Arsenic in the Groundwater of the Red River Delta Vietnam

Patricia Egenton RN BSN CEN CCRNJune 26, 2009

Crisis: Arsenic in the Tubewells

In the 1970’s the United Nations placed tubewells throughout Asia to access groundwater that lied below the surface to provide safe, clean drinking water to the people

Prior to this initiative they had been getting ill from drinking surface water

As the years went on people began to develop diseases and cancers associated with arsenic exposure

The tubewells were the sourceArsenic was leaking into the groundwater from natural

sources and environmental sources

The Red River Delta

Located in the Northern part of VietnamClose to the capital of HanoiDensely populatedRiver provides transport of goods in and out of

Vietnam and China; polluting the riverHalf the country’s rice crops are grown hereHalf the tubewells that service the Delta are

contaminated with high levels of arsenic

Map of VietnamThe Red River Delta is the area in the north between Hanoi and the Gulf of Tonkin

The darker red shades show dense areas of population. The Red River Delta is the most populated area in the north.

A Public Health Threat

Vietnam’s health care system is a mix of public and private coverage

Even with a public health system many go uninsured if they are above the poverty level but cannot afford private coverage

If such a dense population continues to be exposed, more problems will surface as the young people age

THE FOLLOWING SLIDE SHOWS THE BREAKDOWN OF HEALTH COVERAGE IN VIETNAM

The Health Care Plans in Vietnam

Compul-satory Insur-ance

Voluntary Insurance

Uninsured0%

10%

20%

30%

40%

50%

60%

School Children & StudentsPrivate PayYoung Children's FundSocial Health InsuranceHealth Care Fund for the Poor

Source: Vietnam Social Security 2007

Economic Success at Risk

1. Vietnam’s largest exportsa. crude oilb. textilesc. riced. coffee2. Poverty rates 1998 = 37% 2006 = 16%

WOW

Ensuring Healthy Human Resources for Continued Economic Success and Growth

Human resources continue to be in demandSick human resources will drain health care system

and cripple economic growth Infants, toddlers and small children are at higher risks

due to exponential growth periods If the children there today are going to enjoy the

same economic successes, opportunities and growth, they are going to need to be healthy

Vietnam should invest in protecting these specific subgroups to ensure their nations economic stability and growth

What about other groups?

Is choosing to focus on the younger

population social injustice?

Present Initiatives

The World Health Organization, a subdivision of the United Nations, has installed sand filters in many of the tubewells throughout Asia

However, a lot of attention and resources have been focused on Bangladesh where the arsenic levels are higher

The WHO needs to be equitable with resources, since the UN installed them Learn from successes and failures in Bangladesha) are people using the filtered water?b) are people forced to walk farther to the pumps fitted with the filters?c) cost – are they cost efficient?d) education – measure impact?e) funding – private and public options to supplement The WHO’s initiative? f) replacing used filters ? when? who is tracking?g) constant measuring of arsenic levels is necessaryh) constant measuring of arsenic exposure in populations is necessary to

determine effectiveness

Nursing : At the forefront of health maintenance and health education

What the Vietnamese nursing community can do NOW to help keep their people healthy and avoid overexposure to the arsenic contaminated water:

Choose one population to focus on

Evidence based research suggests focusing on pregnant women and growing children

Provide household unit filters as part of prenatal care Educate mothers Communicate via email for convenience

Continue filter use through infancySend replacement reminders and vouchers

Lobby The WHO

to add filters to school

tubewells

Take advantage of the more educated parent and educate the importance of

continuing to protect toddlers

and young children against arsenic

exposure

Monitor progress and compliance to support evidence

based practice

Support your nursing colleagues in Vietnam

What can you do?

a) write to The World Health Organizationb) verbalize the importance of nursing’s role monitoring people’s arsenic levels when using sand filters initiate school programs prenatal care education and distribution programsc) join professional organizations and attend global work groupsd) write to health officials in Vietnam

Collectively, nurses can put pressure on government health officials and influence change

Organize a nursing initiative to give web support to nurses in Vietnam about global safe water practices and educate the nurses there so they feel empowered to make a difference in their communities

FOR MORE INFORMATION:

Visit the following websites:

http://ww2.waterforpeople.org/pdfs/News/Articles/ArsenicWPC_1006.pdf

http://www.waterforpeople.org/site/News2?id=5615

http://www.who.int/mediacentre/factsheets/fs210/en/

Water is precious! Do not waste it!