The Daily March 10, 1999 LETTER FROM AMERICA Bangladeshis Hold the First Arsenic-Poisoning Conference in America Dr Fakhruddin Ahmed writes from Princeton ON February 27 and 28, Bangladeshi chemists in North America held an International Conference on Arsenic poisoning in Bangladesh, at Wagner College, in the Staten Island borough of New York City. Organized by Bangladesh Chemical and Biological Society of North America (BCBSNA) and Intronics Technology Center, Dhaka, the conference was the brain child of Dr. Mohammad Alauddin, Professor of Chemistry at Wagner College. The conference was dedicated to 25-year-old Pinjira Begum of Miapur, in the Pabna district of Bangladesh, who is dying of arsenic-induced cancer. Pinjira Begum was featured in a front page article in the New York Times, on November 10, 1998. The who's who among the arsenic-poison experts of the world attended the conference. Epidemiologist Professor Allan Smith, the keynote speaker from University of California, Berkeley, made the trip as did, Dr. Dipankar Chakraborti of Jadavpur University, Calcutta, the person responsible for bringing the arsenic-poisoning catastrophe in West Bengal and Bangladesh to the world's attention. There were scientists from America, Canada, Sweden, India and Bangladesh; from US Geological Survey, Massachusetts Institute of Technology (MIT), University of Connecticut, Lehigh, Columbia and Harvard Universities. Wagner College, a marvelous host, shared the cost of the conference. Dr. Richard Guarasci, the College Provost, opened the conference. The President of Wagner College, Dr. Norman Smith, hosted a reception for the participants at his gorgeous office overlooking the Verrazano Narrows Bridge that spans the boroughs of Staten Island and Brooklyn. (Dr. Kamal Das, President of BCBSNA, thanked the Wagner College President profusely for hosting the conference.) All in attendance were united in their resolve to bridge another gap - that exists between the technological capabilities of Bangladesh and the USA - and to solve the arsenic poisoning crisis in Bangladesh. The water that the underground tube wells bring up to the surface is considered a mineral. It contains beneficial elements such as iron, calcium and other nutrients. It can also contain deadly poisons such as arsenic and lead. The real safe level of these poisons in drinking water is zero. That is not obtainable. For safe drinking, the World Health Organization (WHO) recommends no more than 10 parts per billion (ppb) of arsenic in water. Bangladesh adopted a much higher level - 50 parts per billion! The rationale behind Bangladesh's embracing of the higher level of poison is that the USA, where drinking water is not a problem, recommends the same level. That was a mistake. On a given day, an average American's liquid intake includes endless cups of coffee, soda (Coca Cola, Pepsi, 7-up), beer and wine. An average Bangladeshi villager drinks water exclusively. And because of the heat, he/she drinks lots of it. And if the water is poisonous, he/she ingests plenty of poison. Therefore, the recommended levels of arsenic in water for Bangladesh should be not higher, but much lower than the level recommended by WHO! Arsenic is a human carcinogen that quietly accumulates in hair, nail and skin. Common symptoms are depigmentation, rashes on palm and soles of feet. As the poisoning advances, it retards the growth of limbs, resulting in deformities, birth defects and abortions. The natural progression of the poisoning is hyperpigmentation, through keratosis and gangrene, to finally cancer. Skin cancer looks like leprosy. People mistakenly believe that it is infectious. The victims are shunned as social outcasts; men do not get jobs, women are denied husbands. Because arsenic is a slow-acting poison, it is not an attention-grabber like a sudden disaster. There is a latency gap in this time bomb. Silently but surely it kills in 15 to 25 years. Unless detected early on, the poisoning is irreversible. 43-98 per cent of the total arsenic is in the most toxic trivalent form. Apart from the widely read Chemical & Engineering News's reporter Wil Lepkowski, the conference was also covered by local vernacular dailies, India Abroad, and for the Voice of America by Ms Zakia Khan. Professor Mohammad Alauddin chaired the morning session on the inaugural day. The afternoon session was devoted to analytical methods for the detection of Arsenic in water. The session was chaired by Professor Abul Hussam of George Mason University, who has developed instrumentation of his own for the detection of Arsenic. In his presentation, Dr Hussam reported on arsenic speciation studies in Bangladesh water, and remarked on the limitations of kit method widely used in Bangladesh for detecting arsenic. At the end of each day, there was a panel discussion on the papers and remedies presented; Drs. Quamrul Ahsan and Shamsuddin Ilias were the co-hosts. All the technical sessions on the second day, dealing with the geological processes and remedial methods, were chaired by the writer. There are about four million tube wells in Bangladesh, one million of which were dug by UNICEF in the 1970s. It is conservatively estimated that 70 million people are poisoning themselves by drinking water from these fountains of death. In 43 of Bangladesh's 64 districts, the arsenic level is more than 50 ppb; in 20 districts the level is between 500 to 2000 ppb! According to the physicist Willard R. Chappell: "If this were the United States, they'd call out the National Guard and get everyone bottled water. But Bangladesh does not have resources. It may be pointed out that Bangladesh's per capita income is 266 dollars. Poor nutrition could also be a factor as to who is affected more adversely." In his presentation, Professor Smith cast some doubt on the role of nutrition in combating poisoning. His study in Argentina showed that Argentinians of European origin, on high protein diet (beef steak), have also been suffering from Arsenic poisoning since the 1930s. The more recent case of Arsenic-poisoning in Taiwan was very well known. Yet, in his talk, Mr. Gourishankar Ghosh, Chief, Water and sanitation Division, UNICEF, said that amidst their enthusiasm to drill tube wells in Bangladesh in the 1970s, UNICEF forgot about the Taiwan experience. The