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Arsenicosis Case Identification, Diagnosis and Management Protocol for Early Patient Medicare Administration and Treatment
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
1-9
Received:
20 January 2015
Accepted:
20 January 2015
Published:
8 March 2015
Abstract: Many countries in the world, especially South Asia e.g., Bangladesh, India, Nepal, Vietnam, China and Myanmar are facing ground water arsenic contamination problems and it has been recognized as an emerging threat and challenge to public health (Ahmad et al, 2004). Pakistan, following the arsenic crisis in Bangladesh and in other neighboring countries, has recognized the need of assessing drinking water quality for arsenic contamination in late nineties (PCRWR 2002). Ground water arsenic contamination has emerged as a serious socio-economic and human health concerns all over the world, including Pakistan. Likewise , around 25-36 % population of two provinces in Pakistan is exposed to drinking water arsenic contamination over 10 ppb. It may be reasonable to disregard the presence of some arsenic in the water, but beyond 50 ppb is considered dangerous (NAPAM 2005). Keeping in view the adverse impacts of arsenic contamination on human health, various initiatives by different governmental and non-governmental departments and organizations were taken, without resource integration and prudent coordination mechanisms amongst the various stakeholders (IUCN, 2007). These practices resulted in wastages of scarce resources, rather than pooling up all the resources and getting maximum. During this process some experiences have been gained related to planning, implementation, monitoring and management of arsenic mitigation. As arsenic contamination causes serious health issues, therefore, the timely identification and diagnosis of arsenicosis patients remained a major problem due to absence of standard operating procedures / protocols . The arsenicosis patients identification was being observed and realized after the appearance of arsenicosis symptoms, like skin pigmentation etc, on the body parts of the effected persons. Over and above, there was no set procedures to administer the treatment and case management of such arsenicosis patients. Therefore, well designed protocols or standard operating procedures have been documented which may assist while carrying out identification of suspected arsenicosis patients. This paper will provide road map for arsenicosis diagnostic procedures, treatment administration , case management and behavioral change communication by creating awareness amongst such affected communities, prior getting prey of arsenicosis victim.
Abstract: Many countries in the world, especially South Asia e.g., Bangladesh, India, Nepal, Vietnam, China and Myanmar are facing ground water arsenic contamination problems and it has been recognized as an emerging threat and challenge to public health (Ahmad et al, 2004). Pakistan, following the arsenic crisis in Bangladesh and in other neighboring countr...
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Resource Integration Based Institutional Framework for Sustainable Drinking Water Arsenic Contamination Mitigation and Management
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
10-19
Received:
23 January 2015
Accepted:
23 January 2015
Published:
8 March 2015
Abstract: Ground water Arsenic contamination has exponentially endangered the human life and complicated the efforts for obtaining and maintaining drinking water quality standards. The deadly contaminant (Arsenic) has created an alarming and catastrophic crises world over, especially in South Asia e.g., Bangladesh, India, Nepal, Vietnam, China and Myanmar who are facing ground water arsenic contamination problems (Islam, 2005). Every affected country is combating the arsenic contamination menace within the framework of their own socio-economic, legal and cultural perspectives which may not be cost-effective and efficient in time and space matrix. The reason might be of devoid of integration approach amongst the key stakeholders. Hence, under the circumstances, there was a dire need of an integrated approach to combat the arsenic contamination which has virtually emerged as a crises situation, thus necessitating formulation of national action plan for arsenic mitigation. Strategies and objectives within the action plan framework are based on the earlier initiatives of addressing the serious issue of arsenic contamination which includes, establishing integrated institutional arrangements and developing capacity, coordination mechanism amongst all the implementing agencies / stakeholders, like, government(s), NGOs, donor agencies and other related departments & organizations (NAPAM, 2005). The prudent institutional arrangements will make policy decisions and legislation to implement resource integration based arsenic mitigation which includes monitoring and surveillance of water quality/ aquifer mapping / treatment and data base thereof, establishing case diagnosis / treatment of affected arsenicosis patients under health department, developing effective and sustainable behavioral change communication strategies. It will also include community participation / social mobilization and developing cost-effective water treatment technologies and establishment of research related infrastructures. The resource integration based action will converge all the financial, technological and human resources in achieving desired objectives cost-effectively, both qualitatively and quantitatively.
