Among the non- Government organizations, Dhaka Community Hospital (DCH) played the pioneering role in bringing the Arsenic issue into limelight. The doctors of DCH found several Arsenic patients when conduction annual health camp in Pakshi on July 3, 1996. The civil surgeon and local journalists were informed it instantly. And the DCH activities on Arsenic began through the incident. The following year, DCH conducted a number of surveys in the country to measure the extent of Arsenic contamination in Bangladesh. At first a survey was conducted in 21 villages of three districts. It by turns also carried out surveys in 64 districts, out of 60, in 1997. The surveys revealed high concentration of Arsenic in the 41 districts, now 54 districts out of 64 districts are affected by arsenic, report revealed on January 2001. Initially, the DCH alone had started the research.  Later it jointly worked with School of Environmental studies of Jadavpur University in Calcutta, especially in conducting the surveys.

The latest activities of the DCH is holding an international seminar on Arsenic and its prevention. The seminar, jointly organized by the DCH and SOES, was held in Dhaka on February 8-12,1998. More than 100 experts, physicians, scientists and environment workers were taking part in the five-day seminar.

Such a seminar by the DCH is not first of its kind. Earlier, it had held two national seminars, three international conference. The first one was held on January 6, 1997 in Dhaka while the second on March 27 in Pabna. Besides, DCH also organized nine more seminars on the issue.
 

DCH chairman with World Bank Team

Apart from carrying out surveys, arranging seminars, symposium and international conference on Arsenic pollution, the Dhaka Community Hospital undertaken various programs to make the people aware of the problem and train-up doctors and health workers.

Under the awareness building program, the DCH organized 1200 community meetings, conducted and training workshops for doctors, paramedics, health workers and NGO activists, and published many arsenic related books, articles,  newsletters and many leaflets on Arsenic pollution.

To combat this serious health problem, the DCH formed 'Arsenic Action Group' (AAG) comprising of scientists, physicians experts and social workers. Besides, various local and foreign organizations and Government institutions are involved in the AAG. These organizations in clued NIPSOM, Asia Arsenic Network, WHO, UNICEF, SOES, Caritas, Oxfam, Disaster Forum, CIDA, NGO Forum For Drinking Water Supply and Sanitation and Singer Bangladesh. To increase public awareness on Arsenic pollution, the AAG took initiative to build a cooperative social movement by exchanging information and keeping contact with various organizations.
 

DCH chairman with World Bank Team in the field

Besides the DCH has participated in meeting, seminars and symposiums organized under Government and non-Government initiative and presented their field-level experience on Arsenic pollution. A delegation of DCH attended the regional consultation meeting held in New in early 97. It was organized by WHO to review Arsenic pollution in Bangladesh and India and determine the required remedial steps. Prof. Quazi Quamruzzaman, the chairman of the DCH Trustee Board, led the DCH delegation at the meeting.

The DCH and Disaster forum jointly arranged the first ever-national seminar on 'Arsenic Disaster in Bangladesh': Two papers were presented in this seminar. One of these focused on the research and activities conducted by DCH on Arsenic-related issues and the other was on the latest situation of Arsenic pollution in Bangladesh and India.

Addressing as Chief Guest of the Seminar, health Secretary Muhammad Ali admitted that health and environment in Bangladesh. He said the Government attached great importance to the problem in order to resolve it. He urged the NGOS to work untidily with the Government to make people aware of the problem.

Analyzing the latest situation of Arsenic pollution in Bangladesh and India, director of SOES Dr. Dipankar Chakraborty said that the situation is much worse in Bangladesh compared to West Bengal.

A number of recommendations were formulated in the first daylong seminar. Some of these are mentioned below:

 1.   The level of Arsenic in the groundwater should be measured and the range of the affected area should be determined. Standard laboratories should be set up and the tube-well was being tested at regular intervals.
 

Water Collection for  Arsenic Testing

2.   The tube-wells in which the water contains abnormally high concentration of Arsenic should be given up and an alternative source of safe drinking water has to be arranged. In such a case, deep tube-wells may be installed. As long as Arsenic-free water is not available, the people of affected areas should be trained to boil water from rives, ponds and canals before drinking using a filter or innovating any other means of making the water Arsenic-free.

3.   Formulating and implementing awareness-building programs to motivate the people to refrain from drinking Arsenic-contaminated water.

4.   Reducing the indiscriminate use of groundwater and increasing the use of surface water. A national water policy may be formulated, if required, to ensure supply of Arsenic-free safe drinking water.

Before conducting country -wide survey on Arsenic pollution in Bangladesh, a four-member team of doctors and experts from DCH received training at the SOES of Jadavpur University, Calcutta. The team visited the SOES laboratory and the affected areas of West Bengal. The members also exchanged views with the affected people and shared experience with the doctors and experts there. Besides, 8 doctors from DCH received special training on the management of Arsenic patients in a training program organized by NIPSOM, a Government organization engaged in health- related activities.

The first survey of Arsenic pollution's solely conducted by the Dhaka Community Hospital while the follow-up surveys were arranged under the joint efforts of the DCH and SOES. The Director of SOES, Dr. Chakraborty visited Bangladesh 7 times in 1996 and 1997 to participate in the surveys and other Arsenic-related activities of the DCH. A part from the DCH, various government and non-Government organizations implemented joint programs with the SOES.

During October 12-15,1996, the DCH carried out the first survey of identification of Arsenic pollution. A ten-member team of doctors and experts from DCH conducted survey in 21 village -12 from Pabna, 8 from Kushtia and 1 from Meherpur district. They examined 930 people suffering from skin diseases and identified 150 of them as victims of Arsenic poisoning.

