Rwanda must create an additional 200,000 jobs per year to absorb its expanding population. Increasing exports could play an important role in achieving this goal. A new policy brief by the IGC outlines the challenges Rwanda needs to overcome to improve its trade balances

Kumar Singh, Chander

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22/06/2017 Reducing Poisoning by Arsenic in Tubewell Water - IGChttp://www.theigc.org/blog/reducing-poisoning-by-arsenic-in-tubewell-water/ 1/5Authors Chander KumarSinghAssistant ProfessorTERI University Alexander VanGeenResearch ProfessorColumbia UniversityPublished on: 11 Mar 2014Countries: Bangladesh, India - BiharResearch themes: Energy Reducing Poisoning by Arsenic inTubewell WaterMillions of tubewells across the Indo-Gangetic plain supplydrinking water that is relatively free of microbial contaminants.However, many of these tubewells tap groundwater that is highin arsenic and should be used only for washing. This columnexplores a new approach to field testing in order to distinguishsafe from unsafe wells, and suggests that people are willing topay for tubewell testing.The number of tubewells installed in the soft sediments of theIndo-Gangetic plain and similar low-lying environments acrossSouth and Southeast Asia has grown exponentially over the pastfew decades. The boom was triggered by the availability ofinexpensive PVC pipes and early installations supported bydonors and non-governmental organisations (NGO) in order toreduce infant mortality. Most tubewells used today, however,were each commissioned privately by a few households poolingtheir resources to pay the equivalent of $50-150 for access towhat was long held to be safe drinking water.A large study conducted in Bangladesh has shown that drinkinggroundwater containing arsenic concentrations an order ofmagnitude higher than the current World Health Organization(WHO) guideline of 10 microgram per liter doubles all-causedeaths, primarily due to cardio-vascular disease (Argos et al.2010, Chen et al., 2011). Arsenic in tubewell water has alsobeen associated with increased infant mortality and impairedintellectual and motor function in children (Wasserman et al.2004, Rahman et al. 2010, Parvez et al. 2011). Exposure toarsenic causes various cancers (Smith et al. 2000) and has beenassociated with a significant drop in household income inBangladesh (Pitt et al. 2012).Household responses to informationMuch of the exposure to arsenic across South and SoutheastAsia is avoidable. Several blanket surveys combined with morelimited monitoring have demonstrated that the distribution ofarsenic in groundwater is highly variable spatially, even with asingle village, but typically stable through time. Within an areaof Bangladesh where half of 5,000 tubewells are unsafe, almost90% of households live within 100 meters of a safe well (vanGeen et al. 2002). Spatial variability therefore makes it harderto distinguish safe and unsafe wells but also represents anopportunity for households to share the subset of safe wells.In response to well testing, between one-third and two-thirds ofhouseholds with an unsafe well have switched theirconsumption to a neighbouring well (Ahmed et al. 2006, Chen22/06/2017 Reducing Poisoning by Arsenic in Tubewell Water - IGChttp://www.theigc.org/blog/reducing-poisoning-by-arsenic-in-tubewell-water/ 2/5consumption to a neighbouring well (Ahmed et al. 2006, Chenet al. 2007, Opar et al. 2007, Madajewizcz et al. 2007, Bennearet al. 2012, George et al. 2012a, Inauen et al. 2013). Switchingbetween existing wells is therefore a promising option in theshort term, while longer-term solutions continue to beinvestigated. Treating groundwater for arsenic at the householdor village-level is a logistically much more complex option thantesting and well-switching and, despite typically higher visibilityin the development community and the media, has had littleimpact (Ahmed et al 2006).The need for field-kit testingThe latest generation of field kits readily distinguishes thesubset of wells within a village that can be used for drinkingand cooking from those