ARSENIC IN DRINKING

WATER IN BANGLADESH

Group 3
Floor de Man, Aldian Giovanno, Gayathri Hari, Ulfa Asrini Mustama, Olaniyi
Oladimeji

ESA-20806: Principles of Environmental Sciences

Supervisors: dr.ir. A. van Vliet, G. Kontothanasis

ABSTRACT
Bangladesh is currently facing the worst arsenic poisoning disaster on earth, with 12.5% of the
whole population, or 20 million inhabitants are being exposed to arsenic. This calls the need for
clear drinking-water since 95% of citizens depend on vulnerable tube well for drinking water
provisioning. This study aims to understand the most suitable solution in reducing human
exposure to arsenic. Literature study is carried out to elaborate affected victims, possible
lowering-arsenic technologies, utilization of other water resources, and stakeholders interests.
Literature studies reports that women and children are the most affected since both groups are
not only at risk for health problem, but also intelligence degradation and social inequalities.
Lowering arsenic technology requires a persistent maintenances and huge financial supports
from other rural institutions, such as government and NGOs, which makes them infeasible to
apply. Deep tube well (DTW) seems to be the most promising solution because of its low
arsenic presence hence it guarantees the citizens health security. Although it is expensive and
does lead to lower groundwater level, DTW can be modified with pipe supply system to
efficiently widespread its usages. In addition, Sono Arsenic Filters (SAF) is also promising
measure for long-term solution for its high arsenic removal rates. Nevertheless, the proper
knowledge of SAF technologies amongst local citizens are essential for sustained usage. Apart
from technical safe water provision, creating public awareness is fundamental to reduce the
number of human being exposed to arsenic poisoning.

Table of Contents
ABSTRACT.................................................................................................................................. i
Table of Contents....................................................................................................................... ii
1. Introduction............................................................................................................................ 1
1.1 Problem Description............................................................................................................1
1.2 Aim and Research Questions..........................................................................................2
2. Problem assessment............................................................................................................. 2
2.1 The victims....................................................................................................................... 3
2.2 Arsenic mitigation measures..........................................................................................4
2.2.1 Arsenic Screening.....................................................................................................4
2.2.2. Arsenic removal technologies implemented in Bangladesh.................................5
2.2.3 Safe water alternative resources..............................................................................6
2.2.4 Social awareness of arsenic risks............................................................................7
3.0 Conclusions and recommendation....................................................................................8
4.0 Stakeholder Analysis........................................................................................................... 9
4.1 Citizens................................................................................................................................. 9
4.2 Government.................................................................................................................... 10
4.3 World Health Organization (WHO).................................................................................11
4.4 Scientists and Researchers...........................................................................................12
4.5 Bangladesh Rural Assistance Committee (BRAC)......................................................13
5.0 Critical Evaluation............................................................................................................. 13
References............................................................................................................................... 15

1. Introduction
1.1 Problem Description
The World Health Organization (WHO) in 2001 stated that about 130 million of the worldwide
population were being exposed to a high (above 50 g/L) arsenic concentration (Van Halem et al, 2009).
The affected countries include Bangladesh, Chile, Argentina, Mongolia, Taiwan, Mexico. These countries
were found having high levels of arsenic (As) occurring naturally in the groundwater. The amounts of As
found in contaminated water vary from several hundreds to over a thousand g/L (Brown and Ross,
2002).
The standard for safe-drinking water according to WHO guideline is < 10g/L (WHO Guidelines
for Drinking-water Quality, 2004), while the national standard for Bangladesh is < 50g/L (Johnston &
Zheng, 2009) which is the old standard for As safe drinking water by EPA, amended in 2001 (US EPA,
n.d.). The current Maximum Contaminant Level (MCL) set by the US EPA for As in drinking water is
<10g/L (US EPA, n.d.) as well as the European Union (EU) standard (Risks, 2010).
Arsenic is a hazardous, carcinogenic element associated with a wide-range of adverse and
chronic health impacts on human body. Drinking the As-contained water is known to cause lung cancer
(Smith et al, 2000), bladder cancer (Lam et al, 2003), melanosis (Milton et al, 2004), hyperkeratosis, and
jaundice (Chen et al, 2011).
As a result of the arsenic contamination of groundwater in most areas of the country, Bangladesh
is currently facing diverse fatal diseases related to arsenic exposure. Survey by UNICEF in 2009 stated
that 20 million inhabitants or 12.5% of the whole population in Bangladesh are at risk of being exposed to
arsenic. Bangladesh consisted of 87,319 villages. Approximately 14,500 villages of 70,610 surveyed
villages were still threatened with unsafe drinking water from wells (UNICEF, 2010).
Dealing (In order to deal) with the As exposure, the Department of Public Health Engineering
(DPHE) under the Bangladesh Ministry of Local Government, Rural Development and Cooperatives
proposed the Bangladesh Arsenic Mitigation Water Supply Project (BAMWSP) in 1998. The program
focused on screening the well in 100 municipalities, training 2,000 doctors and 11,000 health workers,
and improving the supporting laboratory facilities within the DPHE circumstances (NAISU, 2003). Safe
water devices such as pond sand filters, rainwater harvesting, and DTW were introduced in the arsenic
affected areas by the DPHE along with the support from UNICEF (UNICEF Bangladesh,2009).
BAMWSP was initiated when the nature, magnitude, and impact of Arsenic contamination
problem were not being adequately understood by all concerning stakeholders. Co-Funded by Swiss
Agency for Development and Cooperation (SDC), World Bank and the Government of Bangladesh (GoB),

the projects had cost more than US$ 44.4 million (NAISU, 2003). However, Arsenic contamination is still
an endless multi-dimensional phenomenon and its mitigation requires multi-sectoral components for an
effective implementation. The policy integration and health facilities procurement promoted by BAMESP
are not sufficient for handling such multi-dimensional issues.

