Mitigation of Arsenic Contamination
in Rural Areas of Bangladesh
-- The Current Status and Problems --
JICA Expert (Arsenic Mitigation Adviser)
Three months have passed since I came to Bangladesh as JICA's long-term
expert (Arsenic Mitigation Adviser). Now I would like to summarize the current
status and problems of mitigation measures to combat the arsenic contamination
in rural areas in Bangladesh based on the findings of my own surveys and
daily collection of information.
I. The Current Status
1. Safe Drinking Water
In highly arsenic-affected villages various projects have been gradually
undertaken to supply safe drinking water by DPHE, BAMWSP, UNICEF, DANIDA,
both national and local NGOs and others. I have observed the following methods
as their mitigation measures.
A. Household Options
Chowkiderbari, Chandpur Dist., 8/12/00):
This is a round tank of about 1.8 metre high with a diameter of approximately
2 metre. The tank is made of concrete and connected with a gutter which
collects rain water from the tin roof of a house. A few neighbouring families
are using the rainwater harvester (RWH).
In Chowkiderbari, UNICEF bore the whole cost of the installation of the
RWH without any cost-sharing from the beneficiary families. Whereas, in Achintyanagar,
Jhenaidah District, a similar RWH (3,200 litre, Taka 9,000) was installed
with 20% of the cost borne by community people and 80% financed by NGO Forum.
The weakness of this system is that people can use it only a few months
after the rainy season. In Achintyanagar, two families are using this 3,200
litre RWH. If ten people of the two families drink five litre each per day,
the water runs out after 64 days. After that, they have to look for another
source of drinking water.
The tap of the RWH in Chowkiderbari was tied up with thin bamboos in early
December 2000 so that people do not use it.
Arsenic Removal System No. 1
Chowkiderbari, Chandpur Dist., 8/12/00):
This is called "Four Pitcher System". In the second pitcher there are charcoal
and brick chips, and in the third sand. Tubewell water put into the first
pitcher is oxidized while it flows down to the second pitcher, and filtrated
through charcoal, brick chips and sand. Thus arsenic- removed water is kept
in the fourth pitcher. The system is based on the property that arsenic
is adsorbed to iron by oxidization. Therefore, much effect cannot be expected
unless groundwater is iron-rich.
The unit is a traditional system used for removing bacteria at a time when
people used to drink pond water. After the source of drinking water was
switched from a pond to a tubewell, the system has been utilized to remove
iron and reconsidered as an effective way to remove arsenic also since two
and a half years ago.
The system does not require any chemicals. It is cheap (Taka 100) and simple.
It has all the factors that can be accepted by villagers. DPHE is currently
undertaking the test about the effectiveness of the system for arsenic removal.
Arsenic Removal System No. 2
Durbadanga, Jessore Dist., 10/11/00):
This is called "Two Bucket System", implemented by DANIDA. To the tubewell
water poured into the red (top) bucket, potassium permanganate (oxidizing
agent) and aluminium sulfate (coagulant) are added to remove arsenic from
the water. The tubewell water is then filtrated through the sand in the
green (bottom) bucket. The arsenic concentration of 0.5mg/L of the original
tubewell water was lowered to below 0.02mg/L in this system by the measurement
of a field arsenic testing kit.
B. Community-based Options
PSF No. 1
Doaty, Chandpur Dist., 8/12/00):
This pond sand filter (PSF) was installed by UNICEF's full support in July
2000. Nearby there was also a deep tubewell (DTW) sunk by DPHE. On visiting
a household, I found that DTW water was kept for drinking and PSF water
for cooking in separate kalshis in the kitchen.
Here, water is taken from a relatively large pond (80 x 50 metre) for the
PSF. However, villagers were using the pond for bathing and washing. It is
my opinion that any pond for PSF should be kept hygiene for drinking purpose
and not be used for any other purposes.
PSF No. 2
; Samta, Jessore Dist., 3/00):
This is a pond sand filter constructed by the Asia Arsenic Network (AAN)
in January 1999. The pond for the PSF is protected by bamboo fencing and
any use of the water other than drinking is prohibited. All the cares are
taken to prevent bacterial contamination by removing a lavatory to a place
more than 15 metre away and by sterilizing the processed water with chlorine
in the last chamber of the PSF
A doctor of Samta Health Centre checks coliform and other bacilli once
The construction cost was Taka 1,50,000 for the PSF itself and Taka 2,00,000
in total inclusive of other expenses incurred for re-excavation of the pond,
fencing, and the removal of a lavatory. The cost was paid with the grant
given by the Toyota Foundation.
