A
woman shows her hands ravaged by blisters, a telltale sign of arsenic poisoning.
Shanta is one of many villages in which women continue to draw poisoned water.
Members of a local NGO speaking with women in the village of Khazanagar
Bangladesh
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Sounding
the alarm
Dipankar Chakraborti
is the man who brought the arsenic crisis to international attention–first in his
native West Bengal and then later in Bangladesh.
Now the director of environmental studies at Jadavpur University in Calcutta, Chakraborti
first began investigations as a young researcher in 1988. After hearing about unusual
health problems among villagers during a visit to his parents’ West Bengali village,
he sent water samples for testing at the University of Antwerp, Belgium, which reported
high levels of arsenic.
By 1992, Chakraborti realized that the crisis in West Bengal was merely the prelude
to a much bigger calamity over the border in Bangladesh. In one West Bengali village,
he found a lone woman suffering from arsenic symptoms, while her family and neighbours
were not. She said she had come from Bangladesh after marrying, and that other people
back home had similar symptoms doctors assumed were linked to leprosy.
For five years now, Chakraborti has collaborated with doctors from the Dhaka Community
Hospital, which specializes in providing cheap health care for the poor. Together,
they have been surveying the scale of the Bangladeshi problem, treating the poisoned
and exposing the epidemic to the wider world. In April 2000, he published the results
of 240 days in the field. During that time, the team analyzed water samples from
22,000 tubewells in 54 of the country’s 64 districts, as well as 11,000 hair, nail
and urine samples. They found 900 villages with arsenic levels above the government
limit. For Chakraborti, this is “only the tip of the iceberg.”
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“Bangladesh
has become an experimental station of Western countries.”
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Thirty
years ago, Bangladeshi villages began pumping arsenic-laced water in a development
project gone awry. Why will it take another 30 years to halt the biggest mass poisoning
in history?
The story beggars belief.
In the 1970s, international agencies headed by the United Nations Children’s Fund
(UNICEF) began pumping millions of dollars of aid money into Bangladesh for tubewells
to provide “clean” drinking water. According to the World Health Organization, the
direct result has been the biggest outbreak of mass poisoning in history. Up to half
the country’s tubewells, now estimated to number 10 million, are poisoned. Tens,
perhaps hundreds of thousands will die.
Why? Because nobody tested for the natural poison, arsenic, widely found in underground
water. And when a doctor did find traces of the metal, and when Bangladeshi villagers
did start turning up at doctors’ surgeries with the tumours and telltale signs of
arsenic poisoning, the results were swiftly buried so that nobody made the connection.
Even now as the scale of the calamity emerges, nobody is admitting culpability. Not
UNICEF, which initiated the tubewells programme and paid for the first 900,000 wells,
nor the World Bank, a fellow sponsor. Not the Bangladeshi government, or the foreign
engineers and public health scientists who did not think to test the water for so
long.
The same agencies that played godmother to the catastrophe are now wringing their
hands and saying it will likely take 30 years to find all the poisoned tubewells–longer
than it took to sink them all. So why are the authorities and international experts
proving incapable of coming up with a solution?
The roots of the problem go back to the early 1970s when most Bangladeshis living
in the countryside relied on surface ponds and rivers for their drinking water. Sewage
bacteria, however, unleashed a battery of water-borne disease which killed a quarter
of a million children each year, according to the World Bank. So UNICEF sought to
solve the problem by instigating a massive tubewell project to tap into underground
water sources, despite warnings by some local people that they were pumping the “devil’s
water.”
UNICEF explains today that “at the time, standard procedures for testing the safety
of groundwater did not include tests for arsenic [which] had never before been found
in the kind of geological formations that exist in Bangladesh.” But many geochemists,
such as John McArthur at University College London, scoff at such a suggestion. They
blame dogma among public health people with no knowledge of geology, and who equated
underground water with safe water.
Who knew what and when? The Bangladeshi government claims that cases of arsenic contamination
came to its attention in 1993 and concluded two years later that the poisoning was
widespread, with tubewell water the likely cause. But according to Quazi Quamruzzaman
of the Dhaka Community Hospital, the government was told as early as 1985 that Bangladeshis
crossing the border into West Bengal were being diagnosed with arsenic poisoning.
Arsenic is a slow killer. The most obvious signs are the blisters found on the palms
of the hands and soles of the feet, which can eventually turn gangrenous and cancerous.
Meanwhile, the poison also attacks internal organs, notably the lungs and kidneys,
which can result in a battery of illnesses including cancers. Despite the mounting
evidence of contamination, there were no investigations.
The World Bank also maintains that “before 1993, groundwater was never tested for
arsenic,” according to Babar Kabir, hydrogeologist and head of the organization’s
water department. But Peter Ravenscroft, an engineer based in Dhaka for the British
engineering consultancy firm Mott MacDonald, who worked extensively for international
aid agencies on the tubewell programme, says he first found arsenic in groundwaters
in the late 1980s and published his findings in 1990.
