Abstract

The German idiom verschlimmbesserung refers to an intervention that is made with the best intentions to solve a problem but ends up worsening the situation or creating new problems. Past efforts to improve the drinking water supply of Bangladesh are a classic example. Three decades ago, the people of this poverty-stricken country got their drinking water primarily from surface sources, which were often contaminated with fecal pathogens that caused diarrhea, cholera, typhoid, and other life-threatening diseases. In 1971, the United Nations Children’s Fund launched a campaign to drill hand-pumped tubewells into the Ganges Delta alluvium. Hailed as a public health coup, the effort led to a plummet in waterborne microbial diseases throughout Bangladesh. But in the mid-1990s, local physicians noted a steep increase in the incidence of arsenicosis and other arsenic-related diseases—a trend subsequently linked to the drinking of tubewell water naturally rich in the metalloid element. Now scientists at Columbia University have devised an approach that they believe could become part of an overall strategy to resolve the arsenic crisis in Bangladesh. Spearheaded by Alexander van Geen, a senior research scientist at the Lamont-Doherty Earth Observatory, Habibul Ahsan, an associate professor of epidemiology, and Joseph Graziano, associate dean of research at the Mailman School of Public Health, their proposed strategy includes the installation and monitoring of deep community wells in affected villages throughout Bangladesh. There is also a strong emphasis on training and organizing villagers at the community level to secure a source of safe water that is tailored to local needs. The proposed strategy grew out of field work and a well survey conducted through the university’s NIEHS Superfund Basic Research Program, of which Graziano is director. The program was established in 2000 to study the bioavailability, health effects, and geochemistry of arsenic and lead. Projects to date have included bioavailability and geochemistry studies at four Superfund sites, epidemiologic and geochemistry studies of arsenic in drinking water in Bangladesh, and the development of practical remediation strategies for arsenic in wastewater and drinking water.

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