DCH is the pioneer organization in the field of Arsenic contamination in Bangladesh. It really deserves the sole credit for highlight the serious health hazards caused by arsenic contamination in ground water. DCH has implemented deferent kinds of safe water options like River Sands Filter (RSF), Rain Water Harvesting, Dug-well, Water Quality Test etc. About 100000 people are getting arsenic free safe water in arsenic affected areas of Bangladesh. In addition DCH has implemented the following programme on Arsenic Mitigation and Safe Water
1. 500 Villages Rapid Assessment Project
Ministry of Health and Family Welfare & UNDP Financial Survey
DCH community Hospital has completed first house to house arsenic testing and family screening in 500 villages of 29 districts under the project of Ministry of Health and Family Welfare funded by UNDP. The objectives of the screening program was to test all the tube-wells in the selected villages, to identify safe and hazardous well and mark them red or green accordingly, and to identify arsenic patients. It was also required that village maps were prepared and locations of tube-wells reproduced on these maps. Tube-well and health related data were to be collected using pre-tested questionnaire. It was also expected that the results of the findings would be shared with villagers along with appropriate messages on how to address the arsenic problem. The program was divided into two phases.
Phase I: In the first phase of the program, 21 districts were selected from where reports of cases of arsenicosis were available from existing database. From these districts, 200 villages were selected based on reports of existence of contaminated tube-wells from any known source. The program involved 15 teams to carry out the field activities. Each team comprised of three groups: initial screening group, water-quality testing group and health group. The initial screening group and the water quality testing group each had five workers. The health group consisted of nine members. There was one coordinator for supervising the work.
Phase II: With the same criteria of selection, the second phase expended the program to a further 300 villages selected from eight new and earlier 21 districts, the criteria of selection remaining the same. The field staff was divided into four groups with each group having one medical officer, one mapper, one monitoring officer and one field coordinator. Each group was divided into four teams. Each team had two water testers, three health workers and one supervisor. The field staff also included one dermatologist and one field coordinator. There was one coordinator in charge of overall supervision.
A summary of UNDP funded Emergency Arsenic Mitigation Project in 500 villages:
|Total number of Districts||29|
|Total number of Thanas||68|
|Total number of Unions||108|
|Total number of Villages||497||Incomplete or missing data in 3 villages|
|Total number of Families||177,842||In 497 villages|
|Total Population||818,924||In 497 villages|
|Total number of Tube wells||62,782||In 497 villages|
|Population per TW||13||In 497 villages|
|Number of tested TWs||61,631 (98.17%)||% out of total TWs in 497 villages|
|Number of Damaged TWs||1,151 (1.83%)||% out of total TWs in 497 villages|
|Number of TW found Arsenic Positive||32,154 (52.17%)||% out of total tested TWs in 497 villages|
|Number of TW found Arsenic Negative||29,477 (47.83%)||% out of total tested TWs in 497 villages|
|GOB installed TWs||6,636 (10.57%)||% out of total TWs in 497 villages|
|NGO & privately installed TWs||56,146 (89.43%)||% out of total TWs in 497 villages|
|Total number of Patients||2,327 (0.28%)||% out of total pop. in 497 villages|
|Male||1,373 (59.00%)||% out of total patient in 497 villages|
|Female||791 (33.99%)||% out of total patient in 497 villages|
|Children||163 (9.05%)||% out of total patient in 197 villages only|
|Patient/1000 population||2.81||In 497 villages|
|Total Population at risk||459,833 (56.15%)||% out of total pop. in 497 villages|
|Number of villagers with >50 patients||12(2.41%)||% out of 497 villages|
|Number of villagers with 21-50 patients||20(4.02%)||% out of 497 villages|
|Number of villagers with 1-20 patients||155(31.19%)||% out of 497 villages|
|Number of villagers with 0 patients||310 (62.37%)||% out of 497 villages|
2. Action Research on Community Based Arsenic Mitigation in Bera Upazila
(Under 5 upazila UNICEF-DPHE)
Dhaka Community Hospital has implemented an integrated arsenic mitigation project in Bera Upazialla of Pabna District supported by DPHE-UNICEF. The testing and marking all tube wells, the arsenicosis identification and the long term management, rehabilitation and installation of alternative safe water options and water quality monitor, awareness building and community mobilization are the major activities of the project.
