Cell phones help Bangladesh fight arsenic poisoning

When Joseph Graziano looked at the lesions on the palms of the young girl’s hands, he knew the threat of contaminated water in Bangladesh was greater than the medical community had realized.

Most scientists believed it took a decade of exposure to arsenic-tainted water before the open wounds associated with the carcinogenic chemical would manifest themselves on the hands, feet and torso. But the 5-year-old girl standing in front of Graziano proved otherwise.

Now, six years later, there is a straightforward solution that could have saved her: cell phones. By sending cellular telephone text messages to a database, villagers in rural Bangladesh can now locate uncontaminated well water, a project that Graziano, the associate dean for the public health program at Columbia University, has helped develop since 1999.

“I think our big hope is that we’re catching a generation of kids by intervening early and preventing bad things from happening in their lives,” Graziano said.

Throughout Southeast Asia, parts of Latin America and the United States, arsenic is naturally released into the underground water table. Scientists are unsure how the process occurs, but the effects are undisputed. Some 40 million Bangladeshis are exposed to arsenic-contaminated water, which can lead to skin lesions, gangrene and cancer. Columbia researchers have also found that the poisonous chemical is responsible for lowering the IQs of children and that a pregnant mother can pass large amounts of the chemical on to her baby.

“Based on past exposure, cancer rates are likely to double in Bangladesh even if treatment begins now. People think this is the tip of the iceberg,” said Alexander van Geen, a senior research scientist at Columbia University and lead developer for the cell phone project, which falls under the auspices of the university’s Earth Institute.

The best way to address the problem, he said, is to avoid it. Wells can be drilled to a depth where arsenic does not develop, but the trick is finding that safe level, which can vary from area to area. The water may be untainted in one well at 100 feet and in the neighboring village be contaminated all the way down to 200 feet.

The World Bank has so far invested $50 million into testing some 5.5 million wells for arsenic throughout Bangladesh. Van Geen is compiling the test information into a database with a five-year, $15 million grant from the U.S. Environmental Protection Agency's Superfund and the National Institutes of Health.

John Immel, a computer programmer with the project, is developing the database technology while on the ground in rural Bangladesh. Each day he travels into the densely populated villages, which are surrounded by acres of green rice paddies, and tests the database. Inevitably, he said, villagers gather around and ask him how deep to dig their new wells.

He hopes that shortly he will be able to answer their questions simply by sending a cell phone text message, including the village name and district, to the database. If all goes well, he will receive a return text message that lists the safest depths for wells in the area.

“I’m still testing the technology, so I can’t give them an answer prematurely,” Immel said. “But they are desperate to know what is a safe well depth.”

The test pilot project is due to be launched in the spring in Araiharja, a district about a quarter the size of Rhode Island that includes 30,000 wells spread between 300 villages.

In areas where arsenic-free wells have been dug, the team has seen dramatic changes in peoples’ health in just four years.

Through a simple urine test, Graziano has measured the before and after levels of arsenic in several thousand villagers once they began using clean water. He found that their arsenic contamination dropped by at least 25 percent.

While Graziano is encouraged by the data, he said the problem remains that not everyone has a good well. Based on studies in Taiwan where people were exposed for long periods to arsenic-tainted water, cancer rates remained above normal even 40 years after clean water was made available. But he hopes to stop the poisoning early on.

“We see this dramatic decline,” Graziano said, “The visible skin lesions do reverse if the poisoning is not in a very advanced stage.”

Not everyone can afford a $40 phone in an area where the gross domestic product per person is $1,900. But Immel said this would not pose a problem because in almost every village at least one person owns a cell phone. Grameen Bank in Bangladesh makes small loans to village women so that they can purchase phones and start their own small businesses charging a usage fee.

According to Immel, the only significant obstacle to the project is the lack of cell phone coverage in some areas. But even this seems surmountable, due to the 40 percent annual growth in the region’s cell phone market.

“The expectation is that we’ll have full coverage soon,” Immel said.

E-mail: vas2102@columbia.edu