Abstract: Ground water Arsenic contamination has exponentially endangered the human life and complicated the efforts for obtaining and maintaining drinking water quality standards. The deadly contaminant (Arsenic) has created an alarming and catastrophic crises world over, especially in South Asia e.g., Bangladesh, India, Nepal, Vietnam, China and Myanmar wh...
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Sustained Applications of Pesticides and Fertilizers in Sugarcane, Cotton and Wheat Cultivated Areas Causes Ground Water Arsenic Contamination - District Rahim Yar Khan, Pakistan
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
20-30
Received:
30 January 2015
Accepted:
30 January 2015
Published:
8 March 2015
Abstract: Due to over all water scarcity situation, more reliance is made on local groundwater sources for drinking and other human needs /purposes. Most of the boreholes or shallow wells are confined to upper aquifers which are exposed to contamination from all sorts of wastewaters and run-off from agricultural field etc. Water quality monitoring from these ground water sources remained irregular, as main focus was on surface water quality monitoring . Information on seasonal water quality changes in surface and ground water was generally lacking. Natural factors facilitating introduction of arsenic into water are related to geomorphology, tectonic activities and chemical components of water bearing formations (Tong, 2002; Htay, 2004, Fengthong, 2004). Keeping in view the prevalence of arsenic in district Rahim Yar khan , a confirmatory arsenic testing was carried out and it was revealed that out of 45 samples, tested for arsenic contamination, 57.78 % were having more than 100 ppb arsenic contamination and 35.56 % were having arsenic contamination more than 50 ppb, which were higher than the WHO limits. During 2006, UNICEF installed some kind of arsenic removal technologies in the area, which were not sustainable due to lack of technical know and resources essentially needed during post project periods . At the same time no endeavors were made to ascertain the causes of arsenic prevalence for having sustainable alternative arsenic free water sources. The areas was rich for agricultural activities, with sustained use of pesticides and fertilizers . A well planned soil investigation process was carried out upto the depth of 387 feet to find out the existence of arseno-pyrites, the major cause of arsenic contamination. All the soil samples were analyzed in the laboratory by using XRD & XRF equipment. The soil investigation analysis, clearly indicated the absence of arseno-pyrites which could have been responsible for ground water arsenic contamination in the area. This very fact indicates that arsenic contamination was due to leaching of pesticides and chemicals , as cotton, being a major cash crop of Pakistan, consumes more than 70 % pesticides being used in the country and at least a dozen spray sessions are made during a single harvesting season September to November. Therefore keeping in view the above findings, a deep bore hole was installed up to the depth of 387 feet and arsenic contamination at 240 feet depth, was 5-10 ppb, which is within the permissible limits. The deep bore hole was monitored for complete one year and arsenic contamination was found to be within the limits. Thus, deep bore holes are one of the safe alternative drinking water sources, provided soil strata in arsenic hit areas is investigated prior to installing any arsenic removal technologies.
Abstract: Due to over all water scarcity situation, more reliance is made on local groundwater sources for drinking and other human needs /purposes. Most of the boreholes or shallow wells are confined to upper aquifers which are exposed to contamination from all sorts of wastewaters and run-off from agricultural field etc. Water quality monitoring from th...
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Performance Assessment of Installed Arsenic Removal Technologies and Development of Protocol for Alternative Safe Drinking Water Supply Options for Arsenic Hit Areas of Pakistan
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
31-42
Received:
21 February 2015
Accepted:
23 February 2015
Published:
8 March 2015
Abstract: After identifications of arsenic contamination in Pakistan, lot of technological based arsenic mitigation interventions were carried out which could not last longer due to non-availability of filtration media and running spare parts of arsenic removal tanks units in the local market. The in-depth performance analysis of arsenic removal technology (ART) units, clay pitchers and PUR sachet was carried out which showed un-sustainability of these interventions. The main reasons are lack of awareness, illiteracy and unfavorable socio-economic conditions which make the end users in villages/rural areas the most vulnerable to the adverse impacts of any type of contaminated water and own the installed arsenic removal interventions. Therefore, before taking up any arsenic removal project, it is worthwhile to explore those interventions which are compatible to local socio-economic environments. Deeping boring options have been found best suited, as most of the agricultural practices are dependent on ground water- at shallow depths. The soil analysis at deeper depth will help in ascertaining the causes of arsenic contamination due to presence of arseno-pyrites or due to leaching of sustained applications of pesticides & fertilizers. Therefore, in case of absence of arseno-pyrite sediments at deeper depths. Then the best option for provisioning of arsenic free water is deep boring. The active participation of the communities who are the intended beneficiaries of arsenic mitigation is vital for the success of the programme. Lack of awareness and generally unfavorable conditions are also obstacles to mobilizing communities to get the best out of community-based programmes and projects. Therefore, a well designed protocol for alternative water supply has been evolved which will help in provisioning of sustainable arsenic free water.
