Trends in Water Usage and Knowledge of Arsenicosis in Bangladesh: Findings from Successive National Surveys

The presence of arsenic in tubewell water has been identified as a major health problem in Bangladesh. The Bangladesh Government, with international assistance, is attempting to mitigate the effects of arsenic by a major programme of tubewell water testing and education about arsenic and how its ingestion can be avoided. In early 2000 the first nationally representative cluster sample survey of water use in Bangladesh found that knowledge of arsenicosis remained low, tubewell water remained the dominant source of rural water, and few people knew if their tubewell was safe from arsenic contamination or alternatively treated it for arsenic. This paper reports on a follow-up survey of the earlier study population to determine change over two years, and thus for the first time allows a measure of change at the national level. Awareness that there might be something wrong with tubewell water had risen markedly, especially among women respondents. However, there had been only a minor increase in the proportion reporting that they had changed water sources. This indicates a lack of a clear message about the risks involved, and about how to respond to the problem. The health authorities lack good information as to the real dangers involved, and the most appropriate interventions, both in technical terms and in terms of economic and social acceptability. In the absence of such information, the most effective strategy may be to promote more rapid testing of wells and to encourage people to switch wells