Bangladesh

Reducing arsenic poisoning in Bangladesh

© UNICEF/2006/Siddique

Salma Begum and her child in Munshiganj, Bangladesh. Ms. Begum faced social stigma after she began to show symptoms of arsenic poisoning. In some areas of Bangladesh the concentration of arsenic in water is at toxic levels.

By Louise Russell

As part of the launch of ‘Progress for Children No. 5: A Report Card on Water and Sanitation’, UNICEF is featuring a series of stories focused on achieving the 2015 targets set by Millennium Development Goal 7 – to halve  the proportion of people without sustainable access to safe drinking water and basic sanitation.

MUNSHIGANJ, Bangladesh, 11 September 2006 – Salma Begum would lie awake at night, unable to sleep for worrying about who would take care of her children if she died of cancer. Although she hadn’t been diagnosed, what else could explain the discolourings on her arms, the pain and lesions, the feeling that her skin was burning?

“I couldn’t sleep,” she recalls, “not only because I thought, ‘I have cancer, I’m going to die’, but I have three children. What will happen to them when I die?”

But today, Ms. Begum is much more relaxed. She knows that the cause of her symptoms was the arsenic-contaminated water she used to drink from a local well, and now she drinks water that is safer – the rain collected by her family in a tank provided with UNICEF support.

Long-term exposure

Arsenic occurs naturally in groundwater, usually in trace amounts, but in some areas of Bangladesh the concentration of arsenic in water is high enough to be toxic in people who drink it over long periods of time.

Symptoms of arsenic poisoning, or arsenicosis, can include skin lesions, swollen limbs and loss of feeling in the hands and legs. Long-term exposure to arsenic can also lead to cancer, possibly affecting the lungs, bladder and kidneys.

There are an estimated 40,000 cases of arsenicosis in Bangladesh, and public health experts believe there will be more than 2.5 million cases in the next 50 years. Drinking arsenic-free water is the only way to prevent the disease.

A ‘bad disease’

As village life whirs busily around her in the midst of jute harvest, Ms. Begum sits next to her family’s new rainwater tank and talks about her illness.

Her hands feel like she’s been doing hard labour every day of her life. She has black spots on her feet and bad cracks, which fortunately have not become infected. She is hopeful that she stopped drinking the arsenic-contaminated water before her arsenicosis reached a cancerous stage.

Arsenicosis patients in Bangladesh face more than just their physical symptoms. They also have to cope with social stigma and fear from the community.

“When I was first diagnosed with this disease, other family members told me that this was a bad disease,” says Ms. Begum. “They used to hate me. They were scared it was contagious. Nowadays the health workers are coming and saying it’s not a problem. It’s because of our water. It’s not a contagious disease.”

Changing attitudes

UNICEF Bangladesh and its partners have helped raise awareness about arsenic poisoning through mass-media campaigns and by providing health workers with communication booklets and other printed materials.

In UNICEF-supported project areas, people who believe arsenic poisoning is contagious dropped from 70 per cent to less than 25 per cent within one year in 2002. Although stigma for prospective marriage partners has remained, a 2004 arsenic attitudes survey revealed that more than 1 in 4 parents would allow their child to marry an arsenicosis patient, compared to 1 in 20 in 2001.

UNICEF also assists arsenicosis patients by helping to provide safe water alternatives – such as Ms. Begum’s rainwater tank – and by improving diagnosis and care for patients.