Abstract: After identifications of arsenic contamination in Pakistan, lot of technological based arsenic mitigation interventions were carried out which could not last longer due to non-availability of filtration media and running spare parts of arsenic removal tanks units in the local market. The in-depth performance analysis of arsenic removal technology (...
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Trend of Arsenic Exposure through the Food-Chain in Bangladesh for the Past Two Decades
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
43-49
Received:
3 April 2015
Accepted:
4 April 2015
Published:
15 April 2015
Abstract: Large scale use of groundwater for irrigation which is often Arsenic laden, during past two decades, has given rise to the apprehension that this may be resulting in higher Arsenic intake through the food chain. This work was undertaken to determine the trend of average Arsenic exposure of the population in Bangladesh during the period 1990-2010. Based on available data on individual food items, an average estimate of the level of both total and inorganic Arsenic intakes through food chain in Bangladesh have been made using the market basket approach; which is a widely used protocol for such work. The results have been discussed in the light of available information in literature. The results obtained show no significant change in the average intake of inorganic Arsenic during the period. The level of total Arsenic exposure does not also show statistically significant increase in uptake during the study period. Consequently, it is concluded that no restriction is needed on the use of groundwater in irrigation from Arsenic exposure risk consideration of the population. Now that there is no WHO recommended tolerable limit for intake of Arsenic, nationally acceptable limits have to be determined probably by considering cost-benefit analysis.
Abstract: Large scale use of groundwater for irrigation which is often Arsenic laden, during past two decades, has given rise to the apprehension that this may be resulting in higher Arsenic intake through the food chain. This work was undertaken to determine the trend of average Arsenic exposure of the population in Bangladesh during the period 1990-2010. B...
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Integrating Arsenic-Related Environmental Topics into the Education of the Next Generation of Citizens for Arsenic-Hit Communities: Awareness and Mobilization
Julian Tyson,
Ray Kronquist,
Anowara Begum,
Shahena Begum
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
50-55
Received:
16 April 2015
Accepted:
17 April 2015
Published:
28 April 2015
Abstract: Several programs, organized by Chemists without Borders or the University of Massachusetts Amherst, in which secondary school or college students are introduced to the impact of arsenic contamination of the environment, and in particular of groundwater in Bangladesh, are described. A common feature is that students are recruited as members of a research group or investigative team and take ownership of the work by making relevant chemical measurements and participating in discussion of the implications of their findings. Leadership is provided in a hierarchical model in which, very often, more experienced students acting as near-peer mentors guide the activities of the newly recruited members of the groups. In some of the programs, the students work with teachers who have been trained by researchers on the university campus. Both in-school and out-of-school programs are described. A feature common to all is that chemical measurements are provided by low-cost field test kits based on the Gutzeit-Marsh reaction, the modification of which has provided a driving force for a considerable number of research projects for the college students. Many hundreds of students have been impacted and the programs, particularly that in Bangladesh, have considerable potential for empowering the students as agents of change in their communities as they not only take specific action as a result of their engagement but also educate other members of their families and communities about the potential hazards of consuming arsenic-contaminated water and rice and how these can be mitigated. Readers are invited to contribute to sustaining the program in Bangladesh and to initiate their own activities with students.
Abstract: Several programs, organized by Chemists without Borders or the University of Massachusetts Amherst, in which secondary school or college students are introduced to the impact of arsenic contamination of the environment, and in particular of groundwater in Bangladesh, are described. A common feature is that students are recruited as members of a res...
