December 3, 2002
The Daily Star

Arsenic mitigation: A Kushtia experience

Mohammad Amjad Hossain

When Zohara Khatoon, 56, of Shastipur, 20 kilometers off Kushtia town first
marked skin pigmentation and skin lesion on her limbs and palms she did not
realise that these were the effects of drinking arsenic contaminated water
until health assistants from an NGO, Manob Sakti Unnayan Kendro (MSUK)
(human potential development centre), visited her house. Her 22-year old
daughter also complained of the same problem but the symptoms on her hand
were yet to be as distinct as that of her mother's. Zohara Khatoon has
shallow tubewell at her homestead.

I have had the privilege of meeting a good number of arsenic affected
patients in Shastipur recently. They are under observation of MSUK, which
was founded in 2000 in Kushtia by a group of eminent individuals including
professors, physicians, health management experts, lawyers and
agriculturists. The areas in which MSUK has been involved are education,
primary health care and nutrition, water and sanitation.

Momin Sharif, 70, another victim, was adversely affected by arsenicosis. His
condition has been characterised by medical assistants as Keratosis. He
could not move easily and stumbles very often and occasionally vomits. There
are many others like him and Zohara Khatoon. They didn't know how
contaminated there 'potable' water had become.

However, of late, almost all the houses in the affected area of Shastipur
have been provided with innovated two-bucket arsenic removal filter to have
arsenic-free pure drinking water.

MSUK is perhaps first in Bangladesh, which developed a 3-kolshi (pitcher)
arsenic removal water filter system. It may be mentioned that this 3-kolshi
model has been recognised by WHO. Now that 3-kolshi method has been replaced
by two-bucket filter system because of difficulties in commercialisation on
large scale, handling and transportation of the earlier one.

This bucket water filter, known as Sono filter has been gaining popularity
in the rural areas as has been reflected by its use in many households.

The idea of such filter was first floated by Professor Dr. Abul Hussam,
Department of Chemistry, George Mason University in Virginia, USA while the
method was researched and developed jointly by Professor Abul Hussam and Dr.
AKM Munir, who is Chairman, Sono Diagnostic Center in Kushtia. Professor
Abul Barkat, Department of Economics, Dhaka University has been providing
feedback on arsenic problem. Dr. Munir, as I understand from the
discussions, has developed a mechanism to measure arsenic content in the
tubewells installed by UNICEF in Bangladesh and the government of
Bangladesh. Measurement method adopted by Dr. Munir said to be more accurate
and authentic than the kit method adopted by UNICEF.

UNICEF had in fact recommended to Pakistan government for installation of
tubewells in East Pakistan for safe drinking waters in early 60's but UNICEF
never mentioned that arsenic contents were found in tubewells in many parts
of the world including Taiwan and Singapore. According to findings made by
Bangladesh Arsenic Control Society and University of Dhaka, several thousand
people had been suffering from this problem of arsenic contamination and
Bangladesh has been identified as the worst affected country in the world.

Apart from recognition by Bangladesh Arsenic Mitigation water supply project
of Bangladesh government, Sono 3 filter project has the approval of World
Health Organization (WHO). The tests conducted by Sono Diagnostic Centre, a
sister organization of MSUK are commendable. Recently Isotope Hydrology
Section of International Atomic Energy Agency (IAEA) has conducted an
exercise in evaluating tests made by some laboratories in arsenic zone area.
The interlaboratory comparison was conducted in collaboration with WHO-Dhaka
through its environmental health advisor, and the Bangladesh Atomic Energy
Commission where 17 laboratories participated. And performances of six
laboratories are better, which secured four-star and three-star grade. Sono
Diagnostic Centre obtained a three-star grade. IAEA is of the opinion that
"continued inter comparison exercises are needed to maintain analytical
capabilities of the laboratories."

The government of Bangladesh should focus more attention on the mitigation
programmes as the arsenic problem has turned out to be alarming. This has
been reflected in the reports of World Bank and British Geological Survey.
According to these reports, 18 million people in 61 districts of Bangladesh
are affected with arsenic. Arsenic problem in Bangladesh is a recent 
phenomenon, hitherto unknown in the rural area. Therefore, the villagers do
not know its effects on human health. Apart from this, they are living with
superstitions. According to findings by Professor Abul Barkat, Department of
Economics, Dhaka University, social taboo is causing serious problem to
arsenic affected patients, who are often treated by neighbours or relatives
as untouchable.

There are three tiers of affection classified by physicians for arsenic
affected patients. The identification are; a) Melanosis: colour of the skin
begins to change; b) Keratosis: black boils develop on hands and legs will
be thickened; c) Malignancy is the final stage of arsenic contaminated
patient. At this stage patient may be affected by cancer or gangrene.

Kushtia is one of the districts in Bangladesh much prone to arsenic hazard.
This problem, of late, turned out to be alarming in Kushtia. According to
Professor Barkat, arsenic has been characterised as slow poisoning, which
has been prevalent in many parts of the world. Napoleon Bonaparte died of
slow poisoning by arsenic in 1821. Arsenic problem is also the result of
wide scale use of chemical fertilizers and pesticides, which contaminate
ground waters and soils. This is the finding of many research-oriented
organisations at home and abroad. During the period of Ayub regime in
Pakistan agricultural green revolution was brought about by adopting
chemical fertilizers in the agricultural fields. By introducing high
yielding varieties of paddy coupled with fertilizers and pesticides per acre
yield in the fields increased tremendously. Over a period of last four
decades ground waters and soils are contaminated with arsenic at an alarming
rate. In an effort to mitigate arsenic and promote public health Manob Sakti
Unnayan Kendra this year introduced two very important projects in the
district: Primary School Health Care and Sanitation and Integrated Programme
on Arsenic Mitigation and Promotion of Public Health. Introduced in June
2002 Primary School Health Care project aims at reaching benefit to 62
thousand school going children in two hundred primary schools under three
upazilas. Apart from offering arsenic free pure drinking water during school
hours, school children are made aware of arsenic hazard.

An awareness programme has been introduced in the schools by organizing
cultural activities. School teachers are trained to handle Sono 3 pitchers
model 45.45.

Integrated programme on arsenic mitigation and promotion of public health
was introduced on 1 August 2002. This project will bring about benefit to 60
thousand people directly and equal number of people will be the beneficiary
indirectly. Sono filter (model 45.25) will be installed in 1200 households
for supplying arsenic free safe drinking water. Both the projects are
financially supported by Die Licht Brucke and Germany's Ministry of Economic
Cooperation and Development [BMZ].

A number of affected persons, men or women, responded positively to the
efforts made by MSUK. Monowar Hussain of MSUK told this writer that regular
monitoring is being carried out in the affected areas about the effects of
Sono model filter. Affordable technologies to mitigate arsenic in
contaminated water are rather scarce. Successful indigenous technologies
when found such as this of MSUK may be replicated by government agencies to
cope with the gigantic problem.

Mohammad Amjad Hossain is a former diplomat.