are no longer subsidized). This may be done using
either new wells or existing wells (i.e. the new Tara
pump) though consumers would be expected to prefer the low cost piped water
supply options because of its greater benefits. Ultimately consumers’
perceptions of social appropriateness will become the most significant factor in
selection and adoption of an option.
(e) Private sector participation in the provision of
water supplies should be encouraged through economic
incentives. Involvement could be in the form of installing
small piped systems wit overhead tanks serving individual
hamlets or paras. Concessions should be given out
to individual companies for overall installation and
monitoring of systems subject to an overall regulatory
framework but the systems could be managed at the local
level by communities, ideally through some form of cross -
subsidy within the para for the disadvantaged group.
(f) The major non structural option is the use of mass media
(television in particular) to educate village communities in areas of suspected
contamination about the danger of health imbibing arsenic - laden water (by
drinking, cooking, or swallowing), and the protection and conservation of
surface water sources for the purposes of human consumption.
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