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Fact Sheet

On

ARSENIC  #XXI

 September 2003

PREPARED BY:

Disaster Forum

 5/8, Sir Syed Road,

  Mohammadpur,

Dhaka-1200, Bangladesh

Phone #  017-524409

Editorial:

The World Bank-aided $44 million Bangladesh Arsenic Mitigation Water Supply Project was extended by a year from July 1. Execution of the project will now continue with the still unutilized $25 million as bank-funding for the four-year project closed on June 30. The project mainly aims to provide alternative sources of safe drinking water in the arsenic affected areas.

This may sound fine on the surface, but if political will is missing, it will not take us very far. Political will is the most important factor in dealing with the contamination of groundwater by arsenic than anything else, therefore it is very important that the government acts decidedly on this issue. Arsenic poisoning is already harming the nation’s development as the sick have become incapacitated to the extent they can no longer work. This means they are unable to contribute to the economic growth of the country. 

Although we now know that groundwater right across Asia is contaminated and millions and millions of people are at risk, nowhere else are people more vulnerable or less able to cope with this massive environmental health catastrophe than the people of Bangladesh.  There is therefore a need to give the people relief from what is poisoning them and their children but so far, it has not been given the importance it should receive. Every day the people of Bangladesh are dying from the “geological genocide” that has hit the country and unless it is given top priority we shall succumb to its onslaught. The fallen are unable to fight back as apathy has taken over their souls. But an estimated 88 per cent of the people are ignorant of the fact that they are dying from arsenic in the groundwater. The saddest part is the world either does not know or worse, does not care.

To claim that the government and international aid agencies did not understand the geographical extent of the problem or the cause of the arsenic contamination and could therefore do little more than research the problem is just skirting the issue. The role the government has played has been to ignore what they did not wish too see thus they left the people to their fate despite the large number of victims. Both the media and the public have overlooked or underplayed this environmental crisis and public health issue, to our cost.  It is more than time to take action but unless the people recognise that they have a problem, the likelihood of finding a solution diminishes.

Sylvia Mortoza

Gawher Nayeem Wahra

Sumaya Noor

_______________________

Editorial & Compilation Team

September 30, 2003

ARSENIC IN MYANMAR (A message from Win Zin Oo)

"After reading the article on arsenic mitigation by Dr. Zuberi, I think the 'loss of hope' in Bangladesh may repeat in Myanmar.  Most of the agencies involved in the arsenic mitigation programme in Myanmar are just copying the Bangladesh version of arsenic mitigation.  Painting red and green! - "Educating" people to drink water from green well or "alternative sources"!

I think, before giving attention to this issue we need to answer the following questions, honestly: - Are people going to involve in the mitigation process meaningfully if there is no clinical manifestation? Will it be too late if we inform only when clinical manifestation occurs?

- For the agencies which are depending on the donor funding, are they in a position or willing to respond to the complex community situation?

- Are the agencies working on the issue well coordinated?

 - Do we think arsenic mitigation is just finding technical solution or a combination technical solution and overcoming socially complex issue?

What will be our answers?"

Win Zin Oo has worked with UNICEF, UNDP/UNCHS, and Save the Children for their Water, Sanitation and Hygiene Promotion activities in project engineer, project officer and project manager capacities since 1984.

BELATED ADMISSION

At a resent seminar organised by Rural Development and Cooperative Division, the LGRD Minister siad some 3 crore( 30 Million ) people in Bangladesh have so far been affected by arsenic as it continues to engulf groundwater.

He said, skin diseases, cancer, blindness and physical disability are on the rise among the people living in arsenic-prone areas as they are taking arsenic-contaminated water.

He was addressing a national seminar in Dhaka on RDA invented low-cost deep tube-well, aiming to supply arsenic-free water to the people.

Mannan Bhuyian said Bangladesh faces a disaster due to arsenic contamination of groundwater and this problem needs to be addressed before it takes a serious turn.

The LGRD Minister hoped that the newly invented deep tube-wells would go a long way in mitigating the arsenic problem through safe water supply. He said safe water from the RDA deep tube-wells would also contribute to socio-economic development of the country by water supply for irrigation, fish farming and other purposes. Besides, he said, this safe water would also create a favourable atmosphere for food processing, generating employment opportunities.

DHAKA COMMUNITY HOSPITAL

The Dhaka Community Hospital (DCH) reports there are 14,000 patients in the country suffering from clinical arsenicosis but experts attending a recent seminar in the city warned that if people continue to drink ground water instead of surface water, more people will be afflicted. They said 55 million people are drinking water contaminated by arsenic of 10 microgram per litre.

