Bangladesh: Arsenic Poisoning from Tubewells, 2002

Bangladesh has been a success story in the worldwide effort to achieve the goal of universal access to safe drinking water. Thousands of tubewells were installed in villages during the past three decades. Unfortunately, it was discovered more recently that, due to the geology of the region, there are high concentrations of arsenic in the aquifers of Bangladesh.

Recently conducted water testing and passive case detection in selected villages has indicated that there could be a huge number of patients with arsenic poisoning (arsenicosis) in different parts of the country who are yet to be screened and registered. These patients need to be diagnosed and treated appropriately. Lack of knowledge of the epidemiology and pathogenesis of arsenicosis has hindered progress in planning and designing appropriate actions for prevention, control and management of the disease. Also, the capacity of the existing system to deal with the problem of arsenicosis is little known, especially the training and support requirements of health care providers at different levels.

CIET helped in the effort to deal with these problems in two ways. One involved active case-finding in a selected upazila (akin to a district in other countries), then recording epidemiological information from cases and suitable same water-source controls. Analysis aimed to identify which factors, alone or in combination, increase the risk of developing arsenicosis, over and above the consumption of contaminated water.

CIET also helped to assess the capacity of health care providers to diagnose and manage arsenicosis patients. A survey of government and other health care providers sought information about their knowledge, attitudes and practice about arsenic and arsenicosis and allowed a comparison of those with and without specific training about arsenic. The findings have been used in the modification of training modules and programmes and will contribute to changing attitudes and practices of health care providers.

Reports on risk factors and the capacity of health care providers are available from the Library.