suitable only for washing (George et al.2012b). Field-kit testing is vastly preferable to laboratorytesting because the results can be communicated directly to thehouseholds.The problem is that the drilling of new wells continuesunabated and there currently is no financial incentive for testingnew wells. Even in areas where a blanket survey has beenconducted within the past decade, a majority of households donot know the status of their well because it has been installedmore recently and never been tested (George et al. 2012a).Testing for a feeIn a recent intervention in the state of Bihar supported by theInternational Growth Center (IGC), we explored a semi-commercial approach to testing that could potentially reducethe proportion of untested wells in use. Young graduates from alocal university were trained to deploy the ITS Econo-QuickArsenic kit (George et al. 2012b) and to enter data, along withadditional well and household information, directly on a hand-held Global Positioning System (GPS) receiver. 26 small- tomedium-sized villages within a 250 sq. km. arsenic-affected areasouth of the Ganges River were selected for the study. Thevillages were randomly divided in five groups where field testingwas offered to individual households at prices of Rs. 10, 20, 30,40, 50 / test (approximately $0.20-1/ test), respectively.When reaching a village for the first time, testers displayed abillboard-sized map of that village generated in Google Earth toattract attention (Figure 1). A public-health message describingthe risks of drinking high-arsenic groundwater was deliveredand a second map showing the mixed distribution of arsenic ina neighbouring village was shown. The testers then announcedthat they were going to offer to test wells at a given price overthe next several days by going door-to-door through the village.The testers also asked if there were any community wellsassociated with a school, temple, or mosque and typically testedthose sources first.Figure 1. Display of test results from neighboring village with amap produced in Google Earth22/06/2017 Reducing Poisoning by Arsenic in Tubewell Water - IGChttp://www.theigc.org/blog/reducing-poisoning-by-arsenic-in-tubewell-water/ 3/5Test results were attached to each pumphead with a metalplacard colored red (>50 ug/L arsenic), green (>10-50 ug/L), orblue (<10 ug/L) to categorise wells relative to the nationalstandard for arsenic at the time of 50 ug/L and the WHOguideline of 10 ug/L (Rajiv Gandhi National Rural DrinkingWater Mission, Government of India has since matched itsstandard for arsenic in drinking water to the WHO guideline).After the testing was completed, a new Google Earth mapshowing the test results was posted at a central location in eachvillage (the position of the wells was jittered by 20-40 m inorder to limit the identification of specific households).Figure 2 Metal placards with test results attached to pumpheadOf the 1,804 households that could be contacted, 1,195 agreedto have their well tested for a fee. Blue, green, and red placardswere attached to 63%, 17%, and 20% of the tested wellsrespectively. Only 28 households claimed to know the status oftheir well even though this area has repeatedly been the subjectof research and press coverage. When disaggregated to thevillage level, the data show that the proportion of householdsbuying a test gradually declined as the price increased, even ifthis proportion also varied at any given price by +20% fromone village to the other (Figure 3).Figure 3 Relationship between demand for testing for each ofthe 26 villages and price charged22/06/2017 Reducing Poisoning by Arsenic in Tubewell Water - IGChttp://www.theigc.org/blog/reducing-poisoning-by-arsenic-in-tubewell-water/ 4/5Implications for policyThis intervention demonstrated that there is a market to havetubewells tested for arsenic. The 20 Rs price that more thantwo-thirds of households in a village were willing to pay wouldbe sufficient to cover the salary and transportation of a testerwith secondary education, assuming 10-20 wells are tested in aday. However, the generated income would not be