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Clinicians' roles in management of arsenicosis in Bangladesh: interview study

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7438.493 (Published 26 February 2004) Cite this as: BMJ 2004;328:493

Arsenicosis in Bangladesh

Even though this article is only an investigation into the
the role of clinicians in the problem of arsenicosis in
Bangladesh, I was surprised that the important matter
of aetiology is not mentioned. What is the use of
training doctors to recognise the symptomatology while
doing nothing about the cause?

I understand that there has not always been a high
concentration of arsenic in Bangladeshi ground water.
It appears to be related to uncontrolled deforestation in
the Himalayan hills and mountains which form the
catchment area for the Brahmaputra and related rivers.
This is allowing water from the monsoon rains free and
unrestricted flow down the mountainsides till they swell
the river and flood waters in Bangladesh. Arsenic has
perhaps always been there in high concentration, at
least in the Eastern Himalayas, but on fully forested
hillsides the vegetation played a part in controlling the
flow of surface water down the hillsides.

Now, however, water fills the underground aquifers with
unusually high concentrations of arsenic, percolating
up to fill the shallow wells. Boring down to deeper
levels aggravates the problem.

Surely this is an international problem which cannot be
addressed by Bangladesh alone. The Himalayan
states of Nepal, Bhutan and North Eastern India too,
must cooperate.

I am retired now, but used to work in Bihar on the Indian
side of the Bangladeshi border, and was aware of the
problem when it was just becoming recognised.

Competing interests:
None declared

Competing interests: No competing interests

01 March 2004
Bryan E L Thompson
Retired
60A London Road, Kilmarnock, Ayrshire KA3 7DD