Sam Bonal, a technician with the Department of Rural Water Supply takes a water sample in Preah Sdaach district, Prey Veng, as part of the World Health Organization water quality survey.

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RELIMINARY results of a World Health Organization (WHO)-sponsored survey of Cambodia's

water quality have revealed traces of "relatively high levels" of arsenic

in samples of groundwater taken from the provinces of Prey Veng, Kandal, Battambang

and Kratie.

The survey, formulated by WHO-Cambodia in collaboration with the Ministry of Rural

Development (MRD) and the Ministry of Industry, Mines and Energy (MIME), revealed

that 9 percent of a total of 88 rural ground water samples taken in 13 provinces

between March and June indicated arsenic contamination. At least two of the arsenic-contaminated

samples originated from water sources in unnamed provincial capitals.

"It so happens that in our test samples 9 percent of the tests contained some

arsenic...according to WHO water safety guidelines; those 9 percent [of test results]

are relatively high," explained Ministry of Rural Development Secretary of State

Ly Thuch.

Thuch and WHO officials emphasized that determining the full extent of the arsenic

poisoning and its potential human impact required urgent additional testing in affected

areas.

The preliminary survey results also indicated potentially harmful levels of fluoride

and nitrate in "a very small number" of water samples. The survey results

of 4,000 separate analyses for evidence of pesticide contamination of ground water

sources indicated levels "too low to measure".

The water sources surveyed consisted mainly of hand-pump wells built by an array

of organizations including UNICEF, UNDP-CARERE, Partners for Development and Concern

Worldwide.

Thuch said he initiated the survey based on his concern that mass arsenic poisoning

of the type discovered in Bangladesh in 1993 might occur in Cambodia, but insisted

that the survey's preliminary results indicated that the current public health risk

posed by the arsenic was minimal.

"In the short term, it [the presence of arsenic] is not a serious problem,"

Thuch said, explaining that the majority of Cambodia's 40,000 rural wells were built

in the past decade and thus fell short of the 15 to 20 years linked to potentially

fatal arsenic exposure.

However, Thuch said immediate and urgent further investigation of the threat posed

by the arsenic contamination was essential.

"The [water quality] survey shows the need for serious, continuing water quality

testing in Cambodia," he said. "We need financial assistance from donors

to enable WHO to carry out further water quality testing and evaluation of the arsenic

threat."

Steve Iddings, a WHO Environmental Engineer, was unable to give precise figures on

the level of arsenic contamination uncovered by the survey, but echoed Thuch's insistence

that the levels didn't indicate a serious public health threat.

""I'd prefer to say that we [WHO] don't expect the levels [of arsenic in

Cambodian groundwater] to cause problems of the scale of seriousness of Bangladesh

... By and large water quality is quite good but further attention is warranted,"

Iddings said. "There's been no indication of clinical [arsenic] poisoning and

we don't expect any, but further testing is needed to determine to what extent arsenic

occurs [in groundwater] and if any people have been affected."

According to Iddings, the discovery of arsenic contamination in Cambodia's groundwater

sources was "no surprise".

"The Southeast Asian region is known to be pre-disposed to arsenic... Arsenic

occurs in alluvial deposits along river plains," he said. "Since high levels

of these elements were detected in Bangladesh, worldwide attention has focused on

arsenic and fluoride."

Both Thuch and WHO-Cambodia officials urged public calm in the wake of the release

of the survey's preliminary results, describing the health threat of bacteriologically

contaminated surface water as far more immediate and serious than the long-term potential

damage wrought by arsenic.

"Bacteriological contamination remains the greatest threat to human health when

it comes to drinking water," said WHO-Cambodia representative Dr. Bill Piggot.

"This survey is not likely to change that fact."

Piggot's assessment of the relative risk of arsenic contamination of ground water

compared to the bacteriological risks of Cambodia's surface water was echoed by Inga

L Oleksy, Program Manager for Partners for Development (PFD) which has funded the

construction of more than 800 rural wells in Kratie and Stung Treng.