1.2 Aim and Research Questions

The main aim of this report is to find the most promising measures to reduce human exposure to arsenic
through drinking water in Bangladesh. In order to achieve this aim, we will answer the following research
questions:
1. Who in Bangladesh are suffering from the arsenic contaminated drinking water, and how severe?
2. How effective are the implemented measures to reduce human exposure to As through Bangladesh
drinking water?
3. How can technologies mitigate human exposure to As in Bangladesh?
4. What is the role and interest of the various stakeholders in Bangladesh, and how can their interests be
taken into account?

2. Problem assessment
The presence of Arsenic ion occurs naturally in groundwater of Bangladesh is first detected in
1993. Two well-known theories to reveal this jeopardizing phenomenon are oxidation theory and reduction
theory. Both theories explains that arsenic ion were initially in the form of its ore before being transformed.
Nevertheless, human activities, such as pumping the groundwater and recharge reduction can lead to the
acceleration of arsenic ion production. The Arsenic contamination drastically reduce the safe-drinking
water access across the country.
Clean water is a luxurious necessity in Bangladesh. A total of 4.75 well-tubes has been tested
and 1.7 million were found to contain an excess arsenic concentration (above 50 part per billion). It
means that 1 out of 5 tube wells in Bangladesh do not fulfil the governments standard of arsenic
groundwater level. According to National Arsenic Mitigation Information Centre (NAMIC) in 2009, 22
million of citizens live in the area with the excessive quantities of arsenic.
Arsenic contamination in the consumed water is known to cause harmful health effects. Human
exposure to Arsenic leads to various disease. Skin lesions are the most well-known symptom and usually
the first indication of exposure to arsenic. Children are particularly vulnerable to arsenic poisoning. Study
has shown that children being exposed to arsenic caused an impaired cognitive development and
neurological dysfunction (Tyler and Allan, 2014). For women, the situation is worse. Those with
arsenicosis skin lesion are mostly impossible to marry and are at risk to get divorce. This results to the
gender inequality, in which men are much more dominant. Consequently, unmarried women are more
prone to poverty and social exclusion (UNICEF, 2008).

The degradation of health quality is not the only problem encountered by the Bangladesh
government. Slow economic growth also becomes the tangible obstacle induced by the health problem.
The victims of arsenic-contaminated water require subsidies from the government to get over from the
diseases. It is estimated that Bangladesh Gross Domestic Product (GDP) loss due to health care budget
reaches US$ 0.6 billion. However, the loss of productivity as the result of diseases contributes more
considerable economic impact than the cost to cure the sufferers. The citizens unability to work have
decreased the national GDP up to US$ 23 billion (UNICEF, 2010).
The Bangladesh Government has generated policies, in order to deal with three sectors which
are most affected by arsenic contamination, they are National Agricultural Policy, National Health Policy,
and National Water Policy. In agricultural sector, the key focuses are to optimize the water usage, develop
arsenic resistant crops, monitor the agriculture activities to ensure the lowest arsenic level, and organize
campaign for raising awareness. Secondly, the health policy deals with the establishment of the facilities
for arsenicosis patient, sharing patients location distribution, training the medics, improving disease
screening capacity, and introducing school-based arsenic education. Dealing with water sector, the
government focuses on the provision of alternative sources, water treatment technologies, and robust
monitoring system (UNICEF, 2008).

2.1 The victims

In 2001, a nationwide screening in Bangladesh showed that about 20 million people in
Bangladesh had ready access to arsenic contaminated well water (> 50 g As/L) (BGS and DPHE, 2001).
tube wells provide drinking water for more than 95% of the population in Bangladesh (Rahman et al.,
2006). The worst affected districts of Bangladesh lie in the southern part of Bangladesh. In Chandpur for
example, more than 90% of the tube wells contain an As concentration higher than 50 g/L (Chakraborti
et al., 2010). The main cause of these high arsenic levels is the Meghna River, which flows through
Chandpur and brings a high amount of arsenic from the Himalayan mountains (Gardner et al., 2011).
Matlab, a rural area in Bangladesh, is part of the Chandpur district. There is a lot of information available
about the Matlab population, as a result of the Matlab Health and Demographic Surveillance System
(HDSS) (Rahman et al., 2006). HDSS has therefore been very helpful in investigations about the effects
of arsenic in the population.

Figure

1.

Regional

trends

in

arsenic

concentration

in

shallow

tube

wells.

