This insanity, at the expense of the arsenic afflicted people of West Bengal and Bangladesh, must be stopped. Analytical Chemists should be consulted to decide on whether a given analytical method is suitable for deployment, not bureaucrats. I cannot imagine in any case how five different field kits, all based on more or less the same principle, can be compared to prove or disprove the applicability of that technique, without comparison to a standard method. Every time they compared it, it did not work. If the rulers of Florence and their subservient population had their way, the sun will still be revolving around the earth. Our general level of ignorance and callousness on this issue is appalling - "60 MINUTES FOUND IT FIT TO DO A NEWS STORY BUT THERE IS NOTHING IN OUR PROFESSIONAL MAGAZINES!

Delegates at the Second World Water Forum and ministerial meeting highlighted the problem and called for defining new ways for tackling the social and environmental problems affecting the Ganges basin in north-east India and Bangladesh. There was also a good deal of criticism that there was no fresh thinking on this massive social and environmental problem affecting both India and Bangladesh was also good for it emphasised the need for a fresh approach for solving the problem, if poverty and tensions in the area were to be alleviated.

Another important factor was that -although we may think dependence on our ample number of rivers is enough to see us through the crisis - provided purification plants are installed, we must also be aware that many river systems are drying up. For instance, the glacier which supplies the major river that flows through the region, the river Ganges, is retreating, raising fears of shortages and drought downstream.

INTERNATIONAL CONFERENCE ON ARSENIC - Third Dhaka Declaration - 2000

The Dhaka Declaration says a major portion of Bangladesh's groundwater is contaminated with high concentration of arsenic. A large number of people, including children and women, continue to suffer from chronic arsenic poisoning, and more are expected to suffer in the future. The arsenic problem remains a major threat to public health and the social structure of Bangladesh. Supply of arsenic free, safe water is the immediate need. On going efforts need to be accelerated to become effective. Attention also needs to be focused on other issues such as arsenic in food and soil.

Laying emphasis on mobilising the entire nation to combat the arsenic problem, development of a comprehensive water policy through research and giving attention to the needs of the arsenic patients and their management, Declaration says the progress in dealing with the arsenic problem in Bangladesh has been tragically slow. Research is needed for developing a vision for a comprehensive water policy. All agencies, whether government, non-government, donors, national or international, must ACT NOW! To fight arsenic poisoning, the Declaration called for an extensive and intensive public awareness programme on the danger of drinking arsenic-contaminated water and urging drinking water from safe tubewells and alternative sources only, including rain water harvesting.

CONFERENCE OF CHEMICAL & SOIL SCIENTISTS

A leading Japanese scientist yesterday blamed high concentration of peat at sub-soil level for arsenic contamination in the groundwater of Bangladesh, reports BSS.

Dr. Ishiga is conducting field research in collaboration with Rajshahi University since 1996. While analysing the geo-chemical aspects of groundwater of two villages of Jessore and Mymensingh, the Japanese geo-chemist placed emphasis on taking into consideration the rise in the sea level in tackling the arsenic disaster. Dr Hiroaki said he was at the final stage of his study, to be released soon.

PRESS CONFERENCE (Dhaka Reporter Unity Office)

A group working on the arsenic problem called upon the authorities to create alternative sources for drinking water without wasting time screening tubewells. The press conference was followed by a documentary film on arsenic in Bangladesh made by Brotee, a research and training organisation.

The film, "Arsenic Alert" was previously screened at the World Water Forum in the Hague, Netherlands.

HQ Chowdhury, Member of the American Waterworks Association USA said screening of drinking water with field-kits was not accepted anywhere in the world. The plan to screen ground water would only waste a lot of money and will be time-consuming leading to death and misery of millions of people. He called upon policy-makers to accept the fact that ground water everywhere in the country was contaminated and take the initiative to arrange alternative drinking water other than the ground water.

Sharmeen Murshid and Kayes Chowdhury of Brotee opposed the government plan to sink

50,000 deep-tubewells (DTWs) to supply drinking water to the people. They said that about 30 per cent of the DTWs were also contaminated.

The UNICEF and Rotary International project in Manikganj Sadar Thana, about 65 km west of Dhaka, has been hailed as an innovative partnership of UNICEF, a service club and local community workers. It follows the "Calcutta Commitment"; made by Rotary in 1999, which set out an eight-point programme of activities aimed at freeing over 20 million people in Bangladesh and five million in West Bengal from the threat of arsenic-related afflictions within the next five years. Manikganj was selected for the project due to the extensive contamination of tubewells in the thana.

The project in Manikganj Sadar Thana involves a $ 50,000 investment by four Rotary Clubs - Manikganj, Dhaka Central, Dhaka Mid-City and Dhaka. UNICEF is contributing US $ 34,000 for training and testing kits, while ISDCM contributed $ 7,000 and the local community provided $ 4,400. The project has involved the selection of 40 testers from the 11 unions of the thana, who have tested 10,000 tubewells. The testing indicated 47 per cent of the wells with unacceptable levels of arsenic.

The National Steering Committee on arsenic has raised serious concern over arsenic mitigation activities of some ministries and donor agencies. Without naming the ministries it pointed out in a working paper report prepared on June 1 that certain ministries are carrying out certain activities by-passing the steering committee. The committee also noted that a number of donor agencies have financed projects, which are implemented by non-government organisations, without discussing these with the government. As a result, on many occasions review of the proposed activities is not taking place, leading to uncoordinated efforts in arsenic mitigation programmes.

Donor agencies are not only discouraging implementation of projects by sidestepping the committee, some of them do not comply with the rules. This sometimes causes duplication of efforts. Citing an example, an anonymous source said a project to assess the success of community based arsenic mitigation models has been proposed by British donor agency DFID. The two million pound sterling project also aims to improve the health condition of the affected people through affordable, sustainable and integrated community based programme of arsenic mitigation. Dhaka community Hospital would act as DFID's partner in implementing the three-year project. The source said the project has not been placed in the technical committee constituted by the national steering committee for review. The project which is yet to be implemented seeks to be in operation without the committee's approval.

Some other mitigation projects, funded by the World Bank and UNICEF, which are almost identical to the DFID project are in their implementation stage. The projects are the Bangladesh Arsenic Mitigation Water Supply Projects and Action Research Water Supply Project. Both projects involve community based affordable and sustainable water supply mitigation projects.

Items that were discussed at the meeting of 22 September 1999 were confirmed.

i) Public awareness should be created for presentation and use of pond water for drinking purposes after boiling as a substitute for tube well water. The ministry of Health and family welfare and the public health engineering department were entrusted with the responsibility for ensuring implementation of the decision.

ii) Now that the usefulness of the filter for purification of water and the effectiveness of "Spirulina" in reducing the symptoms of affected patients has been established, the concerned authorities will take necessary action for creating public awareness in this regard.

