Around 900 kilometres from Delhi, it is difficult to find a single household unaffected by illness in Tiwaritola village of Ballia﹘a border district cushioned between Uttar Pradesh and Bihar. Reason: presence of high levels of arsenic in groundwater.

“I have been taking medicines for my liver and arthritis since 2000. Even getting up or sitting down hurts, bones ache all the time; uric acid increases, there are problems related to thyroid,” says Tarkeshwar Tiwari, a 63-year-old villager suffering from liver cirrhosis. “I fell ill due to the arsenic. The water here has too much of it. We came to know about this because of my medical investigation.”

Diseases linked to kidneys, liver, gallbladder, uterus or other organs are common in the village. But it is not just Tiwaritola; arsenicosis is a menace in many villages in the district. The disease happens due to long-term use of groundwater with arsenic levels higher than the norms. Risks of cancer increase as body parts develop problems. Dark patches and rashes on the skin, especially on the palms, back and feet, are common symptoms.

In December 2021, the government accepted in parliament that at least 76 inhabited areas in Ballia, which is the most affected in UP, are affected by arsenic pollution. On December 13, in reply to a question in Rajya Sabha, the government said that 107 areas in 10 districts of UP are affected by the element.

On March 22 last year, the government accepted in the House that 150 districts of 21 states have arsenic levels higher than the safety limit. Twenty-eight of 75 districts in UP, 22 of 38 districts in Bihar, 18 of 33 districts in Assam, and nine of 23 districts in West Bengal have dangerous arsenic levels.

However, experts and volunteer organisations say the situation is more grim than what the government data claims.

Dependency on groundwater a problem?

While arsenic is a geogenic problem, and more than 100 countries are facing this menace, there was no information about its health hazards in India until nearly five decades ago. While scientists and researchers continue to probe the reasons behind the spread, there are some who say the problem did not exist before due to the use of surface water﹘from rivers, ponds and open wells﹘for the purpose of drinking and cooking.

According to these experts, arsenic arsenopyrite was present as a mineral in the flood plains of Ganga but it didn’t dissolve in water. However, this changed with exploitation of groundwater since the 1970s, they said.

The chemistry of water sources started changing and the arsenopyrite started to ionise, claimed Dr Ashok Kumar Ghosh, head of the research department in Mahavir Cancer Institute of Patna. He attributed this change in water usage to organisations such as the WHO and UNICEF emphasising on groundwater instead of surface water to avoid diseases like diarrhoea in several developing countries. Because of such suggestions, there was a rise in the use of groundwater with rapid installations of hand pumps and tubewells, Ghosh claimed.

India stands at 120 among 122 countries in the World Water Quality Index. According to a study by IIT Kharagpur, 20 percent of the country today is affected by arsenic and 25 crore people are in danger of developing related diseases.

As per WHO, the concentration of arsenic in groundwater should not be more than 10 micrograms per litre, or 10 PPB (parts per billion), but it is 10, 20 or 50 times the limit, sometimes going up to 100 or 200 times, in India.

The menace was first identified in the country in West Bengal in 1980, with professor Kunal Kanti Majumdar﹘a professor of community medicine at KPC Medical College of Kolkata University who has been an advisor to WHO and UNICEF﹘saying that there are about 60 lakh people in the state who live in areas affected by arsenicosis. “Arsenicosis has been found in more than 1 lakh people. Cancer has been confirmed in 8,000 of these.”

The alarm was rung in UP’s Poorvanchal region by arsenic expert Dipankar Chakravarthy, who died in 2018, when he submitted a report to the government on the presence of arsenic in half a dozen districts of UP and Bihar in the early 2000s.

However, Saurabh Singh, who worked with Chakravarthy and has been observing the issue over the last 17 years through his association with the Varanasi-based NGO Inner Voice Foundation, said, “It took us years to convince government officers, despite numerous meetings, that there’s arsenic in UP and Bihar. Because whenever we went, they parroted the same line that arsenic is in West Bengal, not in UP and Bihar.”

