of the participants at the
held at Dhaka 14th
- 16th January 2002 at the request of the
The recommendations come
in three groups:
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ALTERNATIVE WATER SUPPLY COMPONENT
The alternative water supply groups recognized that:
1. Alternative Water Supply Options
alternative technologies are area dependent and cannot be prioritized for
the whole country;
the country is broadly divided in Shallow Water Table Area, Low Water Table
Area, Coastal Saline Area, Stony Area and Chittagong Hill Tracts Area requiring
no single option can serve the purpose of the people having different social
& economic conditions;
choice of the communities should be given priority in the selection of
there exists knowledge gap in some areas that impedes decision making regarding
selection of alternative technologies for arsenic affected areas
Despite many constraints the following alternative water supply options
In acute arsenic problem areas an alternative safe water point appropriate
in the area is to be provided in each village on an urgent basis following
ongoing national screening program.
Short-term Options (Alphabatically, not in order of priority)
Deep Tubewell (where suitable aquifer is available).
Dug/Ring well (where technically feasible).
Treatment of surface water (adequate quality and quantity).
Treatment of arsenic contaminated water.
2. Site Specific Selection of Options
Proven safe and sustainable technologies implemented under short-term options.
Piped water supply.
The possible sites for different alternative technologies are given
Deep Tube Wells
Manually operated deep tubewells are source of safe and reliable water
supply in many parts of the coastal area. In other areas, safe deep aquifers
may be available to produce water of acceptable quality for water supply.
Dug wells may be constructed where feasible for arsenic safe water supplies.
The areas with aquifers at shallower depth and the hilly areas are suitable
for construction of dug wells. The areas with thick consolidated clay layers
are not suitable for dug well construction. There should be a sanitary
protection and provision for disinfection of dug well water.
Dug/ring wells are to be tested in an acute arsenic problem areas for
arsenic content under following conditions of :
Continuous withdrawal of water for few days
Complete sanitary protection
Contamination from on-site sanitation
Rainwater harvesting has good potential for water supply in arsenic
and salinity affected areas in Bangladesh. It is suitable in the coastal
islands, south-western part of coastal area and hilly regions of Bangladesh.
Surface Water Treatment
Standardization catchments area and storage tank in relation to rainfall
intensity and distribution in Bangladesh.
Monitoring of water quality, particularly during the lean period.
Treatment of surface water can be a option in any part of Bangladesh
having perennial surface water of adequate quantity and of good quality.
The flowing rivers, reservoirs, oxbow lakes protected ponds are preferred
sources. The technologies include:
Slow Sand Filters/ Pond Sand Filters (PSFs)
Pressure filtration followed by disinfection.
Small-scale conventional or prototype treatment plants
Conventional surface water treatment plants
Treatment of Arsenic Contaminated water
Removal of impurities of any health concern.
Desired level of clarification and disinfection.
Some units developed for treatment of arsenic at household and community
levels and installed for experimental use in different parts of Bangladesh
have shown very good potentials for use in water supply in all arsenic
Centralized arsenic removal plant for urban water supply is possible.
In period of scarcity, arsenic treated water may supplement other sources.
Piped water Supply
Protocols for management of sludge and wastewater rich in arsenic are needed
to be developed.
Validation of technologies is essential prior to mass scale use.
Piped water supply is the long-term objective. In an urban center with
piped water supply, the people dependent on shallow tubewells can shortly
be brought under piped water supply through expansion of existing areas
of service coverage. Piped water supply should also be introduced in the
urban centers fully dependent on contaminated shallow tubewells. Arsenic
removal would be required for the few urban centers having arsenic contaminated
Piped water supplies are also possible for clustered households in villages,
growth centers and the rural areas having good rural road network.
Arsenic safe water for piped water supplies may be available from any
sources such as deep tubewell, treated surface or arsenic contaminated
water or water from community dug wells.
3. Monitoring and Surveillance:
Performance and quality of water of the existing safe tubewells and
the proposed short-term options need regular monitoring and surveillance.
4. Institutional Arrangement for Implementation
of Alternative Water Supply
4.1 Vision Statement:
Safe and adequate amount of water will be provided for drinking and
cooking in all households through effective, efficient and sustainable
institutions. Services will be provided and managed locally, which will
be transparent and accountable to the people. National interests and public
goods issues will be addressed by the Central Government.
(Safe: arsenic-safe, free from other chemical and microbiological pollutants)
4.2. Role of the Central Government
4.3. Role of Local Government
a. The governmental policy of decentralized provision of services
related to safe water options through the Union Parishads (UP) should be
operationalized immediately. This will lead to a much closer involvement
of local government in the implementation of safe water options.
A national legislation for water quality and supply for regulation, monitoring
and implementation should be developed. National Water Council must play
an important role in this process.
regulatory capacity of DPHE to provide technical guidance and monitoring
for supply of safe water should be strengthened.
b. UPs should also be involved in mobilizing resources, monitoring and
information management; more specifically registration of tube wells can
be undertaken by the UPs.
a. Local communities must be facilitated and empowered to undertake
planning, implementation and management of safe water options. This should
be based on informed choices. NGOs must play a vital role in this process.