(Responsibility: Ministry of Health & Family Welfare and Local Govt).

iii) Local Government authorities will take into account the recommendations for action proposed at the WHO Regional Consultation meeting before initiating any new short term and long term action programmes.

(Responsibility: Health and Family Welfare Ministry and Local Govt).

iv) Arsenic being a problem of major concern, the National Steering Committee on Arsenic will henceforth be held once a month. Meetings of other committees should be held more frequently.

(Responsibility: Ministry of Health and Family Welfare).

v) In order to ensure effective coordination of the decisions taken by the various committees under different Ministries, a joint meeting of all existing committees should be held immediately and after due consideration only one Scientific Research Technical Committee should be entrusted with the work.

(Responsibility: Ministry of Health and Family Welfare).

vi) As identifying problems related to arsenic contamination problems is a complex task, the Honorable Minister called upon all agencies to work unitedly towards mitigating the problem. He concluded by thanking all those present at the meeting.

1. A seminar was organised by the School of Environmental Science and Management of Independent University, Bangladesh (IUB) at the university campus. The Vice-Chancellor of IUB Prof Bazlul Mobin Chowdhury presided. Convened by Prof M Ali Hossain , many eminent scientists attended the seminar. Dr Kazi Matin Ahmed said the issue of arsenic contamination of groundwater has emerged as one of the largest environmental problem in the world. He said about 35 per cent of the tested wells (both field and laboratory) have been found to be contaminated with arsenic above the Bangladesh standard. Prof Haroun Er Rashid said 20 million people are now drinking arsenic contaminated water everyday.

2. A seminar on "Arsenic Contamination in Groundwater of Bangladesh - Cause, Effect and Remedy" was held June 5, 2000 at the Osmani Auditorium.

The findings were that, within a decade 10 people will die from cancer and one from arsenic-poisoning.

Dr. Shibtosh Roy, Consultant of DCH said the Hospital has so far identified about 7,000 arsenic patients. 53% male; 40% female and 7% children.

The FEJIB, with support from UNICEF, held a two-day media workshop on arsenic which ended with a call for urgent mitigation measures to be undertaken to halt the deteriorating contamination of groundwater. Environment Secretary, Syed Marghub Murshed gave an account of the current governmental activities for mitigating the problem and also emphasizing the need for national, international and regional cooperation. Announcing an award for Arsenic Reporting and Photography, the FEJIB also said it would increase the number of training and fellowship programmes to help raise awareness among the people of the problem.

Some 600 participants from the USA, Bangladesh, India, UK, Argentina, Chile, Vietnam, Switzerland, China, Hungary, Rumania, Canada and other countries took part in the Conference. The five main themes were: Occurrence and Exposure; Health Effects; (Epidemiology), Health Effects (Mechanisms & Metabolism); Intervention & Medical Treatment; & Water Treatment & Remediation. A subordinate theme was the setting & validation of the USEPA maximum contaminant level (MCL) for arsenic in drinking water. The meeting was well attended, presentations were generally good, and the mix of participants, including medics, geologists, geochemists, soil scientists, analytical chemists, epidemiologists, & toxicologists, together with numerous World Bank & UNICEF staff, made for interesting discussion groups.

The abstracts of the meeting are available on the Harvard Web-Site of Richard Wilson.

A photo exhibition (The Arsenic Crisis in Bangladesh), sponsored by the Government of Bangladesh, the World Bank and UNDP, was inaugurated at the World Bank lobby on June 26, 2000 by Ambassador KM Shehabuddin and Shengman Zhang, Managing Director of the World Bank inaugurated a jointly sponsored photo exhibition on "Arsenic-Poisoning in Bangladesh" in the lobby of the World Bank main building in Washington DC.

The photo exhibition was an extension of a similar programme that began in Dhaka in May this year and was organised to help create awareness among the donor countries and multilateral funding agencies in particular and the international community in general of the seriousness of the situation.

Speaking on the occasion, Ambassador Shehabuddin outlined the situation of arsenic poisoning in Bangladesh. He stated that 20 million people were assumed to be drinking arsenic contaminated water and another 75 million were potentially at risk. Fifty-nine out of 64 districts are affected. He mentioned that the government of Prime Minister Sheikh Hasina was committed to effectively deal with the situation and had mobilised local resources to undertake emergency and long-term programmes including the formation of a National Steering Committee.

Appreciating the role of World Bank and UNDP, the Ambassador appealed to other donor countries and multilateral agencies to support government's arsenic mitigation projects. He thanked the World Bank for organising the exhibition as well as assisting Bangladesh in addressing the problem.

Shengman Zhang in his speech acknowledged the nature and extent of the problem and termed it as an unprecedented one. He assured the Ambassador that the Bank would continue its involvement in arsenic mitigation projects in Bangladesh in coming years. Among others, Ms Meiko Nishimizu, Vice-President, South Asian Region of the Bank and Frederic Temple, Country Director in Bangladesh and Baber Kabir, Country Sector Leader of World Bank spoke on the occasion. A host of distinguished experts on arsenic poisoning alternate Director from Bangladesh as well as high officials of the Bank were present at the inaugural session.

With more than an estimated 20 million of its 125 million people assumed to be drinking contaminated water, Bangladesh is facing what is perhaps the largest mass poisoning in history. High concentrations of naturally occurring arsenic have already been found in water from thousands of tubewells, the main source of potable water, in 59 out of Bangladesh's 64 districts. But with the majority of the country's wells yet to be tested, the extent of the problem is still largely unknown. Nonetheless, a significant portion of the country's groundwater has proven to be contaminated with arsenic, mainly in the southwestern, middle, and northeastern parts of the country. Arsenic contamination is highly irregular, so tubewells in neighboring locations or even different depths can be safe.

Arsenic is a silent killer. Undetectable in its early stages, arsenic poisoning takes between 8 and 14 years to impact on heath, depending on the amount of arsenic ingested, nutritional status, and the immune-response of the individual. Until a certain point, contamination may be treated and reversed by drinking arsenic-free water. The effects of arsenic poisoning can vary from skin pigmentation, development of warts, diarrhea, and ulcers during the initial stages. In the most severe cases, arsenic poisoning causes liver and renal deficiencies or cancer that can lead to death.

Arsenic poisoning is difficult to detect because there is a lack of capacity and tools to diagnose it. Furthermore, only a minority of those suffering from arsenicosis can be easily identified from their skin condition. Thus, the majority of arsenicosis cases have gone undetected. To date, several thousands of patients with arsenic-related skin disease have been found in the first limited surveys. Available data on arsenic-related mortality is scarce, but dozens of deaths due to arsenic-induced skin cancer have been reported in the past few years. Because the majority of the country's tubewells were installed in the past two decades, it is likely that many more people will start developing symptoms in the next few years.

