Social impact of aisenicosis uisease: A stuuy on aisenicosis patients of
Sieenagai anu Louhajang upazila unuei Nunshiganj uistiict.
Introduct|on: 1he scale of Lhe problem of arsenlc conLamlnaLlon of drlnklng waLer ln 8angladesh has become lncreaslngly well undersLood slnce arsenlc was flrsL over 10 years ago. lL ls now a naLlonal concern wlLh grave consequences upon human llves and producLlvlLy. Lver slnce Lhe flrsL ldenLlflcaLlon of arsenlc conLamlnaLlon of groundwaLer ln 1993 aL Chapal nawabgan[ ln 8a[shahl ulvlslon, a number of ma[or lnlLlaLlves have been underLaken aL dlfferenL Llmes Lo address dlfferenL lssues relaLed Lo Lhe problem. Lxecut|ve Summary: nea|th prob|ems Arsenlcosls sympLoms can lnclude leslons, hardenlng of Lhe skln, dark spoLs on hands and feeL, swollen llmbs and loss of feellng from hands and legs. Leslons are easlly lnfecLed, pose a LhreaL of gangrene and can be very palnful. Whlle Lhere ls a long laLency of more Lhan 20 years, leslons can appear more qulckly lf arsenlc concenLraLlons are very hlgh. Powever, Lhese sympLoms are usually reverslble lf deLecLed early and people sLop drlnklng arsenlc-conLamlnaLed waLer. Long- Lerm exposure Lo arsenlc can cause serlous healLh problems lncludlng lnLernal cancers of Lhe skln, lungs, bladder and kldney, whlch can be faLal. 1hese cancers can occur wlLhouL Lhe skln leslons. MosL of Lhe deaLhs caused by arsenlc are expecLed Lo be from lung cancer. SLudles have shown exposure Lo arsenlc conLamlnaLed waLer can also cause lmpalred cognlLlve developmenL ln chlldren. Malnourlshed people are Lwlce as llkely Lo develop arsenlcosls as well-nourlshed people. 1here ls no known cure for chronlc arsenlc polsonlng. Powever, people sufferlng from arsenlcosls can recover more rapldly from skln leslons when Lhey eaL nuLrlLlous food or Lake mulLl-vlLamln supplemenLs. LoLlons conLalnlng urea and sallcyllc acld can ease Lhe paln of skln leslons, and also help Lo speed recovery. Soc|a| Impacts eople wlLh arsenlc polsonlng suffer enormous soclal sLlgma ln 8angladesh. Many people belleve arsenlc polsonlng ls conLaglous or a curse. arenLs are relucLanL Lo leL Lhelr chlldren play wlLh chlldren sufferlng arsenlc polsonlng and paLlenLs can be shunned wlLhln Lhelr vlllages. lor women, Lhe slLuaLlon ls worse. ln 8angladesh, a woman's aLLracLlveness lles ln her beauLy whlch ls ofLen [udged by her pale complexlon. 1hls makes lL harder, ln some cases lmposslble, for slngle women sufferlng from arsenlc polsonlng Lo marry. Cnce marrled, women face Lhe rlsk of dlvorce lf Lhey develop arsenlcosls skln leslons. 1hls can be a dlre slLuaLlon ln 8angladesh's male-domlnaLed socleLy, where unmarrled women are more vulnerable Lo poverLy and soclal excluslon. Women are also less llkely Lo recelve early dlagnosls or LreaLmenL. Cb[ect|ve: 1o know Lhe soclo-economlc condlLlon of arsenlcosls paLlenL, 1o know Lhe vulnerablllLy of Lhe paLlenLs, 1o assess Lhe lmpacL of arsenlc ln Lhe socleLy. Methodo|ogy: Method: 1hls sLudy ls a daLa exploraLory sample survey wlLh quallLaLlve sLudy based on ln- depLh lnLervlew. Study area: 1wo arsenlc affecLed upazlla Sreenagar and Louha[ang of Munshlgan[ dlsLrlcL wlll be consldered as research area. opu|at|on of the study: All paLlenLs wlll be consldered as populaLlon for Lhls sLudy. Samp|e and samp||ng techn|que: 1he presenL sLudy wlll be conducLed on Lhe basls of sample survey. 1he samples were Laken purposlvely. Sources of data: lnformaLlon, necessary for Lhe research wlll be collecLed from boLh prlmary and secondary sources. aLlenLs wlll be chosen as respondenLs. 1echn|ques and |nstruments of data co||ect|on: 1o collecL daLa lnLervlew schedule wlll be applled as lnsLrumenL. uslng Lhe lnLervlew schedule, wrlLLen ln 8engall and comprlslng boLh sLrucLured and unsLrucLured quesLlons wlll collecLed by dlrecL lnLervlew Lechnlque. Data process|ng, ana|ys|s & |nterpretat|on: AfLer adequaLe collecLlon of lnformaLlon, lL wlll be edlLed, classlfled on Lhe basls of several characLerlsLlcs, summarlzed and organlzed for Lhe purpose of Lhe sLudy. AfLer processlng and analyzlng of daLa lL wlll be accordlngly lnLerpreLed.
