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The signs of chronic poisoning appeared almost two decades ago, but the issue did not receive official international recognition until 1998. Key players debate when the first signs of contamination appeared, who discovered it, and who tested it, but it is abundantly clear that they were slow to take action. The Bangladeshi government claims that it became aware of contamination in 1993 and knew by 1995 that it was a widespread problem. Officials from the Dhaka Community Hospital maintain that the problem was brought to the government's attention in 1985. Today it appears that at least 59 of Bangladesh's 64 districts have contaminated water. Arsenic has reduced the national safe water supply from 97 to 74 percent.
In the years that followed the UNICEF well-drilling, Bangladesh rejoiced at the prospect of a country freed from water-borne illnesses. Today, Bangladeshis have less reason to celebrate. The people most adversely affected Ð Bangladeshis with lower income, lower levels of education, and lower levels of nutrition - are those least able to help themselves. Arsenicosis, the constellation of disorders that results from years of drinking arsenic-rich water and eating grain that has been irrigated with the pumped water, is inextricably intertwined with poverty. One survey showed that 71 percent of arsenicosis victims are low-income individuals, 29 percent are middle class, and almost none are members of high-income groups. If the demographics of this poisoning were different, would it have taken so long to acknowledge the problem?
The answer seems clear: a catastrophe this widespread would never have gone unattended amongst a wealthier, less marginalized group. Bangladesh faces an instance of what John Tudor Hart dubbed the "Inverse Care Law" in a February 1971 Lancet article. According to Hart, "the availability of good medical care tends to vary inversely with the need for it in the population served." In Bangladesh, the relationship between arsenic poisoning and poverty is not only inversely proportional but symbiotic: the two create a tragic feedback loop of poverty and disease.