(BSG,

2010)

The earliest symptoms of arsenic exposure appear in the skin (Guha Mazumder et al., 1998).
These symptoms include pigmentation and keratosis: the thickening of the outer horny layer of skin of the
palms and soles. In various populations, arsenic toxicity has been signalled through these skin changes.
Rahman et al. (2006) assessed the prevalence of arsenic exposure and skin lesions, and their variation
by different factors such as age, sex, and socioeconomic conditions. According to their study, there had
been a steady increase in arsenic exposure from the 1970s to the late 1990s. This increase was parallel
with the installation of tube wells in Bangladesh; most of these were installed in the 1980s and 1990s.
After 1997, the exposure seems to have decreased. Rahman et al. (2006) stated that this shows an
increasing awareness of the arsenic contamination and a start of a shift to drinking water containing less
arsenic. Higher socioeconomic groups started shifting to tube well water sources in the 70s and 80s, and
seem to have taken the lead again in turning to low or arsenic free water during the 2000s until now.
Men started using tube well water earlier in life than women. However, women have had a
generally higher cumulative exposure than men: they spend more time at home, where the tube wells
were mostly installed. For women, the situation is worse than for men. Those with skin lesions often
cannot find a husband and are at risk to get a divorce. Consequently, unmarried women are more prone
to poverty and social exclusion (UNICEF, 2008). People which are 25-54 at age, have the highest
prevalence of skin lesions. The peak lies at 35-44. On average, these people have been using tube well
water for about 20 years (Rahman et al, 2006). Also children are particularly vulnerable to arsenic
poisoning. Research has shown that children who have been exposed to arsenic, can have an impaired
cognitive development and neurological dysfunctions (Tyler and Allan, 2014).

2.2 Arsenic mitigation measures

The mitigation of arsenic contamination can be conducted by two different approaches,
generating technological solutions and creating social awareness. Technological solutions should be

continuous, integrated, and sustainable. Technological measures refer to have an accurate arsenic
screening system, provide safe alternative water resources, and implement feasible arsenic-lowering
technologies. Creating social awareness must be holistic and able to involve all communities within
society.

2.2.1 Arsenic Screening

Information about the extent of arsenic contamination and its distribution location is crucial for the
future mitigation measures. The South region has more concentrated arsenic than the central and north
regions. The difference in concentration between regions are much different, which makes it difficult for
scientists to predict the level of arsenic contamination. BAMWSP under DPHE and Local Government
Division (LGD) has mapped the distribution of arsenic level in the whole upazilas (sub-district) of
Bangladesh in 2004 (NAISU, 2003).
It is estimated by UNICEF that Bangladesh has 8.6 million tube well and 4.7 million of them have
been screened. Green and red marks are made to classify the safe and unsafe water spot. There are 3.3
million green marks and 1.4 million red marks. This means 1 out of 5 tube well in Bangladesh contains
contaminated water. Also, 54,041 of 87,319 villages across the country have been screened.
The laboratories have a pivotal role to lead the monitoring of arsenic in drinking water. It is
requisite to establish laboratories in upazila scales. Laboratories, both governmental and nongovernmental, should be synchronized to seven existing laboratories of DPHE as the main authority.
Chemicals, updated instruments, and trained personnels are ensured to always meet the minimum
standard for reliable studies to produce the accurate arsenic reports (Dhaka, 2004).

2.2.2. Arsenic removal technologies implemented in Bangladesh

Several technological solutions have been adopted in addressing the menace of arsenic
contamination in drinking water in Bangladesh The overall effectiveness of these technologies in solving
the problem has been inhibited by high costs, maintenance issues and insufficient treatment rate
(Shafiquzzaman, Azam, Moshima, & Nakajima, 2009)
Sono arsenic filter (SAF) is one of the promising technical solutions currently applied in
Bangladesh which has received attention from different groups (Hussam and Munir, 2007). A study
conducted in 2006 over two years period affirmed the effectiveness of SAF (Shafiquzzaman et al., 2009).
Arsenic removal rate can be up to 93% and is feasible to provide clean water for long-term situation. The
concentration of arsenic was found to be reduced to 4-24 g/L, from an average of 200 g/L in tube well
water. One hundred percent of the filters produced water within the Bangladesh standard of 50 g/L, and
50% met the WHO standard of 10 g/L (WHO, 1996).
DPHE developed and implemented the Bucket Treatment Unit (BTU), which principle is based
on coagulation co-precipitation and adsorption processes. The BTUs were distributed across rural areas
in Bangladesh and they were reported to have a good performance in arsenic removal in both, field and

