Roughly 20 million people in Bangladesh, most of them poor villagers, still drink well water containing arsenic above the national safety limit. That was the central finding of a Human Rights Watch report published on 6 April 2016, and the reason was not a lack of technology. Safe deep wells exist and work, but too few of them reach the families who need them most, partly because local politicians steer new wells toward their own supporters.
The crisis has been called "the largest poisoning of a population in history", a phrase from a 2000 paper in the Bulletin of the World Health Organization. Here is how it happened, what arsenic does to the body, what Human Rights Watch found, and what actually helps.
How Bangladesh's wells became poisoned
The story begins with a public health success. In the 1970s Bangladesh had one of the highest infant mortality rates in the world, driven largely by diseases spread through contaminated ponds and rivers. UNICEF, working with Bangladesh's Department of Public Health Engineering and later with the World Bank, promoted cheap hand-pumped tube wells that drew water from underground. Millions were sunk, and deaths from waterborne disease fell.
What nobody checked at the time was arsenic. Standard water testing did not include it. Arsenic occurs naturally in the sediments of the Ganges delta, and it dissolves into groundwater at depths of roughly 20 to 100 metres, exactly where most of the shallow tube wells drew from. Contamination was confirmed across large parts of the country in 1993 and gained international attention around 1995. Water from deeper aquifers, below about 100 metres, is usually much safer.
What arsenic does to the body
Arsenic in drinking water has no taste, colour or smell, so people can drink it for years without knowing. The World Health Organization sets a guideline limit of 10 micrograms per litre. Bangladesh uses an older national standard of 50 micrograms per litre, and the 20 million estimate refers to people drinking water above even that higher level.
According to WHO, long-term exposure causes skin changes such as dark spots and hard patches on the palms and soles, usually after at least five years. It can lead to cancers of the skin, bladder and lungs, and is linked to heart disease, diabetes and lung disease. Exposure in the womb and in early childhood is associated with impaired cognitive development. One study cited by Human Rights Watch estimated that about 43,000 people in Bangladesh die each year from arsenic-related illness.
What Human Rights Watch found
The 111-page report, titled Nepotism and Neglect: The Failing Response to Arsenic in the Drinking Water of Bangladesh's Rural Poor, was based on interviews with 134 people, including villagers, well caretakers, government officials and aid workers, and on an analysis of government data covering about 125,000 water points installed between 2006 and 2012.
The findings were blunt. Many new government wells were poorly monitored, and some had broken down without repair, pushing families back to contaminated shallow wells. About 5 percent of the new wells reviewed were themselves contaminated above the national standard. Government officials and well caretakers told researchers that national and local politicians often decided where new wells went, favouring supporters, relatives and allies over the villages with the worst contamination. One official described the choice of sites as essentially a matter of politics.
Bangladesh policy undermines arsenic response, allows MPs to divert safe wells from the poor https://t.co/dCA4IvSdm8 pic.twitter.com/0KhlC4W4JI
— Richard Pearshouse (@RPearshouse) April 6, 2016
Why the poorest are left behind
Deep wells cost far more to drill than shallow ones, so poor households cannot simply replace their own contaminated pump. They depend on government or donor wells, which makes fair allocation a matter of life and health. When those wells are diverted, the people with the least money and the least political influence are the ones who keep drinking poisoned water.
Richard Pearshouse, the senior researcher who led the study, put the problem plainly: "Bangladesh isn't taking basic, obvious steps to get arsenic out of the drinking water of millions of its rural poor." He warned that millions could die from preventable arsenic-related disease unless the government and donors acted.
Health care adds another gap. Officials have tended to identify arsenic patients mainly by visible skin lesions, yet most people harmed by arsenic never develop them, so many go uncounted and untreated.
Voices from the villages
Many villagers interviewed had never been told that their water could make them ill, or what their symptoms meant. Some had black spots on their skin but had never seen a doctor about them. A woman named Nouka in the village of Balia, whose skin showed the marks of long exposure, told researchers that when it comes to arsenic, health workers usually say: "We have nothing for your illnesses."
Lack of awareness means families keep using the nearest pump, especially when the safe one is a long walk away or controlled by someone else.
What works against arsenic in drinking water
The WHO calls providing a safe water supply for drinking, cooking and irrigation the most important action in affected communities. In practice that includes:
- Testing and labelling wells. Bangladesh tested millions of wells in a national screening programme and painted pump spouts red for unsafe and green for safe, a simple system that lets families switch to a neighbour's safe well.
- Switching sources. Deep tube wells, rainwater harvesting and treated surface water can all replace contaminated shallow wells.
- Removal systems. Household and community filters can remove arsenic, though they need maintenance and safe disposal of the waste.
- Community education. People need to know that clear, tasteless water can still be dangerous, and that crops irrigated with contaminated water can carry arsenic too.
- Monitoring people at risk. Regular checks help catch early signs, usually skin changes, before serious illness develops.
Human Rights Watch also called on the World Bank to check whether roughly 13,000 wells it funded between 2004 and 2010 were contaminated, and on Bangladesh to stop politicians from diverting wells to their allies.
Not only a Bangladesh problem
WHO estimates that around 140 million people in at least 70 countries drink water with arsenic above the guideline limit, including parts of India, China, Cambodia, Vietnam, Pakistan, Chile, Argentina, Mexico and the United States. Anyone who relies on a private well, anywhere, should have it tested by a certified laboratory, and anyone worried about long-term exposure should talk to a doctor.
Bangladesh shows that the science of safe water is well understood. What decides whether a family drinks clean water is often something else: whether the people in charge put the new well where it is needed most.
Sources: Human Rights Watch (2016); WHO fact sheet: Arsenic; Wikipedia: Arsenic contamination of groundwater.
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