Other reports say around 25 million people in 50 districts of Bangladesh are drinking water containing more than 50 microgram of arsenic per litre which is much beyond the permissible limit set by the World Health Organisation (WTO). With more and more people depending on ground water, this number is increasing alarmingly.

CLEAN WATER & HEALTH

Access to clean water is a human right but it is a sad fact that millions of children are drinking water contaminated with high levels of arsenic throughout Bangladesh as the “safe” 'hand  tube wells introduced by WHO, UNICEF, Bangladesh government, NGOs and civil society in the 60s and 70s are no longer safe.

Now the cause of extensive poisoning, cancer, and death, its toxicity is not only affecting the physiology, metabolism and normal growth of children it is also affecting protein synthesis and DNA repair, causing hereditary changes (mutations) leading to cancer, ruining reproductive growth and development and hormone receptors.  Thus the future reproductive ability and normal life of these children have been threatened. It is estimated that over 80 million Bangladeshis have already been exposed, to arsenic toxicity. The majority is below the age of 15.

As the existing approach to arsenic mitigate has so far been “top down” with decisions and ”interventions” decided at the centre, only a fraction of the affected people have been provided with the support they need. More often than not what little support is given is a “one-off” effort. What is needed is a sustainable approach through “community-based organisations” where community members are given options for mitigation, and are given proper support in deciding for themselves which technology they can sustain, and then help them to adopt it.

With the help of the NGOs the methods adopted can be replicated and diffused throughout many villages. Schools could then be provided with safe sources by programmes undertaken by the children themselves, thereby learning the methods and introducing them into their homes and the homes of neighbors. There would be a need to scale up the CBOs in those areas as yet unserved and 

link them with local government, central government departments and agencies like WHO, UNICEF, International NGOs. Thus the approach started from the ‘bottom’ will be small, effective and sustainable.  It should be appropriate for villagers, and implemented widely and quickly.

We are working in a number of villages and have had wide consultations with the suffering villagers.  They are ready to adopt this type of community-based intervention, but they need institutional support and methods that they can adopt as they have no time to waste.  If there is any further delay in assuaging this problem, as the people experience unthinkable suffering and a slow painful death, there will be increased litigation, widespread dissatisfaction, social unrest and countrywide instability. 

The heads of families using contaminated tube well water are feeding it to infants, children and pregnant women.  Dr Zuberi reports he has seen little boys and girls who have been affected by arsenic poisoning and has observed expectant mothers drinking arsenic-contaminated water. Research reports say abortion rates in contaminated areas are significantly higher than in others. This means there is a case for mandatory sealing of all contaminated wells but before that can be done, a safe water source must be provided to all contaminated villages. Awareness building at the community level and advocacy at the decision-making level are both important.

Source: Dr. M.I.Zuberi

   Professor

   University of Rajshahi

   Bangladesh

ARSENIC TREATED WOOD AND A VICTIM

To emphasise the urgency – and the dangers – of neglecting the situation we give below an account of the sufferings of a victim.  Although the source of the poisoning is not the same, the outcome is and we should take recourse to this account to motivate us into action.

The victim is a Canadian who along with members of her family were poisoned over a period of years by a neighbor who insisted on burning CCA pressure treated wood and other chemically treated wood in a woodstove in his garage.

CCA wood is still being reviewed for its health hazards even though many scientists have warned of the potential dangers and advised to keep this wood away from children. How much CCA in playgrounds is responsible for the increasing incidents in learning disorders and other neurological problems is still to be evaluated but this particular victim of arsenic poisoning reports that she has been greatly affected by damage to her cognitive skills. Some of these children will never understand what has been stolen from them and so needlessly.

ARSENIC IN COW’S MILK          

If the arsenic concentration in the soil is very high, growing food crops in that particular soil is risky.  Even crop establishment may not be possible if it is planted in highly contaminated soil. In a pot culture with a soil arsenic concentration of around 100 mg/kg rice plant died immediately after transplantation (unpublished data).

In my research with arsenic I found a high accumulation of arsenic in rice straw when rice was irrigated with As-contaminated water. Rice straw is mainly used as cattle feed in Bangladesh and there might have some linkage with high arsenic concentration in milk and feeding history of these cows. However, other than contaminated straw, drinking contaminated water might have also caused elevated arsenic concentration in bovine milk.

