A new report says that the Bangladesh government is failing to adequately respond to naturally occurring arsenic in drinking water across large areas of rural Bangladesh and an estimated 20 million people in Bangladesh — mostly rural poor — still drink water contaminated over the national standard.

In a report released on Wednesday, Human Rights Watch said approximately 20 years after initially coming to international attention the scenario has been the same.

The 111-page report, ‘Nepotism and Neglect: The Failing Response to Arsenic in the Drinking Water of Bangladesh’s Rural Poor,’ documents how Bangladesh’s health system largely ignores the impact of exposure to arsenic on people’s health. An estimated 43,000 people die each year from arsenic-related illness in Bangladesh, according to one study. The government identifies people with arsenic-related illnesses primarily via skin lesions, although the vast majority of those with arsenic-related illnesses don’t develop them. Those exposed are at significant risk of cancer, cardiovascular disease, and lung disease as a result, but many receive no health care at all.

‘Bangladesh isn’t taking basic, obvious steps to get arsenic out of the drinking water of millions of its rural poor,’ said Richard Pearshouse, senior researcher at Human Rights Watch and author of the report. ‘The government acts as though the problem has been mostly solved, but unless the government and Bangladesh’s international donors do more, millions of Bangladeshis will die from preventable arsenic-related diseases.’

Human Rights Watch interviewed 134 people for the report, including people suspected of having arsenic-related health conditions and caretakers of government wells in five rural villages, as well as government officials and staff of nongovernmental organisations. It also analyzed data regarding approximately 125,000 government water points installed between 2006 and 2012.

‘Moreover, some national and local politicians divert these new wells to their political supporters and allies, instead of the people who most need them.’

‘If the member of parliament gets 50 percent [of the new allocation] and the upazila [sub-district] chairman gets 50 percent, there’s nothing left to be installed in the areas of acute need,’ explained one government official who spoke to Human Rights Watch on condition of anonymity.

Bangladesh isn’t taking basic, obvious steps to get arsenic out of the drinking water of millions of its rural poor.

‘Human Rights Watch also found a serious lack of monitoring and quality control in arsenic mitigation projects. In a small but significant number of cases, some new government wells are themselves contaminated with arsenic above the national standard. A Human Rights Watch analysis of government data found that 5 per cent of the wells reviewed were contaminated above the Bangladesh standard.’

‘The World Bank, which funded the installation of approximately 13,000 rural wells from 2004 to 2010, should promptly and thoroughly investigate whether they are contaminated and, if they are, replace or rehabilitate them.

Bangladesh’s international donors have an important role to play, and they should do more, but with more care’, Human Rights Watch said.’

‘In 1995, an international conference in Kolkata helped draw the world’s attention to the problem of naturally occurring arsenic in the groundwater across huge swaths of rural Bangladesh. From 1999 to 2006, the government, international donors, and nongovernmental organizations oversaw a concerted effort to mitigate arsenic contamination in Bangladesh’s groundwater.’

‘Under the national well screening (the bulk of which occurred from 2000 to 2003) some 5 million wells across the country were tested with field kits and the pumps painted red or green according to whether they were above (red) or below (green) the national standard. The screening found that wells of an estimated 20 million people yielded water with arsenic above 50 micrograms per liter (the national standard).’

‘Since 2006, however, the urgency of such efforts has dissipated. A nationwide study of drinking water quality in 2013 found a similar result to the earlier screening, a rate of contamination that corresponds to some 20 million people exposed to arsenic above this level.’

‘Bangladesh should not allow national and local politicians to divert these life-saving public goods to supporters and allies,’ Pearshouse said. ‘Contaminated government tube wells urgently need to be replaced or rehabilitated, before people lose what little faith they have left in the government’s commitment to provide safe water.’