The PSF has the capacity for 150 households (750 people). The Samta Arsenic
Prevention Committee is in charge of the maintenance and management of the
pond and PSF. Since the pond water dries up toward the end of the dry season,
they consider bringing water from the Betna River approximately 500 metre
away to the pond. The collection of water rate is yet to be considered.
The medium-size PSF that AAN is currently promoting can supply water to
100 households (500 people) and can be constructed at a cost of Taka 1,00,000.
The other expenses for re-excavation of a pond, fencing and maintenance
are to be borne by the community people.
The condition for the installation of a PSF includes the replenishment of
a pond of a suitable size free, the establishment of a solid group of community
people for operation and maintenance, and the availability of pond water
throughout the year.
Arsenic Removal System No. 3
; Rajnagar Bankabarsi, Jessore Dist., 19/12/00)
This is an arsenic removal system with aeration and sand filtration combined.
In Rajnagar Bankabarsi, The JICA Study Team on the Groundwater Development
of Deep Aquifers was testing the effectiveness of the unit.
Arsenic Removal System No. 4
; Rajunagar Bhangabarsi, Jessore Dist., 19/12/00)
This is an arsenic removal system with aeration, gravel and sand filtrations
and adsorption by activated aluminium oxide combined. In Rajnagar Bankabarsi,
The JICA Study Team was testing the effectiveness of the unit.
5) Iron Removal
; Baraipur, Chuadanga Dist., 17/11/00)
This is an iron removal system installed by NGO Forum at a cost of Taka
8,000 (Taka 1,600 was borne by community people). Since the system removes
arsenic as well as iron at the same time, it is being introduced for arsenic
removal in other affected areas. The arsenic of 0.5mg/L in the original
groundwater was removed with iron and lowered to 0.02mg/L when tested with
a field arsenic testing kit.
The sand of the filtration tank is backwashed once a week, but the drained
water is disposed on to the ground from the back of the unit
The arsenic of 0.4mg/L was detected from the drained water that was still
on the ground. It is necessary to examine the disposal of drained water.
6) Deep Tubewell
; Rajnagar Bankabarsi, Jessore Dist., 3/11/00)
The JICA Study Team is conducting a monitoring research on the water quality
of the three deep tubewells (222 metre deep) installed in Rajnagar Bankabarsi
with different types of sealing technologies; namely, cementing, nice-sealing
and mechanical method. They plan to evaluate the cost, effectiveness of
each sealing method, the feasibility of transferring the technologies, and
other factors. Since no arsenic was detected in the pumped up water, villagers
started collecting water from the deep tubewell for drinking
7) Deep Tubewell
; Gopinatpur, Chuadanga Dist., 17/11/00)
This is a deep tubewell (120 metre deep) installed in Gopinatpur village
by DPHE. Measured by a field arsenic testing kit, it was found that the
water contained arsenic of 0.3mg/L. Depending on the places, arsenic is
detected at high concentrations in deep tubewell water. It cannot be said
that a deep tubewell is always safe everywhere.
When I visited Dourbadanga village in the Jessore District on 10 November
2000, I saw a deep tubewell (220 metre deep) sunk by DPHE. The water sample
was checked with a field arsenic testing kit and the arsenic concentration
was only 0.01mg/L. However, due to the salinity, villagers were not drinking
the water. A deep tubewell, as an alternative source for the mitigation
of arsenic contamination, requires careful pre-installation assessment and
2. Medical Treatment
The mitigation of arsenic contamination has so far been stressed on the
supply of safe drinking water as a preventive measures, and only a few organizations
are engaged in treatment of arsenicosis patients. I would like to consider
the medical problems that people in arsenic-affected areas are facing through
the cases studied and taken care jointly by AAN and NIPSOM(DOEH).