Source: Joinal Abedin:

WORKSHOP ON NATURAL ARSENIC IN GROUNDWATER

A workshop on "Natural arsenic in groundwater" will be held at Florence, Italy

on August 18th and 19th 2004. This is a pre-congress workshop at the 32 IGC being held in Florence.

Source: Prof D Chandrasekharam

(Senior Associate, Abdus Salam International Ctr. Theoretical Phy, Italy) Professor, Dept. Earth Sciences and Head, Centre of Studies for Resources Engineering, Indian Institute of Technology, Bombay, India.

ARSENIC CRISIS IN CAMBODIA

UNICEF has provided US$ 375,000 to help the Cambodian Government tackle the problem of arsenic contamination in drinking water. The grant has been given under UNICEF's Global Set Aside Fund, which is used to develop a rapid response to emerging development issues. UNICEF provided Cambodia a similar US$ 180,000 grantlast year to assess the extent of arsenic contamination in Cambodia. The new funding will be used to screen tube-wells in areas of the Country where the risk of contamination of groundwater supplies is high/.

UNICEF Cambodia has already supported the testing of over 5,000 of an estimated 40,000 tube-wells and would assist in the screening of every tube-well in areas at risk of contamination. The UNICEF Representative noted that in addition to testing wells, the Government, international organisations and NGOs     supporting arsenic mitigation programmes must also ensure the provision of alternative arsenic-free water supplies. Part of the funding provided by UNICEF will be spent on the first trial programmes in Cambodia for the provision of arsenic-free water, which will be carried out in areas with the highest contamination rates.       

A preliminary assessment of wells in Cambodia has found arsenic concentrations higher than the provisional limit of 50 micrograms per litre set by the Royal Government of Cambodia in 2002. The Government is currently developing a National Plan for testing tube-wells in Cambodia, a protocol for testing and communicating test information to the community, as well as for developing educational material to be used during the testing programme.  The national plan will identify high medium- and low-risk areas in Cambodia for testing, while mitigation efforts will initially focus on tube-wells in high-risk areas.

COMILLA VILLAGE SCREENING RESULTS

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 found to conform with the sub-continental safety limit of 0.05 mg/L, while the remaining 92.4% tube-wells were found to be contaminated with arsenic above the 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. These efforts are  already yielding positive results in the form of people refraining from using the contaminated water and using only the water from safe (green marked) tube-wells as their source of drinking water. The results of the tubewell screening is given below:

Distribution of tubewells by depth

Distribution of tubewells by installation date

Maximum: - 30 years

Minimum:- 0.17 years

Mean - :6.8 years

Median - 5 years

Mode - 4 years

Distribution of tubewells according to the level of contamination:

In the next phase, a survey was carried out to record the population and tubewells 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.

The Ichhapur Village - Total Households: 407 (i.e. Khanas)

Percentage of population by level of contaminated water consumption

Although no detailed health screening was carried out, a few patients were identified in the village based on spontaneous, "on the spot" screening by the researchers. Many of them are already undergoing proper 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 the utilisation of surface water, especially in the areas of lower delta plain where the ponds contain sufficient water even after the lowering of the 'water table' in the dry season.

A LACK OF MOTIVATION

UNICEF, in cooperation with the Ministry of Health Affairs, Department of Public Health Engineering and BRAC, took up five such Action Research Projects in different parts of the country. The one-year project at Sonargaon Project began in July,1999 and ended in June, 2000 and the evaluation report is expected to be published soon. A survey carried out by UNICEF with the field workers from BRAC showed that 64.5 per cent of the population were at risk of arsenic-poisoning.

There are 25,048 shallow hand tubewells in the area of which 16,171 were found to be contaminated. 8,877 are certified as safe for drinking. The survey also showed a sharp rise in the number of patients suffering from arsenic-poisoning over the past six months. The number of patients rose from 252 to 400 during the

period.  Field workers of BRAC said the number had increased not only due to contamination but also because they had not been identified earlier. Although 70 motivational meetings were held during the six months ending June, 2000, many of these meetings lacked a spontaneous response from people. In fact, around 32 per cent of the population of Sonargoan Upazila are continuing to drink contaminated water. Not so long ago these people were asked to drink the "pure" tubewell water with the result they no longer have a taste for any of the alternatives on offer like rain water (which tastes sour) or water from ponds and dug wells. Moreover, restrictions by the owners on the use of ponds have handicapped this as a source.

