ARSENIC NITIuATI0N ANB RESEARCB F00NBATI0N (ANRF)

Social impact of aisenicosis uisease: A stuuy on aisenicosis patients of

Sieenagai anu Louhajang upazila unuei Nunshiganj uistiict.








Introduct|on:
1he scale of Lhe problem of arsenlc conLamlnaLlon of drlnklng waLer ln 8angladesh has become
lncreaslngly well undersLood slnce arsenlc was flrsL over 10 years ago. lL ls now a naLlonal
concern wlLh grave consequences upon human llves and producLlvlLy. Lver slnce Lhe flrsL
ldenLlflcaLlon of arsenlc conLamlnaLlon of groundwaLer ln 1993 aL Chapal nawabgan[ ln 8a[shahl
ulvlslon, a number of ma[or lnlLlaLlves have been underLaken aL dlfferenL Llmes Lo address
dlfferenL lssues relaLed Lo Lhe problem.
Lxecut|ve Summary:
nea|th prob|ems
Arsenlcosls sympLoms can lnclude leslons, hardenlng of Lhe skln, dark spoLs on hands and feeL,
swollen llmbs and loss of feellng from hands and legs. Leslons are easlly lnfecLed, pose a LhreaL
of gangrene and can be very palnful. Whlle Lhere ls a long laLency of more Lhan 20 years, leslons
can appear more qulckly lf arsenlc concenLraLlons are very hlgh. Powever, Lhese sympLoms are
usually reverslble lf deLecLed early and people sLop drlnklng arsenlc-conLamlnaLed waLer. Long-
Lerm exposure Lo arsenlc can cause serlous healLh problems lncludlng lnLernal cancers of Lhe
skln, lungs, bladder and kldney, whlch can be faLal. 1hese cancers can occur wlLhouL Lhe skln
leslons. MosL of Lhe deaLhs caused by arsenlc are expecLed Lo be from lung cancer. SLudles have
shown exposure Lo arsenlc conLamlnaLed waLer can also cause lmpalred cognlLlve developmenL
ln chlldren. Malnourlshed people are Lwlce as llkely Lo develop arsenlcosls as well-nourlshed
people. 1here ls no known cure for chronlc arsenlc polsonlng. Powever, people sufferlng from
arsenlcosls can recover more rapldly from skln leslons when Lhey eaL nuLrlLlous food or Lake
mulLl-vlLamln supplemenLs. LoLlons conLalnlng urea and sallcyllc acld can ease Lhe paln of skln
leslons, and also help Lo speed recovery.
Soc|a| Impacts
eople wlLh arsenlc polsonlng suffer enormous soclal sLlgma ln 8angladesh. Many people
belleve arsenlc polsonlng ls conLaglous or a curse. arenLs are relucLanL Lo leL Lhelr chlldren play
wlLh chlldren sufferlng arsenlc polsonlng and paLlenLs can be shunned wlLhln Lhelr vlllages. lor
women, Lhe slLuaLlon ls worse. ln 8angladesh, a woman's aLLracLlveness lles ln her beauLy
whlch ls ofLen [udged by her pale complexlon. 1hls makes lL harder, ln some cases lmposslble,
for slngle women sufferlng from arsenlc polsonlng Lo marry. Cnce marrled, women face Lhe rlsk
of dlvorce lf Lhey develop arsenlcosls skln leslons. 1hls can be a dlre slLuaLlon ln 8angladesh's
male-domlnaLed socleLy, where unmarrled women are more vulnerable Lo poverLy and soclal
excluslon. Women are also less llkely Lo recelve early dlagnosls or LreaLmenL.
Cb[ect|ve:
1o know Lhe soclo-economlc condlLlon of arsenlcosls paLlenL,
1o know Lhe vulnerablllLy of Lhe paLlenLs,
1o assess Lhe lmpacL of arsenlc ln Lhe socleLy.
Methodo|ogy:
Method: 1hls sLudy ls a daLa exploraLory sample survey wlLh quallLaLlve sLudy based on ln-
depLh lnLervlew.
Study area: 1wo arsenlc affecLed upazlla Sreenagar and Louha[ang of Munshlgan[ dlsLrlcL wlll be
consldered as research area.
opu|at|on of the study: All paLlenLs wlll be consldered as populaLlon for Lhls sLudy.
Samp|e and samp||ng techn|que: 1he presenL sLudy wlll be conducLed on Lhe basls of sample
survey. 1he samples were Laken purposlvely.
Sources of data: lnformaLlon, necessary for Lhe research wlll be collecLed from boLh prlmary
and secondary sources. aLlenLs wlll be chosen as respondenLs.
1echn|ques and |nstruments of data co||ect|on: 1o collecL daLa lnLervlew schedule wlll be
applled as lnsLrumenL. uslng Lhe lnLervlew schedule, wrlLLen ln 8engall and comprlslng boLh
sLrucLured and unsLrucLured quesLlons wlll collecLed by dlrecL lnLervlew Lechnlque.
Data process|ng, ana|ys|s & |nterpretat|on: AfLer adequaLe collecLlon of lnformaLlon, lL wlll be
edlLed, classlfled on Lhe basls of several characLerlsLlcs, summarlzed and organlzed for Lhe
purpose of Lhe sLudy. AfLer processlng and analyzlng of daLa lL wlll be accordlngly lnLerpreLed.