In Bera Upazilla DCH has tested all TWs using field test kits and has found that 51.5% of the hand tubewells were contaminated. 60 % tube wells have been sank during last 5 years and 53 % tube has got depth between 25 to 60 feet. DCH has installed and was continuing install alternative safe water options. The options include Pond Sand Filter, Rain Water Harvesting (cum Sand Filter), Dug wells, Pitcher filter (Kalshi and Chari)
Water quality tests, e.g. bacterial count and the arsenic concentration following introduction of these options have been carried outdone periodically with field test kits and with the laboratory. The test results have all been communicated to the tube well users. The water qualities of the alternative sources have been found in safe level for drinking and cooking.
In the project, DCH has identified arsenicosis by screening all members of all families in Bera Upazilla. The initial identification of arsenicosis patients was done by skin manifestation and was then confirmed by testing patient’s urine, nail and blood samples. DCH identified 120 patients. Out of them children are 20 %. The Male is 50.8% and female is 49.2%
The patients were being treated by providing arsenic free safe water and vitamins, both of which are closely monitored. 21 serious arsenicosis patients from Bera have been treated in the DCH Hospital.
Regular village meetings are going on with the Bera communities to inform them about arsenic as a health hazard and sensitize them to alternative safe water options and personal hygiene education.
3. Community Based Safe Water supply and Arsenic Mitigation project in Sirajdikhan Upazila
Supported by UNICEF-DPHE
DCH has done arsenic mitigation project Sirajdikhan Upazila of Munshiganj district supported by DPHE-UNICEF. There were 182 villages with a population of 2,72,000 comprising 49,475 families. The purpose of this project was to provide safe drinking water by conducted the following things –
Selection of priority communities, provision of technical advise on alternative water supply technologies (with emphasis on gender considerations) and community selection of appropriate technologies, training on construction of alternative safe water technologiesm construction or distribution of alternative water supply technologies training for caretakers on alternative water supply technology
The major activities were: community involvement, community awareness, community meeting, committee formation, upazila coordination meeting ,selection of appropriate technology, situation analysis and need assessment, site selection, training of mistri, Caretaker and User, installation of option (Dugwell, Pond Sand Filter , Rain water harvesting) and monitoring.
4. ‘Community Based Arsenic Mitigation Project’ in Muktagachha Upazila
Supported by UNICEF-DPHE
In collaboration with DPHE and UNICEF, Dhaka Community Hospital implemented ‘Community Based Arsenic Mitigation Project’ in all the villages of Muktagachha Upazila of Mymensingh. Major activities of this project:
- Hold District, Upazila and Union level briefing workshop with diffident govt. official, local chairman and civil society
- Form Upazilla, Union and Word arsenic mitigation committee (according to GoB guideline)
- Selection of Field Worker from the local areas ( 2 from each word)
- Training to
- Field workers for tubewell testing, mapping, communication campaign, community mobilization
- GoB field level workers (Health, DPHE, Agri. Ext.) and School Teacher, Imam etc. for Communication campaign
- Test and mark (red and green) all tube wells & family survey
- Prepare village resource map including water sources
- Hold village meeting
- Form Village Arsenic Mitigation Committee (VAMC)
- Provide technical advise on alternative safe water supply technologies and ensure the participation of community members in selection of alternative sources /options for arsenic-safe safe drinking water
- Aware communities about arsenic hazard (house to house and community level)
- Coordination among GoB, Local representatives, NGOs, civil societies etc.
Hold lessons learnt workshops at Upazilla and National level for Information dissemination.
5. Arsenic Contamination Assessment of Tube well water
Supported by CARE- Bangladesh.
Dhaka Community Hospital has implemented a project onArsenic Contamination Assessment of Tube well water’ in 2 project areas of Integrated Food Security Program of CARE- Bangladesh. The project was funded by CARE- Bangladesh. The project areas are in 10 districts. SHAHAR areas are in 4 district town and FFP areas are in 6 districts
The SHAHAR project areas were – Tungi ( Gazipur ), Dinajpur, Mymenshing and Jessore.
