TRENDS IN KNOWLEDGE OF ARSENICOSIS AND WATER USAGE IN BANGLADESH

Abstract

Background The presence of arsenic in tubewell water has been identified as a major health problem in Bagladesh. The Bangladesh Government with international assistance is attempting to mitigate the effects of arsenic by a major program of tubewell water testing and education about arsenic and how its ingestion can be avoided. In early 2000 the first unbiased truly random national survey of water use in Bangladesh found that knowledge of arsenicosis remained low, tubewell water remained the dominant source of rural water and that 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. Methodology The 2000 survey conducted interviews with respondents in 3,780 households containing 20,260 individuals (Caldwell et al. 2003; Caldwell et al. forthcoming). It used a random sub-sample of the 1996/7 Bangladesh Demographic and Health Survey, with a sample 42 households selected from 15 villages drawn from each of the country's six divisions. Fifty percent of interviews were conducted with each of male and female respondents. The 2002 survey involved revisits to a 25% random sample of the earlier sample. The participation rate was 97% in both surveys. Findings Awareness that there might be something wrong with tubewell water had risen markedly, especially among women respondents. In the 2000 survey, 20.6% of males and 11.3% females had heard about arsenic. In 2002, 59.7% of men and a remarkable 60.2% of women had done so. The revisit indicated that the NGOs had played the major role in disseminating this information, especially to women. However, the proportion reporting that they were teating their water to prevent arsenic had remained at 2%. Most respondents did not perceive themselves to be at risk. The proportion not treating their water because they did not think their well had arsenic more than doubled from 15.0% to 31.1% amongst men and 13.4% to 36.4% amongst women. Some but not all of these had their well tested. The major reason for not using tubewell water remained a lack of knowledge of what to do—over 50% in both surveys amongst both men and women. Conclusions The information campaign is making headway but a major concern remains a lack of change in water usage and specifically the adoption of methods to reduce the ingestion of arsenic or a move towards using tested tubewells known to be safe. Where this is based upon knowledge that the household well has been tested is safe this is to be welcomed but in many instances it appears to be based upon false confidence in the safety of the household tubewell and continuing uncertainty about the best way of responding to the problem.