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September 03, 2007

The Unintended Consequences of Foreign Aid: Theodore Dalrymple explains how Western policies have poisoned the water supplies of 70 million in Bangladesh

Posted by Theodore Dalrymple

Well-intentioned policies can have disastrous outcomes. Theodore Dalrymple explains how philanthropic Western policies have poisoned the water supplies of up to 70 million in Bangladesh.

The home page of my internet service provider carries news stories. The other day, I noticed two that were next to one another. The first reported that there were record numbers of passes at high grades in the GCSEs, and the other reported that British employers were complaining that young Britons lacked basic skills such as the ability to read and add up.

Could these two phenomena be related in some way, I wondered? Reader, I think that possibly they could be related: indeed, the relationship is so obvious that it hardly needs elaboration.

The juxtaposition of stories is often interesting and instructive. For example, in The Lancet for 11th August 2007, there was a laudatory profile of Joseph Graziano, a pharmacologist and dean of research at Columbia University's Mailman School of Public Health. Professor Graziano heads a team that is trying to tackle arsenic poisoning from the consumption of well-water in Bangladesh. His work, he said, was his life, and I am sure he was not exaggerating. Such dedication is indeed beyond praise.

Six pages away from the profile was another item about the arsenic-poisoning in Bangladesh. It carries a picture of a Bangladeshi man holding up his hands displaying "the characteristic blackening" of arsenic poisoning. Two of the fingers of his right hand have been amputated because of arsenic-induced gangrene.

The text of the article begins with these words:

More than 70 million people in Bangladesh are estimated to be exposed to toxic levels of arsenic from their drinking water in what WHO has called the "largest mass poisoning of a population in history".
Here are the effects:
The symptoms of long-term exposure ot arsenic begin with the blackening of the hands and feet, progressing to nodular growths, and later to open sores and gangrene. Eventually, it can lead to cardiovascular and reproductive damage and to virulent cancers of the bladder, skin, lungs and liver. In children, the exposure is also thought to lead to learning difficulties and other neurological effects. Researchers… say that the arsenic poisoning could double Bangladesh's cancer mortality rate within two decades.
And one of those researchers is reported as having said that:
Once people have been exposed for several years, conservatively estimated at a decade, the DNA damage almost guarantees that cancer is imminent.
What caused the largest mass poisoning of a population in history? After all, the people of East Bengal have not always suffered from arsenic poisoning. Professor Graziano is reported as having remarked:
You can't just make this a natural history of arsenic poisoning.
No, indeed not - for, as we are told, relatively sotto voce as it were:
The sad irony is that the problem is the unintended consequence of a campaign in the 1970s and 1980s by international development organisations, including UNICEF, to get villagers to stop drinking dirty surface water.
It was they who advised and paid for the wells that seem to have poisoned up to half the population of the country.

Let us perform a small thought experiment. Let us suppose that a commercial mining company had, in the course of its operations, poisoned the water supply of 70,000,000 people in this quite specific way. Would that have been regarded as "a sad irony", an unintended consequence of its search for profit, or perhaps as something rather more sinister and indeed typical of the way such companies operate? Would there not have been large demonstrations, probably turning soon to violence, against that company by those in the developed world who habitually express their solidarity with the impoverished victims of exploitation by their own nations' multinationals? It is unlikely that we would ever hear the end of the matter - in such a case, quite rightly.

When people buy their UNICEF Christmas cards, how many of them know what the organisation, and others like it, have wrought in Bangladesh? It isn't even as if such organisations feel any institutional guilt - The Lancet reports that:
For such a massive disaster, the response by international aid agencies has been small, especially since researchers estimate that substantial mitigation could be achieved for less than US$100 million.
In a way this is understandable. As Professor Graziano puts it:
The challenge now is to try to influence policies in Bangladesh, but very cautiously. We don't want to be a bunch of white guys going in and saying, "we know what to do" - the way the international agencies that promoted the original well-digging programme did.
As it happens, I don't really believe that the situation in Bangladesh is a sad irony at all, though of course I don't go as far as to say that it was wished by anybody. I worked for a number of years in another country, Tanzania, in which foreign aid did, or at least permitted and actually paid for, a great deal of harm to be done. It was foreign aid, and foreign aid alone, that enabled the government to remove a very high percentage of the rural population from where it was living and dump it in collectivised villages, as well as to destroy the viable commercial farming sector, thus condemning the country and its inhabitants, apart from senior members of the ruling party, to many years of quite unnecessary pauperdom.

