This action research programme is concerned with safe drinking water in rural
Bangladesh – a matter of grave urgency since the discovery of arsenic in the
groundwater more than a decade ago. Between 35 and 77 million users are
exposed to dangerous levels of contamination, and the implementation of
solutions has been slow and inadequate. Few projects have been undertaken,
and even fewer have managed to develop suitable operation and maintenance
arrangements, to bypass existing power relations, and to extend services to the
very poor.
The aim is to understand these failures and to suggest a more successful
approach. The findings come out of a safe drinking water supply programme,
implemented by the Arsenic Mitigation and Research Foundation (AMRF) in several
arsenic affected villages.
Description of field-level activities
Problem and aim
Physicalprocess
Tube-well testing Site selection
Site selection
An installation site for
the water supply is
selected during a village
meeting. Informal talks
reveal whether the
choice is appropriate or
not. Landownership is
legally vested in the
community. This step is
crucial to avoid
monopolisation of the
water supply by the
landowner.
Installation of the
water supply
With the assistance of
the staff, a contractor is
selected. The
community provides
some material and
logistical support. The
installation process is
monitored to ensure
proper installation.
Setting up an
information centre
A simple shed is set up
and furnished with
posters and information
material. This will help
facilitate the dialogue
between staff,
committee members
and the community (see
social process).
Setting up homestead
gardening
As arsenicosis is
worsened by
malnutrition, affected
households are helped
to establish fruit and
vegetable gardens.
Data collection in the
working area
General geographic
information is collected
about a working area
(usually a union or sub-
district).
Tube-well screening
In several survey
villages, tube-wells are
tested for arsenic (and
marked) in order to
identify those most
seriously affected.
Technology
assessments
Previous and present
drinking water projects
are assessed. Villages
are selected where no
other programmes are
running, or where they
have previously failed.
Money collection and
savings
The committee opens a
bank account and
collects financial
contributions from water
users. The contributions
are not large, allowing
everyone to participate.
Some of the money can
be used to share in the
investment; some for
maintenance. The
committee is
encouraged to meet
once a month in the
information centre to
discuss operation and
maintenance issues, the
use of the bank
accounts, and so on.
Maintenance of the
water supply
Financial contributions
serve to buy and stock
spare parts. The
committee repairs the
water supply whenever
required. Since women
are usually first to signal
problems with the
operation of a water
supply, they have an
important role in the
committee. When
expensive repairs are
needed the committee is
encouraged to collect
more money from water
users.
Water users
Information centre
Tube-well marking Water supply installation
Handpump maintenance
Information centre
Studying existing water
supplies Water supply installation Platform in disrepairHomestead garden
Socialprocess
Household survey School programme
Consultation and
agreement
The implementation
process is discussed
and agreed upon with
the community. The
technologies assessed
during the surveys are
discussed. This leads to
the selection of a water
supply option.
Establishment of a
committee
In a village meeting, the
staff facilitates the
election of twelve
committee members -
both men and women.
With an understanding
of the local socio-
economic conditions,
the staff can better
assist the poor and
improve their
representation in the
committee.
Raising awareness
Information about
arsenic is initially
disseminated during
surveys. Later, meetings
are organised to reach
different social groups
(courtyard gatherings,
school programmes, tea
stall meetings and
information centre
meetings). As people
may be alarmed or feel
powerless, simple
nutritional tips are
suggested.
Treatment of patients
Regular treatment is
provided to arsenicosis
patients identified during
surveys. They are also
given seeds and support
for starting homestead
gardening (see physical
process).
Paramedic training
Orientation meetings
(Non-) Governmental
Organisations in the
working area are visited
to form an idea about
who is doing what on
arsenic.
Socio-economic
survey
In order to select the
poorest survey village,
data are gathered about
the social, economic,
educational and familial
status of households.
Arsenicosis patients
identification
Trained staff screens
possible arsenicosis
patients. This initial
investigation may reveal
more serious poisoning
in some villages.
Maintenance of the
committee
With increased
awareness of the
dangers of arsenic, and
interest in a functioning
water supply, water
users are more likely to
keep an eye on
committee members.
The staff helps to
motivate or replace
inactive members. This
is the beginning of
peopleʼs control over the
committee. To
encourage self-
monitoring in the long-
term, village volunteers
are selected to monitor
committee members
and their duties.
Follow-up treatment
Arsenicosis patients still
require treatment long
after having shifted to
arsenic-free water.
Better diets through
homestead gardens
may gradually replace
medical support.
Paramedic training will
help increasing people's
understanding.
People's
organisations
The committee is
encouraged to become
a 'peopleʼs organisation'
that will independently
establish access to
other public services
(such as sanitation,
education, or road
construction).
Courtyard meeting