The social consequences of the arsenic crisis are far-reaching and tragic. Because of illiteracy and lack of information, many confuse the skin lesions caused by arsenicosis with leprosy. The most hard-hit villages where health problems have gripped a large population are treated much like isolated leper colonies. Within the community, arsenic-affected people are barred from social activities and often face rejection, even by immediate family members. Women are unable to get married and wives have been abandoned by their husbands. Children with symptoms are not sent to school in an effort to hide the problem.

Although scientists in Bangladesh and around the world are investigating the problem, the exact cause of the contamination is still being debated.

A major constraint to addressing the impacts of the arsenic problem in Bangladesh is the lack of information on the extent, causes, and proven remedies. Data on the possible causes of groundwater poisoning are inconclusive; knowledge of long-term, sustainable remedies for the problem are also inadequate; and investigations of appropriate low-cost technical options for alternatives or treated water supply are urgently needed. To address this constraint, the project is helping to strengthen data collection and to establish a National Arsenic Mitigation Information Center to collect, manage, interpret and disseminate all relevant hydrogeological, water quality, health, socioeconomic and technical information necessary to develop strategies, prioritize action, and monitor progress.

The region's high levels of naturally occurring arsenic went undiscovered until the 1990s. So far, action to address the problem has been very slow and arduous. World Bank has jointly with the Government set up a specialised unit at a cost of US $ 50 million, under the Local Government and Rural Development Ministry-Bangladesh Arsenic Mitigation &; Water Sanitation Project (BAMWSP). BAMWSP has been entrusted to find the solution to the phenomenal disaster that Bangladesh is facing today.

Most Bangladeshis obtain drinking water from individual hand-pumped tube wells. 70 per cent of the nation's 127 million residents are small-scale farmers who grow crops on the world's largest delta landscape 59 out of 64 Districts of Bangladesh are contaminated with arsenic. Several technologies are being field tested in Bangladesh-however most have not been validated by the BAMWSP to be replicated.

A seminar was held where Professor Qamruzzaman of Dhaka Community Hospital, Baber Kabir of World Bank office in Dhaka and Professor Willard Chappel of Denver University presented papers on arsenic poisoning. It was followed by a question and answer session. Representative of Embassy of Bangladesh in Washington DC also attended the seminar.

The seminar among others mainly focused on various scientific information on arsenic poisoning in order to identify a scientifically accepted knowledge on the causes as well as remedy of this naturally occurring deadly situation.

The seminar was designed to :

(a) Receive an update on the on-going field activities in Bangladesh (Prof. Quamruzzaman - Dhaka Community Hospital); a presentation on the National Framework for Arsenic Mitigation currently under implementation (Babar Kabir - Water and Sanitation Program, World Bank) and feedback from the 4th San Diego International Arsenic Conference (Prof. Willard Chappel - subject to his concurrence).

(b) The second part of the seminar was a Q&A session, with a group of panelists consisting of experts from Bangladesh and USA, Bank and non-Bank professionals, replying to questions. This was a 90 minute session for discussing the various aspects of the arsenic crisis.

Source: BADC

Source: BADC

Proposed revision to arsenic drinking water standard U.S. Environmental Protection Agency's Office of Water" Office of Ground Water and Drinking Water. May 2000.

"The Agency is proposing to change the current arsenic standard from 50 parts per billion (ppb) to 5 ppb in drinking water." This proposed revision will provide additional protection for 22.5 million Americans from cancer and other health problems, including cardiovascular disease and diabetes, as well as developmental and neurological effects.

The Administrator signed the proposal on 24 May 2000

The current standard of 50 ppb was set by EPA in 1975, based on a Public Health Service standard originally established in 1942. "A March 1999, report by the National Academy of Sciences concluded that the current standard does not achieve EPA's goal of protecting public health and should be lowered as soon as possible." Under the Safe Drinking Water Act Amendments of 1996, EPA is required to promulgate a final rule by January 1, 2001.

EPA is proposing to change the arsenic standard in drinking water to 5 ppb to more adequately protect public health. The proposed arsenic standard is intended to protect consumers against the effects of long-term, chronic exposure to arsenic in drinking water. "The new standard will apply to all 54,000 community water systems, serving approximately 254 million people." A community water system is a system that serves 15 locations or 25 residents year-round (e.g. most cities and towns, apartments, and mobile home parks with their own water supplies). EPA estimates, however, that only 12 percent, or 6,600, of these water systems, serving 22.5 million people, will have to take corrective action to lower the current levels of arsenic in their drinking water." Of the affected systems, 94 percent serve fewer than 10,000 people."

EPA is taking comment on other proposed levels for arsenic. "EPA is for the first time proposing a drinking water standard (5 ppb) that is higher than the technically feasible level (3 ppb). The Safe Drinking Water Act (SDWA) requires EPA to determine the health goal, then to set the standard as close to the goal as technically feasible." The 1996

Amendments to SDWA for the first time granted EPA discretionary authority, if it determines that the technically feasible level does not justify the costs, to adjust the standard to a level "that maximizes health risk reduction benefits at a cost that is justified by the benefits."

Under this proposal, water systems that serve at least 25 of the same people more than six months per year, such as schools, churches, nursing homes, and factories would be required to notify their consumers if the arsenic levels in their drinking water exceed the new arsenic standard. EPA is also proposing a public health goal of zero for arsenic." The health goal is the level below which no known or anticipated health effects would occur." EPA sets public health goals at zero for all known carcinogens for which there is no dose considered safe."

The proposed arsenic rule is open for comment for 90 days.

The arsenic mitigation method developed by the Department of Public Health Engineering (DPHE) and Danish International Development Agency (Danida) is based on the oxidation of all aqueous arsenic to As(V), or arsenate, and subsequent co-precipitation with aluminium sulphate (alum). The materials required are A 2 20-litre plastic buckets (one red and one green); 2 plastic taps; 1 plastic funnel with nipple and elbow; 10" length of PVC pipe; 5 kg coarse sand; flat metallic cover for lower bucket; stirring rod; measuring scoop; chemical powder (4g alum and 0.03g potassium permanganate per 20 L) But the replacement of one pollutant by others is not a solution. Danidas developed arsenic removal method poses serious social, environmental and health concerns:

Plastic and aluminium are both harmful to health. Vinyl chloride (a known human carcinogen), lead, cadmium and other metals are added to plastic to increase its resistance. Distribution of water through plastic pipes has been banned in California, USA as result of concern about the quality of drinking water.

