Contamination of drinking-water by arsenic in Bangladesh: A public health emergency (2000).

Bangladesh is facing a long-term epidemic of "cancer and other fatal diseases" because of contamination of water supplies by naturally-occurring arsenic says WHO. "The catastrophe is on a vast scale and needs to be declared a public health emergency." Professor Allan H Smith, a medical scientistof University of California, who undertook the study for WHO says, "Bangladesh is grappling with the largest mass poisoning the scale of this environmental disaster is greater than any seen before. It is beyond the accidents at Bhopal, India in 1984 and Chernobyl, Ukraine, in 1986." Out of its total population of 125 million, 35 to 70 million people are at risk of exposure to arsenic in their drinking water, Prof. Smith warns adding at least 100,000 casesof debilitating skin lesions are believed to have already occurred in Bangladesh. Prof Smith believes that had a public health emergency been declared, this might have prompted a more rapid response to the problem and millions ofwells and people remain to be examined. "The response tot he arsenic contamination is clear-cut," he states suggesting "provide arsenic-free water the health of the population is at risk and relief cannot wait for further surveys."

Some western marketing companies under the assistanceof donor agencies are taking the advantage of the situation and creatingmarket for their arsenic filtration devices. Many of these devices are notas dependable as told in their publicity materials. Moreover, no effectiveprogramme has yet been taken to give medicare to the arsenic affected patients."

The leaders raised question regarding the laps of thedonor agencies in determining the baseline for the quality of safe drinkingwater when they started pumping money in the field of safe drinking waterand sanitation in the early 70s. They also emphasized the need for a clearsafe drinking water policy in the country. Because, they said, the excessivepresence of Fluoride in the drinking water is also coming up. They warnedthat it would be another issue of health concern soon.

The development leaders in cooperation with a UK-based organization "Bangladesh International Action Network (BIAN)" also submitted a memorandum to the British Prime Minister Tony Blair seeking necessary support and intervention for addressing the Arsenic disaster.

The discussants said that they would take an initiative to submit a memorandum to the speaker of the Jatiya Sangsad so that the Arsenic issue could be discussed in parliament. Professor Qazi Qamruzzaman said that there were committees -- National Steering Committee and Technical Advisory Committee for overseeing and monitoring the arsenic disaster mitigation activities all over the country. But they are hardly found in real operation."

(The Bangladesh Observer - January 17, 2001)

British scientists 'failed to check for arsenic risk'

By Steve Connor and Fred Pearce

19 January 2001

British scientists failed to detect dangerous levels of arsenic in the supply of drinking water implicated in the biggest mass poisoning in history.  Two studies of groundwater quality in Bangladesh carried out by Britishhydrologists failed to monitor natural arsenic levels even though the testingwas suggested in voluntary guidelines drawn up by the World Health Organisation.

The British Geological Survey (BGS), the UK's most prestigious hydrology centre, carried out the studies on behalf of the Bangladeshi government in the mid-1980s and early-1990s, more than six years before arsenic was shown to be the cause of the mystery illnesses affecting millions of people. John McArthur, the professor ofgeochemistry at University College London, said that if the BGS scientists had followedthe WHO guidelines, much of the suffering and many of the deaths might havebeen avoided. "If they had tested for arsenic they would have been able topress the panic button. They would have been believed and the world wouldhave known about it long before it did," Professor McArthur said:

"If they had looked for arsenic they could have found it – thereis no question of that – and remedial action could have happened fiveor eight years before it did."

Millions of Bangladeshis are suffering from arsenic poisoning as a result of drinking contaminated water drawn from some of the 10 million new wells sunk over the past 25 years as part of an international development programme aimed at providing clean drinking water.  Many of the residents of Bangladesh's 68,000 villagessuffer from the early stages of poisoning, such as ulcerous skin growths.The final stages are gangrene and cancer and an estimated 20,000 people a year have died in the tragedy.

Professor McArthur is critical of the oversight that resulted in the BGS failing to find arsenic. "They did not find arsenic because they did notlook for it, even though there were routine, well-established techniquesfor doing so," he said. "They should have analysed for all the trace elements in the WHO guidelines – andthat included arsenic."

Denis Peach, the manager of groundwater systems and water quality at the BGS, accepts that arsenic was one of the "many parameters" in the WHO's "Drinking Water Guidelines" in the early-1990s. "Nevertheless, it was and remains common practice not to measure all the determinants [sic] on the list ... for reasons of costand/or availability of facilities," Dr Peach wrote in a statement. "Some judgement always needsto be made commensurate with the scale of the resources available and theperceived – at the time – likelihood of a problem. In retrospect,we – and others – made a mistake."    The BGS said that there was no reason why it should have tested for arsenicgiven that the scale of the problem did not emerge until the middle of 1997onwards. Arsenic was not routinely measured by most water-quality labs becauseit was not widely thought to be a problem in groundwater, other than in mining regions, it said.However, Professor McArthur said there was no excuse for the BGS not to knowabout the WHO's guidelines on arsenic.

"If one really wanted to be charitable to the BGS, you'd excuse them fornot finding it the first time, but failing to look a second time appearsto be inexcusable."

Courtesy: The Independent News (United Kingdom)

Yet this editorial in The Bangladesh Observer on the same theme, was largely ignored.

In January 1999 the long awaited BGS-Mott MacDonald report, "Groundwater Studies For Arsenic Contamination In Bangladesh" Phase I was published. Many scientists were surprised when they found it contradicted the view that the arsenic contamination of groundwater was caused by a lowering of the water table that had allowed oxygen to get into the aquifers and attack the arsenic bearing iron pyrite deposits in the sediment. Since the publication of this report there has been a persistent controversy on this issue alone. Today there is another. Dr. John McArthur, whose team was the first to report on the geochemistry behind the world's largest outbreak of arsenic poisoning, and a Reader in Geochemistry Geological Sciences at the University College London has accused researchers at the British Geological Survey (BGS) ofwithholding vital data.