Data analysis Committee election
Village volunteers
Patient treatment
Patient screening Committee New road in the villagePatient treatment
OrganisingSurveying Facilitating
Select and
analyse a
village
Establish drinking
water and public
health systems
Improve well-being
through sustainable
water and health
systems
Overview of field-level activities
Physicalprocess
Tube-well testing Site selection
Site selection
An installation site for
the water supply is
selected during a village
meeting. Informal talks
reveal whether the
choice is appropriate or
not. Landownership is
legally vested in the
community. This step is
crucial to avoid
monopolisation of the
water supply by the
landowner.
Installation of the
water supply
With the assistance of
the staff, a contractor is
selected. The
community provides
some material and
logistical support. The
installation process is
monitored to ensure
proper installation.
Setting up an
information centre
A simple shed is set up
and furnished with
posters and information
material. This will help
facilitate the dialogue
between staff,
committee members
and the community (see
social process).
Setting up homestead
gardening
As arsenicosis is
worsened by
malnutrition, affected
households are helped
to establish fruit and
vegetable gardens.
Data collection in the
working area
General geographic
information is collected
about a working area
(usually a union or sub-
district).
Tube-well screening
In several survey
villages, tube-wells are
tested for arsenic (and
marked) in order to
identify those most
seriously affected.
Technology
assessments
Previous and present
drinking water projects
are assessed. Villages
are selected where no
other programmes are
running, or where they
have previously failed.
Money collection and
savings
The committee opens a
bank account and
collects financial
contributions from water
users. The contributions
are not large, allowing
everyone to participate.
Some of the money can
be used to share in the
investment; some for
maintenance. The
committee is
encouraged to meet
once a month in the
information centre to
discuss operation and
maintenance issues, the
use of the bank
accounts, and so on.
Maintenance of the
water supply
Financial contributions
serve to buy and stock
spare parts. The
committee repairs the
water supply whenever
required. Since women
are usually first to signal
problems with the
operation of a water
supply, they have an
important role in the
committee. When
expensive repairs are
needed the committee is
encouraged to collect
more money from water
users.
Water users
Information centre
Tube-well marking Water supply installation
Handpump maintenance
Information centre
Studying existing water
supplies Water supply installation Platform in disrepairHomestead gardenSocialprocess
Household survey School programme
Consultation and
agreement
The implementation
process is discussed
and agreed upon with
the community. The
technologies assessed
during the surveys are
discussed. This leads to
the selection of a water
supply option.
Establishment of a
committee
In a village meeting, the
staff facilitates the
election of twelve
committee members -
both men and women.
With an understanding
of the local socio-
economic conditions,
the staff can better
assist the poor and
improve their
representation in the
committee.
Raising awareness
Information about
arsenic is initially
disseminated during
surveys. Later, meetings
are organised to reach
different social groups
(courtyard gatherings,
school programmes, tea
stall meetings and
information centre
meetings). As people
may be alarmed or feel
powerless, simple
nutritional tips are
suggested.
Treatment of patients
Regular treatment is
provided to arsenicosis
patients identified during
surveys. They are also
given seeds and support
for starting homestead
gardening (see physical
process).
Paramedic training
Orientation meetings
(Non-) Governmental
Organisations in the
working area are visited
to form an idea about
who is doing what on
arsenic.
Socio-economic
survey
In order to select the
poorest survey village,
data are gathered about
the social, economic,
educational and familial
status of households.
Arsenicosis patients
identification
Trained staff screens
possible arsenicosis
patients. This initial
investigation may reveal
more serious poisoning
in some villages.
Maintenance of the
committee
With increased
awareness of the
dangers of arsenic, and
interest in a functioning
water supply, water
users are more likely to
keep an eye on
committee members.
The staff helps to
motivate or replace
inactive members. This
is the beginning of
peopleʼs control over the
committee. To
encourage self-
monitoring in the long-
term, village volunteers
are selected to monitor
committee members
and their duties.
Follow-up treatment
Arsenicosis patients still
require treatment long
after having shifted to
arsenic-free water.
Better diets through
homestead gardens
may gradually replace
medical support.
Paramedic training will
help increasing people's
understanding.
People's
organisations
The committee is
encouraged to become
a 'peopleʼs organisation'
that will independently
establish access to
other public services
(such as sanitation,
education, or road
construction).
Courtyard meeting
Data analysis Committee election
Village volunteers
Patient treatment
Patient screening Committee New road in the villagePatient treatment
OrganisingSurveying Facilitating
Select and
analyse a
village
Establish drinking
water and public
health systems
Improve well-being
through sustainable
water and health
systems
Overview of field-level activities
The diagram shows two basic processes: a physical and a social one. The
physical process relates to technological and ecological assets; the social process
