A number of challenges in health and nutrition remain. These are:
• Improving health care-seeking behaviour such as education, awareness-raising and skills building in recognizing and treating pneumonia and obstetric emergencies.
• Rapid urbanization which creates conditions that make slum dwellers vulnerable to disease as a result of problems of sanitation, hygiene and the supply of clean water.
• The emergence of arsenic in tube well water, leading to arsenic poisoning.
• The potential for HIV/AIDS to develop into a major problem.• Action on a range of fronts to reduce the number of deaths from accidents.
Arsenicosis The widespread incidence of arsenic contamination of water creates health problems for whole communities. Long-term exposure to low concentrations of arsenic in drinking ground water causes painful skin lesions and can result in cancers of the skin, lungs, bladder and kidneys. Tackling the problem means identifying who is suffering from arsenic poisoning (arsenicosis), monitoring water quality, helping communities to find alternative sources of safe water and enabling households to treat water themselves, to make it safe.
HIV/AIDS There are an estimated 13,000 adults living with HIV in Bangladesh. This is below 1 per 1,000 adults in the general population, and less than 1 per cent among vulnerable groups. But despite the low incidence, Bangladesh is considered a high-risk country for several reasons, including:
• sustained high-risk sexual behaviour
• very low use of condoms
• high incidence of self-reported sexually transmitted infections among vulnerable groups
• high levels of HIV/AIDS in the two neighbouring countries, India and Myanmar
• the high proportion of young people, who constitute one third of the population — the highest in the region. There are signs that initiatives to change behaviour are having an impact. This is reflected in declining syphilis rates among female sex workers in some cities and brothels, and in declining needle and syringe sharing rates among intravenous drug users (IDUs). This work needs to be extended to cover more regions and more of the at risk population. There is more detailed information on the HIV/AIDS page of this website.