Two years ago the BGS carried out the first comprehensive chemical testing of tubewell water in Bangladesh. It concluded that thewater being drunk by up to 40 million Bangladeshis contains arsenic at sometimes hundreds of times the recommended safety level of 0.01 mg/litre but, Dr.McArthur says, BGS is refusing to allow him access to most of the measurementsmade on over 2000 water samples taken during the survey. Why this is sois impossible to ascertain, more so because it is not from the on-going PhaseII, but from the completed Phase I and has already been published in graphform in Volume S4 of the BGS-Mott Macdonald report. This detailed data hasalso not been made available to others who are working on the project inBangladesh.

Dr. John McArthur says BGS holds the only comprehensive data set capable of proving which of the disputed theories is right, so he wants it released to the public as the answer will dictate where, in theabsence of practical chemical treatments for the poisoned wells, safer wellscan be dug. He also claims the embargo by BGS is preventing scientists inBangladesh and elsewhere from reaching agreement on how the arsenic got intothe water but BGS refuses to budge from its position and says it will makethe data available later this year. The reason? "Because in some cases" they"were not sure of it, and in other cases it was not important." BGS alsosaid it "wanted to have the first chance to look at [their] data properly"themselves.

DPHE have reportedly asked for the data but BGS has still not handed it over yet, as the data is from Phase I of the study, it is owned by the DPHE on behalf of the government of Bangladesh and therefore is well within its rights to demand it. The situation becomes more intense as it was the same BGS who had in 1992 undertaken a water quality survey on 19 wells and produced the following report and paper: Davies J and Exley C, 1992. BGS Technical Report WD/92/43R. Hydrochemical character of the main aquifer units of central and north-eastern Bangladesh and possible toxicity of groundwater to fish and humans and "The hydrogeochemistry of alluvial aquifers in central Bangladesh" by J. Davies. In: Groundwater Quality; H.Nash and GJH McCall (eds). Chapman Hall, 1994,

The abstract to the second paper states "The groundwaters are all of Ca(HCO3)2 type, suitable for crop irrigation and domestic use." This paper appeared three years after the Indian PHED Report of 1991 into the arsenic crisis in West Bengal and in the same year as: Das et al. 1994. Arsenic contamination of six districts in West Bengal, India: the biggest arsenic calamity in the World. Analyst, 199, 168-170. But neither of these BGS articles mentions arsenic although, according to experts, the data contains many very clear chemical pointers to its presence (high phosphorus and iron, highish bicarbonate) . Nickson et al. (1998, 2000) found arsenic pollution in the areas BGS sampled. Now BGS are funded by DFID to investigate arsenic pollution. BGS collected samples for their Three Thana Survey in February 1997 and March 1998. The accusation levelled at them is they still have not published the important parts ofthat data a full year after they published the unimportant data. However,if as BGS claims, the data is not important, what valid reason can they havefor withholding it? The point is - what if it is important? Who is to decideits relevance? BGS or the owner (DPHE)?

As BGS wrote the volume known as "S4" and also Chapter 6 of Vol S2, plus the Q&A in the Main Report, they and they alone have access to the data -- therefore they and they alone are responsible for suppressing the information. In contrast the Regional Survey (vol S2) published all the results for the 2000+ wells listed whereas in S4 no individual results have been given. As a set of these reports were given to each district XEN, there was every reason to expect they contained the complete data and that theaffected people would be informed. Which brings us to our next question -- Why were the users of the arsenic-contaminated wells in Faridpur, Nawabganjand Lakshmipur not told and warned of the danger from drinking water fromthese wells?

DFID is reported to have written to DPHE asking them to inform the people of the results but without the complete data they could not because they were unable to identify individual owners/users. This is one valid reason why the data must be handed over without delay. In fact the only way to resolve this issue is for the data to be released immediately. This is a matter that has been taken up by the international press and at least one author, Fred Pierce, asked - "Could wrangles over science delay a solution?" It would indeed seem so for if scientists continue to debate the issue they cannot come to grips with the solutions. And as Dr. McArthur says, "with many people in Bangladesh and India still convinced of the oxidation argument, it is a tragedy not to have published the data. Pyrite oxidation would happen mainly in shallow wells [less than 10 metres deep], and theanswer will be to dig deeper wells. But iron reduction would happen at deeperlevels and the answer will be shallow wells." But BGS remains firm aboutnot publishing the information earlier than planned saying: "We didn't putall the data in the first report because in some cases we were not sure ofit, and in other cases it was not important. Also we wanted to have the firstchance to look at our data properly." He says his final report will be completein April and published later this year. The point is - can the people ofBangladesh wait that long?

A new research by McArthur, J.M., Ravenscroft P., Safiullah S. and Thirlwall M.F. called "Arsenic in groundwater: testing pollution mechanisms for sedimentary aquifers in Bangladesh gives a new slant.

Abstract.