to human and organisational assets. The processes run in parallel, and both
roughly follow the three phases of surveying, organising and facilitating. The
first phase leads to the selection of a village. In the second phase, AMRF assists
the community with investments in new assets, such as a water option, a
maintenance committee, knowledge, skills, and so on. In the third phase, AMRF's
direct involvement is reduced, as it begins to support activities leading to the
sustainability of the water and health systems. The diagram represents work-in-
progress, and will be elaborated as new findings emerge from practice.
Approach, processes and phases
Tube-well testing
Tube-well marking
Studying existing water
supplies
Data collection in the working area
General geographic information is
collected about a working area (usually a
union or sub-district).
Tube-well screening
In several survey villages, tube-wells are
tested for arsenic (and marked) in order
to identify those most seriously affected.
Technology assessments
Previous and present drinking water
projects are assessed. Villages are
selected where no other programmes are
running, or where they have previously
failed.
Surveying
Physical Process
Household survey
Data analysis
Patient screening
Orientation meetings
(Non-) Governmental Organisations in
the working area are visited to form an
idea about who is doing what on arsenic.
Socio-economic survey
In order to select the poorest survey
village, data are gathered about the
social, economic, educational and familial
status of households.
Arsenicosis patients identification
Trained staff screens possible
arsenicosis patients. This initial
investigation may reveal more serious
poisoning in some villages.
Surveying
Social Process
Select and
analyse a
village
Outcome of the surveying phase
Site selection
An installation site for the water supply is
selected during a village meeting.
Informal talks reveal whether the choice
is appropriate or not. Landownership is
legally vested in the community. This step
is crucial to avoid monopolisation of the
water supply by the landowner.
Installation of the water supply
With the assistance of the staff, a
contractor is selected. The community
provides some material and logistical
support. The installation process is
monitored to ensure proper installation.
Site selection
Water supply installation
Water supply installation
Organising
Physical Process
Setting up an information centre
A simple shed is set up and furnished
with posters and information material.
This will help facilitate the dialogue
between staff, committee members and
the community (see social process).
Setting up homestead gardening
As arsenicosis is worsened by
malnutrition, affected households are
helped to establish fruit and vegetable
gardens.
Information centre
Information centre
Homestead garden
Organising
Physical Process
Consultation and agreement
The implementation process is discussed
and agreed upon with the community.
The technologies assessed during the
surveys are discussed. This leads to the
selection of a water supply option.
Establishment of a committee
In a village meeting, the staff facilitates
the election of twelve committee
members - both men and women. With
an understanding of the local socio-
economic conditions, the staff can better
assist the poor and improve their
representation in the committee.
Courtyard meeting
Committee election
Committee
Organising
Social Process
Raising awareness
Information about arsenic is initially
disseminated during surveys. Later,
meetings are organised to reach different
social groups (courtyard gatherings,
school programmes, tea stall meetings
and information centre meetings). As
people may be alarmed or feel
powerless, simple nutritional tips are
suggested.
Treatment of patients
Regular treatment is provided to
arsenicosis patients identified during
surveys. They are also given seeds and
support for starting homestead gardening
(see physical process).
School programme
Patient treatment
Patient treatment
Organising
Social Process
Establish drinking
water and public
health systems
Outcome of the organising phase
Water users
Handpump maintenance
Platform in disrepair
Money collection and savings
The committee opens a bank account
and collects financial contributions from
water users. Low contributions allow
everyone to participate. Some of the
money is used for the investment; some
for maintenance. The committee meets
regularly in the information centre to
discuss operation and maintenance.
Maintenance of the water supply
Contributions serve to buy spare parts.
The committee repairs the water supply
whenever required. Women are usually
first to signal problems with operation of a
water supply, and have an important role
in the committee. For expensive repairs
the committee collects more money.
Facilitating
Physical Process
Paramedic training
Village volunteers
New road in the village
Maintenance of the committee
With increased awareness and interest,
water users keep an eye on committee
members. The staff helps to motivate or
replace inactive members. Village
volunteers monitor committee members
and their duties. This is the beginning of
peopleʼs control over the committee.
Follow-up treatment
Arsenicosis patients still require
treatment long after having shifted to
arsenic-free water. Better diets through
homestead gardens may gradually
replace medical support. Paramedic
training increases understanding.
People's organisations
The committee is encouraged to become
a 'peopleʼs organisation' that will
independently establish access to other
public services (such as sanitation,
education, or road construction).
Facilitating
Social Process
Sustainable
development of
water and health
systems
Outcome of the facilitating phase