The FFP project areas were- 222 villages of Kurigram sader, Nagaswari, Rowmari, Rajibpur of Kurigam district, Sagahat and Fulchari of Gaibandha district,Sariakandi of Bogra district , Dherai of Sunamganj district Karimganj and Nikli of Keshorganj district Mohonganj of Netrakona district.
The testing and marking of all tube wells of the project areas, awareness building on health hazard of arsenic poisoning, providing information about available alternative safe water sources and community mobilization were the major activities of the project.
6. Social Acceptance and economic Viability of Alternative Safe Water Options in Some Selected Arsenic Affected Areas of Bangladesh’
Funded by WHO
Dhaka Community Hospital has implemented a project entitled ‘Social Acceptance and economic viability of Alternative Safe Water Options in Some Selected Arsenic Affected Areas of Bangladesh’ jointly WHO. The study of the project included 230Dugwells, 1132 Rain Water Harvestings, 20 Pond Sand Filters and 5 River Sand Filter from 4 Upazilas (Sirajdikhan, Laksham, Muradnager and Bera Upazilas of Munshiganj, Comilla and Pabna districts).
The purpose of the study is to ascertain the social acceptance and economic viability of alternative safe water options which were promoted in arsenic affected areas in Bangladesh.
Methodology: i. A social acceptance and economic viability study was based on a open ended questionnaire survey
ii.10% of all the option users as respondents. The total sample sizes were 674 households.
iii. 5% excess sample was taken to probabilities of data missing. So the final sample size will be 707households.
Determination of sample size:
[RWH: Family coverage 1132, 10% = 113, DW: Family coverage 4600, 10% = 460, PSF: Family coverage 510, 10% = 51, RSF: Family coverage 500, 10%=50]
iv. Water Quality Test: During survey we collected 10% water sample for water quality test from 113 RWH, 23 DW, 2 PSF, 1 RSF done according to protocol.
The project successfully achieved its implementation targets on time.
7. Water Safety Plan Pilot Project’ in Sirajdikhan Upazila of Munsiganj and Bera, Shathia, Sujanager Upazilas of Pabna District.
Funded by DFID-B
Dhaka Community Hospital has implemented a project entitled “Water Safety Plan Pilot Project (Action Research)” with DFID-APSU. The study of the project included 20Dugwells, 10 Rain Water Harvestings, 4 Pond Sand Filters and 1 River Sand Filter from 4 Upazilas (Bera , Santhia, Sujanager in Pabna District and Sirajdhikhan Upazila in Mushigonj District).
The study aims to understand how risks could most effectively managed and promoted water safety in arsenic affected areas in Bangladesh. The study finding covers the water quality, sanitary integrity study and health risk assessment.
Project activities included:
- Reviewing the water safety plans developed at the workshop and suggestion any improvements or changes based on field condition.
- Selection of project area covering the Sirajdikhan upazila under the Munsiganj district and Bara, Santhia, Sujanager upazila under the Pabna district. Sirajdikhan upazila covers 1 River Sand Filter (RSF), 4 Pond Sand Filters (PSF), 10 Dug Wells (DW) and 10 Rain Water Harvestings (RWH) and Bara upazila covers 10 Dug Wells (DW)
- Committee formation
- Improvement of inspection tools, inspection sheets and monitoring record if required
- Undertaking water quality and sanitary condition baseline assessment of water supplies in selected communities.
- Conduction of refresher training with community caretaker and committee on water supply operation, maintenance, monitoring and use of sanitary inspection tools being developed by APSU.
The project successfully achieved its implementation targets on time.
8. Safe drinking water supply through pipe line from dug-well and surface water in rural areas
[Ministry of environment and forest – SEMP]
DCH has completed the household survey, testing of tube-well’s water, marking and mapping of the tube-wells, identified of arsenic patients, local government capacity build up and community awareness build up in target area.
Major activities of this preoject were Identification of the community, Community/Group formation, Finalization/approval of sites ,Training of masons/mechanics, Promotion of sanitation and hygiene, Construction work quality monitoring/supervision, Water quality testing and monitoring, Develop a rural health center, Community capacity building, Caretaker training, Pre-final acceptance inspection, Formal handing over of water options to the respective communities, Post installation follow up.