In the deltaic plain of the Ganges-Meghna-Bramaputra rivers, arsenic concentrations in groundwater commonly exceed regulatory limits (>50 micrograms/litre) because FeOOH is microbially reduced and releases its sorbed load of arsenic tog groundwater. Neither pyrite oxidation nor competitive exchange with fertiliser-phosphate contribute to arsenic pollution. The most intense reduction, and so severest pollution, is driven by microbial degradation of buried deposits of peat. Concentrations of ammonium up to 23 mg/litrecome from microbial fermentation of buried peat and organic waste in latrines. Concentrations of phosphorous of up to 5 mg/litre come from the releaseof sorbed phosphorous when FeOOH is reductively dissolved, and from degradation of peat and organic waste from latrines. Calcium and barium in groundwater come from dissolution of detrital (and possibly pedogenic) carbonate, whilst magnesium is supplied by both carbonate dissolution and weathering of mica. The ⁸⁷Sr/⁸⁶Sr values of dissolved strontium definea two component mixing trend between monsoonal rainfall (0.711 + 0.001) and detrital carbonate) <0.735)

Over the past 13 years we have analysed the water in at least 500 dug-wells in arsenic-affected areas of West Bengal and in the last 6 years in the affected areas of Bangladesh.   In none of the wells havewe found arsenic above 50 ug/l. Please note, minute sand particles with dug-wellor river water may show some arsenic, but that is due to arsenic from sedimentparticles.    Villagers in Bangladesh (Anandipur, Mymensingh Sadar)said that only 10-15 years ago they were using dug wells and only stoppeddoing so because they were told that the underground water was the only optionfor attaining good health & green revolution.  Prior to 1970's the peopleof Bangladesh had been using dugwell water for thousands of years, but hadnever known any arsenic related disease.  

ACTIVITIES BY OXFAM ON ARSENIC ( Final Progress Report of the ArsenicMitigation Programme (Pilot Phase) January, 2000 – December, 2000

Introducing Safe Surface Water Drinking Methodologiesat Household Level: Rainwater Harvesting Systems, Mini-Sand Filters, Pitcher Filters And Pond Sand Filters.

Location : Charbata, Maijdeegram, Purba Karimpur and Narattampur in Sadar Thana, Noakhali & Khazanagar, Kushtia Sadar. Muraripur, Baraichara, Padmabila & Chakhoripur at Shomespur Thana, Kushtia.

Reporting period: 10 month. January 2000-December 2000

Total Cost: Tk. 30,73,554.00

Implemented By: Sagarika, Noakhali; Setu, Kushtia; & Bohn, Dhaka.

Technology: Rainwater Harvesting Systems: Mini-Sand Filters; & Pitcher Filters; Pond Sand Filters.

Coverage: 154 households in 09 (nine) villages in Noakhali & Kushtia District. Of these households, 119 have Rainwater Harvesting Systems. 15 have Mini-Sand Filters & 15 of the remaining households have Pitcher Filters.

Screening of Tubewells & Base-line Survey::

During the pilot phase, two types of tubewells (TWs) were screened: The tubewells installed by the DPHE, hereafter called GOB Tubewells, and those installed by other organisations or privately, hereafter called General Tubewells.

At the start of the programme, Oxfam conducted a training course to 4 (four) field staff and to 17 (seventeen) volunteers. What was undertaken in the classroom was extended to the "on-the-job" training programme. Upon completion of training, the trainees were fit for conducting screening activities in the field. Those tubewells found to be contaminated with arsenic above 0.05 mg/l were marked in red and those containing arsenic below this level were marked in green. The screening of 1429 tubewells in 5687 households was completed under the programme.

During the programme people became aware of the arsenic contamination in the groundwater and its affects on human health with the result they stopped drinking the water from the tubewells marked with red paint. A few tubewells have been broken by the boys of the villages, however, the inhabitants have taken effective measures to meet this crisis which will be discussed later. Testing for arsenic in the tubewells has been performed with a Merck kit and the result compared in the laboratory to ensure theresult of the field tests are correct .

40 nos. of water samples were collected on April 02, 2000 from 04 (Four) cluster villages in Noakhali District from 20 (Twenty) different tubewells. Out of these 60 samples, Half were sent to the laboratory of the Department of Public Health Engineering (DPHE), Comilla and the Bangladesh Council of Scientific and Research Laboratories (BCSIR), Dhaka, in orderto check that the Quantitative Test of Arsenic in the tubewell water wascorrect. The result was compared with the Qualitative in field test usingthe Merck Kit. The chart below shows the test results in the laboratory (Table-2);

Table 2: Comparative Test Result for Arsenic Contaminated Water Samples.

Notes : < = Less than; > = Greater than.

As can be seen from the above table, the qualitative test result using the MERCK Kit showed a higher result than the quantitative tests done in the laboratory. This was because it was difficult to measure thequantity of arsenic below 0.500 mg/l. It may be mentioned here that the costof each test is Taka Five Hundred (Ta. 500) only. This figure is beyond theability of the poor people in the rural areas and also takes too long toknow the test result.

However the test result obtained using the MERCK Kit indicates all the tubewells tested were contaminated with arsenic at a level that will severely affect human health in the near future. The effort of this base-line survey and the marking of all the tubewells is effective by using the MERCK Kit in the field so as to accelerate the work.

Some paraclinical information on the study of the population in the affected area :

Results & Observations

Investigation of urine for arsenic: 1 person out of 60 tested was +ve

In the case of people consuming rainwater: 2 persons out of 30 were +ve

People drinking tubewell water: In some families, the total family members are not drinking rainwater, inspite of having the facility for rainwater harvesting (constructed tank).

The skin condition was the same as before the construction of the rainwater harvesting system, with improvement of some skin diseases which had been treated with the supplied medicine.

The Hb% & ESR was more or less the same as previously. The biochemical change was not significant. Stool & urine examination findings were also more or less same.