It is not comprehensible why an environmentally conscious NGO like DANIDA can introduce a programme that is potentially dangerous. The use of aluminium is of concern. Its neurotoxic effects first appeared during the 1940s when it was observed that direct application to the cortex of monkeys produced convulsions with recurrent seizures (Kopeloff et al., 1947). Several other studies have followed all noting that the central nervous system of rabbits, cats, dogs and ferrets was vulnerable to aluminium, reacting with seizures, neuro fibrillary change, and epilepsy. In 1987 Norwegian researchers pointed to a statistical link between areas with high aluminium in drinking water and Alzheimer disease. Brown (1989) correlated Alzheimer disease with aluminium levels in drinking water in England:

The aluminium concentration in natural water in Bangladesh is quite high. Peuraniemi, Institue of Geoscience and Astronomy, University of Oulu, Finland found aluminium concentration in investigated areas of Bangladesh notably higher than typical values world-wide. Aluminium concentrations in all surface waters greatly exceed that of WHO (1996) drinking water standards in all areas studied (Islam, et al., 2000). There is an increasing number of studies pointing to a pathogenic role of aluminium in the onset of Alzheimer's disease. Aluminium accumulates in the nucleus of tangle-bearing neurons in patients with Alzheimer's disease (Perl and Good, 1988). The primary source of aluminium in drinking water is alum and therefore it is recommended in the industrial countries to reduce use of alum and conventional filtration is also effective. In industrial countries average 2 L water are consumed daily that is 20-45 mg aluminium intake occurs in a 70 kg reference man..

Adding alum will increase the sulphate concentration in drinking water that weak immunised rural population specially children will be additionally subject to diarrhoea diseases. Although sulphate concentration in Bangladesh is generally low but in a few wells show a relatively high sulphate concentration. One may argue that supporters of aluminium do not want to believe aluminium is a hazardous mineral but once the inventor of DDT was crowned with the Noble Prize and it took generations to understand its harmful effects.

The German Occupational Safety Association (HVBG, K#246; ln, Germany, 1999) classifies potassium permanganate as one of the dangerous substances and notified under section O, R9 and R 8-22-50/53 (1999):* Very explosive* Can cause minor to serious skin infection and injury* Reacts vigorously with water* Can cause serious fire with other substances* Very poisonous when inhaled* It is poisonous if it is added to drinking with water. etc. *R50/53 describes that it is very poisonous to the micro-organisms in water and in long term can cause serious harm to water resources. After the introduction of pesticides numerous deaths and injuries occur due to unsafe handling in rural Bangladesh. Besides taste many negative health effects will be added to the rural population of Bangladesh.

Taken from an article by Dr. Jamal Anwar

FIELD SURVEY (August 1995 to February 2000) SOES, Jadavpur University, Calcutta & DCH, Dhaka)

1) 22,003 groundwater samples from 64 districts were analysed. 54 districts have arsenic >0.01 mg/l and 47 districts have arsenic >0.05 mg/l. 918 villages with arsenic >0.05 mg/l have been identified. People in 30 of the 32 districts surveyed for arsenic patients have arsenical skin-lesions.

2) 11,000 samples of hair, nail, urine, skin-scale taken from the affected villages have been analysed. (About 50% of the samples are from people with skin-lesions and the remainder are from people without skin lesions). The result showed that around 90% of the people have arsenic above normal in their hair, nails and urine.

3) 17,896 people have been randomly examined. 3,688 (20.6%) have been identified with skin-lesions

4) The water in 833 deep tube-wells (depth between 100 m to >400 m) have been analysed. 181 samples contained arsenic >0.01 mg/l (21.73%) and 76 samples >0.05 mg/l (9.12%).

5) 15,969 samples from tubewells at a depth of 6.4 m to about 400 m taken from 47 affected districts with arsenic >0.05 mg/l were analysed. The results show that at about 15 - 20 m there is a high level of arsenic. The concentration of arsenic decreases at greater depths.

6) By a simple calculation it is estimated that there are 3.5 million tubewells in 43 districts of Bangladesh containing arsenic >0.05 mg/l.

7) The number of people in these 43 districts exposed to arsenic-contaminated water >0.01 mg/l is estimated at 51 million and the number exposed to arsenic-contaminated water >0.05 mg/l is estimated to be 25 million.

Summary of field survey from August 1995 to February, 2000

Total number of days surveyed: 239 (Two Hundred Thirty Nine) days

Total area of Bangladesh 1,48,393 sq.km

Total population of Bangladesh 120 million

Total no. of Districts in Bangladesh 64

Total no. of Police Station in Bangladesh 490

Total no. of Villages in Bangladesh 68,000

No. of districts surveyed for arsenic in groundwater 64

No. of Districts, area and population where groundwater contains arsenic >0.01 mg/l

54; 1,25,133 sq.km; 109,415,000

No. of Districts, area and population where groundwater contains arsenic >0.05 mg/l

47; 1,12,407 sq.km; 93,483,000

No. of Police Stations surveyed 222

No. of Police Station where groundwater found >0.01 mg/l 179

No. of Police Station where groundwater found >0.05 mg/l 147

No. of villages surveyed 1063

No. of villages with arsenic in groundwater >0.01 mg/l 1015

No. of villages with arsenic in groundwater >0.05 mg/l 918

Districts surveyed for arsenic patients 32

No of districts where patients found 30

No. of Police Stations surveyed for arsenic patients 71

No. of Police Stations where patients found with arsenical skin lesions 67

No. of villages surveyed for arsenic patients 241

No. of villages where people are suffering from arsenical skin lesions 214

No. of people examined from the affected villages 17896

No. of people with arsenical skin lesions 3688 (20.6%)

Total number of water samples examined for arsenic 22,003

Percentage of water samples with arsenic >0.01 mg/l - 73.34%

Percentage of water samples with arsenic >0.05 mg/l - 53.47%

Total number of hair samples from 210 villages where arsenic patients have been identified and % of samples with arsenic above the toxic level 4386 (83.15%).

Total number of nail samples from 210 villages where arsenic patients have been identified and % of samples with arsenic above normal 4321 (93.77%)

Total number of urine samples from 20 villages where arsenic patients have been identified and % of samples with arsenic above normal. 1084 (95.11%)

Number of skin-scale samples and % of samples with arsenic >1 mg/kg 705 (97.44%)

Total number of tubewell water samples from 54 districts where arsenic in groundwater is >0.01 mg/l 21530

% of samples >0.01 mg/l in 54 districts 74.95%

% of samples >0.05 mg/l in 54 districts 54.64%

Total no. of tubewell water samples analysed from 47 districts where arsenic in groundwater >0.05 mg/l 20987

% of samples >0.01 mg/l in 47 districts 76.50%

% of samples >0.05 mg/l in 47 districts 56.05%

Total no. of deep tubewell water samples (300 ft and below) analysed 833

No. of deep tubewell samples with arsenic >0.01 mg/l 181 (21.73%)

No. of deep tubewell samples with arsenic >0.05 mg/l 76 (9.12%)

Total no. of days in field survey 239

No. of days for water collection and identifying villages with arsenic patients 97

No. of days for water, hair, nail, urine, skin-scale collection and clinical examination by medical team in affected villages 142

Summary of 27 days detailed field survey from April 1999 to February 2000.