More Related Content

PDF
The worst mass poisoning in history
PPTX
Governments: Thomas Chiramba, UNEP, 16th January UN Water Zaragoza Conference...
PPTX
Optimising community management of rural water services
PPTX
Rich -india stakeholder engagement presentation (feb 19 2013)
PDF
Integrated Urban Water Management - Tools and Training. By Kalanithy Vairavam...
PPTX
Overview of faecal sludge management challenges and practices
 
PPT
Leading With Sustainability Webinar - December 15, 2011
PDF
Faecal-Sludge-Management-WASH-Problem-Exploration-Report
The worst mass poisoning in history
Governments: Thomas Chiramba, UNEP, 16th January UN Water Zaragoza Conference...
Optimising community management of rural water services
Rich -india stakeholder engagement presentation (feb 19 2013)
Integrated Urban Water Management - Tools and Training. By Kalanithy Vairavam...
Overview of faecal sludge management challenges and practices
 
Leading With Sustainability Webinar - December 15, 2011
Faecal-Sludge-Management-WASH-Problem-Exploration-Report

What's hot (11)

PDF
State of the Water Sector Report 2014 presentation
PDF
Waterkeeper submission: Review of Ontario’s Environmental Bill of Rights and ...
PPTX
Market research and products concepts for sanitation: CCI
PPTX
Water for the urban poor_AJ James_2013
PPTX
Action research for social learning and water governance – a facilitative ser...
 
PPTX
Fecal Sludge Management
PDF
LHWP Information Sheets
PPTX
Challenges in expanding water access via Watercredit_Nayakam _2013
PPTX
Output Based Incentives for Urban Sanitation - WSP 21nov11
PPT
AfricaSan 2011: WASHCost findings - Catarina Fonseca
 
State of the Water Sector Report 2014 presentation
Waterkeeper submission: Review of Ontario’s Environmental Bill of Rights and ...
Market research and products concepts for sanitation: CCI
Water for the urban poor_AJ James_2013
Action research for social learning and water governance – a facilitative ser...
 
Fecal Sludge Management
LHWP Information Sheets
Challenges in expanding water access via Watercredit_Nayakam _2013
Output Based Incentives for Urban Sanitation - WSP 21nov11
AfricaSan 2011: WASHCost findings - Catarina Fonseca
 
Ad

Viewers also liked (8)

PPSX
Presentacio G
XLSX
Kardex y Inventario
PDF
Ecce report
DOCX
Cubicaje[1]
PPT
Presentació XARXA MARGOT
PPTX
Brandongalicia
PPSX
Presentacio v1mpf
PPT
Jell o!!!!
Presentacio G
Kardex y Inventario
Ecce report
Cubicaje[1]
Presentació XARXA MARGOT
Brandongalicia
Presentacio v1mpf
Jell o!!!!
Ad

Similar to AMRF activities (20)

DOC
Watsan training sample proposal
PDF
MaintreamingGenderinWaterResources_WorldVision Process
PDF
Coniwas annual report 2011
PDF
A Framework for Action
DOC
Exercise: Watsan logframe with blanks
PPT
Session Harmonization 2c - Lambert Olweny
 