I|nd|ngs:
(A) Soc|o-econom|c cond|t|on of respondents: MosL of Lhe respondenLs (70) are female age
beLween 33 Lo 70 years old and 30 of respondenLs are male. now all of Lhem are permanenLly
seLLled ln Lhls area buL half of Lhem are mlgraLed from oLhers places of Munshlgan[ dlsLrlcL
excepL Lhree respondenLs from larldpur and Madarlpur dlsLrlcL. All Lhey are less educaLed
person, hlghesL educaLlonal quallflcaLlon of Lhelr famlly member ls beLween class flve Lo PSC
level and Lhelr average famlly lncome are 10,000/= (1k. 1en Lhousand only).
(8) Water uses by pat|ent:
(8.1) Water uses by respondent after be|ng pat|ent:
urpose of
use
u1W
(Creen)
ercenLage
()
S1W (8ed) ercenLage
()
Surface
WaLer
ercenLage
()
urlnklng 30 100 0 0 0 0
Cooklng 8 27 0 0 22 73
PP
acLlvlLles
3 17 18 60 7 23
Wash &
cleanlng
3 17 18 60 7 23
CLhers 0 0 0 0 0 0

All respondenLs are drlnklng arsenlc safe waLer from deep Lube-well afLer belng paLlenL and
Lhey collecL surface waLer for cooklng. Also Lhey use oLhers sources waLer for washlng, cleanlng
and oLhers household acLlvlLles.



0
20
40
60
80
100
urlnklng Cooklng PP acuvlues Wash &
cleanlng
CLhers
Water uses by respondent aher be|ng panent
u1W (Creen) S1W (8ed) Surface WaLer



Durat|on of |nadequate Water:
lnadequaLe
WaLer
All over
Lhe year
ercenLage
()
8alny
Season
ercenLage
()
ury
Season
ercenLage
()
u1W (Creen) 0 0 0 0 20 67
S1W (8ed) 0 0 0 0 20 67
Surface
WaLer
0 0 0 0 30 100






0
20
40
60
80
100
120
All over Lhe year 8alny Season ury Season
Inadequate Water
u1W (Creen)
S1W (8ed)
Surface WaLer
(8.2) Water uses by respondent before be|ng pat|ent:
urpose of
use
u1W
(Creen)
ercenLage
()
S1W (8ed) ercenLage
()
Surface
WaLer
ercenLage
()
urlnklng 3 10 26 87 1 3
Cooklng 2 7 1 3 27 90
PP
acLlvlLles
2 7 24 80 4 13
Wash &
cleanlng
2 7 24 80 4 13
CLhers 0 0 0 0 0 0