4.0 Implementation of Alternative Options.

Oxfam - GB, Bangladesh/ Sagarika/ Setu & Bohn's pilot programme has been implemented in 02 (two) Districts, 03 (three) Thanas and 09 (nine) Villages. As noted above and the following options were introduced/constructed in the search for providing safe drinking water.

Note : ** Activities stopped due to managerial problems. Situation in Sagarika did not permit their completion. Figures shown in parenthesis only implemented.

There is sufficient data to evaluate the efficacy of the alternative options and also to inform those involved in water/ hygiene/health of several important observations.

In general the water of Rainwater Harvesting System was found to of good quality (75%) as grade A. Combined result is 90.30% of grade-A & B respectively.

Those of the samples taken from ponds and unprotectedsources, as well as unhygienic conditions have shown the presence of faecalcoliform contamination. (100%).

Samples taken from the Rainwater Harvesting Tank, those that have been well cleaned before the collection of water show an improved quality (100%).

Most of the contamination to Rainwater Harvesting Tanks occurs due to the unhygienic collection of water, e.g. dirty and rusted roof, rotten leaves, etc.

13.39% of the samples taken from household containershave shown 7.59% faecal contamination even though the water has been collected from a safe source. This happens due to unhygienic water handling.

From the data and general survey information, the following conclusion has been attained:

The community believed that water from all the alternative options was safe whether or not it was protected. (i.e clean, rust &dirt free etc.).

Indiscriminate installation of alternative options without sanitary protection and feasible site selection can expose a community to risk of an epidemic, because the community perceives even contaminated water to be of good quality.

The Programme suggests that the focus should be on improving the existing water sources as well as providing new sources where provenfeasible in all respects.

Unhygienic handling and storage of water is the main source of contamination. To prevent the contamination of water from the point of collection to the point of consumption requires the undertaking of a vigorous promotion of sanitation and personal hygiene practice.

The Programme recommends that emphasis be given to promoting better hygiene at household level. During the current programme, VillageHealth Workers and Village Health Volunteers were trained to under take thiswithin their area of operation.

The details of water testing reports are available atSagarika liaison office, Maijdee, Noakhali.

Report By: MOZAMMEL HOQUE

Project Engineer

Arsenic Mitigation Programme

Oxfam-GB, Bangladesh.

The Department of Occupational and Environmental Health (DOEH) conducted some comprehensive arsenic activities in villages Rajarampur of Nawabganj, Samta of Jessore, Hajigonj of Chandpur, Hossainpur and Nilkanda of Narayanganj. These encompassed the identification and management of arsenicosis cases, identification of contaminated tubewells, distribution of arsenicpurification domestic filters and arsenic removal chemical packets for purificationof water, plus an awareness program. Some of the activities have been supported by WHO, UNICEF and Asia Arsenic Network (AAN). In Samta DOEH and AAN hascarried out a detailed study and established a group of the arsenic exposedpopulation for observation of its long-term effects.

Now DOEH, in collaboration with AAN, is implementing a "Mobile Arsenic Centre Project" in arsenic affected villages of Khulna and Barisal Divisions. Under this project, the screening of tube wells for arsenic contamination; identification of patients and their management, and the provision of safe community water sources that are suited or acceptable to the villagers through community participation with the cooperation and support of the villagers and the local NGOs.

DOEH, with the collaboration of Asia Arsenic Network,conducted a house to house medical survey for arsenicosis patients as a partof the 'Mobile Arsenic Centre Project` in the Villages of Agarhati (April17-18, 2000) and Durbadanga (November 10-11,2000) of Chuadanga. 500 new arsenicosis patients were identified. Medical treatment was provided to the newly identified patients and surgical intervention and chemotherapy was arranged for 5 patients having neoplastic manifestations.

To be able to use the surface water, DOEH in collaboration with AAN are installing Pond Sand Filters (PSFs) which have been found to be efficient in various arsenic affected villages, plus a cost-effectivecommunity based surface water treatment plant as a source of arsenic-freesafe water option. With the collaboration of the Asia Arsenic Network, theyalso constructed four PSF in four different arsenic affected villages.

With the collaboration of AAN, one improved sealed deep tube well has been installed in an arsenic-affected village This well will be observed over a prolonged period for suitability as an option of arsenic-free water.

DOEH encourages the utilisation of rainwater for cooking and drinking and has disseminated the know-how related to rainwater collection and storage in several arsenic affected areas.

Research and Publications of Department of Occupational EnvironmentalHealth :

For dissemination of information and knowledge gathered through research DOEH members participated in national and internationalseminars, and published articles in both national and international journals.

DOEH members have also produced a book in Bangla on the arsenic issue, 'Arsenic, Panite Dushan O Shastya Shamashya' and a training manual in English.

DOEH has a collection of photographs showing the different grades of arsenicosis manifestation and has made them available to many organisations and individuals involved in arsenic activities. These photographs are contributed by Dr. Sk. Akhtar Ahmad of DOEH.

NIPSOM students, with the supervision of DOEH faculties, performed about 15 research studies (as dissertation) related to the arsenic issue. These different research papers generated much important technical information.

With the collaboration of the Department of Environmental Design, Kyushu Institute of Design (JAPAN) and the Asia Arsenic Network,DOEH completed an in-depth socio-economic survey on arsenic poisoning inthe village Samta.

DOEH is continuing its research activities on variousaspects of Arsenic Contamination including its consequences and mitigation.

International Publications:

1) Hypertension and Arsenic Exposure In Bangladesh. Hypertension, 1999; 33(1): 74-78.

2) Arsenicosis in a Village of Bangladesh. Int J Env Health Research,1999; 9(3): 187-196.