PPT
Experience and situation of wate management in rural districts of Same & Kigo...
PPTX
South African Water Caucus Overview Nov 2017
PDF
Community Managed DEWATS in Kathmandu Valley, Nepal
PPT
2015 WASH e-Summit (Part 1): An Introduction to Water, Sanitation, and Hygien...
PPTX
Intro to help davao nov 2010
PPTX
Civil Society: Shauna Curry, 16th January UN Water Zaragoza Conference 2015
PDF
MHA FPX 5028 Assessment 4: Water Quality Improvement Action Plan
PPT
Innovative participatory community managed drinking water delivery approach i...
PDF
The Challenges of Wastewater Management in Rural Communities
PDF
Bunaken Island | Nov-15 | Improving the water supply, sanitation and hygiene ...
PPT
Going From Centralized Wastewater Treatment to Decentralized Wastewater Treat...
PDF
GWP Poster - RWH in Rural Communities
PPTX
Cà phê sáng Phi lợi nhuận 03/2016: Trách nhiệm với đối tượng thụ hưởng
PPTX
Water survey report cause of water survey impact of water scarcity
Watsan training sample proposal
MaintreamingGenderinWaterResources_WorldVision Process
Coniwas annual report 2011
A Framework for Action
Exercise: Watsan logframe with blanks
Session Harmonization 2c - Lambert Olweny
 
Experience and situation of wate management in rural districts of Same & Kigo...
South African Water Caucus Overview Nov 2017
Community Managed DEWATS in Kathmandu Valley, Nepal
2015 WASH e-Summit (Part 1): An Introduction to Water, Sanitation, and Hygien...
Intro to help davao nov 2010
Civil Society: Shauna Curry, 16th January UN Water Zaragoza Conference 2015
MHA FPX 5028 Assessment 4: Water Quality Improvement Action Plan
Innovative participatory community managed drinking water delivery approach i...
The Challenges of Wastewater Management in Rural Communities
Bunaken Island | Nov-15 | Improving the water supply, sanitation and hygiene ...
Going From Centralized Wastewater Treatment to Decentralized Wastewater Treat...
GWP Poster - RWH in Rural Communities
Cà phê sáng Phi lợi nhuận 03/2016: Trách nhiệm với đối tượng thụ hưởng
Water survey report cause of water survey impact of water scarcity

Recently uploaded (20)

PDF
sustainability-14-14877-v2.pddhzftheheeeee
PDF
1 - Historical Antecedents, Social Consideration.pdf
PDF
Flame analysis and combustion estimation using large language and vision assi...
PDF
Taming the Chaos: How to Turn Unstructured Data into Decisions
PDF
UiPath Agentic Automation session 1: RPA to Agents
PDF
Getting started with AI Agents and Multi-Agent Systems
PDF
Comparative analysis of machine learning models for fake news detection in so...
PPTX
Configure Apache Mutual Authentication
PDF
Improvisation in detection of pomegranate leaf disease using transfer learni...
PPTX
AI IN MARKETING- PRESENTED BY ANWAR KABIR 1st June 2025.pptx
PDF
“A New Era of 3D Sensing: Transforming Industries and Creating Opportunities,...
PPT
Geologic Time for studying geology for geologist
PPTX
The various Industrial Revolutions .pptx
PPT
Galois Field Theory of Risk: A Perspective, Protocol, and Mathematical Backgr...
PDF
Five Habits of High-Impact Board Members
PDF
Consumable AI The What, Why & How for Small Teams.pdf
PDF
How ambidextrous entrepreneurial leaders react to the artificial intelligence...
PDF
A review of recent deep learning applications in wood surface defect identifi...
PDF
A contest of sentiment analysis: k-nearest neighbor versus neural network
PDF
Hybrid horned lizard optimization algorithm-aquila optimizer for DC motor
sustainability-14-14877-v2.pddhzftheheeeee
1 - Historical Antecedents, Social Consideration.pdf
Flame analysis and combustion estimation using large language and vision assi...
Taming the Chaos: How to Turn Unstructured Data into Decisions
UiPath Agentic Automation session 1: RPA to Agents
Getting started with AI Agents and Multi-Agent Systems
Comparative analysis of machine learning models for fake news detection in so...
Configure Apache Mutual Authentication
Improvisation in detection of pomegranate leaf disease using transfer learni...
AI IN MARKETING- PRESENTED BY ANWAR KABIR 1st June 2025.pptx
“A New Era of 3D Sensing: Transforming Industries and Creating Opportunities,...
Geologic Time for studying geology for geologist
The various Industrial Revolutions .pptx
Galois Field Theory of Risk: A Perspective, Protocol, and Mathematical Backgr...
Five Habits of High-Impact Board Members
Consumable AI The What, Why & How for Small Teams.pdf
How ambidextrous entrepreneurial leaders react to the artificial intelligence...
A review of recent deep learning applications in wood surface defect identifi...
A contest of sentiment analysis: k-nearest neighbor versus neural network
Hybrid horned lizard optimization algorithm-aquila optimizer for DC motor