laboratory conditions (Sarkar et al., 2000; Kohnhorst and Paul, 2000). The BTU technology has been
modified by Bangladesh University of Engineering and Technology to get better results in arsenic removal
(Ahmed, 2001). It can be built by locally available materials and is effective in removing arsenic if
operated properly and it remains a viable technology for arsenic removal at household level at low cost.
Poor mixing and variable water quality particularly pH of groundwater in different locations of Bangladesh
were identified as limiting factors for the performance in rapid assessment (Ahmed, 2001).
DPHE-Danida fill and draw units use the principles of oxidation, coagulation and sedimentation.
To the tank with a tapered end the oxidant and coagulant are added to the water and are then mixed with
a propeller and the water is allowed to stand and the sludge settles down at the bottom of the tank. The
sludge contains the coagulant along with the arsenic (Zaved & Khan, 2016). The Danida fill and draw
units are both installed at the household and community level. The major advantage of this technique for
arsenic removal is that it is an easy procedure. The major disadvantage of this process is the formation of
sludge has to be disposed in an environment friendly manner and not cause further pollution (Sarkar &
Rahman, n.d.). The unit cost of these filter units in US $250 and the maintenance cost of the filters is
around US $15 (Zaved & Khan, 2016).
Arsenic and Iron Removal Plants (AIRPs) are tanks in which the water drawn from the tube
well is stored and the process of sedimentation and aeration occurs in the tanks. The air oxidation of iron
and arsenic occurs in the storage and co precipitation of the elements occurs. The water is then
transferred to a chamber with brick pieces and sand particles which then filters the water and transfers it
to a new tank for public use. The AIRPs have shown removal efficiencies of 84-98% and 66-98% for iron
and arsenic respectively (Zaved & Khan, 2016). Surveys show that the AIRPs are most effective in areas
where iron is naturally present in the water sample which help in the oxidation of As(III) to As(V). Surveys
also show that the AIRPs are very well accepted by the communities. The majority of the installed AIRPs
are not maintained well in most places and most of them were discontinued to be in use due to
destruction of the platforms and also disbelief among people about the effects of arsenic (Brennan &
McBean, 2011). Unit cost of AIRPs is about US $200 and around 1 US $ per person per year in a
community (Zaved & Khan, 2016).

2.2.3 Safe water alternative resources

The National Policy for Arsenic Mitigation and Implementation has promoted the utilization of
other water resources such as DTW, dug wells, pond-sand filters, and rainwater harvesting. The
proportion of different water supply modes in Bangladesh is explained by the table below.

.
Table 1. Population coverage by different modes of water supply (Source: DPHE, 2000)
Most water in Bangladesh comes from shallow tube wells (STW) with 80% coverage and piped water
supply with 10% coverage.

These are the most common methods for accessing water. STW are

commonly used by the inhabitants in rurals, while pipe water supply is mostly applied in urban areas
(Dhaka, 2004). Millions STW installed manually by the local drillers results in the health risk of arsenic
exposure. However, STW that meets the WHO guideline of 10 g/L for As in drinking water are more
likely to contain detectable levels of E. coli and, therefore, potentially also pathogens (Islam et al,2001).
This is thus the installation of SWT needs to target the aquifers safe from arsenic which can be done by
sediment color tool (Hossain et al, 2011).
Pond-sand filters (PSF), very shallow shrouded tube well (VSST), shallow shrouded tube wells
(SST), and rainwater harvesting (RWH) are provided in various affected areas in Bangladesh (Jakariya et
al., 2005, 2007; Inauen et al., 2013) by 1% of all Bangladesh inhabitants. Although they are well-accepted
in the absence of another safe drinking water, their maintenance is difficult. PSFs are extremely prone to
microbial contamination (Hoque et al, 2000). VSST and SST require expensive artificial shrouding in
order to be installed on normal tube well (Rahman and Al-Muyed, 2009). Rainwater methodology highly
depends on the nature, its quantities are limited, and cost the high price for maintenance (Khan, 2011).
Dug or ringwell is not favorable with only 1% coverage of people using it. This is the most traditional
method of groundwater withdrawal. The drawbacks are insufficient water and at risk from microbial
contamination (Hoque et al, 2000).
DTW have been used by a lot of communities during past few decades. It appears to be a
promising alternative for arsenic problem in Bangladesh. The deep aquifers where water comes from are
separated from another shallow contaminated aquifer by impermeable layer. Hence, the water is sterile
from any varieties of arsenic ions. The water generated from DTW is naturally safe from contamination.
Less than 1% of DTW in Bangladesh are known to exceed the government standard of 50 g/L,
especially in north-western region (Khan, 2011). Moreover, except for DTW, all alternative water options
are vulnerable for microbial contamination. However, drilling processes to build DTW are costly (Rahman

and Al-Muyed, 2009). Due to the high cost of establishment, their number are limited. Many inhabitants
living in rural area with a far distance from DTW are not able to access clean water from DTW
(Shafiquzzaman, 2009).

2.2.4 Social awareness of arsenic risks

In the last few decades, arsenic-safe water options have been introduced in Bangladesh. Most
citizens have access to these options. In 2010, approximately two-third of households in Bangladesh
were using the available arsenic-safe water options for drinking (Inauen et al., 2013). Through community
education, people have been encouraged to switch to green-painted wells with lower arsenic
concentrations (Gardner et al., 2011). In 2004, interviews were conducted in Matlab about the use of tube
wells. 60% of respondents who were aware that their household water source was contaminated with
high levels of arsenic, reported that they had switched to another source of drinking water (Aziz et al.,
2006). Another study showed that both additional education and periodic reinforcement of the message
that arsenic is a hazard to health, nearly double the proportion of the people switching to an arsenic-safe
water option (Ahmed et al., 2006). However, in 40-50% of the cases increased knowledge still does not
translate into a switch to arsenic-safe options. A study of DTW use in Sreenagar in Bangladesh showed
that social factors are much more important determinants of water source usage, than awareness of
arsenic (Inauen et al, 2013).

