The Role of Anthropology: Part I

Various modes of education have been employed in recent efforts to raise awareness about the dangers of arsenic poisoning. Door-to-door information campaigns have been very successful in fostering behavioral change in pilot studies (Madajewicz, Pfaff, van Geen, Graziano, Hussain, Momotaj et al., 2007; Opar et al., 2006). More broad-based media operations have been shown to elicit a similar increase in popular knowledge, yet are less likely to result in community-initiated well testing (Madajewicz et al., 2007). Several investigations have shown that sensationalization of the problem elicits the most powerful responses from community members. “Drinking arsenic-contaminated water is like drinking poison” is a slogan that prompted a widespread demand for safe water in affected communities, particularly from concerned parents (Hadi, 2003). In communities where there have been limited education campaigns, however, the gravity of the situation is not widely understood, and thus change has been slower to reach these areas (Caldwell, Smith, Caldwell, & Mitra, 2005; Ushijima, Inaoka, Kadono, Murayama, Nagono, Nakamura et al., 2001).

The education of rural inhabitants is of crucial importance in curbing the spread of arsenicosis, yet a more concrete mode of information transmission must be developed in order to reach all of the individuals at risk (Rahman, Sengupta, Ahamed, Chowdhury, Lodh, Hossain et al., 2005). A theoretical framework of risk communication has previously been employed in relation to other public health crises, and is an area that could well be explored further with respect to the epidemic of arsenicosis (Driedger & Eyles, 2003). For instance, is risk better understood on the large scale (macro) in terms of statistics, or on a smaller scale (micro) that emphasizes the disease burden felt by individuals/ community groups? Studies have also examined the use of a common sense model (CSM) in risk assessment (Severtson, Baumann, & Brown, 2006). To what degree is common sense applicable in the context of rural Bangladesh?

Education initiatives enable individuals living in affected areas to list—and use—sources of safe water, and they have begun to accurately associate symptoms such as melanosis and keratosis with arsenic poisoning instead of leprosy (Caldwell et al., 2005). Despite these advances, arsenicosis is still widely believed to be a contagious condition, ultimately perpetuating the associated stigma. A study of stigma toward leprosy victims in Bangladesh indicated a lesser quality of life and a poorer mental health status in patients than in the general populous (Tsutsumi, Izutsu, Islam, Maksuda, Kato, & Wakai, 2007). According to stigma theory, being marginalized from a group causes one to feel reduced to only part of a person, or to feel discarded from the remainder of society (Major & O'Brien, 2005). A parallel study could be conducted with sufferers of arsenic poisoning, potentially shedding light on the interaction of victims within their villages and on the changing perceptions of arsenic as popular knowledge is increased.


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