(C) Informat|on about arsen|cos|s d|sease:
aLlenLs have been sufferlng from Arsenlcosls for 6 monLhs Lo 23 years.
lnlLlally Lhey felL skln leslons, paLch areas of lncreased skln plgmenLaLlon, scables,
overall paln, weakness, sleeplessness eLc.
ln maxlmum cases when AM8l fleld sLaff vlslLed Lhelr area, Lhe shared Lhelr condlLlon
and Lhey ldenLlfled posslble arsenlcosls sympLoms and referred Lhem Lo Al1AM (parLner
nCC of AM8l) where Lhey were dlagnosed as arsenlcosls paLlenL and were prescrlbed
LreaLmenL.
Some paLlenLs wenL Lo governmenL and prlvaLe hosplLal/cllnlc and dlagnosed as
arsenlcosls paLlenL.
now all paLlenLs are under Lhe free LreaLmenL of AM8l.


0
20
40
60
80
100
urlnklng Cooklng PP acuvlues Wash &
cleanlng
CLhers
Water uses by respondent before be|ng panent
u1W (Creen) S1W (8ed) Surface WaLer
(D) Lxpenses and d|ff|cu|t|es:
All paLlenLs have been recelvlng LreaLmenL from Lhey were dlagnosed as arsenlcosls
paLlenL.
MonLhly expense of Lhelr LreaLmenL ls near abouL 1k. 300, ln some cases Lhey have no
expenses.
Some female paLlenLs have Lo go far away for recelvlng LreaLmenL, someLlme Lhelr
husband makes obsLacle Lo go ouL.
MosL of Lhe paLlenLs have been neglecLed or lgnored by Lhelr famlly members as well as
socleLy.
(L) Att|tude of fam||y and soc|ety towards pat|ents:
ln very few cases famlly members seem Lo arsenlcosls dlsease LhaL can be spread Lo
oLhers famlly member. 1haL's why Lhey have separaLed paLlenL from oLhers.
All paLlenLs Lry Lo hlde Lhelr dlsease from nelghbor and relaLlves, so LhaL Lhey can easlly
Lake parL lnLo soclal funcLlon and relaLlve's occaslons.
Some paLlenLs are faclng problems Lo geL marrled of Lhelr son or daughLer.

kecommendat|on:
1oLal WaLer CuallLy LesL
Mapplng and lmproved undersLandlng of CroundwaLer and MoblllzaLlon of Arsenlc
1lme Serles Analysls of ConLamlnaLlon Lo ldenLlfy luLure 1rends
lmproved MonlLorlng and LvaluaLlon
aLlenL ldenLlflcaLlon and Survelllance
Local Level WaLer CuallLy 1esLlng CapaclLy uevelopmenL
Conc|us|on:
Arsenlcosls paLlenLs are reporLlng fewer soclal problems as awareness lncreases. AlLernaLlve
supply of safe waLer opLlons ls necessary for rapld expanslon of Lhelr use. CC, nCC and prlvaLe
secLor should be lnvolved comblng ln developlng of approprlaLe waLer supply opLlons.