I|nd|ngs: (A) Soc|o-econom|c cond|t|on of respondents: MosL of Lhe respondenLs (70) are female age beLween 33 Lo 70 years old and 30 of respondenLs are male. now all of Lhem are permanenLly seLLled ln Lhls area buL half of Lhem are mlgraLed from oLhers places of Munshlgan[ dlsLrlcL excepL Lhree respondenLs from larldpur and Madarlpur dlsLrlcL. All Lhey are less educaLed person, hlghesL educaLlonal quallflcaLlon of Lhelr famlly member ls beLween class flve Lo PSC level and Lhelr average famlly lncome are 10,000/= (1k. 1en Lhousand only). (8) Water uses by pat|ent: (8.1) Water uses by respondent after be|ng pat|ent: urpose of use u1W (Creen) ercenLage () S1W (8ed) ercenLage () Surface WaLer ercenLage () urlnklng 30 100 0 0 0 0 Cooklng 8 27 0 0 22 73 PP acLlvlLles 3 17 18 60 7 23 Wash & cleanlng 3 17 18 60 7 23 CLhers 0 0 0 0 0 0
All respondenLs are drlnklng arsenlc safe waLer from deep Lube-well afLer belng paLlenL and Lhey collecL surface waLer for cooklng. Also Lhey use oLhers sources waLer for washlng, cleanlng and oLhers household acLlvlLles.
Durat|on of |nadequate Water: lnadequaLe WaLer All over Lhe year ercenLage () 8alny Season ercenLage () ury Season ercenLage () u1W (Creen) 0 0 0 0 20 67 S1W (8ed) 0 0 0 0 20 67 Surface WaLer 0 0 0 0 30 100
0 20 40 60 80 100 120 All over Lhe year 8alny Season ury Season Inadequate Water u1W (Creen) S1W (8ed) Surface WaLer (8.2) Water uses by respondent before be|ng pat|ent: urpose of use u1W (Creen) ercenLage () S1W (8ed) ercenLage () Surface WaLer ercenLage () urlnklng 3 10 26 87 1 3 Cooklng 2 7 1 3 27 90 PP acLlvlLles 2 7 24 80 4 13 Wash & cleanlng 2 7 24 80 4 13 CLhers 0 0 0 0 0 0
(C) Informat|on about arsen|cos|s d|sease: aLlenLs have been sufferlng from Arsenlcosls for 6 monLhs Lo 23 years. lnlLlally Lhey felL skln leslons, paLch areas of lncreased skln plgmenLaLlon, scables, overall paln, weakness, sleeplessness eLc. ln maxlmum cases when AM8l fleld sLaff vlslLed Lhelr area, Lhe shared Lhelr condlLlon and Lhey ldenLlfled posslble arsenlcosls sympLoms and referred Lhem Lo Al1AM (parLner nCC of AM8l) where Lhey were dlagnosed as arsenlcosls paLlenL and were prescrlbed LreaLmenL. Some paLlenLs wenL Lo governmenL and prlvaLe hosplLal/cllnlc and dlagnosed as arsenlcosls paLlenL. now all paLlenLs are under Lhe free LreaLmenL of AM8l.
0 20 40 60 80 100 urlnklng Cooklng PP acuvlues Wash & cleanlng CLhers Water uses by respondent before be|ng panent u1W (Creen) S1W (8ed) Surface WaLer (D) Lxpenses and d|ff|cu|t|es: All paLlenLs have been recelvlng LreaLmenL from Lhey were dlagnosed as arsenlcosls paLlenL. MonLhly expense of Lhelr LreaLmenL ls near abouL 1k. 300, ln some cases Lhey have no expenses. Some female paLlenLs have Lo go far away for recelvlng LreaLmenL, someLlme Lhelr husband makes obsLacle Lo go ouL. MosL of Lhe paLlenLs have been neglecLed or lgnored by Lhelr famlly members as well as socleLy. (L) Att|tude of fam||y and soc|ety towards pat|ents: ln very few cases famlly members seem Lo arsenlcosls dlsease LhaL can be spread Lo oLhers famlly member. 1haL's why Lhey have separaLed paLlenL from oLhers. All paLlenLs Lry Lo hlde Lhelr dlsease from nelghbor and relaLlves, so LhaL Lhey can easlly Lake parL lnLo soclal funcLlon and relaLlve's occaslons. Some paLlenLs are faclng problems Lo geL marrled of Lhelr son or daughLer.
kecommendat|on: 1oLal WaLer CuallLy LesL Mapplng and lmproved undersLandlng of CroundwaLer and MoblllzaLlon of Arsenlc 1lme Serles Analysls of ConLamlnaLlon Lo ldenLlfy luLure 1rends lmproved MonlLorlng and LvaluaLlon aLlenL ldenLlflcaLlon and Survelllance Local Level WaLer CuallLy 1esLlng CapaclLy uevelopmenL Conc|us|on: Arsenlcosls paLlenLs are reporLlng fewer soclal problems as awareness lncreases. AlLernaLlve supply of safe waLer opLlons ls necessary for rapld expanslon of Lhelr use. CC, nCC and prlvaLe secLor should be lnvolved comblng ln developlng of approprlaLe waLer supply opLlons.