No. of districts surveyed 24

No. of districts, area and population where groundwater contains arsenic >0.01 mg/l

24; 47,911 sq. km; 49,844,000

No. of districts, area and population where groundwater contains arsenic >0.05 mg/l

23; 45,732 sq. km; 47,626,000

No. of new districts identified where groundwater contains arsenic >0.05 mg/l 5

No. of police stations surveyed for arsenic 42

No. of police station where groundwater contain arsenic >0.01 mg/l 41

No. of police station where groundwater contains arsenic >0.05 mg/l 39

No. of new police station found where groundwater contains arsenic >0.05 mg/l 11

No. of villages surveyed for groundwater arsenic contamination 144

No. of villages found where groundwater contains arsenic >0.01 mg/l 142

No. of villages found where groundwater contains arsenic >0.05 mg/l 130

Districts so far surveyed for arsenic patients 24

No. of districts where arsenic patients identified 20

No. of new districts where arsenic patient identified 5

Police Station so far surveyed for arsenic patients 42

No. of police Station so far identified patients with arsenical skin lesions 37

No. of new Police Station so far identified patients with arsenical skin lesions 16

No. of villages so far surveyed for arsenic patients 121

No. of villages so far identified with people suffering from arsenical skin lesions 98

Population examined from the affected villages for arsenical skin lesions 6716

No. of people identified having arsenical skin lesions 952 (14.18%)

Total no. of water samples examined for arsenic from hand-tubewells 3119

No. of water samples & percentage with arsenic >0.01 mg/l 2545 (81.60%)

No. of water samples & percentage with arsenic >0.05 mg/l 1767 (56.65%)

Total number of hair samples analysed 1054

Percentage of hair samples with arsenic above the toxic level 89.35%

Total number of nail samples analysed 1000

Percentage of nail samples with arsenic above normal 94%

Total number of urine samples analysed 41

Percentage of urine samples with arsenic above normal 97.5%

No. of skin scale samples analysed 115

Percentage of skin scale samples with arsenic >1 mg/kg 100%

THE GEOLOGICAL SURVEY OF BANGLADESH

The Geological Survey of Bangladesh has taken up a programme to find out the cause, source and mobility of arsenic in the ground water of Bangladesh. The program also includes:

i) collection of arsenic related data,

ii) detection of contaminated and Arsenic free aquifers,

iii) to help different organizations for arsenic free ground water supply,

iv) to exchange views and data in national and international level and

v) to grow awareness among the people about arsenic poisoning.

Based on a survey of 1072 tube wells (each tube well is taken at possible corner of 1 sq. km grid)

In Brahmanpara and Kasba thana, we have detected an impervious layer at the depth ranging from 33 m to 40 m below which the water (aquifer in the Dupi Tila Sandstone) is arsenic free. Aquifers below the organic rich layers contain high arsenic level. However work is still in a preliminary stage.

A copy of the study, "Emergency Programme for Mitigation of Arsenic Contamination of Groundwater in Bangladesh," is now part of a Health Ministry document. The survey covered 200 villages in 48 selected thanas in 21 districts.

Now that this 1998 report is available, analysis should be done in as disaggregated a manner as possible. The report is however based on 200 villages that are acknowledged by the researchers to have been chosen for being "hot spots" therefore we must not fall into the trap of extrapolating the data to the whole of the country. We suggest there should now be a thoughtful enquiry,.

Findings in brief: More than 7000 people are suffering from arsenic cancer (arsenicosis) in these 200 villages and new cases are being detected everyday. "A vast majority of the people in the affected villages had no idea of their cancer status because visible signs do not show. Among the sufferers, males in the age group 16 to 40 predominate but children below the age of 5 have also not been spared. Internal damage to organs cannot be ruled out.

The study was carried out by the Dhaka Community Hospital Trust under contract.

A Technology Assessment Group has been established to review technology options, and funds are being provided to local researchers to undertake studies on all aspects of the arsenic problem. The results of these investigations could have an impact on Bangladesh's policies in key sectors such as water resource management, agriculture, health, and environmental management.

Training and capacity building efforts also play an important role in the project. The project is working to strengthen the ability of communities to carry out and maintain the new water supply and sanitation systems. Training for medical universities and colleges on arsenic diagnosis is also included. Training materials on arsenic-related diagnosis and patient referral are being provided to the medical and field staff of the Directorate General of Health Service, as well as to the Bangladesh Medical Association that serves as the apex organization of private and government medical doctors.

A. ANSTO and CRC have developed an innovative process for oxidising and removing arsenic from tubewell water. In December 1998, the process was field tested in the Sonargaon Thana by a visiting team of Australian scientists. The tests were observed by a senior chemist and engineers from the Department of Public Health Engineering.

The objectives were:

i) to reduce the arsenic concentration in the waters to less than the current drinking water limit in Bangladesh of <0.05 mg/L.

ii) to oxidise the arsenic so that it could be more effectively removed.

iii) to show that the technology is simple and suitable for use by the rural population.

In order to analyse arsenic during these trials an "in-the-field" analytical method was developed. As the method may be useful for routine survey analysis, the reliability of the method was also evaluated.

In the ANSTO-CRC process scheme (Khoe et al, 1997), instead of chlorine, the process uses sunlight and iron salt to accelerate the arsenic oxidation reaction with air and the added iron is also used as a precipitation agent for arsenic removal. The co-precipitated arsenic is settled and removed with the iron hydroxide sludge. This is a simple arsenic removal process which can be used in rural areas with no infrastructure such as electricity.

Development work conducted in Australia included bench-scale tests with synthetic water, the adaptation of an American Public Health Association method for in-the-field analyses of arsenic (APHA, 1992), and the design and manufacture of prototype solar trays and settling urns.

Analyses of five tubewell waters in Sonargaon show that 60 to over 90% of arsenic was present as arsenic(III) and iron was in a reduced oxidation state. It was observed that when exposed to air for about one hour, some tubewell waters turned turbid with whitish precipitates. Preliminary chemical modelling studies using MINTEQA2 (EPA, 1991) indicated that the tubewell water is saturated with respect to limestone, iron-phosphate and iron-hydroxide compounds. Bicarbonate is the major anion in the water.

The readings taken for the oxidation-reduction potential of the water do not correspond to that of the water in the ground as exposure to air resulted in the readings rising. It appears that dissolved ferrous in the groundwater was converted to ferric by dissolved oxygen causing the measured potential (in milliVolt), which is dependent on the dissolved ferric/ferrous concentration ratio, to rise.

It was also observed that a significant bicarbonate alkalinity is invariably present in the tubewell water. Because of the buffering effect of the bicarbonate alkalinity, no lime- or alkali-addition is required for pH adjustment even when a significant quantity of iron salt is added, thus making the iron coprecipitation process simpler and more versatile. The resultant pH is usually about pH 7 which is in between the optimum pH values for the removal of arsenic(V) and arsenic(III) by iron co-precipitation i.e. pH 4-5 and pH 8-9 respectively (Pierce and Moore, 1982; Robins et al., 1988).

