The Bangladesh Observer
 
June 20, 2004
 
Editorial
 
Doctors’ Training And Clean Water Supply

Speaking at the inaugural function of the training programme for doctors on the management 
and diagnosis of arsenicosis patients, the Health Minister, Dr Khondoker Mosharraf Hossain, 
said, 29 million people in the country are exposed to arsenic.  He said that arsenic has been 
detected at an unacceptable concentration in the tubewell water of 61 districts out of the 64 
in the country.  This is nothing new but what is perhaps surprising to note is that although 
it is nearly 6 years since DCH held their first International Conference on Arsenic in Bangladesh, 
it is only now that the Bangladesh Medical Association (BMA) in collaboration with the Ministry
of Health and Family Welfare has organised training for doctors said to number more than 300. 
This is a small enough number but as these doctors after training are expected to provide 
training to other doctors at field level, these numbers should multiply.

One of the problems has always been that doctors could not recognize arsenic poisoning and often 
misdiagnosed it. This is due to the fact that they had no exposure to the symptoms of arsenic 
poisoning and also to the fact that it often takes on the normal symptoms of other diseases 
thus the basic cause has all too often been missed. But now that people are dying from arsenic, 
this can no longer be allowed to continue so, belated as it may be, we laud the efforts of the 
BMA to bring their doctors up to date with diagnosis and treatment,

Another problem that has arisen is that a tubewell close by is convenient, and no one would like 
to return to the days when carrying water some distance took up much of a woman’s day.  The result 
of this was that 97 per cent of the population became habituated to drinking groundwater.  Now 
UNICEF and water experts are advocating a return to surface water for drinking purposes which 
will call for another massive public education campaign – a sort of campaign in reverse because 
persuading people to quit the habit of drinking tubewell water in favour of a return to ponds, 
rivers and dugwells may not be so easy this time round.

But, as the Health Minister says, prevention is still the lone solution to arsenic-poisoning and 
the government has put special emphasis on proper diagnoses and management of diseases through 
mass awareness but the government must also devise ways for getting clean water to the people. .. 
Although even here there are problems as different areas and mindsets will require different solutions. 
For example dug wells may be for some while pond sand filters may be good for others and deep tube wells 
for others still.  Rainwater harvesting is yet another option.

Project Well, a California-based NGO funds a project that provides safe drinking water to the villages 
in the arsenic prone region of West Bengal, India.  The safe water is provided by constructing 
inexpensive, easily adaptable, shallow, concrete dug wells.  But the NGO cautions that, in spite 
of nine awareness programmes that included puppet shows held by Project Well and a local NGO Loka 
Kalyan Parishad (LKP), some of the dugwells are not being used as expected. This, they say, is 
due to the installation of too many options in the same area as a result of a lack of coordination 
between NGO's working in the villages and lack of proper planning. 

Project Well recommends, and we should pay attention that we need: 1) proper coordination and 
planning; 2) the need for villagers contributions; 3) creating a local database using hand held 
GPS device and GIS software; and 4) developing a State level Arsenic Information Bureau with an 
online database on government and NGO action on alternative sources for arsenic safe water provision.

The 12th session of the Commission on Sustainable Development (CSD) opened on 14th April in New York 
to undertake the first critical assessment of policies and programmes instituted by governments 
following the 2002 World Summit in Johannesburg. At this meeting the interdependent problems of 
water, sanitation and human settlement will be discussed, but it has been our experience that 
discussion does not always bring about solutions that are affordable. Yet there is a technology 
based on the germicidal effect of ultraviolet light that we have mentioned over the years that 
could do the trick.  UV disinfection is an extremely safe, reliable method of disinfecting drinking 
water for daily use. It is rapid, inexpensive, leaves no taste or odor in the water. And best of all 
it is cheap as the cost of disinfecting one year’s drinking water (at 10 litres per day per person is 
only about US$1.50 per person. This includes all supplies, filters, electricity, a service contract, 
etc. for a community of 2000 persons. This technology was demonstrated in Dhaka in the late nineties 
but nothing ever came of it, mores the pity as it could have been the preventive that saves life.