3) The Relationship of Arsenic Levels in Drinking Water and the Prevalence Rate of Skin Lesion in Bangladesh. Environ Health Perspect, 1999; 107:727-729.

4) Arsenic contamination of ponds in Samta village and water purification system using pond water. Arsenic Contamination of Groundwater in Bangladesh, Interim Report of Research at Samta village, published byAsia Arsenic Network, Research Group for Applied Geology of Japan and Department of Occupational and environmental Health, NIPSOM., Bangladesh, April 1999: p 64-69.

5) Arsenic in ground water and arsenicosis in Bangladesh. Into J Env Health Research, 1997; 7(4): 271-276.

6) Diabetes mellitus associated with arsenic exposurein Bangladesh, Am J Epidemiol 1998; 148: 198-203.

7) Ground water calamity in Bangladesh. Current Science 1997; 73 (1) 48-59.

National Publications:

1) Arsenicosis and Sex Differentials, JOPSOM (Journalof Preventive & Social Medicine), 1999; 18(1) 35-40.

2) Arsenicosis: Neoplastic Manifestations Of Skin, JOPSOM (Journal of Preventive & Social Medicine), 1998;17(2): 110-115.

3) Chronic Arsenicosis: Management by Vitamins A E C Regimen. JOPSOM (Journal of Preventive & Social Medicine), 1998; 17(1):19-26.

4) Arsenic Contamination in Ground Water and its Effect on Human Health with Particular Reference to Bangladesh. JOPSOM (Journalof Preventive & Social Medicine), 1997; 16(1): 65-73.

5) Modified arsenic field test kit: A cheap and easy device for detection of arsenic in water. JOPSOM (Journal of Preventive & Social Medicine), 1997; 16(2): 143-150.

1) Ground Water Arsenic Contamination and its Effect on Human Health in Bangladesh, 8th. Annual Scientific Conference (ASCON), ICDDR,B, Dhaka, February 13-14, 1999:p-5-6.

2) Health Effects Due to Arsenic Toxicity In Bangladesh, The 3rd Forum on Arsenic Contamination of Ground Water in Asia, MiyazakiUniversity, Japan, November 22-23, 1998:p-5-6.

3) Arsenic Contamination in Ground Water and its Effects on Human Health with particular Reference to Bangladesh, International Conference on Arsenic Pollution of Ground Water in Bangladesh: Causes, Effects and Remedies. Dhaka, Bangladesh, February 8-12, 1998.

1) Arsenic in Drinking Water, Health Effects and Management : A Training Manual. Published by Department of Occupational and Environmental Health, NIPSOM, Dhaka, June 1997.

2) Arsenic, Water Contamination and Health Hazards (Bengali), Edited by Sk. Akhtar Ahmad, ISBN: 184-31-0804-X, February 2000.

Detailed screening of tube-wells was carried out using NIPSOM field kit and subsequently the tube-wells were marked with the specified colors, thereby rendering them identifiable by the population as either safe or unsafe, (red for contaminated tube-wells (arsenic content > 0.05 mg/L), green for safe tube-wells (arsenic content < 0.05 mg/L)] . Water from only 12 (twelve) out of a total 159 tube-wells in the village were foundto conform with the sub-continental safety limit of 0.05 mg/L, while theremaining 92.4% tube-wells were found to be contaminated with arsenic abovethe safety limit.

At the same time, a communication campaign was carried out by way of meetings with different sections of the community; group discussions; house to house visits by researchers and field assistants; in order to build up public awareness of the arsenic contamination related problems. Theseefforts are already yielding positive results in the form of people refrainingfrom using the contaminated water and using only the water from safe (greenmarked) tube-wells as their source of drinking water.

In the next phase, a survey was carried out to recordthe population and tube-wells on a household basis and to identify the households and/or population served by individual tube-wells. The objective of carrying out this survey was to identify the extent of contamination in the specified area and the population at risk.

Although no detailed health screening was carried out, a few patients were identified in the village based on spontaneous, "onthe spot" screening by the researchers. Many of them are already undergoingproper medical treatment.

At present the oxidant and coagulant based Emergency De-arsenation units are undergoing field trials. After completion of the field trial the de-arsenation units will be supplied to the affected population without access to present safe water sources (i.e. green marked tube-wells) in the project area and under supervision of the 'Arsenic Mitigation Committee'.

For a long term solution to the crisis we are going to start building a Pond Sand Filter [PSF] in the village, as we prefer theutilisation of surface water, especially in the areas of lower delta plainwhere the ponds contain sufficient water even after the lowering of the 'watertable' in the dry season.

Source: Arsenic Research Group [BDRM]. The Arsenic Research group is conducting an action-research project combining geosciences, mitigation and health issues at the village Ichapur, Comilla; with funding from the PRPA of Grameen Trust.

The JICA Study Team began a study of groundwater development of the deep aquifers with a view to providing safe drinking water to thearsenic affected areas in Western Bangladesh. The main objective was to preparea master plan to cope with arsenic contamination of groundwater.

The following villages were selected as "Model Rural Areas." -- Bara Dudpatila (Chuadanga District, Damurhuda Thana, Howli Union, Dudpatila Mauza) -- Rajnagar Bankabarsi (Jessore District, Keshabpur Thana, PanjiaUnion, Rajnagar Bankabarsi Mauza) -- Krishna Chandrapur (Jhenaidah District,Maheshpur Thana, Fatehpur Union, Chandpur Mauza)

Household interviews on socio-economic conditions, testing of tubewells, drilling of deep wells, performance test of arsenic removal equipment, core boring, and diagnosis of arsenic patients. Household interviews and testing of tubewells has already begun, however due to flood in the area of study, the activities have not been completed.