Yet it wasn’t until 1998 that the international community finally appeared to accept
some responsibility for solving the mass poisoning of Bangladesh. The World Bank
announced an emergency three-year programme to identify the killer tubewells using
simple tests and to “put in motion concrete actions [to] combat a major health crisis
with devastating effects on the lives of millions.” With almost every one of the
country’s 68,000 villages potentially at risk, the Bank said it would initially survey
4,000 villages and draw up action plans for each. This “fast-track project” was to
be the first phase in a 15-year programme to screen the country’s tubewells.
But the “fast-track” programme took another year to negotiate between the international
agencies and the Bangladeshi government, pushing its completion date to late 2002.
And inquiries by the UNESCO Courier have revealed that the programme remains mired.
Richard Wilson, a leading analyst of the crisis from Harvard University’s department
of public health, says “the project is stalled.” He blames the Bangladeshi government’s
failure to “decide how to spend the money” and says that leading officers at the
Bank are privately “most upset about it.”
The Bank denies this publicly. Khawaja Minnatullah, a water specialist at the World
Bank’s Dhaka office, says: “It is not stalled. There is now steady progress after
an initial slow pace.” But so far, he says, only 800 villages have been screened,
little more than one percent of the country’s villages. And few if any action plans
have been completed because, says Minnatullah, scientists have failed to find a “proven,
affordable” method of removing arsenic from village pumps.
While little changes in the lives of most villagers, local scientist and activist
Dipankar Chakraborti (see
box)
is shocked to find a flood of foreign consultants gearing up for a junket on an even
bigger scale than the original tubewell programme. “I cannot accept that 50 percent
of the fund will go to foreign consultants. Bangladesh has become an experimental
station of Western countries.”
Not that indigenous action has had a flying start. The Bangladeshi government created
a steering committee which in turn set up an expert committee in September 2000 “to
detect the causes of arsenic contamination across the country”–a matter that most
experts believed to have been long since resolved.
While the official programme has stuttered, many non-governmental organizations–and
none more so than Chakraborti and his colleagues at the Dhaka Community Hospital–have
been filling the gap. But the task is far too big for any NGO. Shahida Azfar, UNICEF’s
representative in Dhaka, told a conference in the city last May that “to date, only
250,000 tubewells have been tested. If we keep this up it will take us 30 years to
complete the testing.”
And now it appears that even this baleful calculation may be optimistic. According
to Minnatullah, screening of the first 800 villages revealed 70 percent more pumps
than estimated beforehand. “Current observations indicate that there are about 10
million handpumps,” he told the UNESCO Courier–more than twice as many as assumed
when the programme was set up.
Indeed the WHO released a report in September estimating that between 35 and 77 million
Bangladeshis may be drinking water containing more than the safety limit of 10 parts
per billion of arsenic. According to the report’s author, Allan Smith of the University
of California, Berkeley, the scale of the disaster is “beyond Bhopal; beyond Chernobyl.”
There is no way yet of predicting which of the country’s tubewells is safe and which
carries a promise of disease and death. A study by David Kinniburgh of the British
Geological Survey, published in June 2000, found that neighbouring villages, and
often even neighbouring households, drink water with vastly different levels of poisoning.
There is no alternative, he concluded, but to test almost every tubewell in the country
(see
box).
It seems likely that water from about half of all the country’s tubewells, in more
than 40,000 villages, exceeds the WHO limit, many by several hundred times, according
to the health organization. The figure may be rising. Chakraborti recently reported
disturbing new evidence from Faridpur district where some wells tested in 1995 as
safe are becoming contaminated.
The amount of arsenic in the water is a few parts per million at most. But over the
years it accumulates. It can take a decade or more of drinking poisoned water before
the physical symptoms emerge. Official figures show some 8,500 people have been diagnosed
with arsenic poisoning. But nobody doubts that there is massive under-reporting in
Bangladesh’s largely rural and desperately poor population of 128 million, for whom
there is no national health service.
“Twenty thousand people could die each year,” according to the UN Development Programme.
The possible death toll is difficult to calculate because some cancers typically
take 20 years to emerge. Smith estimates that in many parts of southern Bangladesh,
one in ten adult deaths could soon be from arsenic-triggered cancers of internal
organs, such as the bladder and lungs. People are made more vulnerable by poor nutrition,
the large volumes of water they drink (typically five litres a day, says Chakraborti),
and because they may ingest more arsenic through eating rice irrigated by poisoned
water and then boiled in it.