Role of Communities and NGOs
b. There should be a strong focus on capacity development at the local
and/or community level for technical implementation and monitoring.
4.5. Role of the Private Sector
a. The private sector can play a key role in implementation of safe
water options and interacting with the end users. This role should be included
in the mainstream national policy for provision of safe water options and
development of innovative, enterprising solutions should be encouraged.
Formation of user groups for local implementation and monitoring should
be encouraged throughout the country with support from NGOs and the local
4.6. Capacity Development
a. Institutional capacity development for the regulatory functions
and monitoring should be undertaken by the Central Government (Ministry
of LGRD and Cooperatives).
Involvement of private sector in financing of well monitoring and safe
water options should be encouraged through tax relief and other incentives.
b. Capacity development at the local and community level should include
technical capacity for installation, operation & maintenance, and monitoring
should be a key element of the national policy. This should also include
the capacity for information management and reporting.
4.7. Information Management and Applied Research
5. Task Force
Knowledge and information should be managed centrally to ensure transparency
of the implementation process. Ready accessibility of information to all
stakeholders is essential. Governmental institutions, such as NAMIC, should
undertake this sustained role of functioning as an information warehouse
at the national level.
Centers of excellence on relevant research on safe water options should
be developed. These centers should focus on existing information and knowledge
leading to identifying and conducting research on key areas.
A Task Force led by DPHE may be constituted to undertake prioritizations
of safe water options and develop strategies for their implementation.
The Task Force should focus on: (i) a clear time frame for implementation;
(ii) the formulation of a protocol that includes technological and socio-economic
criteria; and (iii) a strategy for information management and dissemination.
The Task Force will formulate the roles and responsibilities of the
ministries, departments and directorates, local government institutions,
research institutions, private organizations, NGOs and CBOs.
The information emerging from the Task Force should be adequate for
making informed choices by communities.
6. Researches and Development
There are many areas of research and development in diverse fields of
alternative water supplies in Bangladesh. Some of them are listed below:
Leaching characteristics of arsenic rich sludges under different conditions
and possible contamination from arsenic rich effluents produced by arsenic
Development of construction, operation and maintenance manuals for each
of the following:
Water treatment plant
Piped water supply
Effect of sanitary protections on arsenic content of dug well water.
Development of effective, affordable and environment friendly arsenic removal
technologies for use in rural areas of Bangladesh.
Analysis of water supply situation including population exposed to arsenic
contamination based on updated data available from on-going studies and
national screening program.
An evaluation of effectiveness, impact and replicability of arsenic mitigation
initiatives in Bangladesh.
Study of water treatment plants in operation in Bangladesh: identification
of problems and possible solutions for application in the design of alternative
water supply technologies.
overriding priority for the health of the people of Bangladesh is to ensure
access to wholesome and pure, arsenic free, and bacteriologically safe,
water. Time is too short, we need to
Implication of health effects and impacts
were presented and discussed by more than thirty experts from home and
abroad. Three key presentations in the fields of diagnosis, treatment and
research were debated and recommendations made thereon.
Case Diagnosis Guideline
- Prof. M A Khalique Barbhuiya
- Prof. M Mazibul Haque
- Dr Harunur Rashid
diagnosis guidelines: - Summary
Three Flow Diagrams were suggested as diagnostic
guidelines by Professor MA Khalique Barbhuiya
Following extensive discussion amendments
were made and one comprehensive flow chart was agreed that can be used
at the field level. The flow diagram for diagnosis of arsenicosis
(PART-I) is not yet available in digital form to this webmaster.
Issues related to Arsenicosis both clinical
and public health should be incorporated in the Undergraduate Medical Curriculum
as well as Training of Paramedics
Set-up and maintain an effective and
proper referral chain for clinical case management of Arsenicosis cases
Preventive and Social Medicine should
Health Workers need to be trained as
soon as possible on case detection and management
Detection and reporting of cases should
be implemented - the hierarchical classification was endorsed
Establish a Multidisciplinary National
Task Force for identification, monitoring and recommendations on (mitigation
of) health impacts
Management - Summary
The Management Protocol provided a table
containing - Manifestation, Stages and Recommended Management process.
As the asymptomatic patients won't seek
any clinical intervention - it should be deleted from the management protocol.
Scientific proof is necessary before
incorporating the anti-oxidants like Beta Carotene and vitamin C and E
in the recommended management protocol.
The structure of the Management Protocol
should not contain any staging
Add follow-up and counseling to the
The role of Keratolytic Agents is merely
palliative - if given, then 5-20% salicylate should be used.