In eight upazilas of the district, arsenic has been detected in a good number of tubewells. The number of affected people has risen to 422 and the death toll is said to be ten. According to the Public HealthEngineering Department (PHED), out of a total of 819 deep-tubewells in theseeight upazilas, the water in two has been found to be contaminated. Of atotal of 83,6191 shallow-tubewells, the water of 16,808 has been found contaminatedwith arsenic. 2,047 tube-wells are out of order. The break up of shallowtubewells found contaminated is: Sadar - 174, Keshabpur - 375, Sarsha -238, Monirampur - 469, Jhikorgacha - 15,481 and Abhoynagar upazila - 71.

A source at BRAC said the water in 41 per cent of tubewells in Jhikorgacha upazila is contaminated with arsenic. A survey report of a voluntary organisation, the Agricultural Advisory Society says the quantity of arsenic in the tubewells in the district is 30 times higher than the WHO limit. In Jhikorgacha and Sarsha upazilas, the quantity is 45 times higher. A source in the district Health Department said 422 men and women have been attacked with arsenicosis. Of these 206 are from Jhikorgacha, 129 from Chowgacha, 75 from Sarsha, five from Abhoynagar, four from Sadar and three from Keshabpur upazilas. Sources at Grameen Bank and BRAC said seven people had died from arsenic-poisoning in village Shamanta in Sarsha upazila. Fazlur Rahman of Ujjal village and Monsur Ali of Jafarnagar village in Jhikorgacha upazila and another person from Prembug village in Abhoynagar upazila have also died from arsenic related diseases.

Panic is spreading in the northern region of Bangladesh as arsenic related diseases now affect a large number of people due to the consumption of arsenic-contaminated groundwater. (UNB).

In Gaibandha District, the Dhaka Community Hospital with the aid of PHED and an NGO, tested the water of 341 tubewells in Saghataand Fulchhari upazila. The test results showed that the water in 48 of thetubewells contained arsenic beyond the permissible limit. The reports alsoshowed that the water of some of the areas in 10 out of 16 districts arecontaminated. These tubewells have been sealed. After examining 5,499 peoplefrom 757 families, 14 were found to be suffering from arsenic-related diseases.Arsenic beyond the permissible limit was also found in the tubewell watersof Bogra, Joypurhat, Nilphamari, Thakurgaon, Lalmonirhat, Panchagarh, Kurigram,Gaibandha, Dinajpur and Rangpur districts. Sources said water samples from600 tubewells were sent to Javadpur University in Calcutta for testing. ThePublic Health Engineering Department with the assistance of UNICEF, has takenup a programme to install arsenic-free deep tubewells in different districts.People in the arsenic contaminated areas have been advised to drink surfacewater after boiling and rain water.

International Opinion on Field Kit for arsenic analysis

The Mercuric Bromide stain method was evaluated in a Round Robin exercise. The arsenic concentrations for a solution of arsenic at 50 µg As/L in distilled water had relative standard deviation 75%". (The arsenic field kits are based on mercuric bromide stain method principle). The mercuric - bromide stain method is incapable of providing a quantitative meaningful result (Results with RSD &lt;= 10%) below concentration of 150 µg As/L". (Arsenic exposure and health effects edited by: C.O.Abernathy, R. L. Calderon, W. R. Chappell, Chapmann &; Hall, 1997, page-18)

The kit is not only inadequate to screen water samples containing less than 100 ppb of arsenic, it also provides toxic arsine gas that may be health hazard." (Arsenic exposure and health effects edited by: C.O. Abernathy, R.L. Calderon, W.R. Chappell, Chapmann &; Hall, 1997, page-30).

In India and Bangladesh the present permissible limitof arsenic in drinking water is 50 µg/l and we believe soon it maybe 10 µg/l. The reasons for saying this are (1) WHO guide line valueis 10 µg/l (2) the USA is expected to change its maximum permissiblelimit (3) our field data shows that a given concentration of arsenic in drinking water affects people with poor nutrition levels more than those with better nutrition levels, and in arsenic affected area of W. Bengal and Bangladesh millions are suffering from malnutrition (4) adult people of West Bengaland Bangladesh drink in an average 4.0 liter of water per day (Ph.D. Thesis,Status of Arsenic Problem in Two Blocks out of Sixty in Eight GroundwaterArsenic Affected Districts of West Bengal, India; Badal Kumar Mandal, JadavpurUniversity, Calcutta, India, 1998) when the present WHO guide line valueand maximum permissible limit 10 µg/l and 50 µg/l have been arrivedon the basis of 2.0 liter of water consumption per day. Thus for poor nationsarsenic in drinking water should be even less than WHO limit.

If the Government of India and Bangladesh recommend the level of arsenic in drinking water to 10 µg/l then the data we aregoing to generate spending millions of dollar will not be so useful and wehave to go for sensitive instrumental techniques as we cannot expect to getany reliable data at the 10 µg/l level from the presently availablefield kits. So it will be a wise decision to select an instrumental techniquethat can determine 5 µg/l of arsenic in 95% confidence level and instrumental technique will be much cheaper compared to Field-Kit if large number of samples are analysed, as is going to be the case in West Bengal and Bangladesh.

The School of Environmental Studies (SOES), Jadavpur University is suggesting FI-HG-AAS technique that can measure arsenic in the level of 5 µg/l (with 95% confidence). Over the last 10 years, SOES has applied this technique to analyse for arsenic 80,000 water samples, more than 13,000 urine samples, about 10,000 each hair and nail samples and about 1,000 skin-scale samples from 9 affected districts of West Bengal and 42 districts of Bangladesh. Finally School of Environmental Studies (SOES) very strongly feels that attempts to introduce Field Kits by spending millions of dollars would only mean waste of money (details report will be circulated soon).

