West Bengal || Bangladesh
Middle Ganga Plain, Bihar ||
27 days detailed field survey information from April 1999 to February, 2000
Problem related to identification of arsenic patients by Field-workers1
At the time of testing tubewells in
many villages, field workers from different organisations told some villagers
that they had arsenical skin lesions. The field workers handed over a
card to each member (Photograph-1) where it is written about their arsenic
concentration and whether they have arsenical skin lesions or not. But
after our survey with dermatologist and examining them and analysing the
water they were drinking, we found many of them are not arsenic patients.
1. Miss Susama Das (F/22) of villages Brahmankanda, P.S. Kotalia, Faridpur Sadar and Dist: Faridpur is a student of BA (Hons). The field surveyor told her that she is an arsenic patient but actually she is not. She said that she was suffering mentally after she was told that she was an arsenic patient. Her water is safe to drink. Similar is the case for Mr. Hasan Ali (M/45) of the same village.
2. In district Sirajganj, P.S. Ullapara, village Bhadbara MD. Abu Taher, Abul Hossain, Mohatab Alam, Moniruddin were told they were arsenic patient by those testing with field kit, but actually they are not.
3. Mini Aktar (F/14) of Nowdapara (Municipal area) P.S. Bheramara, district Kushtia was told that she was an arsenic patient. Her mother said that Mini cried for a few days on learning that. She is not, however, an arsenic patient. Similarly Abdul Mannan (M/50) was identified as an arsenic patient from same village.
4. Amalendu Biswas, Ex-Chairman of village Satpar P.S./Dist Gopalganj told us that he became very upset after knowing that he was an arsenic patient. Field workers after examining him told that he had arsenical skin lesions. Our medical team examined Mr. Biswas and found he has no arsenical skin lesions. Mr. Biswas told that he now feels that he has got a new life.
5. Tajul Islam of village Kathalia, PS: Haziganj, Dist: Chandpur was also identified as an arsenic patient because he had black spots on his body (Photograph-2). But we found that those spots were not due to arsenic (we also analysed his hair, nail and water).
These are only a few examples
that out of the many we met during our field survey that had been wrongly
identified as arsenic patients.
Do the Arsenical Skin Lesions Disappear with Chelating Agent, Safe Water, Nutritious Food, and Multi-Vitamins!
So far as we know there is no medicine available for chronic arsenic toxicity. Chelating agents have not yet shown any positive evidence of cure for those suffering from chronic arsenic toxicity with arsenical skin lesions. In fact, chelating agent on principle is for acute toxicity. It is said that the only treatment for chronic arsenic patients is safe water, nutritious food, multi vitamins and some daily exercise. During our 13 years of field survey in arsenic affected villages in West Bengal, India, 5 years in Bangladesh and follow up studies of those taking safe water, nutritious food (with extra oral multivitamins) and interviewing a few hundred patients, we have been drawn certain inferences about the effect of safe water, nutritious food, multivitamins and daily exercise on those having arsenical skin lesions. The inferences are:
1. If arsenic contaminated water is discontinued (even without nutritious food) when diffuse melanosis (blackening of skin) occurs, colour of the skin almost gets back its normal colour in most patients. With nutritious food and vitamins, the colour returns to normal quickly.
2. If contaminated water is discontinued, when spotted melanosis just starts, the melanosis may fade away. Nutritious food and vitamins no doubt have a positive effect in this process. This is true for most affected people, but not all. This is also true of those getting very mild keratosis. Normally keratosis appears after spotted melanosis. However, there are exceptions.
3. If the spotted melanosis and keratosis are quite visible (+), then safe water, nutritious food, multivitamins, and some daily exercise help in reducing the spotted melanosis and keratosis, but skin lesions do not disappear completely. During our interviews and follow-up studies, we found that in 20-40% cases there was a decreasing trend but the lesions had not fully disappeared (exceptions are there, however). In almost all cases, white spots (leucomelanosis) slowly replace black spotted melanosis. Overall survey shows that the affected persons feel much better when they take safe water, nutritious food, oral multivitamins and do a bit of daily exercise.
4. In case of those having plenty of melanosis and keratosis (++ or +++), the discontinuation of contaminated water leads to the slow conversion of black spots into white spots and may be a gradual reduction of the existing keratosis. The keratosis may get reduced but do not disappear. There is, however, not aggravation of melanosis or keratosis.
5. A few patients (n = 15) with severe melanosis and keratosis (++ or +++) from arsenic affected area of West Bengal were monitored for the last 5 years. In the beginning they had elevated levels of arsenic in their hair, nail and skin scale. However, after using safe water and with nutritious food and vitamins, the arsenic concentration in the biological samples slowly started decreasing. At present, the arsenic concentration in most of them is close to normal, but still they have substantial amount of melanosis (leuco) and keratosis. From time to time, they cut their keratotic lump but with time it grows again. A percentage of those having severe keratosis and melanosis are getting cancerous growth in their keratosis. Some patients have even died because of internal cancer (only a few were diagnosed). So far, from Bangladesh, we have identified 15 patients having cancerous growth among those with severe arsenical skin lesions. Some typical examples are cited.
These are only a few examples
out of many.