deadly water went untested for two decades! Mr. Ghosh believes that emphasis should now be on saving children. Dr. Bibudhendra Sarkar, an expert on metal-related diseases from the University of Toronto, showed a video of the victims from a recent visit to Bangladesh, that brought tears into every eye in the audience. Dr Dipankar Chakraborti believes that what is known about arsenic poisoning in Bangladesh is only the tip of the iceberg. Where Bangladesh is failing is in the management of the problem, he says. In remote villages, people do not know that they are arsenic patients. In one village in Jamalpur, 80 per cent of the people suffer from arsenic poisoning. The bad news is that it is estimated that only 33 per cent of tube wells in Bangladesh are safe. The good news is that there is not a single village in Bangladesh where all the tube wells are unsafe. Bangladesh is a land of rivers, wetlands, lakes - there are over 11,000 cubic meters of fresh water for every person. Yet, there is excessive use of ground water for irrigation (80 per cent), drinking and cooking (10 per cent) and industry (10 per cent). More, or deeper tube wells is not the answer. 100-200 ft tube wells can be the most contaminated. Luckily, the food chain has not been contaminated. Dr Alan Welch of US Geological Survey showed how arsenic can be released from iron oxide through an increase in pH. Dr. Muhammad A. Miah of the University of Arkansas wondered whether Farakka Barrage had something to do with the arsenic contamination in Bangladesh. Dr. Shibtosh Roy reiterated the effort expended by Dhaka Community Hospital in analyzing hair, nail and urine samples to establish the magnitude of arsenic poisoning in Bangladesh. Dr Stute of Columbia University presented their study on how Arsenic is mobilized in sediments and transported by ground water. Dr Prosun Bhattacharya of Royal Institute of Technology, Sweden, reminded everyone that arsenic, the 20th most abundant element in the earth's crust, is not a "contamination;" it is a natural occurrence. Dr Timir Hore was concerned about the faulty construction of tube wells in Bangladesh. Good construction should be double-cased to avoid vertical seepage from upper to lower aquifer. He explained why of the two tube wells separated by 10 feet, one can be contaminated and the other safe, and how faulty construction can result in bacterial contamination of groundwater. He suggested that contaminated tube wells be sealed, not just painted red. Ms Susan Murcott of MIT summarized the remedial methods currently available, as well as her experience with fresh water harvesting in Myanmar. Dr Mohammad Alauddin summarized the analytical techniques currently in use and recommended ways of handling massive number of samples. Analysis of water from 15 locations in Dhaka city in his laboratory showed an arsenic level of less than 3 ppb. Dr. Arup Sengupta of Lehigh University discussed a water purification system, in operation in India, capable of providing arsenic-free water to at least 400 families for 10 years (Cost: $1500 per unit; he was willing to split the cost of the first unit in Bangladesh.) Dr Alauddin volunteered to install the first unit in Bangladesh, at his own cost. Dr Dalilur Rahman presented analysis of water collected from four tube wells in Dhamrai, out of which one was exceedingly pure! (He was advised to put a fence around the well and commercialize the water!) Finally, Dr A H Khan of Dhaka University Chemistry Department presented data on arsenic in water collected from Noakhali, Sitakund and Chittagong. He answered questions on the current thinking in Bangladesh on this life and death issue. Now that the problem has been enunciated, what is the solution? The best solution is not to attempt to "purify" poisonous water, but to move away from it altogether to "purified" surface water. Every claim of filters that make arsenic disappear, must be regarded with skepticism. It's not that simple. Emphasis should be on "safe" drinking water, not merely Arsenic-free water. The affected population must be urged to drink water from safe tube wells, IMMEDIATELY! These must be monitored regularly. The non-safe ones should be sealed off permanently. There is a saying that, "Pani bashi khabe"; if you have to, drink aged water. Let water age in a kalshi; some harmful minerals may be absorbed. Filtration through 0.1 micron filters also helps. Arsenic waste can be placed in cow dung, where it will be methylated, according to reports. Arsenic hospitals must be set up for the victims. Most importantly, over-dependence on ground water must be ended. Efforts must be made to tap other sources of water, such as harvesting of rain water (bacterial contamination is an easily overcome problem), which are practiced by our neighbours in Myanmar and Thailand. Low-cost water treatment plants to purify surface water must be considered seriously. Bangladesh must terminate its master-servant relation with UNICEF and WHO, and rely more on its own scientists. Ironies abound in this tragedy. Switch from surface to underground water was a jump in technology. Alas, technology is not always benign. In a country of "water, water everywhere," there is "not a drop to drink!" This writer was touched by the depth of the warmth and goodwill for Bangladesh exhibited by non-Bangladeshis attending the conference. MIT's Ms Susan Murcott broke down as she described the suffering of the people. That goodwill must be harnessed for the good of Bangladeshi villagers. Drs Dipankar Chakraborti, Bibudhendra Sarkar and Timir Hore were all born in Bangladesh. There was genuine disappointment with Bangladesh government's inadequate response to the catastrophe. Arsenic-poisoned Bangladeshis write to Dr. Dipankar Chakraborti for help, not their own government! The first case of arsenic poisoning in West Bengal was reported in the Daily Telegraph in 1983. Bangladesh government was informed of arsenic poisoning in its ground water in 1992, but was very slow to act. Since Dhaka was not affected (I am not convinced of that) the government sat tight. The patriotic Bangladeshi expatriate community in North America is willing, eager and desperate to aid their fellow country folks in their hour of need. The question is: will the Bangladesh government let them, or stand in the way?