“On the banks of Ganga…if you look from Kanpur to Kolkata, then you’ll find that at least 5,000 cancer cases have developed in the last 15 years…when our team goes and examines the water, they find it's happening because people have been drinking water polluted with arsenic for a long time…And the concentration of arsenic is extremely high, at some places we have found 500 PPB, 1000 PPB and even up to 3000 PPB.”

However, governments seemed to remain oblivious to the problem, especially in UP and Bihar. While there are several patients in Handia and Kaudihaar blocks of Prayagraj district with symptoms of arsenicosis, a list of affected districts presented on December 13 last year by the Ministry of Jal Shakti﹘while responding to a question related to the arsenic problem in the Rajya Sabha﹘did not have Prayagraj district in it.

Newslaundry sent a list of questions to Akhand Pratap Singh, executive director of UP water and sanitation mission and special secretary of the Namami Gange and rural water supply department, as well as the Namami Gange principal secretary Anurag Srivastava. Queries were also sent to the DMs of Ghazipur and Ballia, which are among the most affected districts in UP. This report will be updated if we receive a response.

The tragedy has been unfolding in Bihar too.

In Chakani village, about 100 kilometres from Bihar’s Bhojpur, Abhimanyu Singh’s mother Lalpari died from cancer a few years ago, with arsenicosis symptoms on her skin. Saying that the doctors had pointed to arsenic, Singh claimed, “Due to being close to the Ganga, we have ample water, but what can we do about the arsenic present in the groundwater?”

Dr Arun Kumar, a scientist at Mahavir Cancer Institute who has been conducting field research on patients with arsenicosis, said, “In the past few years, during research in arsenic-affected areas, we have seen that people are drinking water with many times more arsenic than the safe limit. According to research, if someone is drinking only 2 litres of water with more than 10 PPB of arsenic, then within a few years there’s a chance of 1 person out of 500 developing cancer…some of our tests showed arsenic levels higher than 500 PPB…In this condition, one out of 10 persons has a higher chance of developing cancer.”

Ashok Kumar Ghosh of the institute said “people didn’t believe us” when we “started working in 2003” in “Patna, Bhojpur, Bhagalpur and Vaishali”. “Especially the government claimed that it was all rubbish and these scientists keep blabbering…arsenic might be in Bangladesh but not in Bihar.”

‘Link between cancer, arsenic and water’

Nupur Bose, a professor in the environment and water management and geography departments in Patna’s A N College, has worked on arsenic-affected areas for about 20 years, and has created a large database of arsenicosis patients.

“The number of cancer patients is increasing in Mahavir Cancer Institute, which we collaborate with on many projects for scientific research. We have found that these patients are coming from places we identified as arsenic-affected areas in 2004 and 2005. We even remember the names of those people. We checked our database and discovered that these patients are the same people who had handpumps installed with extremely high arsenic levels. We went to those regions again and verified this.”

Dr Ashok Ghosh said the institute now has photographs of hundreds of patients who have arsenicosis and cancer. “A strong correlation has been found between arsenic and gallbladder cancer which we are also researching. Patients who are coming here are coming from arsenic hot spots.”

Early deaths?

Many claim that people are dying early in arsenic-hit areas as compared to the average life expectancy in the country (67.5 years for men and 69.8 years for women).

“Nobody survives beyond the age of 55-60. People who have good food regimes and can buy clean drinking water are the ones who are relatively safer,” said Chandrabhushan Singh, a social worker who helps arsenic-hit patients in the districts of Bihar and eastern UP.

Rajendra Yadav, whose mother Samal Devi died of cancer a few years ago, said, “People are poor, they have no choice but to drink contaminated water. They have no money for treatment when they fall ill. Their diet is not nutritious. What else would happen other than death?”

In part II: Arsenic in the food chain, how it affects social dynamics

(This report has been brought about with help from the Thakur Family Foundation; the foundation has not interfered in any editorial decision)