1) Seriously-affected Patient who Recovered his Health
Mr. Rezaul Morol of Samta village, Jessore District, was walking with an
aid of a stick when a doctor of NIPSOM examined him in December 1996
. His whole body was covered with hyper-melanosis, he had hyper-keratosis
on the palms and soles, and he was suffering from bronchitis, enlargement
of the liver and peripheral neuritis. Following year he was hospitalised
in Sharsha Thana Health Complex and took arsenic-safe water, nutritious
food, vitamins A, C and E, and chelating agent. When he left the hospital
three months later, his symptoms were so substantially improved that he
could start working as rikishaw-van driver
NIPSOM doctors say about medicines for arsenic poisoning: "Safe water first,
safe water second, safe water third, and then nutrition and vitamins as
2) Skin Cancer Patient No. 1
Mrs. Fulslat of Samta village, Jessore District, was found to have had skin
cancer of 4 x 5.5cm size on the parietal region of the head
during the medical examination survey conducted by AAN and NIPSOM(DOEH)
in February 1998. She had an operation at the Yamagata Dhaka Friendship
Hospital in May 1999 and her skin cancer was removed
She was very much pleased and said that her second life had begun.
In December 2000 a doctor of AAN medical team from Japan found six skin
lesions on her scalp which were suspected to be of cancer
All of them appeared afresh after the operation of one and a half years
3) Skin Cancer
Patient No. 2
Mr. Ijjat Ali (Photo
of Mazdia village, Jhenaidah District, had skin cancer on the palms of both
hands (Photo #21)
and on the left groin. He had an operation
at the Yamagata Dhaka Friendship Hospital in October 2000 and returned
home early December. However, since the cancer under the artery of the left
groin had not been removed, he is now receiving chemotherapy since December
†4) Skin Cancer Patient No. 3
Mrs. Rokeya Begum
of Marua village, Jessore District, had skin cancer on the right palm
She had an operation at the Yamagata Dhaka Friendship Hospital in December
2000 and returned home early January 2001.
3. Community Participation
Arsenic mitigation activities by international organizations and major NGOs
are generally undertaken jointly with a local NGO active in one particular
village. The local NGO encourages villagers to form a committee so that
the committee may act as the principal body to organize mitigation work.
According to AAN experience, members of such a committee are decided among
the village leaders. One of the main functions of the committee is to collect
funds to operate and maintain a newly installed option of alternative source
of safe water. The running of the fund including the management of money
is under the supervision of the local NGO during the initial stages. The
committee needs some experience to become an independent running organization.
1. Safe Drinking Water
As reported in I.-1., various systems to supply safe drinking water are
being introduced in highly arsenic-affected villages. There are systems
that are accepted by the community straightaway whereas for the implementation
of some other systems contractors and/or villagers may have to be properly
The former is a system that is cheap in cost, necessary materials of which
are easily obtained, and that is simple in operating and maintaining. Such
systems are to be replaced in future by highly advanced systems. The latter
has some difficulties in cost, construction and operation/maintenance aspects.
However, such an option is feasible by improving the abilities of contractors
and/or villagers, which will, in turn, be a basis of installing a permanent
measures such as a piped water supply system.
In the planning of measures for safe drinking water, concerned people often
quote the necessity of "emergency" and "permanent" measures or "short-term",
"mid-term" and "long-term" measures. However, those classifications are
not clear with respect to the division of "emergency" and "permanent", or
"short-term", "mid-term" and "long-term". It would be necessary to form
a public understanding in this respect as to what condition allows the move
from emergency to permanent, or from short-term to mid-term and long-term
measures. Here I would like to investigate from the viewpoints of the effectiveness
of systems implemented as alternative sources of safe drinking water, their
costs, and the development of villagers' ability, taking the above-mentioned
cases into consideration.
1) The Effectiveness of Systems
The first requisite of any system for arsenic contamination mitigation is
to be able to supply safe drinking water. The "safe drinking water" means
the water that meets the Bangladesh standards set for coliform and other
bacilli and any hazardous substances as well as arsenic. When applying arsenic
or iron removal equipment, it is important to dispose sludge properly to
prevent the second contamination. When using of chemicals, cautions are
to be taken so that no such chemicals remain in the processed drinking water.
The more advanced, the more technology the system requires to solve the
problems of meeting water standards, sludge disposal, residual chemicals
and so on.