sufficient tocover the estimated total cost of testing when quality-control bya supervisor, a durable metal placard with the test result, kitsupplies, and a GPS unit of 100-150 Rs/ test ($2-3) areincluded. These additional costs would therefore have to becovered centrally in future testing campaigns.The State Health Society of Bihar has been contacted to discussthe possibility of a state-wide expansion of the tubewell testingcampaign. Efforts to test millions of tubewells whose status isunknown should be initiated in other states of India andneighbouring countries affected by high arsenic levels ingroundwater.Watch a video of Chander Kumar Singh presenting theunderlying research at the 2nd IGC South Asia GrowthConference (July 2013; New Delhi)Reducing poisoning by arsenic in tubewell water : Chand…Further ReadingAhmed, M.F., S. Ahuja, M. Alauddin, S. J. Hug, J.R. Lloyd, A.Pfaff, T. Pichler, C. Saltikov, M. Stute, and A. van Geen,Ensuring safe drinking water in Bangladesh, Science 314, 1687-1688, 2006.Bennear L, A Tarozzi, A Pfaff, HB Soumya, KM Ahmed, A vanGeen, Impacts of a randomized controlled trial in arsenic riskcommunication on household water supply choices inBangladesh, Journal of Environmental Economics andManagement, http://dx.doi.org/10.1016/j.jeem.2012.07.006,2012.22/06/2017 Reducing Poisoning by Arsenic in Tubewell Water - IGChttp://www.theigc.org/blog/reducing-poisoning-by-arsenic-in-tubewell-water/ 5/52012.Chen, Y., A. van Geen , J. Graziano , A. Pfaff, M. Madajewicz,F. Parvez , I. Hussain, Z. Cheng, V. Slavkovich, T. Islam, and H.Ahsan, Reduction in urinary arsenic levels in response to arsenicmitigation in Araihazar, Bangladesh, Environmental HealthPerspectives 115, 917-923, 2007.George CM, Graziano JH, Mey JL, van Geen A, Impact onarsenic exposure of a growing proportion of untested wells inBangladesh, Environmental Health 11:7, DOI: 10.1186/1476-069X-11-7, 2012a.George, CM, Y Zheng, JH Graziano, SB Rasul, JL Mey, A vanGeen, Evaluation of an arsenic test Kit for rapid well screening inBangladesh, Environmental Science and Technology, acceptedAugust 2012b.Inauen J, Hossain MM, Johnston RB, Mosler H-J, Acceptanceand use of eight arsenic-safe drinking water options inBangladesh. PLoS ONE 8(1): e53640.doi:10.1371/journal.pone.0053640, 2013.Madajewicz, M., A. Pfaff, A. van Geen, J. Graziano, I. Hussein,H. Momotaj, R. Sylvi, and H. Ahsan, Can information aloneboth improve awareness and change behavior? Response toarsenic contamination of groundwater in Bangladesh, Journal ofDevelopment Economics 84, 731–754, 2007.Opar, A., A. Pfaff, A. A. Seddique, K. M. Ahmed, J. H.Graziano, and A. van Geen, Responses of 6500 households toarsenic mitigation in Araihazar, Bangladesh, Health & Place 13,164-172, 2007.Parvez F, GA Wasserman, P Factor-Litvak, X Liu, V Slavkovich,AB Siddique, Rebeka Sultana, Ruksana Sultana, T Islam, D Levy,JL Mey, A van Geen, KM Khan, J Kline, H Ahsan, JH Graziano,Arsenic exposure and motor function among children inBangladesh, Environmental Health Perspectives 119:1665-1670,2011.Pitt, M, MR Rosenzweig, N Hassan, Identifying the hidden costsof a public health success: Arsenic well water contamination andproductivity in Bangladesh, PSTC Working Paper Series 2012-02. http://brown.edu/academics/population-studies/sites/brown.edu.academics.population-studies/files/uploads/2012-02-PSTC-Working-Paper.pdfRahman A, LA Persson, B Nermell, SE Arifeen, EC Ekstrom, AHSmith, M Vahter, Arsenic exposure and risk of spontaneousabortion, stillbirth, and infant mortality, Epidemiology 21, 797–804, 2010.Smith AH, EO Lingas, M Rahman, Contamination of drinking-water by arsenic in Bangladesh: a public health emergency,Bulletin of the World Health Organization 78, 1093-1103, 2000.Wasserman, G.A., X. Liu, F. Parvez, H. Ahsan, P. Factor-Litvak,A. van Geen, Z. Cheng, V. Slavkovich, I. Hussain, H. Momotaj,J. H. Graziano, Water arsenic exposure and children’sintellectual function in Araihazar, Bangladesh, EnvironmentalHealth Perspectives 112, 1329-1333, 2004.

Reducing poisoning by arsenic in tubewell water

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