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close this bookContamination of Drinking-Water by Arsenic in Bangladesh: A Public Health Emergency (WHO, 2000, 16 p.)
close this folderEmergency intervention programme
View the document(introduction...)
View the documentStrategies to reduce exposure
View the documentSimple diagnosis in the field
View the documentTreatment
View the documentOngoing monitoring

Ongoing monitoring

Despite some attempts to educate communities, large numbers of people continue to drink from the same contaminated water sources used before the introduction of an intervention. Other water testing programmes carried out with the aid of community health workers have indicated that community awareness increases as a consequence of the programmes (45). Therefore, continuing education and monitoring needs to be integrated into existing health services, whether governmental or nongovernmental.

Guidelines for programmes aimed at continuing to educate and monitor populations exposed to arsenic should include advising these populations about the arsenic in drinking-water, the sources of arsenic-free water, and the importance of compliance with treatment programmes, including nutrition. Field workers should make monthly home visits to those villages that are most seriously affected. Field workers should be equipped with a continuing education plan, topical creams for keratoses, vitamin tablets, and medicines for fungal infections.

Patients should be advised where to seek additional medical care if needed. The physicians and paramedical staff serving the most affected areas should receive special training in understanding arsenic toxicity, disease outcomes and treatment options.

The possibility of continuing exposure to arsenic through water or food should be monitored through the testing of urine samples. Currently, there is no recommended field kit for urine testing. Therefore, samples should be sent to a reference laboratory equipped to measure arsenic in biological specimens.

In addition to obtaining biological samples, field workers should interview patients and ask them where they currently get their drinking-water to assess whether they are complying with the intervention or whether they are continuing to put their health at risk by drinking contaminated water. These regular interviews will provide opportunities for ongoing health education.