AMRF activities

  • 1. This action research programme is concerned with safe drinking water in rural Bangladesh – a matter of grave urgency since the discovery of arsenic in the groundwater more than a decade ago. Between 35 and 77 million users are exposed to dangerous levels of contamination, and the implementation of solutions has been slow and inadequate. Few projects have been undertaken, and even fewer have managed to develop suitable operation and maintenance arrangements, to bypass existing power relations, and to extend services to the very poor. The aim is to understand these failures and to suggest a more successful approach. The findings come out of a safe drinking water supply programme, implemented by the Arsenic Mitigation and Research Foundation (AMRF) in several arsenic affected villages. Description of field-level activities Problem and aim
  • 2. Physicalprocess Tube-well testing Site selection Site selection An installation site for the water supply is selected during a village meeting. Informal talks reveal whether the choice is appropriate or not. Landownership is legally vested in the community. This step is crucial to avoid monopolisation of the water supply by the landowner. Installation of the water supply With the assistance of the staff, a contractor is selected. The community provides some material and logistical support. The installation process is monitored to ensure proper installation. Setting up an information centre A simple shed is set up and furnished with posters and information material. This will help facilitate the dialogue between staff, committee members and the community (see social process). Setting up homestead gardening As arsenicosis is worsened by malnutrition, affected households are helped to establish fruit and vegetable gardens. Data collection in the working area General geographic information is collected about a working area (usually a union or sub- district). Tube-well screening In several survey villages, tube-wells are tested for arsenic (and marked) in order to identify those most seriously affected. Technology assessments Previous and present drinking water projects are assessed. Villages are selected where no other programmes are running, or where they have previously failed. Money collection and savings The committee opens a bank account and collects financial contributions from water users. The contributions are not large, allowing everyone to participate. Some of the money can be used to share in the investment; some for maintenance. The committee is encouraged to meet once a month in the information centre to discuss operation and maintenance issues, the use of the bank accounts, and so on. Maintenance of the water supply Financial contributions serve to buy and stock spare parts. The committee repairs the water supply whenever required. Since women are usually first to signal problems with the operation of a water supply, they have an important role in the committee. When expensive repairs are needed the committee is encouraged to collect more money from water users. Water users Information centre Tube-well marking Water supply installation Handpump maintenance Information centre Studying existing water supplies Water supply installation Platform in disrepairHomestead garden Socialprocess Household survey School programme Consultation and agreement The implementation process is discussed and agreed upon with the community. The technologies assessed during the surveys are discussed. This leads to the selection of a water supply option. Establishment of a committee In a village meeting, the staff facilitates the election of twelve committee members - both men and women. With an understanding of the local socio- economic conditions, the staff can better assist the poor and improve their representation in the committee. Raising awareness Information about arsenic is initially disseminated during surveys. Later, meetings are organised to reach different social groups (courtyard gatherings, school programmes, tea stall meetings and information centre meetings). As people may be alarmed or feel powerless, simple nutritional tips are suggested. Treatment of patients Regular treatment is provided to arsenicosis patients identified during surveys. They are also given seeds and support for starting homestead gardening (see physical process). Paramedic training Orientation meetings (Non-) Governmental Organisations in the working area are visited to form an idea about who is doing what on arsenic. Socio-economic survey In order to select the poorest survey village, data are gathered about the social, economic, educational and familial status of households. Arsenicosis patients identification Trained staff screens possible arsenicosis patients. This initial investigation may reveal more serious poisoning in some villages. Maintenance of the committee With increased awareness of the dangers of arsenic, and interest in a functioning water supply, water users are more likely to keep an eye on committee members. The staff helps to motivate or replace inactive members. This is the beginning of peopleʼs control over the committee. To encourage self- monitoring in the long- term, village volunteers are selected to monitor committee members and their duties. Follow-up treatment Arsenicosis patients still require treatment long after having shifted to arsenic-free water. Better diets through homestead gardens may gradually replace medical support. Paramedic training will help increasing people's understanding. People's organisations The committee is encouraged to become a 'peopleʼs organisation' that will independently establish access to other public services (such as sanitation, education, or road construction). Courtyard meeting Data analysis Committee election Village volunteers Patient treatment Patient screening Committee New road in the villagePatient treatment OrganisingSurveying Facilitating Select and analyse a village Establish drinking water and public health systems Improve well-being through sustainable water and health systems Overview of field-level activities