The three-pitcher filter since it was cheap and its raw materials easily available, proved to be popular. The tubewell sand filter system could become popular provided they were made available to people at a subsidised rate. One tubewell sand filter costs about Taka Five Thousand. The old-style dug well is probably destined to be popular as prior to the introduction of tubewells, these traditional wells were the popular source of pure drinking water. Chinmoy Mutsuddi, an UNICEF official said, "We have re-excavated and renovated 35 wells of the area, some of them dug more than 300 years ago." It was felt that the government should pursuade UNICEF to continue funding these projects for sometime more.

Source: The New Nation 

PEOPLE ARE INDIFFERENT TO THE EFFECT OF ARSENIC ON HEALTH

During a visit to village Uporajarampur, Chapainawbgonj Dr Zuberi saw some dug-wells that had been provided by the Christian Commission for Development in Bangladesh (CCDB) with the help of Christian Aid’. There were also some Rainwater Harvesting Tanks provided by IDE but there was no water in either.

Women came to the dug-wells to collect water but on finding them empty they went to the ‘red’ painted tube wells and filled their pitchers with the contaminated water. When asked, a woman said they have been doing this for several weeks now ever since the dry season began.

As the dug-wells did not contain water, most households were compelled to drink the arsenic contaminated water. Several meetings with villagers indicated that they were aware of the situation; but said they have no alternative. Dr. Zuberi advised the villagers to use arsenic reducing filters, but when they went to buy them they found they were not available. As a consequence their little children, would-be mothers, young growing sons and daughters, are all forced to drink arsenic contaminated water knowing well what the consequences will be.

In many cases villagers are negligent because they do not want to collect water from a distance. Some collect only enough water for drinking but they are still using contaminated water for cooking. In some villages the level of awareness is low, and they tended to give little importance to the possibility of arsenic toxicity.

As solar disinfection of surface water (SWD) and solar oxidation and removal of arsenic (SORAS) can be adopted easily as a cheap and reliable safe water option in villages, Dr. Zuberi’s team is introducing these alternatives in the villages they visited - but it will take time and effort to convince the villagers of the reliability and safety of the method. They are thinking of adopting a ‘community-based programme to introduce SWD and SORAS in arsenic affected villages’ and need the participation, support and awareness generating materials (papers, pictures, data, and charts) for an effective and immediate outcome.

In the village of Ulipur in Bogra villagers removed the ‘RED’ paint from the tube wells and were drinking the water. Most of the villagers gave no importance to  arsenic and did not even want to waste their time talking about it.

Mr Abul Hossain said when arsenic was detected in his tubewell he re-sunk it three times but failed to find arsenic-free water. The local Department of Public Health Engineering (DPHE) had earlier selected four members of his family for training on arsenic mitigation and provided three pitcher filters for arsenic removal however they did not use the water from these pitchers and instead used the water from the contaminated tube-wells!

There have already been five deaths in the village (two women and three men) due to arsenic poisoning. Each and every member of his family had symptoms of arsenic toxicity on their body: They had warts on their hands and feet; swollen belly. Not one of them can now work as they feel too weak and short of breath.

Mr. Sohrab Pramanik of Rajapur village (Pabna) did not allow workers to paint his tube well ‘RED’ even after learning it was contaminated. Workers tested the water twice in his presence but failed to persuade him to stop drinking the water with the result that he and his family are continuing to drink contaminated water. .

At village Rajarampur people are drinking arsenic-contaminated water although they are fully aware of the risk.  Many mention the distance to clean wells; crowding; waiting time, labor shortages, and poverty as difficulties. Women and children are more aware about the risks of drinking contaminated water.

Local CCDB workers reported that four of the nine newly dug wells in Chapai Nawabganj and one out of three in Pabna are contaminated with arsenic. As dug wells are considered the best option for sustainable intervention for the provision of safe drinking water, this can only be considered alarming.

Villagers need organisational support from within to learn, adopt, and implement the simple methods that need little expenditure.  What more is needed is an institution of their own; traditional institutions (samaj, gosthi, even the extended family) have broken down.  Shall we be able to do this?

Village Bholadanga has 250 to 300 families mostly land less peasants and some low-caste cobblers/cleaners. 35 persons have died so far; 70 to 80 are in a bad condition with visible symptoms; again many among them are young.  The CoB-Arsenic Mitigation Project (AMP) with the help of Christian Aid’s fund had tested all the 204 tube –wells in 2002 and found 70% contaminated with more than 50 ppb arsenic.  Only those affected having visible symptoms on skin have been provided with vitamins A,E,C for one month, yet many could not be supplied with because of limited funds; less serious patients were not attended for.