3.0 Conclusions and recommendation

Around 20 million Bangladeshis drink arsenic contaminated water. After years of exposure,
arsenic can cause various critical health effects. Arsenic contaminated drinking water has broader
negative impacts aside from health issue. It causes a great deal of social and economic inequalities
amongst people. Approximately 95% of the citizens use well water, while the majority of wells in these
areas proceed the national guideline of 50 ug/L. Women are worse affected than men. They have a
higher exposure and their skin lesions can cause social exclusion and poverty. Also, children are
particularly vulnerable to intelligence degradation which results in a dire picture for the future generation.
Arsenic contamination is a public disaster which calls for the need of effective arsenic removal measures
In this report, different technological solutions were discussed. These are mostly filters or units
that can lower the arsenic concentration in drinking water, for example the Bucket Treatment Unit (BTU),
DPHE-Danida fill and draw units, and AIRPs. However, all these technologies are not socially accepted
due to the poor maintenance, poor upkeep of the technologies and dependency on government and other
institutions for installation and maintenance. Another solution could be the usage of different water
sources. For this, we looked at rainwater harvesting, pond water and STW. However, these sources were
all found to show microbial contamination. Also the suitability of rainwater harvesting varied from place to
place and is dependent on the amount of rainfall. With respect to pond water the people are sceptical
about its usage.

DTW are probably the most socially accepted solution for the arsenic mitigation. It is easy to use
and maintain. Therefore, we recommend the use of DTW as a short-term solution to the problem. Since
the DTW are widely accepted by the public, installation and promotion of DTW will increase the access of
safe drinking for a larger part of the population. However, the DTW cannot be considered as a permanent
solution. Studies have shown that the extensive drawing of water from the water table brings about
lowering of the water table as well as seeping of arsenic contaminant from other water sources.
Therefore, there is a need for looking into more permanent solutions such as pipe water system or
technological solutions.
SAF can be considered as a long term solution to the problem. Since 2007, Bangladeshis have
started to use SAF because of its high arsenic removal rates. However, it requires intensive evaluation
and maintenance. Dependency on governments and NGOs are too high. Most of the households are
unwilling to pay for filters. There would be a necessity of extensive subsidy for the effective removal of
Arsenic through these filters. Also, for the use of SAFs, people have to be educated about the advantages
of technology and be trained with the required technical skill for filter maintenances.
Spreading awareness among the people plays an important role as well in the mitigation of
arsenic problem. In the last 15 years, approximately two-third of households have switched to arsenicsafe water sources. However, still around 40-50% who know the effects of arsenic did not switch to a safe
water option. Other factors than education, such as social factors, play a bigger role in water source
usage.

4.0 Stakeholder Analysis

4.1 Citizens
Bangladeshi citizens are highly affected by arsenic in drinking water. Arsenic exposure has been
estimated to account for at least 24,000 deaths per year nation-wide (Inauen et al., 2010). The worst
affected districts of Bangladesh lie in the southern part of Bangladesh, since the groundwater in this
region is most contaminated. While cities and municipalities supply most of their water from deep,
arsenic-free aquifers, rural and peri-urban areas rely mostly on privately-owned tube wells. One out of 5
tube wells in Bangladesh do not fulfil the governments standard for a safe arsenic level. In the southern
part, the vast majority of the tube wells are contaminated.
Bangladeshi citizens are aware of the arsenic problem, especially those who live in medium or
high risk areas (Ahmed et al., 2006). However, there are still many people who did not (yet) switch to an
arsenic-safe water option. There are several factors which account for the high use of arsenic
contaminated drinking water. In general, it can be stated that all safe water options involve more time or
effort. Bangladeshi citizens are mostly use their own private tube well. The use of community wells
requires a big behavioural change. Furthermore, it is shown that the use of available arsenic-safe water
options is mainly related to distance, but also to perceived taste and social barriers for women play in a
role in sticking to drinking the arsenic contaminated water. Approximately two-third of the Bangladesh

citizens use the available arsenic-safe water options for drinking. Household arsenic removal filters, piped
water, community removal and well-sharing are the most used options. DTW, pond sand filters and dug
wells were used by approximately half the people who had access to these options (Inauen et al., 2013).
Already tens of thousands of DTW have been installed by governmental and NGOs (Inauen et al.,
2013). They are often shared or community wells, which means citizens have to walk there several times
a day. The walking distance is approximately 100 meters on average. 12% of the people drinking arseniccontaminated water switch to these wells. The wells have also had an indirect impact on the Bangladesh
citizens: after the installations of DTW, numerous households reinstalled their own well to greater depth.
Research showed that DTW, along with piped water supply, have high acceptance scores.
Compared to other arsenic-safe options, people give a high rating to temperature and taste of the water
(Inauen et al., 2013). The main downside for DTW is that it is highly perceived as time-consuming. 56% of
the citizens in Bangladesh say they keep consuming contaminated water because the DTW are too far
away (Shafiquzzaman, 2009). Especially non-users find the distance particularly difficult to cope with.
This could be the reason why their commitment to use DTW is below average and why only
approximately half of the respondents use them (Inauen et al., 2013).
Although DTW already had an impact on the use of arsenic-safe water, still some requirements
should meet in order to further help the citizens. The installation of more DTW will reduce the distance
from the users. It is important that the wells are placed in a central location, where women are not
discouraged to go. Technical innovations, such as the use of multiple hand pumps attached through
lateral pipes to a single borehole, may help overcome distance barriers.

