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Arsenic mitigation: The case of Bangladesh

Drinking arsenic-contaminated water over a long period of time can be fatal, and Bangladesh is the most seriously arsenic-affected country in the world.

Through its largest arsenic-response programme, UNICEF has partnered with the Government of Bangladesh and with non-governmental organizations to test water sources in the country, raise awareness about arsenic poisoning (arsenicosis), improve patient health care and help provide safe water.

Water supply coverage in Bangladesh is very high, with approximately 9 million shallow, manually drilled wells, called ‘tube wells’, serving nearly the entire rural population of 100 million. But in 1993, naturally occurring arsenic-contaminated water was detected in shallow groundwater.

To reveal the extent of the problem, UNICEF supported national random surveys. Beginning in 1999, it supported blanket testing of every tube well – public and private – in arsenic-affected areas. More than 1.5 million wells have been tested with UNICEF support, while other partners have tested an additional 3.5 million wells.

Wells meeting the government drinking-water limit of 0.05 milligrams per litre are painted green, while wells exceeding the limit are painted red. Communities have been informed that water from a red well can only be used for household purposes, not for drinking or cooking.

One in five of the country’s tube wells exceed the government limit, putting some 20 million people at risk. There are more than 8,000 villages where 80 per cent of all wells are contaminated, including more than 2,000 where every single well is unsafe.

Tube well screening was linked with patient surveys, which found nearly 40,000 people suffering skin lesions, the most visible form of arsenicosis. UNICEF supported doctors’ training for the surveys and the provision of simple medicines to patients.

The development of the national arsenic communication strategy, led by UNICEF, included mass media and interpersonal communication. Picture books were produced for use by health-care workers, and religious and community leaders. Field workers, who use simple kits to test wells for arsenic, have been some of the most effective agents for relaying information about arsenic poisoning and dispelling its associated myths.

Awareness about arsenic poisoning has improved dramatically, with basic knowledge being much higher than it was five years ago. In UNICEF-supported project areas, for example, people who believed arsenic poisoning was contagious dropped within one year from 70 per cent to less than 25 per cent. Although stigma for prospective marriage partners persists, a 2004 survey revealed more than one in four parents would allow their child to marry an arsenicosis patient – up from 1 in 20 in 2001.

Blanket testing has allowed villagers to share safe wells and to identify depths where arsenic is less prevalent. Where safe wells are scarce, alternative sources – including deep tube wells, dug wells, pond- or river-water filters, rainwater tanks and arsenic-removal systems – are promoted.

Communities choose the option best suited to their needs, considering costs and such possible health risks as contamination by other chemicals or germs. They are responsible for selecting sites, contributing to set-up costs, and maintaining and operating the alternative drinking-water sources.

Government and other partners have provided more than 100,000 new water points, which can serve millions of affected people. UNICEF has supported the installation of 14,000 of these new water points in highly arsenic-affected areas, providing safe water to half a million people.

Thanks in part to tube well testing, awareness-raising campaigns, and the installation of new safe water points, the number of people actually drinking contaminated water is now estimated to be about 12 million. Arsenic mitigation is an important component of UNICEF’s new Country Programme running through 2010, and UNICEF will continue its support as long as the people of Bangladesh are exposed to unsafe levels of arsenic in their drinking water.

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WASH priority countries

The realization of children’s right to survive and reach their full potential is UNICEF’s overall objective in water, sanitation and hygiene (WASH). A growing body of evidence demonstrates how essential these services are in saving children’s lives, improving education prospects, building gender equality, and reducing poverty while encouraging sustainable development.

WASH programmes are founded on strengthening nationally identified priorities that will increase equitable access to, and use of, safe water and basic sanitation services, and promote life-saving hygiene practices – which have proved to be tremendously effective in fighting disease and can be as simple as hand washing with soap.

For 2006–2015, UNICEF sets out to support these priorities through new strategies that will guide country offices as they work with governments, communities, families and sister agencies in the common purpose of reaching specific Millennium Development Goal targets.

One strategy encompasses 60 priority countries and seeks to bolster water, sanitation and hygiene facilities; incorporate these vital services in schools; promote drinking-water safety; monitor global indicators; and ensure emergency preparedness.

The priority countries were identified based on criteria including under-five mortality rates, total child deaths, rural water supply and sanitation coverage, basic education and current rates of progress in achieving sector targets.

Seven objectives will direct UNICEF programmes in WASH priority countries:

1. Promote a balanced national WASH framework for programmes. This will have as its main pillars interventions to increase safe water and sanitation coverage, the promotion of behavioural change and support to an enabling environment.

2. Support intersectoral approaches. For maximum effect, water supply, sanitation and hygiene need to be coordinated or integrated with programmes in such fields as education, health and nutrition.

3. Provide support for scaling up sustainable WASH programmes. The WASH programme will support efforts to harmonize and align aid delivery and to accelerate progress towards strengthening national development strategies and operational frameworks.

4. Ensure effective decentralization and community choice. With its partners, UNICEF will work to support community management in rural WASH service delivery by building skills, knowledge and resources. UNICEF will also continue to support national governments in formulating policies, and by providing financial, technical and capacity-building support.
5. Promote safe and sustainable water supplies through improved water-resource management. A water protection and conservation element will be included in all UNICEF WASH programmes in priority countries. Specific support will focus on community management of local water resources. UNICEF will work closely with partners to ensure that national policies support effective water-quality monitoring and, where necessary, improvement programmes.

6. Focus on sanitation, water quality and hygiene at the household level. UNICEF will continue to promote safe and affordable household toilets, home water treatment and improved household hygiene.

7. Address children’s rights to health and education. Providing water, sanitation and hygiene in schools meets children’s right to education and to a safe and healthy environment.

Additionally, priority countries, like all other programme countries, will benefit from a basic package of WASH activities. These consist of advocacy and technical support in the areas of drinking-water quality; hygiene awareness and behaviour change; emergency preparedness; and national monitoring of achievements towards the Millennium Development Goals.

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