A comparison of these analyses with preliminary analyses completed in February and June shows that the concentration of arsenic and other solutes do not change very much with time.

The significant phosphorus concentration prevents the direct analysis of arsenic in the water using the molybdenum-blue colorimetry technique. Consequently, during the analytical procedure, arsenic is converted to arsine gas which is collected in a chloroform solution for analysis.

B. Earth-Identity Project, an NGO, held a three-week long programme at Kachua in Chandpur district to provide support to the local inhabitants. State Minister for Planning Dr Mohiuddin Khan Alamgir inaugurated the Arsenic Remedial Programme financed by the Japanese NGO Earth-Identity Project. As part of the programme, the organisation will supply to the local people a kind of medicine "Stevens arsenic remover" that can free tubewell water from arsenic contamination. The water would also be free from heavy metals like lead, cadmium, iron and pesticides at a minimum cost of about Tk 250 for a family for one year.

The Stevens Institute of Technology at New Jersy in USA invented the medicine. Dr X. Meng, an associate professor of the institute is the co-inventor of the technology for Arsenic remedy along with Dr M. Korfiatis of the Institute. He said they found the water of the Kachua areas with contamination of arsenic at a level from 0.1 milligram to 0.8 milligram per litre (mg/l).

Stevens' Arsenic Removers have been distributed among 6 families in Kachua thana for pre-testing. The highest level of arsenic found at the tubewell water in Kachua is 0.8 ppm. After treating the arsenic contaminated water with Stevens' Arsenic Removal the level was reduced to 0.025 ppm. The permissible level of arsenic for Bangladesh is 0.05 ppm. The Earth Identity Project will monitor these 6 families for three weeks. BAMWSP will also monitor the project. Later the technology will be submitted to the Technical Advisory Group (TAG) of the government for approval. Dr Meng said it would take at least two years to reach the marketing stage for the technology. Technical and scientific support will be given to the Earth Identity Project by Stevens Institute of Technology for about two years.

SOES; Jadavpur University, Calcutta is the scientific adviser to a project funded by Japan Government to Chandranath Basu Seva Sangha, village-Betai, Block Tehatta, District Nadia. The goal of the project was:

1) To assess the magnitude of arsenic calamity in Tehatta Block through water analysis.

2) Field survey with medical team to know the extent of people's suffering.

3) Coloring green to safe tube-wells and red to arsenic contaminated tube-wells. Green tube-wells to be rechecked after every 6 months.

4) To find out the possibility of alternative source of drinking water (rainwater, river water, pond water, lake water, dug-well, ring-wells etc. after proper purification) with peoples participation.

5) Arsenic removal from contaminated hand tube-well adopting suitable technology with people's participation.

For more details please contact Dr. Dipankar Chakraborty

School of Environmental Studies Jadavpur University

Calcutta - 700 032 India

Tel: 91 33 4735233

Fax: 91 33 4734266

Email: dcsoesju@vsnl.com

The fight against groundwater arsenic contamination is showing some signs of success.

The emergency programmes jointly taken up by the government and the World Bank (WB) to address the massive public health problem have provento be quite successful.

Experimental use of five different water filters have shown that high concentration of arsenic can be completely removed from tubewell water at a relatively cheaper cost. The foreign but environment-friendly technologies, now in an experiment stage in six thanas in six districts since last April, are projected to be very effective in addressing the problem that has put millions of lives at risk. The thanas are, Bheramara, Golapganj, Iswardi, Uzipur, Gopalganj Sadar and Hajiganj.

"The filters are easy to use and affordable," said an official working under the project.

"Data received from villages (816) where the experiment is in progress shows that the technologies have high rate of acceptance. People find the filters easy to use and they have expressed their satisfaction. The tubewells in the six thanas have arsenic more than the permissible level of 50 parts per billion or 0.05 mg/L.

The experiment is being done under a 44.4 million dollar Bangladesh Arsenic Mitigation Water Supply Project (BAMWSP). A technical advisory group (TAG) of BAMWSP is monitoring the programme. Meanwhile, in Pabna, one of the badly affected areas, a programme undertaken jointly by the government, Unicef and Dhaka Community Hospital to supply locally developed arsenic free water has become successful.

(The Daily Star)

A possible breakthrough in arsenic treatment has been found after extensive clinical experiments in Bangladesh. Clinical study suggests that spirulina, a green blue algae having a very high concentration of micronutrients and vitamins, may have good effects on people suffering from heavy metal poisoning like arsenic.

A recent non-randomised study by the Bangabandhu Sheikh Mujib Medical University (BSMMU) found tremendous improvement in skin manifestation of arsenicosis patients after they were given a daily does of 10 grams of spirulina each for four months. As the study was confined to hospital-based patients, a further epidemiological study was necessary under strict protocol to validate the effect of spirulina on a larger size of population.

Dr AZM Iftikhar Hussain, a leading public health expert and also a senior instructor at NIPSOM, and his associate researcher Dr Hasina Momotaj, conducted this study. The study was conducted in three villages in Narayanganj district where hand-pumped tubewells were known to be contaminated by arsenic. (The Daily Star)

Gano Shasthya Kendro has selected a village as a model village were they are digging "wells" for the provision of safe drinking water .

Gono Shastya selected 11 areas for conducting their activities. They have so far tested a total of 3501 tube wells. In Kashinathpur Thana under Pabna district 3133 tubewells were tested out of which 1021 were found to be contaminated.

One of the major activities is identifying arsenocosis patients within these 11 selected project areas and provide necessary treatment for the patients.

The Gono Shastya Kendro is providing training to their health workers in the following areas:

1) How to test the tubewells for arsenic content

2) How to identify patents with arsenocosis

3) Providing information on arsenic for their health programme.

Gono Shastya Kendro is taking up an initiative to test all the tubewells within their 11 project areas (in total almost 40,000). They are also sinking more tubewells within the affected areas to provide "safe drinking water" to the people.

FUTURE WORK PLAN

CARE

The WATSAN Partnership Project of CARE has selected Rajshahi & Chapai Nawabganj as its working area. 10 (ten) Thanas have been selected for the project and to date, 1945 tubewells have been tested for arsenic. 212 have been found to be contaminated.

84 males & 73 females were found to be suffering from arsenic-related diseases between March 1999 to April 2000.

In order to mitigate the patients’ sufferings they have advised them to

i) Drink arsenic free water and

ii) To take nutritious food

iii) To contact the Thana Health Complex for immediate treatment.

CARE has been conducting a training programme for PNGOs staff and MOHFW staff on HBC and Arsenic Mitigation. The PNGOs are conducting training to Village Development Committee (VDC) members. At the same time the staff of the PNGOs are undertaking various sessions to the community on HBC "Arsenic Mitigation"

1) To address the problem of arsenic-contamination by raising awareness among the people and by providing alternative safe water options.

2) To develop the capacity of the PNGOs to enable them to provide support and technical assistance to VDCs.