Tests conducted by the All India Institute of Hygieneand Public Health have confirmed that the water in Alipore contains arsenicbeyond the levels recommended by WHO..

The Calcutta Municipal Corporation instructed officesusing water with high arsenic content to stop using the water from thesesources. Tests conducted by AIIHPH reveal high arsenic content in many ofthe samples, including those from 1 Belvedere Estate, Regional Met Centreand the National Library.

1. Belvedere Estate, tube well no.1 - 67 micrograms/litre

2. New tube well at 1, Belvedere Estate - 47 micrograms/litre

3. 30 Belvedere Estate, new tube well - 27 micrograms/litre

4. National Library, t.w. no. 1 - 20 micrograms/litre

5. National Library, t.w. no.2 - 20 micrograms/litre

6. Regional Met Centre,t.w. no.1 - 120 micrograms/litre

7. National Test House, t.w. no.1 - 33 micrograms/litre

SURAWATI SENGUPTA

STATESMAN NEWS SERVICE

CALCUTTA, Dec. 4. -

The National Water Management Plan Draft Development Strategy prepared by the Water Resources Planning Organisation (WARPO)]. The NWMPpresents a firm plan for the next five years, an indicative plan for thefollowing five years, and a perspective plan to 2025.... The Plan will bereviewed and updated every five years, set in the context of developmentindicators for the coming 50 years." -

Source Introduction, Summary of Options.

A draft final version of "WaterAid: Arsenic 2000 - Overview of Bangladesh arsenic - Draft Final Report" is now available. It includes an extensive "who is doing what in arsenic" section. The final report is expected to be published in January 2001.

"The conclusion and way forward is separated into an emergency or short-term. strategy and a long-term strategy. The long-term strategyis further divided into urgent issues and those that are essential but notas urgent. It is imperative that two distinct yet systematic strategiesare developed to enable full coordination and guidance to organisations active in arsenic mitigation. The strategies should run in parallel with each other and ensure formal lesson learning and dissemination of documentation between the different and complimentary approaches. A clear distinction can be made between a strategic long-term aim and an emergency mitigation programme."

Abstract:

Drinking of arsenic-contaminated tubewell water has become a serious health threat in Bangladesh. Arsenic contaminated tubewells are believed to be responsible for poisoning nearly two-thirds of this country's population. If proper actions are not taken immediately, many people in Bangladesh will die from arsenic poisoning in just a few years. Causes and consequences of arsenic poisoning, the extent of area affected by it, and local knowledge and beliefs about the arsenic problem - including solutions and international responses to the problem - are analyzed. Although no one knows preciselyhow the arsenic is released into the ground water, several contradictorytheories exist to account for its release. Initial symptoms of the poisoningconsist of a dryness and throat constriction, difficulty in swallowing, andacute epigastric pain. Long-term exposure leads to skin, lung, or bladdercancer. Both government and nongovernmental organizations (NGOs) in Bangladeshforeign governments, and international agencies are now involved in mitigatingthe effects of the arsenic poisoning, as well as developing cost-effectiveremedial measures that are affordable by the rural people."

Paul, Bimal Kanti; De, Sujata. J. American Wat. Res. Assoc. 36(4) (August) 799-809.

A rather disconcerting revelation by Smith A.H.; Arroyo A.P.; Guha Mazumder D.N.; Kosnett M.J.; Hernandez A.L.; Beeris M.; SmithM.M.; Moore L.E, says that arsenic-induced skin lesions have been detectedamong the Atacameno people in Northern Chile despite good nutrition and centuries of exposure (2000). This destroys the notion that long-term consumptionof arsenic cause people to develop immunity.

Writing in "Environmental Health Perspectives, 108(7), 617-620, the researchers say:

Abstract:

It has been suggested that the indigenous Atacameno people in Northern Chile might be protected from the health effects of arsenic in drinking water because of many centuries of exposure. Here we report on the first intensive investigation of arsenic-induced skin lesions in this population. We selected 11 families (44 participants) from the village of Chiu Chiu,which is supplied with water containing between 750 and 800 g/L inorganicarsenic. For comparison, 8 families (31 participants) were also selectedfrom a village where the water contains approximately 10 g/L inorganic arsenic. After being transported to the nearest city for blind assessment, participantswere examined by four physicians with experience in studying arsenic-inducedlesions. Four of the six men from the exposed village, who had been drinkingthe contaminated water for more than 20 years, were diagnosed with skin lesionsdue to arsenic, but none of the women had definite lesions. A 13-year-oldgirl had definite skin pigmentation changes due to arsenic, and a 19-year-oldboy had both pigmentation changes and keratoses on the palms of his handsand the soles of his feet. Family interviews identified a wide range of fruitsand vegetables consumed daily by the affected participants, as well as theweekly intake of red meat and chicken. However, the prevalence of skin lesionsamong men and children in the small population studied was similar to thatreported with corresponding arsenic drinking water concentrations in bothTaiwan and West Bengal, India - populations in which extensive malnutritionhas been thought to increase susceptibility. "

Abstract:

To determine the relationship of arsenic-associated skin lesions and degree of arsenic exposure, a cross-sectional study was conducted in Bangladesh, where a large part of the population is exposed through drinking water. Four villages in Bangladesh were identified as mainly dependent on wells contaminated with arsenic. We interviewed and examined 1481 subjects 30 years of age in these villages. A total of 430 subjects had skin lesions (keratosis, hyperpigmentation, or hypopigmentation). Individual exposureassessment could only be estimated by present levels and in terms of a doseindex, i.e., arsenic levels divided by individual body weight. Arsenic waterconcentrations ranged from 10 to 2040 g/L, and the crude overall prevalencerate for skin lesions was 29/100. After age adjustment to the world populationthe prevalence rate was 30.1/100 and 26.5/100 for males and females, respectively.There was a significant trend for the prevalence rate both in relation toexposure levels and to dose index (p < 0.05), regardless of sex. Thisstudy shows a higher prevalence rate of arsenic skin lesions in males thanfemales, with clear dose-response relationship. The overall high prevalencerate in the studied villages is an alarming sign of arsenic exposure andrequires an urgent remedy.