They collected 74 samples of nails, 74 samples of hair, 65 of skin-scales, 63 of urine and 27 of tube-well water. After testing in the laboratory, 70 nails (95%), 71 hair (96%) 59 urine (94%) and 27 samples (66%) of tube-well water were found containing abnormally high concentration of Arsenic. Each and every samples of skin-scales were found containing Arsenic more than the normal value.

If was also found that the urine of 28 percent affected people contains 100-1500 times higher than the normal level of Arsenic. The nails of 47 percent people contains 8-20 times more Arsenic, skins of 98 percent people contains 100 times more Arsenic and 20 percent water samples contains 100-900 times more Arsenic.

The DCH formally announced the results of the survey through a press conference of November 26, 1996. The countrymen for the first time came to know about the Arsenic pollution from an institutional source. The DCH initially sought help from Bangladesh Council for Scientific and Industrial research for testing the samples. But as the fees were high, the DCH contacted with the SOES and tested the samples in their modern laboratory at lower cost. Thus a joint venture of the DCH and SOES was initiated regarding research of Arsenic pollution.
 

The joint Surveys of DCH-SOES

After publishing the results of its first survey, the Dhaka Community Hospital revealed the fact of possible Arsenic pollution in 53 districts of the country. A large number of Arsenic patients have already been found in these districts. On the basis of this fact, the DCH decided to conduct extensive survey in these 20 districts. At this stage, the DCH in collaboration with the SOES started survey in 14 districts to identify Arsenic patients and test water. They had a plan to conduct the survey in all the 20 districts, but due to time constraint, they reduced the number of districts to 14. This was the first joint survey of the DCH and the SOES. Director of the SOES Dr. Dipankar Chakraborty and a 19-member team of skin specialists took part in the survey.
 

RAP Team

A total of 1066 adult skin patients from 45 villages were examined under the survey conducted from December 20, 1996 to January 5, 1997. Of the total, 63 percent or 673 patients were identified as Arsenic patients. Some 561 of the total examined patients found affected with Arsenic related diseases. The number of examined women was 505, of which 295 were identified as Arsenic patients.

Samples of nail, hair, skin-scales and urine of the patients were collected in the survey. Later samples of drinking water were also collected and examined. The 14 districts that were brought under the survey were Pabna, Kushtia, Faridpur, Rajbari, Gopalganj, Bagerhat, Khulna, Jessore, Magura, Meherpur, Chuadanga, Chandpur, Luxmipur, and Noakhali. The survey revealed that the most affected districts are Luxmipur, Chandpur, Jessore, Faridpur, Kushtia and Pabna. And then all districts are covered.

The third survey was conducted in 24 districts. It was jointly conducted by the DCH and SOES and also participated by the NIPSOM and the Geology Department of Rajshahi University. The results of the survey were published through a press conference in late December of 1996. The results of the survey were published through a press conference in late December of 1996. The results showed that 19 out of the 24 districts were affected with Arsenic pollution and about 20 million people of these districts were at the risk of being affected wither Arsenical diseases. Tube-well water of four districts contains Arsenic below the WHO recommended value (0.01 mg/l). Arsenic less than the maximum permissible level (0.05 mg/l) was found in the water of only one district. In the rest 19 districts, Arsenic was found between the level of 0.05 mg/l and 2.9 mg/l. Under the survey, samples of 1343 tube-well water, 214 hair, 222 nails, 118 skin-scales and 26 urine were tested. Besides, 400 skin disease patients were examined and identified as victims of Arsenic poisoning.

In June, 1997, the DCH and SOES published the results of the survey conducted 28 of the 34 suspected districts. On the basis of geological similarities between Bangladesh and West Bengal, the SOES earlier suspected that the 34 districts of Bangladesh might be affected with Arsenic pollution. Announcing the results of the survey, the expert team of DCH and SOES said Arsenic of above the maximum permissible limit was found in the water of all the 28 districts except one and about 35 million people of these districts were at the risk of Arsenic pollution. Water from a total of 3577 tube-wells were examined in the survey. Of the total, 1341 (37.49%) tube-wells WHO recommended value. That means water of these tube-wells were safe. The concentration of Arsenic in 645 tube-wells was between 0.01 mg/l and 0.049 mg/l. Water of the rest 1591 tube-wells was not suitable for drinking due to the presence of Arsenic above the level of maximum permissible limit. One of the mentionable aspects is, such a high level of Arsenic in the water of such a large number of tube-wells was not found earlier in any other survey. Some 62 samples under the survey contained Arsenic above the level of 1.0 mg/l, 88 contained 0.70 to 0.99 mg/l and 130 contained 0.05 to 0.699 mg/l. This survey proved that Luxmipur is the most affected district of the country. Besides water samples, 1471 hair, 1474 nails and 606 urine samples were analyzed in the survey Of them, 90 percent hair, 98 percent nail and 96 percent urine samples were found containing abnormally high level of Arsenic. Some 100 skin-scales samples were tested in the survey and all were found with high level of Arsenic. Survey was conducted among the skin patients of 20 out of the 27 districts identified as Arsenic affected. Arsenic patients were found in 18 districts. Some 1630 persons including children were examined in the survey conducted in 45 villages of the 18 districts. Fifty eight percent of the examined patients were found with symptoms of Arsenic poisoning.

Later, the DCH and SOES jointly conducted some more survey across the country. Of those the first one was conducted in 33 districts, the second in 41 districts, the third in 58 districts and the last one in 64 districts. The results of the last survey were published at the end of 1999. It showed that 54 districts out of 64 affected with Arsenic pollution. Apart from these broad-base surveys, the DCH and SOES conducted an extensive survey at village Samta in sharsha thana of Jessore district.