3) To provide multi-channel dissemination of information and to reinforce efforts for social mobilisation with DASCOH.

4) Mapping, identification and testing of all arsenic affected tube wells in the operational area villages in collaboration with BAMWSP

5) To work with DPHE/ BAMWSP and other agencies in the designing and testing of alternative containers and reservoirs for use as viable arsenic free water supplies.

6) To test different options of safe water catchment, e.g. SODIS; SORAS; Dug Wells; and appropriate water pitcher techniques, etc.

7) Exchange of information and collaboration with other partners.

GB is implementing an "Action Research Community Based Arsenic Mitigation Project"

in Kachua Thana under Chandpur District

The Project began in August 1999 and is to continue to August 2000. All the tubewells in Kachua Thana have been tested and work on installation and demonstration of alternative water options and monitoring is going on.

240 patients with arsenocosis have been identified. 146 male, 79 female and 28 children.

Provision for medical support such as a supply of vitamins and ointment has been made under the advice of physicians

The project area covers Narshingdi; Perojpur; Moheshkhali; Hatia; Munshiganj; and Shahpara. The decision was that as these areas are free from contamination with arsenic they could sink around 4500 tubewells after testing for arsenic.

RDRS has selected an area in north Bangladesh. These areas are less affected by arsenic than others. However still they are disseminating information on the dangers of arsenic through group discussions.

1) How to measure arsenic with different types of kits.

2) Result of union-wise tubewell tests by GB borrowers (tester)

The "NGO Forum For Drinking Water Supply And Sanitation" has covered twelve regions of Bangladesh for identifying arsenic-contamination. Working in 58 districts, 257 Thanas and 2800 villages, they have managed to detect 2548 contaminated tubewells out of a total of 10797 tubewells.

NGO forum has in their mitigating programme implemented Rainwater Harvesting; Pond Sand Filter and Bucket Filter.

1) Random survey for arsenic by testing of water samples in the intervention areas and monitoring those areas that may be under threat.

2) Installing new tube wells after testing for arsenic.

3) Testing all newly installed tube wells and unaffected tube wells of the intervention

areas every after 6-month for detecting the presence of arsenic.

4) Analysing the situation analysis through an extensive survey and through other means.

5) Identification of arsenic patients and referring them to the nearest health facilities.

6) Establishing and developing a mini-laboratory for the regular testing of the water supply.

1. Bangladesh Arsenic Mitigation Water Supply Project (BAMWSP) has begun supplying arsenic free water in Hajigonj; Gopalgonj; Uzirpur; Sinagar; Kachua; Kishoreganj; and Ishwardi Upazillas.

Under this project experts have launched a public awareness campaign in these upazillas so as to familiarise the local population with pitcher filters; rain water harvesting; and other techniques.

Ninety-seven filtering units are working in the upazillas where five technologies are in use

The cost-effectiveness and ecological aspects of arsenic reducing technologies developed by the United Kingdom, Japan and other countries will be carefully monitored in all seven upazilas and if proved successful, these technologies would be implemented in other areas where there is arsenic contamination.

The World Bank and the Swiss Development Corporation are funding this project in association with the Local Government and Rural Development Ministry and Department of Public Health Engineering (DPHE).

2. Dhaka Community Hospital has implemented an integrated Arsenic Mitigation Project in Bera Upazilla under Pabna District. This is a joint venture project of DPHE-UNICEF-DCH.

Testing and marking of all tube wells, identification of arsenic patients. Long term management, rehabilitation of alternative safe water options and water quality monitoring. Awareness building and community mobilisation

DCH tested all the tube wells in Bera Upazilla using field test kits and found that 51.5% of the hand tubewells were contaminated.

DCH has installed alternative safe water options as follows

i) Pond Sand Filter

ii) Rainwater Harvesting (cum Sand Filter-treating arsenic contaminated tube well water in the dry season)

iii) Dugwells

iv) Pitcher Filter (Kalshi and Chari)

3. The development of arsenic mitigation options is one of the major components of the Watson Partnership Project. The WPP is experimenting with different practical aspects of promising low-cost arsenic mitigation water supply technologies. The options are arsenic reduction and alternative water sources. As part of the action research, Bucket Treatment Unit (BTU) method and SORAS Treatment Method are being practiced at laboratory and field level.

The SODIS Method is being implemented on a limited scale in the project area to improve the microbiological water quality of water. The potential of other options such as rainwater harvesting, dug wells are also being examined. These technologies are being examined in the context of improving hygiene behavior; user acceptability; and community management.

SODIS (Solar Disinfection) is a simple, low cost technology, which can purify microbiologically contaminated water with the help of sunlight. The procedure is simple and comprises a PET bottle (used mineral water bottle) with half painted laterally black. Water is exposed to direct sunlight for seven to eight hours with the painted portion facing downwards. The ultra-violet rays from the sun heat the water to nearly 50 C which results in the destruction of the micro-organisms in the water making it safe to drink. The most important aspect of this technology is that it eliminates the possibility of contamination during handling.

SORAS (Solar Oxidation and Removal of Arsenic):

The basic principle is the irradiation of water with sunlight in PET or other suitable transparent bottles to reduce the level of arsenic in the water from 5 mg/L to levels below 0.05 mg/L. The SORAS method is based on photochemical oxidation of As(III) followed by precipitation or filtration of As(V) adsorbed onto Fe3. SORAS will typically reduce the content of arsenic by more than a factor of 10 at virtually no cost.

PROSHIKA and Canadian International Water Purification Firm Limited (CIWP) has entered into an agreement for manufacturing of low-cost water purifiers for household use in urban and rural Bangladesh. Used in 26 countries from Nicaragua to Vietnam, this water purifier, called the Canadian Water Purifier (CWP), can effectively remove arsenic as well as parasites, bacteria and viruses from water. It can successfully treat water from river, ponds, shallow and deep tube-wells irrigation, canals, rain water and contaminated water as well. (BSS)

Proshika will set up a factory for the production of surface water treatment plant under a joint collaboration with a Belgium company, Altech, for ensuring supply of arsenic free pure water. Proshika President Dr Qazi Faruque Ahmed and Altech representatives Jean Minet and Serge Aulotte signed an agreement on the joint venture at a simple ceremony at Proshika Bhaban yesterday. Mahbubul Karim, Proshika senior vice-president, Dr JP Dutta, director (Information) and JK Baral, director (Health), were present at the signing ceremony, says a press release. The surface water treatment plant is capable of purifying surface water of river, canal, pond, beel and other water body to the tune of 1500 litre per hour which can meet pure water need requirement of 300 to 400 families. The plant will particularly be suitable for the arsenic and salinity prone areas of the country as it is designed to remove any such contamination of water. The plant costing around Taka 8 lakh can be installed by public organisations or private individuals in both rural and urban areas alike. (The Independent)

The joint DPHE-BGS project 'Groundwater Studies of Arsenic Contamination in Bangladesh' began in January 1998. The project was funded by the UK Department for International Development (DFID). One of the main aims of the project was to assess the scale of the groundwater arsenic problem in order to aid the rapidly-developing arsenic mitigation programme. A second aim was to increase our understanding of the origins and behaviour of arsenic in Bangladesh aquifers. These aims were subsequently expanded to include a broader range of hydrochemical parameters.