  • 3. Physicalprocess Tube-well testing Site selection Site selection An installation site for the water supply is selected during a village meeting. Informal talks reveal whether the choice is appropriate or not. Landownership is legally vested in the community. This step is crucial to avoid monopolisation of the water supply by the landowner. Installation of the water supply With the assistance of the staff, a contractor is selected. The community provides some material and logistical support. The installation process is monitored to ensure proper installation. Setting up an information centre A simple shed is set up and furnished with posters and information material. This will help facilitate the dialogue between staff, committee members and the community (see social process). Setting up homestead gardening As arsenicosis is worsened by malnutrition, affected households are helped to establish fruit and vegetable gardens. Data collection in the working area General geographic information is collected about a working area (usually a union or sub- district). Tube-well screening In several survey villages, tube-wells are tested for arsenic (and marked) in order to identify those most seriously affected. Technology assessments Previous and present drinking water projects are assessed. Villages are selected where no other programmes are running, or where they have previously failed. Money collection and savings The committee opens a bank account and collects financial contributions from water users. The contributions are not large, allowing everyone to participate. Some of the money can be used to share in the investment; some for maintenance. The committee is encouraged to meet once a month in the information centre to discuss operation and maintenance issues, the use of the bank accounts, and so on. Maintenance of the water supply Financial contributions serve to buy and stock spare parts. The committee repairs the water supply whenever required. Since women are usually first to signal problems with the operation of a water supply, they have an important role in the committee. When expensive repairs are needed the committee is encouraged to collect more money from water users. Water users Information centre Tube-well marking Water supply installation Handpump maintenance Information centre Studying existing water supplies Water supply installation Platform in disrepairHomestead gardenSocialprocess Household survey School programme Consultation and agreement The implementation process is discussed and agreed upon with the community. The technologies assessed during the surveys are discussed. This leads to the selection of a water supply option. Establishment of a committee In a village meeting, the staff facilitates the election of twelve committee members - both men and women. With an understanding of the local socio- economic conditions, the staff can better assist the poor and improve their representation in the committee. Raising awareness Information about arsenic is initially disseminated during surveys. Later, meetings are organised to reach different social groups (courtyard gatherings, school programmes, tea stall meetings and information centre meetings). As people may be alarmed or feel powerless, simple nutritional tips are suggested. Treatment of patients Regular treatment is provided to arsenicosis patients identified during surveys. They are also given seeds and support for starting homestead gardening (see physical process). Paramedic training Orientation meetings (Non-) Governmental Organisations in the working area are visited to form an idea about who is doing what on arsenic. Socio-economic survey In order to select the poorest survey village, data are gathered about the social, economic, educational and familial status of households. Arsenicosis patients identification Trained staff screens possible arsenicosis patients. This initial investigation may reveal more serious poisoning in some villages. Maintenance of the committee With increased awareness of the dangers of arsenic, and interest in a functioning water supply, water users are more likely to keep an eye on committee members. The staff helps to motivate or replace inactive members. This is the beginning of peopleʼs control over the committee. To encourage self- monitoring in the long- term, village volunteers are selected to monitor committee members and their duties. Follow-up treatment Arsenicosis patients still require treatment long after having shifted to arsenic-free water. Better diets through homestead gardens may gradually replace medical support. Paramedic training will help increasing people's understanding. People's organisations The committee is encouraged to become a 'peopleʼs organisation' that will independently establish access to other public services (such as sanitation, education, or road construction). Courtyard meeting Data analysis Committee election Village volunteers Patient treatment Patient screening Committee New road in the villagePatient treatment OrganisingSurveying Facilitating Select and analyse a village Establish drinking water and public health systems Improve well-being through sustainable water and health systems Overview of field-level activities The diagram shows two basic processes: a physical and a social one. The physical process relates to technological and ecological assets; the social process to human and organisational assets. The processes run in parallel, and both roughly follow the three phases of surveying, organising and facilitating. The first phase leads to the selection of a village. In the second phase, AMRF assists the community with investments in new assets, such as a water option, a maintenance committee, knowledge, skills, and so on. In the third phase, AMRF's direct involvement is reduced, as it begins to support activities leading to the sustainability of the water and health systems. The diagram represents work-in- progress, and will be elaborated as new findings emerge from practice. Approach, processes and phases