"We must assess the risk of a 20-year long term [exposure] risk of arsenic in

relation to the immediate impact of people using unsafe [surface] water sources,"

Oleksy said. "If people switch to surface water sources [due to a fear of potential

arsenic contamination], incidents of gastroenteritis would increase, which affects

the weakest, such as children under five and pregnant and breast-feeding mothers,

and would have a dramatic impact on Cambodia's infant mortality rate."

Successfully addressing the arsenic contamination threat depended upon linking the

matter to wider water quality issues, Iddings said.

"We hope to be able to fund a long-term public health campaign ... not just

focusing on arsenic but using it as a vehicle to educate the public on the importance

of personal and public hygiene and the need to keep water sources clean," he

said.

According to Thuch, further testing to determine the extent of the arsenic contamination

and its possible human impact would begin in mid-September following the release

of the survey's final report and a series of meetings with concerned international

organizations, NGOs and related Government ministries.

"We hope to equip mobile teams with water testing kits that will work with village

development committees to share information on how to avoid [arsenic] contamination,"

he said.

PFD has already reacted to WHO confirmation that one of the contaminated water sources

in Kratie was a PFD-funded well.

PFD's Country Representative Michael Chommie told the Post that a pre-planned USAID-funded

water quality surveillance program of PFD's Kratie and Stung Treng wells "had

been moved up" as a result of the survey findings.

Jamie Meiklejohn, spokesperson for UNICEF-Cambodia, which has dug approximately 12,000

wells in Cambodia in the past decade, told the Post that the agency was awaiting

Cambodian government recommendations on how to handle the contamination.

Iddings stressed that numerous "mitigating factors" made the potential

health impact on communities adjacent to arsenic contaminated water sources difficult

to predict.

"It depends on factors such as how the water is treated, filtered and settled

and whether people nearby actually are consuming the water," he said.

For communities found to be dependent on water sources judged to be seriously contaminated

with arsenic, Iddings said that abandonment of the water source might prove to the

most cost-effective solution to the problem.

"Technical [solutions] to arsenic contamination are either too expensive or

unsustainable at the household level," he said. "When no good alternative

exists, people would be guided to another [water] source in a worst-case scenario."

Thuch says a successful resolution of the arsenic contamination will remain the focus

of his tenure at the MRD.

"We are determined that Cam-bodia's rural population receive the same quality

of water enjoyed by people in the cities," he said. "There must be no more

double standard in water quality for the rural and urban populations."

 

Asia's arsenic crisis

 

ARSENIC is a naturally occurring, water-soluble compound whose toxicity has

been noted for more than 4,000 years.

Although a dose of 125 grams is enough to kill an adult, arsenic is better known

for its chronic, long-term impact through water contamination.

Arsenicosis manifests itself after eight to 15 years of long-term consumption of

arsenic-laced water through symptoms that are often mistaken for leprosy: abnormal

black-brown pigmentation of the skin, thickening of the skin on palms and soles,

gangrene in the lower extremities and skin cancer. In the most serious of cases,

arsenic poisoning can result in liver and renal deficiencies.

Arsenic poisoning is difficult to detect and is treatable only in its early stages

by switching to arsenic-free water sources.

In Bangladesh the drilling of thousands of tubewells in the 1970s through arsenic-rich

alluvial soil has resulted in what scientists now describe as the worst case of mass-poisoning

in human history.

Twenty million of Bangladesh's 120 million people are now dependent on arsenic-contaminated

water sources and the number of arsenic-related deaths in the country is growing

exponentially each year.

"Bangladesh's experience [with] arsenic toxicity in drinking water and the suffering

of her people in the affected areas could be a valuable lesson for other developing

countries on the severity of public health hazard as a result of arsenic contamination

in groundwater," writes Bangkok-based water consultant T V Luong in a briefing

paper on the Bangladesh experience. "Early detection of arsenic contamination

and prevention of human exposure hold the key for the protection and control of [this]

public health hazard."