[An article originally carried in the “Asia Arsenic Network” Newsletter No. 3, January 30 1998]

by: Sachie Tushima

Dr. Sk. Abdul Hadi , Medical Officer of Bangladesh's National Institute of Preventive & Social Medicine (NIPSOM) in Dhaka, who accompanied me then, kindly explained: “In the rural area of Bangladesh, it is not compulsory for parents to register a newly born baby with the authority. Hence Rezaul himself does not know his date of birth.”

When I visited Samta early May 1997 for the second time , Rezaul was suffering badly. Black spots (pigmentation) that covered his body were swollen like hardened scabs, and some of them on the thigh were sharply cracked showing red flesh. As soon as he made a small movement, such cracks gave him unbearable pain running through his whole body. He had a high temperature, too. He appeared to have difficulties in breathing and occasionally breathed a deep breath like a sigh. I was afraid that Rezaul would die if he were left as he was.

According to Rezaul , black spot began to appear on the skin five to six years ago, and they became swollen and gradually hardened. In particular, the symptoms grew badly around the shoulder joints and elbows and from the insteps to the feet to the femoral region. On the palms and soles tiny knobs appeared first and developed bigger and bigger into the size of small peas. He suffered attacks of pain when he tried to hold something or walk. Later he felt very weak and often just lay in the bed. “I was just crying then”, he said.

Rezaul had never seen a doctor. His father was an agricultural labourer and his income was meager. It could not have been easy for him even to feed his five children. None of them have been to school. Rezaul himself used to work with his father when he was well and earned Taka 25 per day. “Though it was lucky if I could work three day s a week…” murmured Rezul with downcast eyes.

“This will be the first and last stay in hospital. I will never be able to come home alive.” So he felt when he visited the Sharsha Thana Hospital later in May 1997. He was holding a stick in one hand and in the other hand a prescription and some money for medicine given by Dr. Sk. Akhtar Ahmed of NIPSOM who had been in Samta earlier that month for a survey to identify arsenicosis patients in the village.

The pain that ran through his body and the itch that would not diminish even while lying down drove him out of the room. With the help of a stick he walked in the corridor or wandered in the garden, but soon he felt exhausted and returned to the room, again to lie in bed.

“I may not be alive tomorrow…” -- Rezaul was seized with such fear every day. When he recalled his days in hospital during my interview, five months after his hospitalization, a gloomy cloud passed over his face.

“I think I was lucky to have three solid meals at the hospital. I was particularly happy to be able to drink safe water as much as I wanted. You see, I had learned from a Japanese survey team (*) that my black spots (pigmentation) on the skin, knobs (keratosis) on the palms and soles, the swelling (edema) on the right leg and the tumid belly ( hepatomegaly ) were all due to a disease called arsenic poisoning and that it was caused by drinking arsenic contaminated water from the well. ”

In March 1997, during the joint survey by the Asia Arsenic Network (AAN) , Miyazaki University of Japan and NIPSOM, it was found that the water of the well Rezaul's family had been using contained arsenic of 1.16mg/L. The well was sealed immediately, but the family had been drinking its water over the past six to seven years. Rezaul's brother, Ziarul (17), and his sisters, Anjuara (13) and Pilu (9), clearly manifest arsenic-related skin lesions such as pigmentation or keratosis. His father, Lokman Ali (51), also has many black spots like big freckles on the chest, although they are not as significant as Rezaul's . Probably, the water Lokman Ali drank at his workplace was not so contaminated as the one near his house.

However, Rezaul's mother died seven years ago, showing similar skin symptoms to his. It is obvious that the family had been exposed to arsenic contamination longer than the past six to seven years, through it is almost impossible to verify it now.

While he was in hospital, Rezaul took penicillamine , vitamins A, C and E daily, as well as arsenic-free safe water, as prescribed by Dr. Akhtar . After one month, his health recovered so well that he almost forgot the days when he had felt difficult even to breath. Soon, though very slowly, the hardened scab like black spots became less conspicuous. The belly, too, seemed to be caving in.

Two and a half months later, Rezaul returned alive in Samta. He had never felt homesick when he was in hospital, but cried on the ragged edge of death . He could not stop the tears running down his cheeks when he saw his family again. His younger brother and sisters cried too, and welcomed him home.

On regaining his health, though he still has some disorders on the bronchus, Rezaul had a burning itch to work and earn. “I know I have not worked enough for a long time because of my ill health while my brother, Ziarul , has been working hard in the field. I always felt ashamed and guilty for that. You know, if I had got a job, everyone of my family could certainly have enjoyed a better life.”

It is not easy to find a job in a little village like Samta, however. Regretfully, Rezaul whiles away his time chatting in a village cafe. Naturally, he is neither content nor happy with this. “If possible, I would like to open a grocery shop, selling rice, salt, mustard oil, …” Rezaul talks about his dream. Without literacy, and without funds, his future may be full of thorns, though.

However, he looked far livelier in October 1997 compared with the Rezaul I had know n from previous meetings. He even looked more handsome than before, too. It was because he had recovered his health and grown his hair.

(*) Obviously it is Rezaul's misapprehension that he learned from a Japanese survey team that he was suffering from arsenic poisoning. In December 1996, Dr. Akhtar of NIPSOM introduced him as one of the arsenicosis patients to the AAN team which was probably the first visitors to Samta from Japan. This remark of his may tell that he remembers clearly the encounter with foreigners as an unforgettable incident.

POSTSCRIPT:    Mr. Rezaul Morol started working as rikishaw -van puller in 1998.   He got married to Aleya in 2001 and is a father of two daughters now.   (This information was added in November 2005).