Annexure: Case SLudy-1 Lat|fa h|de herse|f from fam||y because of arsen|cos|s LaLlfa 8egum (30) llves aL Coalpara of Shologhar unlon wlLh her husband Abdus SaLLer and elghL son and daughLer. Shologhar ls Lhe one of mosL arsenlc affecLed area of Sreenagar upazlla under Munshlgan[ dlsLrlcL. lor long Llme she used Lo drlnk arsenlc conLamlnaLed waLer. As a house wlfe she musL sLay maxlmum Llme aL home and she has no alLernaLlve source of safe waLer. Per flnanclal slLuaLlon ls noL so good. Maln lncome source of her famlly ls forelgn currency earned by her son. She has no land for culLlvaLlon. LaLlfa 8egum feels bad ln her body llke-skln leslons, patch areas of increased skin pigment, scabies, feeling pain in whole body, weakness from last six month. She did not share with her family member. Because, first time she thought it is normal scabies. When it increases day by day she feels its not normal scabies but she did not share with her family member or others person because of being neglected or ignored by family and society. When AMRF frontline staff went to field visit to her area, she discusses with them about her present physical situation. At the primary stage they identified her as an arsenicosis patient by symptoms, after that they referred her to AMRF head office for doctor consultancy. Finally doctor identified that she is affected by arsenic and prescribe her for treatment. At present she takes medicine regularly from AMRF as well as AMRF staff follow-up to her regularly. Last two years she drinks arsenic free water from deep tube-well. Whole year she can take arsenic free water from deep tube-well except summer season due to inadequate water rather than other season. Now she uses surface water for cooking as well as sallow tube-well for washing and another purpose. After affected by arsenicosis she faces some problem. Sometime she becomes unable to cook and cannot stand and walk normally. That time she cannot do work for her family. Last year she affected some disease like- fever, headache, cold beside of arsenicosis. At present she wants to release from this disease and she also motivating other people for drinking safe water.
Case SLudy-1 Ioshna |ost her stream at fam||y and soc|ety because of arsen|cos|s !oshna 8egum (23) llves ln a hardcore poor [olnL famlly wlLh her day labor husband Md. Saldul lslam, she has Lwo chlldren, faLher-ln-law, moLher-ln-law and slsLer-ln-law. lrom her chlldhood she llves ln souLh madanlmondol, Lhe mosL arsenlc affecLed area of Laohagonf upazlla under Munshlgon[ dlsLrlcL. Per famlly use Lo drlnk arsenlc conLamlnaLed waLer from chlldhood. She goL marrled elghL years before wlLh her nelghbor ln a resLrlcLed famlly. 1haL's why she has Lo sLay aL home wlLhouL excepLlonal case. now her famlly has Lo Lransfer Lhelr house Lo nearesL unlon kumarbhog because of adma 8rldge. !oshna feels someLhlng bed ouL of her body llke leslons, patch areas of increased skin pigment, scabies, pain in whole body, weakness, sleeplessness since five years after born of her first child. Her mother also affected by same disease before her. For that reason, her father and mother-in- law seems to its a disease by genetically spread to her so that her husband and other family member can also be affected. Thats why her husband separated everything even pot, glass, cloth, room from her. They did not take care of her and she always been neglected by family as well as society. When AMRF frontline staff went to field visit to her area, she discusses with them about her present physical condition. At primary stage they identified her as an arsenicosis patient by symptoms, after that they referred her to AITAM (partner NGO of AMRF) for doctor consultancy. Finally doctor identified that she is affected by arsenic and prescribe her for treatment. After some days her mother also has come for treatment. At present both are taking medicine regularly from AMRF as well as AMRF staff follow-up her regularly. Sometime AMRF cannot distribute medicine, that time her family does not buy medicine for her. Last three days ago she informed us that her mother-in-law also affected by arsenicosis. Primary stage AMRF staff identified as arsenicosis patient and refers to AMRF head office. Five years ago when she knows that arsenicosis is dangerous disease affected by arsenic contaminated water, than she was trying to drink safe water. But she did not get safe water easily because of unavailability of deep tube-wells. Now they collect safe water from neighbor home. Some time they forbid to take water. Thats why they have to drink arsenic contaminated water. Now she uses surface water for cooking as well as sallow tube-well for washing and another purpose. Sometime she becomes unable to cook and cannot stand and walk normally. That time she cannot do work properly for her family. For this reason her family member have done miss behave with her and some time physical tortured by her husband. Now she wants to release from this disease and she also motivating other people for drinking safe water.