2) The Cost
For an alternative source of drinking water, both the installation fee and
the operation and maintenance expenses are required. The villagers' willingness
and ability to bear a part of the cost largely depends on not only their
economic condition but also on their understanding of the importance of
taking safe water. In case the installation fee is high, financial aid may
be required from international organizations, ODA funds of advanced countries
or major international NGOs as well as from the Government of Bangladesh.
In principle, all the costs incurred for operation and maintenance should
be borne by beneficiaries.
It is assumed that the more advanced the system is, the higher cost is required
for construction, operation and maintenance. Therefore, the change of villagers'
consciousness and the increase of their income are the conditions essential
to the installation of such systems.
3) The Development of Villagers' Ability
Villagers are required to have the ability to manage a system installed
as an alternative source of safe drinking water. The ability is required
in two aspects; namely, (1) to maintain and check the system technically
and (2) to manage the fund collected from beneficiaries and run the fund.
It is difficult to imagine that villagers will keep on making use of any
system that requires technical and managerial abilities beyond those of
It is also difficult to introduce any system widely unless such a system
is constructed with locally available materials and by the hands of local
contractors. The contractor's ability is an important factor when considering
whether any system is acceptable or not.
The more advanced a system is, the more important such development of abilities
2. Medical Treatment
In consideration of the cases introduced in I.-2. and others, I would like
to summarize the medical side of mitigation in terms of medical knowledge,
cost, and the development of villagers' ability.
1) Medical Knowledge
First, the knowledge to identify arsenicosis patients and to classify them
into certain groups of symptoms is called for. In highly arsenic-affected
areas, there are some patients with skin cancer, and the knowledge to confirm
skin cancer at initial stages is important.
Arsenicosis patients with mild symptoms may improve by taking arsenic-safe
water and nutritious food. Those with moderate and severe symptoms should
receive treatment with medicines in addition to arsenic-safe water and nutritious
food. All of nutritious dietary, effective medicines and the treatment of
arsenicosis patients will be the target of future studies and developments.
For patients suffering from advanced cancers require surgical operations
Skin cancer at an initial stage (Photo #19) can be easily removed if a surgeon
and simple facility are available. The cost in this case is not much. However,
if patients have to bear the cost, only rich people can receive medical
care and the poor cannot, which will create discrimination. In case of the
medical care for moderate and severe patients, too, there may occur similar
discrimination unless some assistance is available.
The medical expenses incurred for the operation of skin cancer patients
introduced in I.-2. amounted to several times of their families' annual income.
It was not possible for them to pay, and AAN paid the bills. It is hoped
that some public insurance system be established to reduce economic burden
on the patients' side. Until then, it would be difficult for a cancer patient
to receive an operation and/or chemotherapy without any assistance.
3) The Development of Villagers' Ability
Among the patients with hyper-keratosis on the soles, there were many cases
that bacteria got through the cracked skin and the part became festered.
In another case, a patient had to stay on in hospital after the surgery
of cancer since it was not possible for him to disinfect the wound at home.
It is required to develop the concept of health and sanitation among villagers
and to spread simple medical knowledge. It is also important to further
develop the abilities of local health workers.
As explained in I.-1., in arsenic-affected areas various types of systems
are being introduced as alternative sources of safe drinking water, with
each having a problem. Those systems will vie with one another in the rural
area of Bangladesh for a long time. Who is going to coordinate this complex
development and where? To carry out permanent mitigation measures, the development
of villagers' abilities as well as the improvement of effectiveness of systems
and medical knowledge is dispensable condition.
I feel that some social system is required to implement mitigation measures
effectively in the rural area. It is a comprehensive mitigation system under
which the extent of arsenic contamination will be clarified, safe drinking
water supplied, and medical care and awareness education undertaken. The
system will develop the abilities of community people and will prepare the
basis for permanent mitigation measures.
I will discuss more about the system in III.-3. below.
áV. Japan's Cooperation
1. Safe Drinking Water
The JICA Study Team has been conducting a survey on the development of groundwater
in the three districts of Jessore, Jhenaidah and Chuadanga on the southwestern
region of Bangladesh. One model village is set up in each district and there
they supply water from the arsenic removal plants and deep tubewells. Among
villagers the improved (= sealed) deep tubewells are most popular.
