title: Searching for an optimum solution to the Bangladesh arsenic crisis.
abstract: Searching for an optimum solution to the Bangladesh arsenic crisis: Thirty years ago Bangladesh experienced very high levels of infant and child mortality, much of it due to water-borne disease in deltaic conditions where surface water was highly polluted. In what appeared to be one of the great public health achievements, 95% of the population were converted to drinking bacteria-free tubewell water from underground aquifers. Recently, it has been shown that perhaps 20% of this water is arsenic contaminated and alternatives to tubewell water have been sought. This paper reports on two national surveys collaboratively carried out in 2000 by the Health Transition Centre, Australian National University and Mitra and Associates, Dhaka: A census of tubewells and a household survey of tubewell use and arseniosis. The study found that the tubewell revolution has been promoted not only by health considerations but also by the demand for a household water facility and the desire by women to reduce workloads associated with using surface water. Because of this, and because the population had absorbed the message about safe tubewell water, it is argued that the movement away from the use of tubewell water should be as limited as possible, even if this means using safe tubewells which are often found in the neighbourhood. To enable such a move the most urgent need is not changing the source of water but comprehensive national water testing providing essential information to households about which wells are safe and which are not.
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, ACT 0200, Canberra, Australia. Bruce.Caldwell@anu.edu.au <Bruce.Caldwell@anu.edu.au>
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Caldwell
authors.forename: John C
authors.initials: JC
authors.lastname: Caldwell
authors.forename: S N
authors.initials: SN
authors.lastname: Mitra
authors.forename: Wayne
authors.initials: W
authors.lastname: Smith
mesh_terms: D001151:Arsenic / Q000009:adverse effects / Q000032:analysis*; D020261:Arsenic Poisoning / Q000453:epidemiology / Q000517:prevention & control*; D001459:Bangladesh / Q000453:epidemiology; D004781:Environmental Exposure / Q000032:analysis*; D004784:Environmental Monitoring; D062665:Epidemiological Monitoring; D005191:Family Characteristics; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D019216:Metals, Heavy / Q000009:adverse effects / Q000032:analysis; D010067:Ownership; D012494:Sampling Studies; D012989:Soil Pollutants / Q000009:adverse effects; D014874:Water Pollutants, Chemical / Q000032:analysis* / Q000506:poisoning; D014881:Water Supply / Q000032:analysis* / Q000592:standards
chemical_list: D019216:Metals, Heavy; D012989:Soil Pollutants; D014874:Water Pollutants, Chemical; D001151:Arsenic