4.2 Government
Ministry of Local Government Rural Development and Cooperatives (MLGRDC) is the main
authority of Government of Bangladesh (GoB) to deal with arsenic environmental problem. MLGRDC
establishes two key departments, DPHE and LGD in order to divide job specialization. LGD plays pivotal
roles in managing arsenic issues on Bangladesh and DPHE is the lead technical organization responsible
for arsenic mitigation planning and its implementation (UNICEF, 2010).
The Government has spent more than US$ 200 million to provide safe water access for 20 million
people, being threatened with high level of arsenic exposure (UNICEF, 2010). Through BAMWSP,
MLGRDC focus on screening and preventive roles. Screening was the first initiated measure to
investigate the arsenic distribution. Between 2000 and 2006, nearly 5 million wells had been tested and
54,000 villages had been screenend for their arsenic contamination extents (UNICEF, 2010). After
screening, the projects were mainstreamed into sanitation and clean water provision. Working with a
number of non-governmental institutions and local communities, the governments has successfully
provided 705,094 public safe water point in 2009 (UNICEF, 2010). Several innovations have also been
implemented, such as development of Bucket Treatment Unit (BTU), Arsenic and AIRPs, and ion-

10

exchange resin filters (Khan, 2011), stevens institute of technology filters, and sana 3-pitcher filters
(NAISU, 2003).
In order to decide the most suitable mitigation measure, government needs to consider water
quality and quantity, affordability, reliability, life expectancy, convenience, time consideration, gender
issues, operational safety, risk distribution, logical sustainability of system, user acceptability, necessary
operation and maintenance training, information education and communication (NAISU, 2003). It is also
important that MLGRDC have proper strategic plans, distinct orientation, time-management, duties
distribution, and evaluation of the overall works to support the existing solutions (Khan et al, 2011).
Taking all drawbacks and advantages into consideration, government emphasizes STW and DTW
to deal with arsenic contamination. Alternate safe water from STW and DTW could be conventionally
accessed or be integrated with piped supply system. Though the presence of DTW is still not comparable
to STW as the main source of water supply, it seems to be often suggested by most of government
collaboration with several institutions because of security reason. Along with WaterAid Bangladesh, and
Village Education Resource Centre (VERC), government have installed DTW specifically in arsenic prone
area. Also, DPHE and Danish International Development Agency (DANIDA) have contributed to build
1,000 DTW in 2004. GoB and Asian Arsenic Network (AAN) through Mobile Arsenic Centre (MAC) project
also proposed the use of DTW in some Khulna Bengali (Division) (NAISU, 2003).
From 2000 to 2010, citizens had been using more DTW water and less STW water. The coverage
of water supply mode had dramatically raised from 6% to 23.5%. DTW is a better source for provisioning
clean water in the coastal area where shallow water is highly contaminated with arsenic and less portable
because of high salinity (NAISU, 2003). However, in some soils without the presence of separating layer
between deep and shallow aquifers, DTW could produce poisonous water. Many experts have convinced
the government to establish a long-term recommendation for alternative option with the proper use of
surface and deep water. DTW might be successful to provide sterile water, but it is still unsustainable and
clearly not designed for future exploitation. Dealing with this drawback, government works with industries
and NGOs to install piped water supply system which utilize the DTW as the supplying resource
(Dhaka,2004).
LGD and DPHE, as the representatives of central government, have roles to legislate water
quality and supplies, and develop monitoring-mitigation implementation. Their collaboration with Union
Parishads (UP), as the smallest rural administrative is essential. UP is a driving actor to operationalize
decentralized provision of safe water policies. They have the power to mobilize resources, manage
monitoring and information system, and specifically ensure peoples security.

4.3 World Health Organization (WHO)

People in Bangladesh use tube wells as the source of water for their daily needs. Millions tube
wells were installed in almost districts throughout Bangladesh. In 1993 Arsenic was first detected in water
in Nawabganj, Bangladesh (Khan et al, 1997). Following this discovery, WHO later measured the arsenic

11

contaminated water in various laboratories. The measurements showed that the sampled water contained
high concentration of arsenic which far above the maximum level permitted by Bangladesh government,
50

g/l (WHO, 1996).

As published on Bulletin of the WHO in 2000, arsenic in drinking water was classified as a public

health emergency. Millions of people in Bangladesh were exposed to arsenic through drinking water. Most
of contaminated groundwater are found in rural areas where comunication and education are often limited
and also enlarge the intervention programmes (Smith et al, 2000).