It has become clear that there are some problems to the improved deep tubewells
(150 to 200 metre deep). For instance, there are areas where there is no
clay layer (which is essential to do the sealing) along the way to the deep
aquifer, there are places which deep groundwater is saline, it is likely
to take some time for the sealing technologies to be learnt, and so on.
Accordingly, the number of sealed deep tubewells to be installed in a year
will not be large.
AAN completed the construction of a large-size PSF (for 150 households)
in Samta, Jessore District, in January 1999. Currently, two middle-size
PSFs (for 100 households) are being constructed in separate villages. AAN
plans to install some kind of options as a means of supplying an alternative
source of safe drinking water in 20 villages per year.
Both sealed deep tubewells and AAN-type PSFs can be implemented only with
the improvement of construction skills of contractors and the technical
and managerial abilities of villagers. As such, it will be difficult to
construct many such facilities within a short period of time. Priority for
mitigation should be given to severely affected villages by identifying
them through a screening survey.
On the other hand, it is also important to plan mitigation measures for
safe drinking water in mid- and long-term perspective. While trying to improve
the construction skills of contractors and the technical and managerial
abilities of villagers, it is also required to prepare for permanent measures.
2. Medical Treatment
When AAN have found patients in arsenic-affected village they visited, AAN
provide moderately and severely affected patients with medicines and give
support to those with skin cancer.
Dr. Nobuyuki Hotta of AAN paid his third visit to Bangladesh in December
2000 and called at various affected villages. Before returning to Japan,
he commented: "I am afraid that the number of skin cancer patients will
rise enormously in Bangladesh if the arsenic contamination continues as
it is. To find them at an early stage it is important to educate medical
personnel so that they can distinguish skin symptoms. Since cancers on the
internal organs are likely to increase, it is necessary to start the mitigation
in this respect, too".
It is my opinion that Japan can contribute a great deal toward the training
of dermatologists, the establishment or enrichment of facilities for the
surgery of early skin cancer, and the provision of a system for treatment
of cancers. These will be the cooperation that can be undertaken with medium-
and long-term prospects.
3. Arsenic Centre
As stated above, in highly arsenic-affected areas various types of options
to supply safe drinking water are being introduced on an emergency basis.
In villages a comprehensive approach is required not only to obtain another
source of safe drinking water but also to provide patients with medical care
and to promote community participation. It is important, therefore, to establish
a social system to coordinate these activities and proceed with mitigations
of high-degree. I myself have a plan for an "Arsenic Centre" to function
as the nucleus of such a system.
At the Arsenic Centre a group of experts (medical doctors, chemists, civil
engineers for the supply of safe drinking water and social workers) is posted,
necessary apparatus and materials are equipped, medicines are kept, and
simple treatment and surgery will be undertaken. The Centre will promote
comprehensive mitigation measures in the locality, give guidance to the
people of affected villages in respect of skills and management, and help
village-level committees become independent. Through these activities all
the mitigation measures undertaken will be firmly established in the community,
which, in turn, I think, will become the basis to prepare permanent measures
for drinking water such as a piped water supply system in the future.
The source of revenue of Arsenic Centres and the running bodies will be
the subjects for me as JICA long-term expert (Arsenic Mitigation Adviser)
to study further.
4. Selection of an Area for Cooperation
I think it necessary to make Japan's plan clear at an early stage as to
which area of Bangladesh and what kind of cooperation they are going to
Japan's cooperation currently promoted is the survey on the groundwater
development of deep aquifers by the JICA Study Team and the grass-root activities
by AAN. The former is working in the three districts of Jessore, Jhenaidah
and Chuadanga, whereas the latter targets the ten districts of the Khulna
Division that includes those three districts. Japan's mitigation measures
will achieve great results when it is carried out comprehensively in coordination
with these two attempts on a mid- and long-term basis.
I think it preferable to select an area for Japan's cooperation in the Khulna
Division avoiding the duplication of work in the places where BAMWASP, UNICEF,
DANIDA and NGOs are already present. I would like to consider that in the
area an Arsenic Centre will be set up as an experiment, and then the Centre
will undertake comprehensive mitigation measures while preparing for a water
supply system of higher level and an appropriate medical care system.
(1st February 2000)