9 .Bangladesh- Australia Centre for Arsenic Mitigation project:
Supported by AusAID, Australia
This was AusAID funded project Implemented by Dhaka Community Hospital, Associated with GHD, CSIRO, CRC and South Australia University (Australia). There were 4 components of the project, which were implemented in different parts of Bangladesh to mitigate the arsenic problem.
Program 1: Establish the Bangladesh Australia Centre for Arsenic Mitigation
To establish a Centre for Arsenic Mitigation in Bangladesh which was set up at Dhaka Community Hospital (DCH), and capable of providing professional ongoing advice on safe water and food, human health and well being to arsenic affected communities through Resource Centre.
Program 2: Safe Clean Water
To determine the most appropriate treatment methods or alternative water supply options (surface water/rainwater) for providing safe drinking water and establish their application more widely.
Program 3: Safe Food
To establish a program which enabled the Government of Bangladesh to obtain a better understanding of the potential for exposure to arsenic via the food channel, the significance of this exposure, and the strategies that should be adopted at the village level to reduce the risk associated with this exposure.
Program 4: Community Health Education
To develop and implement Community Health Education System in conjunction with the local communities.
10. Analyzing the socio-economic conditions for the implementation and maintenance of Arsenic risk mitigation measures
Swiss Federal Institute of Aquatic Science and Technology (Eawag), Switzerland
Dhaka Community Hospital conducted a survey as a part of a multidisciplinary research project initiated by the Swiss Federal Institute of Aquatic Science and Technology (Eawag), Switzerland. The outcome of this survey was help to develop a framework for mitigation of geogenic contaminants.
The main objective of this household survey is to identify and analyze household level socio-economic conditions, drinking and other water usage patterns and their relationship with a household’s ability and willingness to pay for arsenic free drinking water. This survey was also identify the household level stockholder’s preferences for a particular mitigation option and any current constraints preventing the adoption of any arsenic mitigation options
During the Survey activities we found that many people were using arsenic contaminated tube-well water for drinking and cooking purpose. Majority of the population of the survey area were awarded about arsenic contamination in tube-well water. But they were drinking and cooking with arsenic contaminated water due to availability of safe water option, habituated with tube-well water use, lack motivation and training to change the habituate to use safe water options like rainwater harvest, dug-well, RSF and PSF etc. and limitation on arsenic removal filter and deep tube-well. Implementing areas: Sirajdikhan (6 Village), Munshigonj, Sujanagar (3 village), Pabna ,Ishwardi (1 Village) Pabna, Laksam (3 village), Comilla.
13. Wilson Arsenic Mitigation Prorame:
Arsenic Foundation INC
DCH has implemented on arsenic mitigation programme with financial assistance from Prof. Richard Wilson, Department of Physics, Harvard University, USA. Under this programme total 66 dug well (renovated & installed) with pipeline network installed and 1418 families 7632 Population are getting arsenic free safe water. Almost 126 arsenicosis patients are gradually improving by drinking safe water. This program was working at three phases.
Phase-1 Renovated & Installed 39 DW (1 with pipe line system)and covered 631 families Serving 3250 users
Phase 2 Installed 17 DW (with pipe line system ) and covered 518 families Serving 2903 users
Phase 3 Renovated 9 DW & newly installation of 1DW(with pipe line system) and covered 269 families serving 1479 users
The project successfully achieved its implementation targets of sixty-six dug wells and pipe networks in Harvard project area in Pabna district, on time. There was a very positive community attitude to seeking alternative water options. The community supported the project and project personnel throughout the implementation period. Each committee decided on a contribution of 20 Tk. per household per month from the community and the caretakers are collecting this. The money is used for maintenance and electricity charges for the pump. Each committee has taken responsibility for maintaining the option. The water column in dug wells at the driest period was 6 to 8 feet. This amount is sufficient to serve the communities.
Wilson Arsenic Mitigation Program : River Sand Filter (RSF)
Under this programme we provide arsenic free safe water to the community of arsenic affected area. DCH has installed 6 River Sand Filters with pipe line system in Sirajdikhan upazila. The objectives of the programme are:
To share with policy makers, researchers, donors & investors who are engaged or interested in providing arsenic free drinking water, on our experience and learning from the alternative water option, To spread all over the country by accepting as a model from the success of this program of the alternative water option.