In order to see the effects of

contamination, the Dhaka Community Hospital and the School of Environmental Studies conducted a
three-week survey from December 1996 to January 1997. They visited 18 affected districts and examined
the 1630 adults and children, 57.5% of them had skin lesions due to arsenic poisoning (Ahmad et al,
1997).
WHO plays a role in mitigating arsenic contamination through International Programme on
Chemical Safety (IPCS) which includes arsenic in 10 WHOs major public health concern. WHO sets the
basis standard of arsenic in drinking water is 1 0

g/l

worldwide. However, it is possible for Member

States to set higher level of the guideline value under local circumstances (WHO, 2016).
People believe what they see, in this case, they might find it difficult to believe that the water they
consume everyday which appear as crystal clear contain a high concentration of toxic. From a public
health standpoint, the immediate intervention seems to be more effective in mitigating the exposure
through existing technology (for example, with some improvement rather than introduce the affected
people to some unfamiliar methods such as the use of chemical for water treatment and harvesting rain
water and using another source (Smith et al, 2000). This is more likely considering the human behaviour
that tend to prefer the simple method.
Professor Smith of U. Cal. Berkeley stated that "the basic treatment is to supply the patient with
drinking water that is free from arsenic. This is the first priority. Indeed, in the absence of good evidence
for the effectiveness of other treatments, the second priority is to continue providing arsenic-free water,
and the third priority is to monitor patients to ensure that they remain unexposed to arsenic." (WHO,
2002).

4.4 Scientists and Researchers

The arsenic contamination in drinking water in Bangladesh has elicited a growing attention in the
scientific world. Researchers both within and outside the country alongside with international agencies
have been working on technical bailouts to address the problem of such magnitude. The underlying
interest of scientists is to develop effective solutions both for the mitigating and adaptive interventions.
The development of viable technologies for the removal of arsenic and also the technical means of
reducing human exposure to arsenic in drinking water. The adaptive measures are the means to deploy
alternative water sources of drinking/potable water in the affected regions of Bangladesh.

12

Bangladesh Council of Scientific and Industrial Research (BCSIR) have been working on
developing several technologies to address the problem. Scientific research has been directed towards
the mapping and improved understanding of groundwater and mobilization of Arsenic. A lot is being done
through scientific research in time series analysis of contamination in order to identify future trends
(Position Report, BUET).
Scientific research has informed several projects e.g. DPHE-Danida Arsenic Mitigation Pilot
Project and other interventions of international agencies like WHO and United Child Education Fund
(UNICEF) in Bangladesh (Shafiquzzaman et al, 2009). Long-term groundwater studies throughout
southern Asia have been initiated with the goal of finding low-cost solutions to what WHO calls the largest
mass poisoning in history (Mark, 2010).
The influence of scientists and researchers is largely premised on the availability of financial
resources to exert the possibilities of the solutions. The commitment of other stakeholders (government)
to embrace and implement plausible findings is crucial. The prospective planning should be engaged
through research both for the immediate and the long-term approach to the problem in Bangladesh. This
could be achieved through active collaborations.
The arsenic safe drinking water technologies have been gaining increasing acceptance by the
citizens in the affected areas. However, the acceptance of these mitigation measures could still be
improved. More studies could be conducted by the scientists and researchers to further investigate the
mitigation measures from a social point of view. It is important to further research what factors
compromise the acceptance of DTW, and social interventions could help to increase the usage of DTW.

4.5 Bangladesh Rural Assistance Committee (BRAC)

Formerly known as the Bangladesh Rural Assistance Committee and later known as Bangladesh
Rural Advancement Committee and now known as Building Resources Across Communities. The BRAC
is one of the largest NGOS which has been working across the country extensively for arsenic mitigation.
The arsenic safe drinking options promoted by BARC are DTW, arsenic removal filters, pond sand filters,
piped water supply system and two-headed and three-headed tube wells. To increase the access to safe
water BRAC has a programme called BRAC WASH, which carries out a lot of activities for providing safe
drinking water. The various activities undertaken by the BRAC WASH for providing safe water include
installation of pipe water systems, installation of DTW, and testing of the water quality.
The demand for clean drinking water is much higher than the supply, hence it is necessary or
Bangladesh to have more DTW. The DTW are the most appropriate for this region because of the
comparatively lower cost and are user friendly.
BRAC WASH has already undertaken the construction of over 6000 tube wells all over the
Bangladesh and we would continue to aid the government further for the installation of more DTW. In
order to increase community involvement, the cost had been shared with the community in the earlier
projects. The community contributes to about 10-12% of the total cost. This gives the community a sense

13

of ownership and encourages them to maintain it. This practise of the community paying partly for the
installation of DTW, would increase the use of water from DTW in the community and hence suggest that
we should extend this practise towards the new DTW that are to be installed.
Laboratory analysis of the installed tube wells, to test for the presence of arsenic, is done before it
is open to public use. If any traces of arsenic are found, the tube wells are marked and should be sealed
off from public use. The sealing off of the DTW would prevent the people from further using the tube well
closest to them if unsafe. This would ensure that the new DTW are indeed safe.
BRAC has also observed subsequent increase in the use of safe drinking water among people
with increased awareness to the effects on arsenic on the human body and the importance of safe
drinking water. Thus continuation of these programs to increase awareness and the use of mass media
as a platform for educating people would play a part in sensitisation of the people towards negative
impacts of Arsenic contaminated drinking water.
As mentioned earlier the higher demand for clean drinking water than the supply there is a need
for more tube wells. The BRAC would aid the government of Bangladesh for the installation as well as
increasing awareness among the people.

