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Mahfuz Anam: That means we are an exception, drinking maximum ground water. Is that a reasonable conclusion?
Atiqur Rahman: I don't know enough about all countries to answer that. The unique situation in Bangladesh was the health problem associated with surface water. Forty years has been spent in moving people from surface water to ground water. It has been a massive governmental, non-governmental donor-driven effort.
When I was a child, I used to get a ground water that was exposed to surface in a well in the other part of Dhaka. Water would be pulled up by a bucket. That was my childhood. I remember watching with excitement a tubewell being sunk. Everybody said, it has a filter. With this pure water, you won't get a stomach upset. So that was a positive move at that point in time.
I don't think the hand pump was a malevolent foreigner coming in and doing something. The deep tubewell and that whole politics of agriculture is much more deep in politics, in global trade, money-making, big business.
Surface water is not just next to your door. It is in the river. It could be from 30 yards to 10 kilometres away. You could have ponds, but these dry out at a certain time. So it's a mixture of a number of specific responses to the availability of water.
Bangladesh and Canada are the largest per capita water countries. Bangladesh is second. But we don't have it when we need it.
In Bangladesh, because of the very nature of its geology, which is very flat apart from a few bits, the surface water and ground water get connected very easily. The reason today Dhaka has ground water problems, you have to go deeper for water, is because the water table of Dhaka is sinking. There are two reasons. One is the charging that takes place.
With rivers running criss-cross all over the country, there is a recharging of ground water all of the time. This happens in to ways. The lateral which comes from the rivers which comes from the rivers recharging an area, and vertical which comes from rain water recharging an area. Dhaka doesn't get recharged that much because we have cemented lots of the area.
On the question of arsenic, I think the fundamental agreement that we can have is that we don't know too many of the answers. We have just started asking the questions.
A person must have the right to get pollution-free water. The arsenic problem is not just a pollution problem, a health problem, its an agricultural problem as well. In terms of policy, our green revolution which has spread across Bangladesh with all its limitations, has happened through the mechanism of ground water.
Mahfuz Anam: At this stage can we have this understanding that the effect of ground water on agricultural products like IRRI rice and others is not yet known?
Atiqur Rahman: Ground water in several places has sufficiently high arsenic content which is pumped into agriculture, but we don't know if that is entering the rice, the food chain directly. Indirectly it enters the water. We don't have any evidence as yet. So there are a lot of uncertainties about this.
What I have seen in the data so far from Dhaka Community Hospital, from UNICEF and others, is that not only one village has arsenic, it is that this house has got arsenic and that hasn't. So it's a very micro-level of availability at a point of time. A tubewell that doesn't have arsenic today, tomorrow may have it. This begs the strategy of identifying each tubewell for its arsenic content. So monitoring becomes a key issue. Identifying and monitoring. DPHE now puts a red mark on the one that has arsenic to caution the people so they go to the one which doesn't have.
We have exposed ground water. There is a hypothesis, and as a scientist I cannot vouch for it, that the exposure of oxygen into the system releases arsenic, dissolves it and mobilises it into the water stream. However, some scientists say that aeration is a good thing.
It is a challenge. The problem of arsenic has come to stay with us for a long time. It is a major problem. For management purposes, we have a problem. We have a macro-management system. But the problem is a micro-problem. This is a mobilisation problem. We have learnt a lesson from poverty alleviation. We know that we haven't reached the poor.
I can say with reasonable confidence that we will not have all the answers within the next three years.
The science involves at least understanding where its coming from, the BGS will begin to answer this question. It is not a horizontal mapping. It is vertical mapping. We will have to know at what depth it is there. We have to know at what level it isn't there too, as to whether we will go for deep tubewell or not. If it is oxygen causing this, how do we know we are not doing the same and contaminating the water when we go deeper?
The first Flood Action Plan was one area where people got involved and showed that such planning is not necessarily the answer to the problem. The National Environmental Plan was one which shows non-literate people are not a bunch idiots. They can plan. They can come in. They can do positive. They can contribute to the national planning.
The first issue is information, quality information, distinguished between science and non-science and nonsense. To be able to say this is what we know and how do we communicate this message clearly.
We have the challenge of diarrhoeal diseases, of food security and of arsenic in the ground water. They are inter-related, maybe more of one and less of another.
The question is of information, mobilisation, awareness. We can mobilise the people. But we still don't know what simple messages to give. There is an arsenic newsletter I can circulate around so people can have a rough idea where we are.
People have the right to information. People have the right to not only arsenic-free water but to pollution-free water as well.
Mofazzel Hoque: Ground water and surface water should be used in a very well-managed manner. Over 28 per cent of the tubewells are affected in arsenic-affected areas known to us. Experts say that if one drinks contaminated water for more than ten years, then there is a possibility of arsenic manifestations.