(Tondel M.; Rahman M.; Magnuson A.; Chowdhury I.A.; Faruquee M.H.; Ahmad Sk.A. Environmental Health Perspectives, 107(9), 727-729)

Abstract:

The release of metals during weathering has been studied in order to assess its geochemical controls and possible effects on environmental health in Bangladesh. A total of 27 soil samples and 7 surface water samples were collected from four locations covering three major regions in the country. Results show that weathering effects are a strong function of climatic conditions. Surface waters are typically enriched in Al, Mg, Ca, Na, K, As, Ba, Cr, Cu, Ni, Pb and Zn. The solubility of metal ions, organometallic complexes, co-precipitation or co-existence with the colloidal clay fraction are the main processes that lead to metal enrichment in lake and reservoir water. Aluminium concentrations exceed World Health Organization (WHO) drinking-water standards in all samples, and in two regions, arsenic concentrations also significantly exceed WHOstandards. The elevated levels of As indicate that arsenic contaminationof water supplies in Bangladesh is not confined to groundwater.

(Md. R. Islam; W. P. Lahermo; R. Salminen; S. Rojstaczer; V. Peuraniemi Environmental Geology 39(10), 1083-1089.)

The Bangladesh Arsenic Mitigation Water Supply Project has begun producing a printed newsletter.

The health consequences of arsenic poisoning in drinking water was studied in an action research into community based arsenic mitigation project implemented by BRAC in collaboration with the Department of Public Health Engineering (DPHE) and UNICEF. The impact of arsenic poisoning onhealth of the exposed people in the two upazilas; Sonargaon and Jhikorgachhaof Narayanganj and Jessore districts respectively was

studied. The status of the arsenicosis patients of these two areas isshown at Table 1..

The identification and categorisation of the patientswere done observing the external visual manifestation of arsenicosis. Thesymptoms for three stages were 1st stage: melanosis (spotted, diffuse), keratosis, (spotted, diffuse), conjunctivitis, bronchitis, gastro-enteritis; 2nd stage: depigmentation, (leucomelanosis - rain drop pigmentation), hyperkeratosis, oedema of legs (non-pitting), peripheral neuropathy, nephropathy (early stage), hepatopathy (early stage) and 3rd Stage: nephropathy (late stage), hepatopathy (late stage), gangrene, cancer (skin, bladder and lung).

 Table: Details of arsenicosis patients in Sonargaon & Jhikorgachha upazilas.

The number of affected people are on the increase in both the upazilas.

Patients were found in cluster form, i.e. not evenly distributed across the affected areas. A well-planned research programme is needed to determine the factors behind the scattered and clustered distribution ofarsenicosis patients in Bangladesh. If this research can determine the reasonswhy some are affected while others being in the similar situation are not,why males are more affected than females, it may provide a better understandingof the problem. Several members of the same family and only certain villageswere often affected. This indicated that there were other factors which influenced the effects of arsenic on the body. The clustered distribution of patients might be due to differences in nutritional status, diet or other social factors which influenced the severity of arsenicosis. The concentration of arsenic in water and the period of exposure might also be responsible for such clustered distribution.

The health situation of some of the affected patientshas deteriorated recently. Bleeding cough and swelling of the body, whichmight be associated with arsenicosis complications, have been observed inthree patients in Jhikorgahha. The average age of 33 years is significantas this is the prime dangerous reproductive age for women and most activefor both men and women. Poisoning in this age may cause serious health consequences for both the pregnant mother and the newborn child. A minor girl of 5 years was also found to develop arsenicosis symptoms. Another case was Motiar Rahman, 35, of Jafarnagar village of Jhikorgachha who developed melanosis on hisbody six months ago although he has been drinking arsenic free safe watersince last one and a half years. This implies probably that the load of arsenic consumed earlier was strong enough in developing the symptoms and the period for which he is consuming safe water is not enough to recover from the poisonous effects. He may need more time to recover.

Twelve patients were given Spirulina tablets for six months. Afterwards, all the patients identified in the two upazilas were provided with Carocet tablets (a combination of

vitamin A, C, and E). Salicylic acid, an ointment, is being provided to some selected patients to soften the hardening of the affected parts of the palms and the footsoles of the patients. All these patients are under close monitoring. The stages of external manifestation of the affected parts of the patients and their feeling are being monitored. A

mixed result was found when patients were asked how they felt after the treatment had started. In some cases the external manifestation improvedsignificantly.

Social impact of arsenic problem was also noted in the two upazilas. Most of the problems are with the young girls with symptoms of arsenicosis at the time of their marriage. Some arsenic affected school-going children had to stop going to schools as they were neglected by their classmates. People in a cluster or family affected by

arsenicosis are avoided by others in their social activities. This situation is improving with the increased awareness on arsenic issues. All these findings reveal that there are still many questions regarding the incidence of arsenicosis.

Taken from an article written by Md. Zabed Hossain of BRAC Research and Evaluation Division.

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