The villagers were asked to drink water from the ‘green’ tube-wells; 3 old dug-wells have been renovated and 4 dug-wells newly established; many families consider safe-water sources long distance away from their homes and often drink water from ‘red’ tube-wells. While we were discussing arsenic mitigation, a little girl was noticed washing hands and then drinking from a ‘red’ tube well; when interrupted she discontinued and said that the nearest ‘green’ tube-well is several houses away. I observed that most of the households do not have enough water-pots (earthen-ware pitchers traditionally used by the poor for storing water) for day’s supply; one pot is the usual and they go for re-filling when it becomes empty; so running out of water and using the nearest tube-well, though ‘red’ is very common. When asked about this many women talking to us agreed that this happens at night or during rains or when the person is very tired and thirsty; they also reported that it is difficult to stop the children who have developed the habit of drinking water directly from the tube-wells.

In the low-caste village of Paschimpara of Bholadanga there are about 120 Families. There are some 50 hand tube-wells, all marked ‘red’ except 4/5; many of the 35 deaths occurred here. Villagers described how they have been affected –  for 6-7 years, at first they did not know arsenic from the tube-wells is causing their distress.

We were surprised to see that how lightly they take the arsenic problem. There were other green tube-wells, there is a Dug-well provided by CoB-AMP a small distance away but they still consumed the contaminated water with their children and infants!

Definitely, there is much to do about ‘AWARENESS BUILDING’ among the villagers; they do not realise the seriousness of the situation. Very little could be done by those who are now working in a very small number of affected villages. Also the approach that some one (NGO/Govt. department/ agents) will just test the tube-wells and then others will do the awareness/mitigation activities – an approach currently adopted in Bangladesh.

Another important aspect of arsenic mitigation came up during a discussion with local newspaper reporters and leaders in Alampur village. There are more than 100 Shallow Tube Wells (STWs) in this arsenic–affected village which are using the same aquifer as the contaminated hand tube-wells. Many are used almost round the year and 12/14 hours a day. There are 45 STWs in the other affected village. They are intensely used during the Boro (dry season) paddy cultivation and must have been importing tons of arsenic to the surface! There is no soil test done yet. When I requested them as leaders of the village why not introduce ‘wheat’ during winter (Boro) season crop which require much less water, they said that they do not have a suitable HYV wheat for their region! Why not local variety? Yield less they said. Why not maize or vegetables?  They agreed that that could save soil and produce some return. I mentioned that intensive Paddy cultivation is the most damaging agricultural activity and that we must reduce rice consumption and cultivation if we want to save our environment. The villagers present were motivated to consume less rice – they are used to taking rice meals thrice a day (if they can afford it), little vegetables and fruits; other major items as WHEAT / POTATO with lots of vegetables and fruits which can save them from Arsenic and also help save their environment.

The community workers of CoB are doing their best but had very little support for meeting the needs; Christian Aids support is running out this year. They are afraid whatever little they are doing now will be stopped soon. What a pity!

Dr. Zuberi's recommendations for removing arsenic contamination are as follows:

- All options for safe drinking water should remain open; they should be standardized and monitored, but availability and affordability of viable options is more important. At any cost the people MUST get safe water.

- Labeling tube wells red should be compulsory and there should be legal obligation; it is better to remove or seal them.

- Mitigation and awareness creation should be an ‘emergency crisis’ activity, all possible resources and persons should be involved.

- Participation of village people and women is essential, a ‘must’ for rapid success.

- Action is what is needed. Policymaking and decision taking has already eaten up too much valuable time and caused irreparable losses.

- Nutritional intervention and removal of arsenic from the body are also much-needed interventions. This will save the body from the arsenic load and future harm and enable the affected people to regain their ability to work, otherwise millions will lose their jobs and work affecting the country’s economy and creating a burden on society.

BRAC AND UNICEF

BRAC and UNICEF in a bid to tackle the arsenic menace in different parts of Sonargaon upazila have been pursuing the treatment of surface water with: Pond Sand Filter (PSF), Rainwater Harvesters (RWH), treatment of ground water with home-based filters and use of shallow ground water through dug-wells. A number

of alternative safe water options are now in operation as demonstration units to raise the level of awareness in the community.