“So far as we know there is no medicine available for chronic arsenic toxicity,”
says Quamruzzaman of Dhaka Community Hospital. The only treatment is safe water,
nutritious food and time. This can clear up the skin blotches on people in the early
stages of poisoning. But once gangrene and cancer have taken hold they may be beyond
hope.
Where is the situation worst? Chakraborti says “one of the worst villages I have
ever visited” is Stadium Para in Meherpur district, right on the border with India.
Here nine residents have already died of cancerous ulcers caused by arsenic. One
was only 25 years old. But, after five years of surveying, he nominates the southeastern
village of Seladi as “in all probability the most arsenic-contaminated village in
the world.” Here 72 out of 73 tubewells are contaminated. No fewer than 21 contain
arsenic at more than 1,000 parts per billion, and the highest at 4,000 ppb, or four
hundred times the WHO limit.
In some villages almost everyone is affected. In other villages, only a minority
are poisoned. But they may suffer worst of all. “Nobody wants to come in contact
with them,” says Jinat Nahar Jitu of Dhaka Community Hospital. “They are barred from
coming out of their homes or even from using water from clean wells.” Wives are divorced
and children turned away from schools, primarily out of an unfounded fear that they
may infect others.
That is what happened to Pinjra Begam, a pretty 15-year-old, shortly after her marriage
in 1988 to Masud Rana, a mill-worker. Her skin became mottled and blotchy, the tell
tale signs of arsenicosis.
The blotches turned to ugly sores that became gangrenous. Her husband left her for
another. Cancer took hold and spread to her lungs. She finally died in her home village
of Miapur Paschim Para, near the banks of the River Ganges, in May last year, aged
just 26. She left three children, aged seven, five and one. Soon Pinjra’s children
will also likely develop the same symptoms as the arsenic levels accumulate in their
bodies.
There are some technical solutions to providing safe drinking water for the people
of Bangladesh–albeit hard to execute in such a poor, ill-educated and rural countryside
(see box). But first the millions of dangerous tubewells have to be identified. The
slow progress of the World Bank programme so far could prove a mortal blow. In his
September report, Smith warned that “the worst thing that can possibly be done is
nothing.” But for most Bangladeshis caught up in this disaster, nothing is exactly
what is being done.
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Where
does the arsenic come from?
The arsenic
probably originates in the Himalayan headwaters of the Ganges and Brahmaputra rivers,
and has lain undisturbed beneath the surface of the region’s deltas for thousands
of years in thick layers of fine alluvial mud smeared across the area by the rivers.
According to David Kinniburgh of the British Geological Survey, who has recently
completed a detailed study of the arsenic’s route into millions of tubewells, the
arsenic concentration in the mud is not extraordinary. Time is the culprit. The mud
in Bangladesh lies thicker, wider and flatter than almost anywhere on Earth. It can
take hundreds or thousands of years for underground water to percolate through the
mud before reaching the sea. All the while it is absorbing arsenic.
This, says Kinniburgh, helps explain the diverse pattern of arsenic concentrations
in tubewell waters. The contaminated wells almost all take water from a depth of
20 to 100 metres. Shallower wells are clean because they contain mostly recent rainwater
or water flowing swiftly through the sediments. Deeper wells tap water in older sediments
which have by now been flushed clean of arsenic. It will take thousands of years,
says Kinniburgh, before the rest of the arsenic will wash away into the Indian Ocean.
Many underground water sources around the world contain arsenic. Parts of Taiwan,
Argentina, Chile and China have all suffered epidemics of skin diseases, gangrene
and cancer as a result. Smith’s analysis of the Taiwan epidemic in particular helped
set the WHO arsenic standards for water and is the basis for his current predictions.
Bangladesh, he says, is quite unprecedented.
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What
next?
In the first
step of the mammoth task of testing the country’s tubewells, volunteers, aid workers
and officials paint the dangerous ones red, which should only be used for washing.
The villagers are supposed to use the safe wells exclusively for drinking, but that’s
not easy when the lucky one is found in someone else’s backyard.
In the longer run, part of the answer lies in sinking deeper wells to tap cleaner
water. But it will take millions of dollars to install these wells in addition to
the needed surface tanks and distribution pipes. Also some deep tubewells in West
Bengal have started bringing up arsenic months or years after they were opened.
Another idea is to adopt traditional methods such as ponds and tanks to “harvest”
rainwater. This will work in some places, says Shahida Azfar from UNICEF, but “there
is not enough rain all year for that to be feasible as the main strategy.”
Could the tubewell waters be treated? While a large number of ideas for filters and
chemical treatments have been tried out in the past two years, there is “no proven
affordable arsenic removal technology available yet,” according to Khawaja Minnatullah
of the World Bank.
Most experts warn against blanket solutions. Each village needs its own plan. And
none of them can begin planning until it knows which of its tubewells are pouring
poison into villagers’ buckets.
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