10. Piped Water Supply System from River Sand Filter for Shushunda Village along with Health & Hygiene Education
Supported by Mercy-Malaysia
Dhaka Community Hospital (DCH) made a survey on Arsenic in 2001. About 99% tube-wells were found arsenic contaminated and about 150 arsenic patients were diagnose in Shushunda village After this DCH implemented some arsenic mitigation, patient management and awareness programme from its own fund and there were some government mitigation as well. But it was not sufficient and they had to manage by themselves. In February 2012 DCH did another survey and found majority of the tube-well are arsenic contaminated and huge number of patients are increased. Before implementation of RSF in Shushunda village there was no arsenic free safe water option. So DCH and Mercy Malaysia selected this village for installation of RSF.
To supply arsenic, chemical and bacteria free safe water to the community through piped water supply system of River Sand Filter at an affordable cost for drinking and cooking purposes in arsenic affected village.
To provide medication and skin ointment for 350 arsenicosis patient for a year to reduces symptoms of arsenicosis among the villagers.
Project Activities and Outputs
|Selection of site & beneficiaries; area mapping of the pipeline network Drawing & design of RSF unit||A functioning RSF unit installed at Shushunda Village30 tap points installed to deliver water directly to household level. This reduces safety risk of young children and women who collect water up to 3 times and as much as 80 litres a dayAverage 5 families are included in one tap point. The RSF unit is currently supplying filtered water to 130 families (equivalent to 650 people) through the 30 tap pointsAnother 350 to 400 community members from nearby villages fetches water directly from the unit through the 3tap outlets availableHence in total, the RSF is currently serving the drinking water needs of more than 1000 people each day|
|Mobilisation of community members by formation of a Management Committee & training of a caretaker Formal hand-over of the RSF unit to the Management Committee||A Management Committee, consisting of female and male community members and a caretaker were appointed amongst the community membersThis structure is established to inculcate sense of ownership and increase sustainability of the project200 Taka is collected from each tap point (where 5 families are involve in one tap point) each month for caretaker allowance, electricity charges and general maintenance of the unit|
|Water quality testing||The 2 rounds of water testing conducted recorded results within the permissible levelTests conducted were pH, fecal coliform, total coliform, arsenic, turbidity, conductivity and Total Dissolved Solid (TDS)|
|Arsenic patient management||Salicylic acid and multivitamins are distributed to 150 confirmed arsenic patients in Shushunda VillageThe distribution has been conducted since January 2013 and will be done until December 2013|
|Continuous monitoring and evaluation (M&E)||M&E related documents prepared for the project as follows: – Background of DCH and MM – Management Committee members and their tasks – Selection criteria – Beneficiary list – Contact details of the relevant staff (both MM, DCH HQ and field staff) – Complaints Form and Suggestion Box These information is displayed at the village bazaar (market) and at the Shushunda RSF Unite|
11. Arsenic Mitigition Project
Supported by MERCY Malaysia (MM)
Arsenic Mitigation Project:
MERCY Malaysia is working on an Arsenic Mitigation Project in the village of Kabarikhola, Bangladesh, which aims to provide publicly accessible safe and arsenic-free water. The project features a man-made well locally referred to as Indara, which is a community-based safe-water option. This involves renovating the well and supplying safe arsenic-free water to households through an extensive pipeline network. This project is a collaboration of MERCY Malaysia and the Dhaka Community Hospital.
12. Rain Water Harvesting (RWH) Programme
Supported by MERCY Malaysia (MM)
DCH has implemented the RWH programme to provide arsenic-free safe water to households of the underprivileged people of Ruppur, Kabarikhola, Ratangonj and Jadupur Pabna in collaboration with MERCY Malaysia. 180 RWH preservers have been installed in villages which include Ruppur, Kabarikhola, Ratangonj and Jadupur. About 400 families are benefitting from this programme. The overall cost of one RWH preserver is estimated at BDT Tk 30,000.00 which is about USD400. The preservers are given free of charge, however, users need to pay their own maintenance cost. There are very positive community attitude to seeking alternative water options. At the household level the community has accepted RWH as an alternative to the arsenic contaminated tube well. The community is supportive of the RWH project. The caretaker keeps records of incidences of diarrhoea amongst the beneficiaries of RWH. The RWH is very high in efficiency in the turbidity of arsenic affected communities.