As I quickly discovered in Tanzania and elsewhere, foreign aid offers a lucrative career in good working conditions to middle class people of the developed world who want a little adventure in their lives, and who would once have been colonial officers; and it offers tempting opportunities for malversation of funds to their bureaucratic counterparts in the Third World. This symbiosis is the natural consequence of asking precisely the wrong question: not where wealth comes from, but where poverty comes from.

As far as I am aware, not a single country has ever been lifted from poverty to prosperity by foreign aid, though no doubt many individuals have been so lifted. I do not mean any personal asperity when I remark that, when Professor Graziano told The Lancet that working with the multidisciplinary team which is trying to solve the arsenic poisoning of Bangladesh was
one of the most wonderful experiences of my life,
I could not help but think of that line from the old Flanders and Swann song to the effect that
It all makes work for the working man to do.
Theodore Dalrymple is a writer and worked for many years as an inner city and prison doctor.

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70,000,000? Wow, who would have thought that foreign aid was literally worse than Hitler?

Posted by: Rob spear at September 3, 2007 04:42 PM

The article is not clear as to the original source of the arsenic.

Is the aresnic naturally occurring in the ground, or was the ground water contaminated by human activity?

Posted by: edh at September 3, 2007 09:53 PM

The arsenic is naturally occuring (as it is in other parts of the world). Wells dug to certain depths strike water contaminated with it.

Posted by: Chris at September 3, 2007 11:17 PM

edh: Yes, it is naturally occurring. There has been much written about it. While in not disagreeing with the author's main points, I find his comparison to mining activities a little disingenious. In that case we are discussing an externality passed on to local residents. Here we are dealing with a failure to properly explore what sounded like a good idea.

Posted by: PJH at September 4, 2007 12:06 AM
Is the aresnic naturally occurring in the ground, or was the ground water contaminated by human activity?
Probably naturally occurring. Many places have naturally occurring arsenic at many times the legal limits allowed in the US and other advanced countries, especially if water is transmitted through or erodes igneous formations. That the wells weren't tested for arsenic and other contaminents when they were drilled is incredible. The effects of high levels of of arsenic in drinking water were well known in the 1970's. Posted by: Bryan at September 4, 2007 12:48 AM

"Trick or treat for UNICEF!"


Posted by: Hucbald at September 4, 2007 02:10 AM

From the British Geological Survey (

"There is clearly a very serious problem of arsenic contamination in groundwater in much of southern and eastern Bangladesh. In terms of the population exposed it is the most serious groundwater arsenic problem in the world. The contamination occurs in groundwater from the alluvial and deltaic sediments that make up much of the area. Description of the problem is complicated by large variability at both local and regional scales. The arsenic is of geological origin and is probably only apparent now because it is only in the last 20-30 years that groundwater has been extensively used for drinking water in the rural areas. However, the arsenic has probably been present in the groundwater for thousands of years."

Moreover: "The principal treatment is to provide the patient with arsenic-free drinking water. The Bangladesh Standard for arsenic in drinking water is 0.05 mg/l. This standard was based on World Health Organisation (WHO) advice at the time when the regulations were drafted. In 1993 WHO lowered their guideline value for arsenic to 0.01 mg/l. This value has not been adopted in either Bangladesh or India."

