When BEST Intentions Go Awry: Arsenic Mitigation in Bangladesh


MSPH-12-0003.0 This case is about a public health response to the widespread arsenic contamination of groundwater in Bangladesh. It focuses on a Columbia University clinical trial of a potential treatment for arsenic poisoning. It presents for student consideration the challenges of conducting research in rural, less developed and culturally insular communities. It also raises the issue of aiding communities while studying them, which is complicated by funding restrictions and the possible skewing of results.

In 2007, a group of researchers from Columbia University and the University of Chicago began fieldwork for the Bangladesh Vitamin E and Selenium Trial (BEST) in Laksam, a rural, culturally conservative community southeast of the capital Dhaka. As part of the 10-year study, and to meet requirements to improve conditions for participants, the researchers distributed free water filters. Despite careful adherence to ethical guidelines and an exacting set of operating procedures, the BEST study ran into problems when a disgruntled former field worker—who sold the same type of water filter that BEST distributed—successfully persuaded the local press to write stories that accused the researchers of poisoning villagers.

Use the case to discuss international public health research, media management, or the logistics and ethics of conducting research on human subjects, particularly in geographically and culturally remote areas. What obligations do researchers have to participants and their communities? How can researchers working in developing countries navigate local conditions and deal with cultural, economic and political interests on the national and regional level? What additional training might help public health specialists and scientists work in these settings—crisis management, communications, etc?

This case is suitable for courses or classes about international public health research, human subject research, or crisis management.


This case was written by Ted Smalley Bowen and Kirsten Lundberg, Director, for the Case Consortium @ Columbia. (0612)

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