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Social Behavioural Change Communication (SBCC) Strategies for Community Awareness, Mobilization and Participation for Adoption of Arsenic Free Water Consumption Practices -Pakistan
Islam-ul-Haque,
Munir Khan,
Muhammad Shafqat,
Shahid Durez
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
56-66
Received:
15 April 2015
Accepted:
16 April 2015
Published:
12 May 2015
Abstract: Arsenic contamination has emerged as a serious public health concern in Pakistan. Arsenic is an emerging serious issue at least in two provinces Punjab and Sindh where about 3% and 16% of water sources are contaminated with levels of arsenic over 50 ppb. The percentage of water sources with concentrations above the WHO level of 10 ppb is 20% and 36% respectively in Punjab and Sindh. Both shallow and deep sources have arsenic contamination and therefore testing of every water sources is necessary. A recent study on prevalence of arsenicosis confirmed presence of 40 cases in the study population giving a prevalence 140/100,00 for established and borderline cases. Keeping in mind its adverse impacts on human health, government with financial support of UNICEF launched various arsenic mitigation programmes and installations of various arsenic removal technologies, i,e household levels water filters, community based arsenic removal tank units and deep boring interventions. Unfortunately, all these interventions proved to be un-sustainable primarily due to devoid of community ownership. Lack of awareness, illiteracy and unfavorable socio-economic conditions make the end users in villages/rural areas, the most vulnerable to the adverse effects of any type of contaminated water. The overall increase in illiteracy rates in Pakistan, particularly in rural environment are the contributing factors which magnifies the mind set of arsenic affected communities to adopt safe drinking water best practices. Hence, there is a dire need to develop a sustainable and effective mechanism for Social & Behavioral Change Communication (SBCC), including the development of communication support materials, within the government structure such as health, education, and social welfare, with the support from print & electronic media and civil society. Though lot of efforts were made yet the current level of awareness cannot be regarded as satisfactory. Thus keeping view the importance of behavioral change communications, comprehensive communication behavioral change strategies, based on Knowledge , Attitude & Practices ( KAP) were evolved and implemented in the arsenic hit areas to ensure community mobilization, participation and ownership which is an important aspect towards post arsenic mitigation projects sustainability.
Abstract: Arsenic contamination has emerged as a serious public health concern in Pakistan. Arsenic is an emerging serious issue at least in two provinces Punjab and Sindh where about 3% and 16% of water sources are contaminated with levels of arsenic over 50 ppb. The percentage of water sources with concentrations above the WHO level of 10 ppb is 20% and 36...
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Monitoring and Impact Evaluation System for Arsenic Mitigation Interventions - Arsenic Contamination Areas of Pakistan
Islam-ul-Haque,
Muhammad Nasir
Issue:
Volume 3, Issue 3-1, June 2015
Pages:
67-78
Received:
27 March 2015
Accepted:
29 March 2015
Published:
5 May 2015
Abstract: Drinking water arsenic contamination has emerged as a big nuisance to public health and approximately 137 million people around the world consume arsenic contaminated water, exceeding the WHO threshold of 10 μg/L. In Pakistan context, various arsenic mitigation initiatives were undertaken by different NGOs and government departments which were confined to one time measure and resultantly turned to be un-sustainable. Continuous surveillance of drinking water sources is crucial for the well being of humans for which systemised procedures for regular monitoring of the arsenic contaminated water sources has been evolved. Identifications of contaminated water sources for random and blanket arsenic testing surveys will make the monitoring & evaluation process more reliable and prudent. Grid system approach for taking water samples has been discussed and evolved which yield meaningful results. For field test validation, 10% of water samples are recommended to be tested in the laboratory by using atomic absorption spectrometer (ASS). Well thought out institutional arrangements / linkages have been evolved for achieving government buying which is necessary to make the monitoring and evaluation process sustainable. Though, the donors and NGOs have played an important role in addressing the arsenic contamination issues in many countries, including in Pakistan, yet the ultimate ownership for the success of interventions lies with the government and its line departments.
Abstract: Drinking water arsenic contamination has emerged as a big nuisance to public health and approximately 137 million people around the world consume arsenic contaminated water, exceeding the WHO threshold of 10 μg/L. In Pakistan context, various arsenic mitigation initiatives were undertaken by different NGOs and government departments which were conf...
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