5.0 Critical Evaluation

Since arsenic in drinking water is a major health problem in Bangladesh, a lot of stakeholders are
involved. In this stakeholder analysis, five of them were included. The first stakeholder is the group of
citizens living in the contaminated areas. This is the most affected stakeholder. Because the main arsenic
problem is in the rural areas, many of the people who are suffering are poor and have a low influence.
Secondly, Bangladesh Ministry of Local Government, Rural Development and Co-operatives (MLGRDC)
is included in the stakeholder analysis. They have a high influence, since they are highly responsible for
the policy and its implementation. Furthermore, the role of the WHO was looked at. There are several
international organizations involved in the Bangladesh arsenic problem. WHO is particularly important,
since they monitor human health worldwide. They are barely affected, since they are not stationed in
Bangladesh. WHO has a medium influence: they do not directly determine the policy. BRAC is one of the
most important NGOs in the arsenic problem, and therefore also included in this stakeholder analysis.
BRAC is involved in the measures taken to mitigate the problem. Similar with WHO, they are little affected
and have a medium influence. The final stakeholder taken into account, is the group of scientists.
Scientists help in investigating different aspects of the problem. They are little affected and have a low
influence. The position of these five stakeholders is illustrated in the matrix below.
Highly Affected
Citizens
Government
(MLGRDC)

14

Scientists

WHO, BRAC

Little Affected, low influence

High influence

Table 2: Stakeholder matrix

In the stakeholder analysis, there is a tendency on (more) DTW implementation in order to

mitigate the arsenic problem. DTW can yield the lowest arsenic concentration and are more socially
accepted than other mitigation measures. A lot of DTW have already been installed. However, half of the
citizens could not use DTW because of the far distance to access DTW. Furthermore, the Bangladeshi
are used to using their own wells and therefore it is difficult to switch to arsenic-safe wells. Also various
social factors play an important role. More citizens would switch to DTW, if they are closer to their homes.
This can be achieved by integration with a pipe system. If more DTW were to be installed, the DTW would
automatically be closer to certain groups of citizens. If it is possible to install these on central locations,
where women are not discouraged to go, this would be a great help for the citizens.
The MLGRDC is the main authority of the Bangladesh government to deal with the arsenic
environmental problem. So far, the government spent more than 200 million to provide safe water for the
20 million people threatened by arsenic. The government has successfully provided over 700,000 safe
water points, using different technologies. The government has focussed on STW and DTW to deal with
arsenic contamination until now, considering various factors which are important in the successfulness of
arsenic mitigation. Although almost all mitigation measures are really expensive on the short term,
implementation of DTW would eventually be more economical viable, since arsenic related health
problems cost more than a billion USD per year. DTW could be integrated with a piped supply system.
Due to the efforts of the government along with other organisations, citizens have been using more water
from DTW. However, many experts have convinced the government to establish other long-term
recommendations for safe water options. DTW might be successful to provide safe water, but is
unsustainable and not designed for future use.
WHO is concerned about public health. Their first priority in arsenic mitigation is to supply the
patients with arsenic free drinking water. From a public health standpoint, it is most effective to intervene
the exposure through existing technology and not spend too much time on long-term projects to invent
new technologies. WHO is in favour of using DTW for now. DTW are a quick measure, which can be
implemented and promoted on a short-term.
The BRAC is one of the largest NGOs which has been working across the country extensively for
arsenic mitigation. The arsenic safe drinking options promoted by BARC are DTW, arsenic removal filter,
Pond sand filter, piped water supply system two-headed and three-headed tube wells. BRAC is
supporting the installation of DTW. The BRAC also can help in increasing the awareness among the
public regarding the importance of using DTW for clean arsenic free drinking water.
Researchers both within and outside Bangladesh have been working on solutions for the arsenic
problem in Bangladesh. Scientists are able to develop various technologies in order to lower the amount

15

of arsenic in the drinking water. Furthermore, they can reflect on the effectivity of the various measures
taken and advise governmental organizations on their policies. Scientists have done this a lot already and
are willing to continue doing so. However, scientists are highly dependent on financial resources. If there
is enough money available, scientists could work on long-term, sustainable technologies aside from DTW.
All these stakeholders see the implementation of more DTW as a viable option. Since quickness
of the solution has a high priority (WHO), it would be good to install more DTW and actively promote the
use of them. The MLGRDC and BRAC have an important role in this. Integration of DTW with a pipe
water system would bring the arsenic-safe water closer to the citizens. This would help the citizens a lot
and increase the use of arsenic-safe water. Since DTW are not sustainable on the long term, continuing
investments in research for other technologies is really important. This way, eventually a shift will be
made to a sustainable arsenic-safe drinking water source.

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