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The worst mass poisoning in history

The worst mass poisoning in history, Bangladesh, Arsenic

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The worst mass poisoning in history

  1. 1. Physicalprocess Tube-well testing Site selection Site selection An installation site for the water supply is selected during a village meeting. Informal talks reveal whether the choice is appropriate or not. Landownership is legally vested in the community. This step is crucial to avoid monopolisation of the water supply by the landowner. Installation of the water supply With the assistance of the staff, a contractor is selected. The community provides some material and logistical support. The installation process is monitored to ensure proper installation. Setting up an information centre A simple shed is set up and furnished with posters and information material. This will help facilitate the dialogue between staff, committee members and the community (see social process). Setting up homestead gardening As arsenicosis is worsened by malnutrition, affected households are helped to establish fruit and vegetable gardens. Data collection in the working area General geographic information is collected about a working area (usually a union or sub- district). Tube-well screening In several survey villages, tube-wells are tested for arsenic (and marked) in order to identify those most seriously affected. Technology assessments Previous and present drinking water projects are assessed. Villages are selected where no other programmes are running, or where they have previously failed. Money collection and savings The committee opens a bank account and collects financial contributions from water users. The contributions are not large, allowing everyone to participate. Some of the money can be used to share in the investment; some for maintenance. The committee is encouraged to meet once a month in the information centre to discuss operation and maintenance issues, the use of the bank accounts, and so on. Maintenance of the water supply Financial contributions serve to buy and stock spare parts. The committee repairs the water supply whenever required. Since women are usually first to signal problems with the operation of a water supply, they have an important role in the committee. When expensive repairs are needed the committee is encouraged to collect more money from water users. Water users Information centre Tube-well marking Water supply installation Handpump maintenance Information centre Studying existing water supplies Water supply installation Platform in disrepairHomestead garden Socialprocess Household survey School programme Consultation and agreement The implementation process is discussed and agreed upon with the community. The technologies assessed during the surveys are discussed. This leads to the selection of a water supply option. Establishment of a committee In a village meeting, the staff facilitates the election of twelve committee members - both men and women. With an understanding of the local socio- economic conditions, the staff can better assist the poor and improve their representation in the committee. Raising awareness Information about arsenic is initially disseminated during surveys. Later, meetings are organised to reach different social groups (courtyard gatherings, school programmes, tea stall meetings and information centre meetings). As people may be alarmed or feel powerless, simple nutritional tips are suggested. Treatment of patients Regular treatment is provided to arsenicosis patients identified during surveys. They are also given seeds and support for starting homestead gardening (see physical process). Paramedic training Orientation meetings (Non-) Governmental Organisations in the working area are visited to form an idea about who is doing what on arsenic. Socio-economic survey In order to select the poorest survey village, data are gathered about the social, economic, educational and familial status of households. Arsenicosis patients identification Trained staff screens possible arsenicosis patients. This initial investigation may reveal more serious poisoning in some villages. Maintenance of the committee With increased awareness of the dangers of arsenic, and interest in a functioning water supply, water users are more likely to keep an eye on committee members. The staff helps to motivate or replace inactive members. This is the beginning of peopleʼs control over the committee. To encourage self- monitoring in the long- term, village volunteers are selected to monitor committee members and their duties. Follow-up treatment Arsenicosis patients still require treatment long after having shifted to arsenic-free water. Better diets through homestead gardens may gradually replace medical support. Paramedic training will help increasing people's understanding. People's organisations The committee is encouraged to become a 'peopleʼs organisation' that will independently establish access to other public services (such as sanitation, education, or road construction). Courtyard meeting Data analysis Committee election Village volunteers Patient treatment Patient screening Committee New road in the villagePatient treatment OrganisingSurveying Facilitating Select and analyse a village Establish drinking water and public health systems Improve well-being through sustainable water and health systems Problem and aim: This action research programme is concerned with safe drinking water in rural Bangladesh – a matter of grave urgency since the discovery of arsenic in the groundwater more than a decade ago. Between 35 and 77 million users are exposed to dangerous levels of contamination, and the implementation of solutions has been slow and inadequate. Few projects have been undertaken, and even fewer have managed to develop suitable operation and maintenance arrangements, to bypass existing power relations, and to extend services to the very poor. The aim is to understand these failures and to suggest a more successful approach. The findings come out of a safe drinking water supply programme, implemented by the Arsenic Mitigation and Research Foundation (AMRF) in several arsenic affected villages. ARSENIC CONTAMINATED DRINKING WATER IN RURAL BANGLADESH Proposed approach, processes and phases: The diagram shows two basic processes: a physical and a social one. The physical process relates to technological and ecological assets; the social process to human and organisational assets. The processes run in parallel, and both roughly follow the three phases of surveying, organising and facilitating. The first phase leads to the selection of a village. In the second phase, AMRF assists the community with investments in new assets, such as a water option, a maintenance committee, knowledge, skills, and so on. In the third phase, AMRF's direct involvement is reduced, as it begins to support activities leading to the sustainability of the water and health systems. The diagram represents work-in-progress, and will be elaborated as new findings emerge from practice. "The Worst Mass Poisoning in History" Author: Crelis Rammelt (PhD Candidate, Environmental Policy and Management) in collaboration with the AMRF staff in Bangladesh. Email: Website: New York Times, 1998