  • 4. Tube-well testing Tube-well marking Studying existing water supplies Data collection in the working area General geographic information is collected about a working area (usually a union or sub-district). Tube-well screening In several survey villages, tube-wells are tested for arsenic (and marked) in order to identify those most seriously affected. Technology assessments Previous and present drinking water projects are assessed. Villages are selected where no other programmes are running, or where they have previously failed. Surveying Physical Process
  • 5. Household survey Data analysis Patient screening Orientation meetings (Non-) Governmental Organisations in the working area are visited to form an idea about who is doing what on arsenic. Socio-economic survey In order to select the poorest survey village, data are gathered about the social, economic, educational and familial status of households. Arsenicosis patients identification Trained staff screens possible arsenicosis patients. This initial investigation may reveal more serious poisoning in some villages. Surveying Social Process
  • 6. Select and analyse a village Outcome of the surveying phase
  • 7. Site selection An installation site for the water supply is selected during a village meeting. Informal talks reveal whether the choice is appropriate or not. Landownership is legally vested in the community. This step is crucial to avoid monopolisation of the water supply by the landowner. Installation of the water supply With the assistance of the staff, a contractor is selected. The community provides some material and logistical support. The installation process is monitored to ensure proper installation. Site selection Water supply installation Water supply installation Organising Physical Process
  • 8. Setting up an information centre A simple shed is set up and furnished with posters and information material. This will help facilitate the dialogue between staff, committee members and the community (see social process). Setting up homestead gardening As arsenicosis is worsened by malnutrition, affected households are helped to establish fruit and vegetable gardens. Information centre Information centre Homestead garden Organising Physical Process
  • 9. Consultation and agreement The implementation process is discussed and agreed upon with the community. The technologies assessed during the surveys are discussed. This leads to the selection of a water supply option. Establishment of a committee In a village meeting, the staff facilitates the election of twelve committee members - both men and women. With an understanding of the local socio- economic conditions, the staff can better assist the poor and improve their representation in the committee. Courtyard meeting Committee election Committee Organising Social Process
  • 10. Raising awareness Information about arsenic is initially disseminated during surveys. Later, meetings are organised to reach different social groups (courtyard gatherings, school programmes, tea stall meetings and information centre meetings). As people may be alarmed or feel powerless, simple nutritional tips are suggested. Treatment of patients Regular treatment is provided to arsenicosis patients identified during surveys. They are also given seeds and support for starting homestead gardening (see physical process). School programme Patient treatment Patient treatment Organising Social Process
  • 11. Establish drinking water and public health systems Outcome of the organising phase
  • 12. Water users Handpump maintenance Platform in disrepair Money collection and savings The committee opens a bank account and collects financial contributions from water users. Low contributions allow everyone to participate. Some of the money is used for the investment; some for maintenance. The committee meets regularly in the information centre to discuss operation and maintenance. Maintenance of the water supply Contributions serve to buy spare parts. The committee repairs the water supply whenever required. Women are usually first to signal problems with operation of a water supply, and have an important role in the committee. For expensive repairs the committee collects more money. Facilitating Physical Process
  • 13. Paramedic training Village volunteers New road in the village Maintenance of the committee With increased awareness and interest, water users keep an eye on committee members. The staff helps to motivate or replace inactive members. Village volunteers monitor committee members and their duties. This is the beginning of peopleʼs control over the committee. Follow-up treatment Arsenicosis patients still require treatment long after having shifted to arsenic-free water. Better diets through homestead gardens may gradually replace medical support. Paramedic training increases understanding. People's organisations The committee is encouraged to become a 'peopleʼs organisation' that will independently establish access to other public services (such as sanitation, education, or road construction). Facilitating Social Process
  • 14. Sustainable development of water and health systems Outcome of the facilitating phase