In Pakshi, Pabna and Chapainawabganj there are old cases of arsenic manifestation for three generations. In other places there aren't such old cases. That means this is increasing with the increase in the exploitation of ground water, with the insertion of oxygen of the air into ground water.
If we drink arsenic-contaminated water, we won't die today or tomorrow. It will take time.
There are solutions like the deep tubewell, pond-side filters, ring wells, dug wells and alternatives.
As arsenic is quite uncertain at different depths, once the hydro-geological tests are done, it will be very easy for the government and the donors to invest money in an appropriate and effective manner.
In last April there was consultation between Indian experts and Bangladeshi experts and also some global experts. There were some recommendations. The UNDP emergency project is also considering this. The recommendations are quite acceptable.
There is problem with the management. We see that 50 per cent of the pond-side filters are not used properly. They should be monitored. They should be motivated.
It is possible to overcome this problem. It needs attention and to expedite the assessment as well as the research activities.
Dr. Quazi Quamruzzaman: Dhaka Community Hospital is a small hospital, dependent on people's good will and selling our services at a low cost. It has become so difficult for us. We are in the red for 35 lac taka for doing these tests. I don't know how we are going to pay. We are already in debt for ten and a half lac taka for arranging an international conference to draw attention Dhaka. Unfortunately, we haven't got any support from any organisation working in Bangladesh, especially international organisations. We had to beg to them to send their people. Because we didn't go for project funding, nobody was interested. This was rather surprising because we thought we would do it ourselves, self-financed, and people would come and participate.
When we found this arsenic problem in Bangladesh, we contacted most of the organisations which are involved in safe water. Nobody knows how many tubewells there are in Bangladesh. In about 20 villages, we are told sometimes that there are 100 tubewells, sometimes we are told there are 200 tubewells. We sometimes found very interesting information. Every tubewell in Bangladesh is registered. But when you ask for information, it is not available.
UNICEF and DPHE say they have done thousands of tubewells in different villages. But going to the same villages, we found they have taken into account all the government tubewells, not the others. I am just giving you some of the percentages of the tubewells and you can see how data collection is done in Bangladesh and what sort of results come in.
In Digholia, a village in Khulna, has got government 41, which have been tested, private 269 which have not been tested. The DPHE people had tested the government tubewells, but we are getting this data. The manner in which we are collecting the data should be assessed. We are not getting correct information.
Then we are talking about vertical, horizontal, but there are many thing in between vertical and horizontal. What is happening there?
Bangladesh is a disaster-prone country. It is surviving on its own resources. And people like us, the NGOs, government agencies, we are thriving on them. Actually, they are the ones who are supporting us and we are trying to solve their problems to support ourselves.
I don't know how many persons are working on arsenic at this moment in Bangladesh. But you don't see them here. I found projects in Europe who collected money on the arsenic problem. I found consultants making 10 visits for 25 thousand dollars, working on arsenic in Bangladesh. How many people came on WHO money to do arsenic research, we don't know. But where is the information?
I found a lot of NGOs working on arsenic. Where is their information? The Community Hospital has collected this information to show that Bangladesh has got this problem. We went door-to-door to international organisations for help. Unless we form a project with an international consultant, we don't get anything. In villages we found that people in Bangladesh have solved their own problem.
I really appeal to international organisations who work in Bangladesh to have some commitment to the people of Bangladesh and share the information with people who are working in Bangladesh.
The collected data from the field is so questionable, but we have done our collecting in the laboratory. We have begged every organisation to have a simple machine in Bangladesh which costs only one and a half lac taka, to do this data, but all of this remains confined to paper. The larger of money is spent to bring field kits to test the data on the field and collecting water to be done again by the laboratory. Why is this going on?
About the government, this is another experience. When the government formed these committees, actually the people in Bangladesh who are in water, whatever they say they know since 1993, I don't think so. Most of them know from 1985 because people from here went to India for treatment. An Indian organisation wrote a letter to the Bangladesh government and WHO in 1990 that there are patients coming from Bangladesh so be careful. So on what basis did WHO bring consultants into Bangladesh? On what information? And what happened to those reports? A certain report was rejected at the time by an international conference, and last week I find the government trying to find ways of implementing the report. Why is the government trying to implement a report which has been rejected at an international conference? We protest.
I won't go into the details right now. I want to hold the international conference arranged by Dhaka Community Hospital smoothly, then I will go into the matter. We have been threatened already. The Health Ministry has told us we must have nothing subversive on our paper. I could not make them understand it is about chemicals, health and all. They replied that whatever the matter may be, they had to see what we had written about Bangladesh, about the government of Bangladesh. We had to produce a list of all the international list of people coming here, their bio-data, their positions. I don't know which century we are living in. We had to vouch for them. Then only we were told that they could come. So this has been an experience.