Annexure:
Case SLudy-1
Lat|fa h|de herse|f from fam||y because of arsen|cos|s
LaLlfa 8egum (30) llves aL Coalpara of Shologhar unlon wlLh her husband Abdus SaLLer and elghL
son and daughLer. Shologhar ls Lhe one of mosL arsenlc affecLed area of Sreenagar upazlla
under Munshlgan[ dlsLrlcL. lor long Llme she used Lo drlnk arsenlc conLamlnaLed waLer. As a
house wlfe she musL sLay maxlmum Llme aL home and she has no alLernaLlve source of safe
waLer. Per flnanclal slLuaLlon ls noL so good. Maln lncome source of her famlly ls forelgn
currency earned by her son. She has no land for culLlvaLlon.
LaLlfa 8egum feels bad ln her body llke-skln leslons, patch areas of increased skin pigment,
scabies, feeling pain in whole body, weakness from last six month. She did not share with her
family member. Because, first time she thought it is normal scabies. When it increases day by
day she feels its not normal scabies but she did not share with her family member or others
person because of being neglected or ignored by family and society. When AMRF frontline staff
went to field visit to her area, she discusses with them about her present physical situation. At the
primary stage they identified her as an arsenicosis patient by symptoms, after that they referred
her to AMRF head office for doctor consultancy. Finally doctor identified that she is affected by
arsenic and prescribe her for treatment. At present she takes medicine regularly from AMRF as
well as AMRF staff follow-up to her regularly.
Last two years she drinks arsenic free water from deep tube-well. Whole year she can take
arsenic free water from deep tube-well except summer season due to inadequate water rather
than other season. Now she uses surface water for cooking as well as sallow tube-well for
washing and another purpose.
After affected by arsenicosis she faces some problem. Sometime she becomes unable to cook
and cannot stand and walk normally. That time she cannot do work for her family. Last year she
affected some disease like- fever, headache, cold beside of arsenicosis. At present she wants to
release from this disease and she also motivating other people for drinking safe water.









Case SLudy-1
Ioshna |ost her stream at fam||y and soc|ety because of arsen|cos|s
!oshna 8egum (23) llves ln a hardcore poor [olnL famlly wlLh her day labor husband Md. Saldul
lslam, she has Lwo chlldren, faLher-ln-law, moLher-ln-law and slsLer-ln-law. lrom her chlldhood
she llves ln souLh madanlmondol, Lhe mosL arsenlc affecLed area of Laohagonf upazlla under
Munshlgon[ dlsLrlcL. Per famlly use Lo drlnk arsenlc conLamlnaLed waLer from chlldhood. She
goL marrled elghL years before wlLh her nelghbor ln a resLrlcLed famlly. 1haL's why she has Lo
sLay aL home wlLhouL excepLlonal case. now her famlly has Lo Lransfer Lhelr house Lo nearesL
unlon kumarbhog because of adma 8rldge.
!oshna feels someLhlng bed ouL of her body llke leslons, patch areas of increased skin pigment,
scabies, pain in whole body, weakness, sleeplessness since five years after born of her first child.
Her mother also affected by same disease before her. For that reason, her father and mother-in-
law seems to its a disease by genetically spread to her so that her husband and other family
member can also be affected. Thats why her husband separated everything even pot, glass,
cloth, room from her. They did not take care of her and she always been neglected by family as
well as society. When AMRF frontline staff went to field visit to her area, she discusses with
them about her present physical condition. At primary stage they identified her as an arsenicosis
patient by symptoms, after that they referred her to AITAM (partner NGO of AMRF) for doctor
consultancy. Finally doctor identified that she is affected by arsenic and prescribe her for
treatment. After some days her mother also has come for treatment. At present both are taking
medicine regularly from AMRF as well as AMRF staff follow-up her regularly. Sometime
AMRF cannot distribute medicine, that time her family does not buy medicine for her. Last three
days ago she informed us that her mother-in-law also affected by arsenicosis. Primary stage
AMRF staff identified as arsenicosis patient and refers to AMRF head office.
Five years ago when she knows that arsenicosis is dangerous disease affected by arsenic
contaminated water, than she was trying to drink safe water. But she did not get safe water easily
because of unavailability of deep tube-wells. Now they collect safe water from neighbor home.
Some time they forbid to take water. Thats why they have to drink arsenic contaminated water.
Now she uses surface water for cooking as well as sallow tube-well for washing and another
purpose. Sometime she becomes unable to cook and cannot stand and walk normally. That time
she cannot do work properly for her family. For this reason her family member have done miss
behave with her and some time physical tortured by her husband. Now she wants to release from
this disease and she also motivating other people for drinking safe water.