In order to meet these objectives, hydrochemical surveys were undertaken at various scales - national, thana and village. Two national-scale surveys were undertaken: (i) a systematic survey of 61 of the 64 districts of Bangladesh involving the collection of 3534 tubewell samples, and (ii) a survey of 113 tubewells from the national water quality monitoring network maintained by the Bangladesh Water Development Board (BWDB). Three thanas (the sadar thanas of Nawabganj, Faridpur and Lakshmipur districts) were also selected as Special Study Areas for a broader range of investigations. In one of these thanas, a single mouza or village (Mandari, Lakshmipur) was selected for a detailed survey using on-site arsenic analysis with an Arsenator. A limited amount of monitoring (time series) data have also been collected from tubewells and piezometers in the three Special Study Areas. The data collection and analysis have been completed and the Final Report is presently undergoing final checking and review.

The project was undertaken in two Phases. Phase I was undertaken jointly with Mott MacDonald Ltd. The principal findings of Phase II were presented at a Workshop in Dhaka on 30 March 2000.

The results of the project will be made available in a variety of formats as soon as possible.

Scientists have found that, in a significant number of samples in the Special Study Areas which are described in Volume S4 of the BGS-Mott MacDonald Phase I Report BGS did not, for reasons best known to themselves, choose to mention the lead in the groundwater. They reported only median values, which can be bad news if you're in the wrong 50%. The lead analyses was discovered only by accident after finishing the report and while compiling computer files for the CD archive.

Nickel is not mentioned in the text of Volume S2 although it is identified at the end table in the appendix. I must accept responsibility for not highlighting this. This has been brought to the attention of WB and DFID, and pointed out at two seminars in Dhaka.

One nickel value is 200 times WHO, though I have my doubts about analysis and have requested BGS/DFID to urgently repeat the analysis. Further high nickels were found in the Special Study Areas (but also not mentioned in S4). These are important omissions which should be looked into.

In 1988 we were encouraged to submit a proposal to the World Bank in Bangladesh for studies to help in the arsenic crisis. This was hand carried in April 1999. The purpose of this memo is to describe what has been done since that time.

We have taken an integrated approach to the whole problem.

Study of hydrogeology and hydrochemistry by Professor Charles Hawey, formerly Harvard, now MIT, Poisons Laboratory together with Professor and staff from Bangladesh University of Engineering Technology (BUET).

Partial funding for 3 years was available from US National Science Foundation in March 2000. Professor Hawey and 2 graduate students visited in April 2000 and drilled 12 test tube wells. Core samples are being analyzed at MIT and Dhaka. Water samples are being taken every 2 weeks. The areas include:

Understanding the motion of arsenic in the aquifer Understanding the chemistry and availability of arsenic

Epidemiology study using biomarkers. This has just received partial funding for 5 years from US National Institutes of Health. Professor Christiani proposes to use a similar protector to that used successfully in Taiwan, and take nail samples, and hair samples and use a nutrition survey. If extra funds can be found he will study in addition the effect of nutrition supplements. Professor Christiani (Harvard School of Public Health & Massachussets General Hospital) has initiated discussion with Dhaka Community Hospital on collaboration, and Dr. Quamruzzaman will visit Harvard on June 28th and 29th to finalize the details, (Funding only became available in April 2000).

Study and testing of various water purification schemes. We have studies, in the USA, two schemes suitable for a medium scale (50 person) . – that of Badqer and Nicholaidis. Funding is needed for testing in a Bangladesh setting (Professor s Jack Spengler and Timothy Ford from Harvard - Professor Nicholaidis from University of Connecticut )

4) Measurement capability.

An important issue is rapid, and accurate testing of Arsenic in well water.

Together with DCH we helped in testing of Dr. Walter Keseves arsenator in the field. ( An undergraduate from Harvard was helping here). We have to help in making it more "user friendly".

Communication to Bangladeshi population we have no direct program on this yet, but note that our students speak, or learn, Bengali.

Student involvement: We have been ask to generate extraordinary excitement among students and send as many over as can be accommodated. An undergraduate spent a year at DCH, (and translated a nurse's manual from English to Bengali); another student will spend six weeks this summer at BRAC and will spend six weeks at DISOESU at Calcutta. Both now speak Bengali. We are looking for funds to get two or three Bangladeshi students to Harvard for Ph.D. study and research (research partially in Bangladesh).

Our primary contact point with this work is with Dhaka Community Hospital (DCH) I (Professor Richard Wilson) have been at each of the three arsenic conferences and have been asked to be an international advisor. Dr. Quazi Quamruzzaman is meeting with the World Bank in Washington DC, on June 26th and 27th and would like Professor Wilson to accompany him to help present the DCH program.

We hope that the World Bank can either resuscitate the Harvard proposal or allow us to modify and resubmit it.

Communication to the scientific community the press and the world. This has been a priority for myself. We had requested funds from World Bank under the INFODEV program but it was felt to be outside the scope. I have proceeded to set up a website with limited funds (personal funds).

Richard Wilson

Many people are being subjected to social problems due to wrong diagnosis and such errors should be avoided as far as possible because of the mental agony it causes.

Experts at DCH have said they have discovered many such cases. For example, in Kachua, Grameen Bank personnel have identified 48 people as suffering from arsenicosis when only one was so affected. Similarly in Manikganj Sadar, ISDCM had diagnosed 56 cases but DCH could confirm only two.

Misdiagnosis seems to be occurring due to the inability of field workers and paramedics to identify patients.

BRAC has however engaged doctors in diagnosing patients with the result that misdiagnosis is very rare.

DCH has identified 120 arsenic patients in Bera, 240 in Kachua and 316 in Jhikargacha thanas. In Manikganj, DCH surveyors have so far found 24 arsenicosis cases, 15 of them were later confirmed in laboratory tests. Their investigation is still on-going in Manikganj Sadar.

Forty-two doctors of DCH divided into two groups for field-screening and laboratory-testing are working to identify arsenic patients under the "Developing and Implementing Protocols of Management of Arsenicosis" under a GOB-UNICEF joint project. Under this project BRAC, Grameen Bank and Integrated Service for Development of Child and Mother (ISDCM) are working on identifying arsenic patients in four thanas. DCH is identifying arsenic patients and their management in the four thanas. In the first phase, Bera of Pabna district, Kachua of Chandpur, Jhikhargacha of Jessore and Manikgonj Sadar Thana have been chosen.

Doctors from DCH say hair nail, skin and urine samples collected from patients are sent to Calcutta Jadavpur University for analysis.

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