About our field experience, we found the people of Bangladesh actually the rural people, are so hospitable, really enlightened, you would be surprised. They would sometimes tell us, look, I'm suffering from this, why don't you take my body, examine it and if it helps some other people, do it. Any woman or man, make no problem. They show their bodies, their skin.
There are many problems. We found villages where women were divorced because the people thought their arsenic symptoms were leprosy symptoms.
One of the questions is, on what scientific basis does WHO say.05 milligrams is safe? Any level of arsenic is arsenic. Is the basis simply because the US has accepted it?
About the programme for safe water, tubewells. We are doing another thing here again. We are trying to solve arsenic just thinking about arsenic. But it is a water problem which started 40 years ago. So we should go back and think about it. We have seen in the villages people deciding to take water from certain pond and use it. Wells are being protected. The people have developed their low-cost community based solutions. The plants and all set up in West Bengal had to be closed down because they couldn't pay the electricity bill.
What is happening in Bangladesh. Arsenic is a good business in Bangladesh now. It is a very good fund-mobiliser. It is a very good article writer. It is very good to let yourself be known as working on arsenic. So the Community Hospital decided to get out of it. But we had to do this international conference. This conference aims to bring all the people working on arsenic together. Arsenic is a new issue. It is known as the kind of poison and has been used at different times, but little research has been done on it. When we contacted people and tried to prove that arsenic is a problem in Bangladesh, different international organisations came into contact with us. News was published in the Washington Post, the Guardian and such. People from different part of the world contacted us. So we though we would bring them here and have a developed guideline about what is going to happen about arsenic and what we are going to do.
It is a unique conference. It is going to be the biggest in the world where arsenic has ever been discussed. We have nearly 80 countries coming, nearly 175 people, mostly people committed over a period of research on arsenic are coming. I am sorry to say, very few donors are coming. So we don't see much interest from the NGOs in this country. We have a very good response from our academic people, from universities, teachers, students, very little from NGOs. We will take all the participants on field visits to Chandipur, Lakshmipur district, very affected areas. Nearly 60 per cent of the tubewells are affected there. So were are taking nearly 175 people to spend the day there. Then we will start the conference.
We are having patients from each district at the conference so they can interest, can answer questions, can be consulted. The Community Hospital has surveyed 60 districts. We actually go to the place and try to find out who has skin lesions. Then we test the hair, nails, biopsy from the skin and urine and then test the tubewell water which they are drinking. So from the patient we go to the source. All of these testing has been carried out in Jadabpur University. Other than the water testing, unfortunately the other testing has not been done in Bangladesh. The Atomic Energy centre can do hair tests, but you need 200 gms of hair for the tests. That is the type of equipment there. So we do everything in Jadabpur University. In this manner we have covered 60 districts, 161 thanas, 486 villages, water collected from 8065 tubewells, number of districts found contaminated 52 where the toxicity was higher than that recommended by WHO. The population of these 52 districts is 92 million. The districts found contaminated with high toxic level 41. The population there is 76 million. So this shows that arsenic is a problem in Bangladesh.
There is an idea that arsenic is a very recent things. But it is not. We have had to amputate the leg of a certain patient because of arsenic poisoning. Such poisoning doesn't come in six or seven years. It takes about seven to eight years to go to the kin. Then to go to that level, it takes about 20 years.
A frightening thin in Bangladesh is these lesions showing up in children. Nowhere else in he world are these lesions showing up in children. They are less than 10 years. In one village we found, out of 42 patients, 10 or eleven were under age. This is perhaps because of the high toxic level, because of the nutrition level. We don't know. But there is arsenic poisoning in Bangladesh's drinking water. In one village we found 146 tubewells, with only eleven unsafe. So it is difficult to say that everybody in the village is affected. In Chandpur we found high toxic level in the urine, but no lesions on the body. So maybe there is an immunity mechanism.
It will not be possible to monitor nearly four million tubewells regularly. It will not be possible to have a very low cost monitoring system of which we can assure quality. But if the people of Bangladesh can survive with an alternative source of water, we would think about it.
My suggestion is that everyone, national and international NGOs, everyone please first share your information. I really appeal to our big NGOs. You hold a lot of power. Please share information. Let not just your project area people be safe, let the whole Bangladesh be safe.
My appeal to international organisations is don't bring specialists. They come for two weeks, they don't know what they are seeing. They might be nice people, experts on the subject, but to understand the matter in Bangladesh is very difficult. Even people with 26 years to 30 years of politics are finished in one day. This is Bangladesh. So people come here, give advice, we try to follow it and the people of Bangladesh are in trouble.
I must congratulate the World Bank. Its recent approach to Bangladesh's problems is one of the highly praiseworthy things. They made a point that all data should be shared and there should be a national data registrar. So, knowing the muscle of the World Bank, I also appeal to them that this not be only for Dhaka Community Hospital. It should be for the other NGOs too.
I invite all present here to participate in the international conference. Thank you