The management protocol should include
a footnote as follows:
Vitamin C and E is thought to be helpful for Arsenicosis Management but
are yet to have a proven role.
supplement should be given to those who are malnourished
Up to this date 73 research studies have
been conducted or are ongoing on health impact of Arsenic Exposure - 8
on management or clinical trials
There is a need for coordinated research
- both interdisciplinary and intersectoral was highly emphasized
A multi-disciplinary, autonomous, International
Centre for Arsenic Mitigation should be established in Bangladesh
High quality laboratories for epidemiological
and diagnostic investigation should be established in Bangladesh
A multi-disciplinary, autonomous, International
Centre for Arsenic Mitigation shouldbe established in Bangladesh
There is a need to coordinate research
- including interdisciplinary and intersectoral research.
Keep room for Investigator Initiated
study - exposure, cases including the dose-response relationship
for research in health are:-
Clinical trials - showing the effect
of antioxidants and other drugs
Effects on young, especially neonates
Effects on Reproductive Health
Health effects/impacts of alternative
Long-term cohort - interdisciplinary
Bio-availability and food chain
for research in health are:-
Low cost management
Pre-clinical - GI tract (absorption
Non-cutaneous manifestation and involvement
of other organs
Long-term risk associated with arsenic-caused
Pharmocodynamics and kinetics of arsenic
in the body
Factors related to Arsenicosis
Recommendation of the Hydrogeology
Screening of Tubewells
Monitoring of screened tubewells
Government has given due priority of screening of all tube wells. It is
recommended that the process be accelerated and screening of all the tube
wells both hand pumps and irrigation wells (approx. 10 million) be completed
by field kits on Priority Basis in highly contaminated areas in accordance
with the guide lines of the Governments Policy for Safe Water Supply and
Sanitation, 1998 . ( Short term)
testing facilities should be available to people at a reasonable cost.
Quality control of field surveys is essential for which Reference Laboratories
to validate field test results be established on a priority basis (short
System be developed to monitor the presently found safe wells, if possible
once a year ( mid term goal).
Immediate mapping be based on existing data of tubewells on Arsenic concentration
and depth of wells if location is available. This should be used as local
level guide for new tubewells (short term ).
Priority Project should be undertaken to find criteria for mapping the
Upper, Middle and Lower aquifers ( Holocene and Plio-Pleistocene sediments)
on Upazila as units. Union level exercise may be tried at a later date
( mid term).
Because arsenic is related to geology, a priority
project should be undertaken for mapping of facies, geometry and chemistry,
and classification of the Holocene sediments and correlate them to the
In those areas where groundwater is known to be safe, it should continue
to play a role in providing safe water supplies. But this must be supported
by a monitoring program (short term).
In arsenic affected areas, no new irrigation wells should be installed
in the arsenic safe aquifer to protect the presently safe water supplies.
This aquifer is frequently found at greater depth. (Short term).
The abstraction rate of the safe aquifers needs to be determined to assess
the potential for sustainable future water supplies from this resource
Ensure that the entire population has access to arsenic safe water (mid
Determine uses that require arsenic safe water such as cooking, drinking
and agricultural, etc (short term).
Monitor the quality and quantity of groundwater for those purposes requiring
safe water particularly for arsenic (mid term).
Develop enforceable standards for water well construction to prevent cross-contamination
of aquifers (short term).
# Investigate the source,
release mechanism and mobilization of arsenic in the ground water on a
priority basis ( short term).
#Detailed analyses and transport
properties of the aquifer sediments should be undertaken (mid term).
#Research on soil build-up of arsenic
through arsenic laden irrigation water and bio-availability of arsenic
and its subsequent entry into crop, agriculture and food chain (mid term).
#Evaluate methods of in-situ
arsenic removal from groundwater as an alternative method for supplying
arsenic safe water ( mid term).
Administrative and Legal Issues
Evaluate the effects on hydrologic and geochemical systems to actual and
future development of the groundwater resource (short term).
Identify isotopic signature of arsenic contaminated water from arsenic
safe deeper aquifers and to study the interactions between shallow and
deeper aquifers (mid term).
Investigate the seasonal changes in arsenic concentration and other information
required to develop a reliable and cost effective monitoring program (short
Develop simple tools to assist local drillers in site and depth selection
Groundwater is a valuable natural resource. A suitable "Groundwater Act"
should be enacted to control all activities regarding sustainable groundwater
exploration, development and management (short term).
A national standard should be established for arsenic content of irrigation
by groundwater (short term).
There is no single organization in the country that deals with all aspects
of groundwater although all our neighboring countries have organizations
such as "Groundwater Commission", "Groundwater Board" or "Groundwater Agency".
The Government should create or identify an organization bringing all the
personnel working on groundwater under one umbrella organization.
Government should coordinate all stakeholder activities in the sector based
upon their approved strategy.
Local Government Institutions should be given sufficient resources in recognition
of its key role in ensuring provision of arsenic safe water to the people.
An international center for groundwater related research and training needs
to be established in the country.