Posted by: J. Graham at September 4, 2007 02:24 AM

Did I miss something here. Was the poisoning caused by UNICEF digging wells or was the arsenic caused by some other reason. Elephant urine? Monkey crap? This is the most idiotic piece of anti environmentalist nonsense I've ever read and there's no shortage of competition. Because UNICEF tried to stop Banglideshi's drinking from surface puddles, for some reason this source of water is not terriibly popular in the US either, they are responsible for these folks getting arsenic poisoning. No word from Theodore on what actually introduced the arsenic into the ground water. I'm a trad Republican but I have to wonder what idealogues lilke Theodore think they are accomplishing with this kind of bs. It make intelligent and thoughtful Republicans a laughing stock just like the Schiavo nonsense. They are not related but they are a reflection of the thought patterns of these people. Basically they are crazy, there's no other explanation for it. And let me tell you this kind of obscurantism is going to wreck us as serious party of govt.

Posted by: John at September 4, 2007 02:34 AM

The aquifier is contaminated with the arsenic, so the wells should never had been dug. (The rocks have the arsenic in them.) The surface water is contaminated, too, but probably by things easier to deal with by low-tech means. Before modern water-treatment technologies, humans consumed their water as broth (which had been boiled for hours as part of cooking the soup bones), or diluted wine or beer. Both methods are great at dealing with bacterial contamination.

What they need are water filters. I just replaced mine -- $25 for the cartridge, my third one in 9 years.

Posted by: cathyf at September 4, 2007 05:02 AM

Arsenic is a salt that accumulates in the ground in any dry area. The western part of the US has a lot more than east of the Mississippi, for example.

Posted by: geo at September 4, 2007 06:57 AM

This is such a stretch as to be absurd.
You want to do a little bashing of the international aid sectors, but you dont really pull it off.

What is wrong, in principle, with helping people dig wells, for chrissakes? How on eath is this analogous to what the old colonial offices did? How is this analogous to your little village resettlement experience in Tanzania? People who have little access to clean water, and you help them dig wells - how can you possibly ciriticize that?

Oh, turns out the well water is contamined. Yes, that is a terrible tragedy and a very sad irony.

Your solution is what - dont do things like that? Dont help people dig wells when they dont have clean water?

And BTW - foreign aid is not intended to be, by itself, the pathway to prosperity. It is a means of infusing capital and / or needed services into places that often have the most dire problems - or just do not have immediate access to such funds or services that they very much need.

Hundreds of millions of people have been kept alive or cured of disease, or vaccinated against disease or recieved some form of emergency aid to keep them going. It is for them and thier society to work out the pathway to prosperity - the foreign aid is just that - necessary assistance to jump start the process or to keep the populace from suffering some devastating hit that they are not prepared to deal with.

Snarky BS like this post has the danger of doing incalculable harm to real people in the real world - by seeming to advance a case that foreign aid is, by its nature, either useless or necessarily evil. Shame on you.

Posted by: JoeCitizen at September 4, 2007 09:49 AM

The arsenic source is natural. Further info is here:

Incidentally I don't think that comparisons to Hitler are helpful. Apart from Godwin's law, I think there is a moral distinction between wicked consequences and wicked intentions.

A better analogy would be "worse than the British Empire". We are accused of causing or not alleviating famine in India on a vast scale during our rule, most recently during WWII. . No aid worker wants to be compared to the British Empire, especially unfavourably.

Posted by: TDK at September 4, 2007 11:15 AM

The arsenic contamination was caused by the construction of tubewells without preliminary investigation: in other words, the deeper wells penetrate strata containing arsenic. You can obtain further information here:


Posted by: Fairfax at September 4, 2007 11:16 AM

Could it be that the native Bangladeshis knew better than Bono and the do-gooders from UNICEF?

Posted by: Arsenic Rage Boy at September 4, 2007 04:11 PM

I'm struck by the mixture of selective aliteralism and a sort of stumpy literalism evident in some of the comments. Dalrymple's piece isn't at all ideological; the man is distinctly pragmatic and has celeritously and tirelessly written about the pernicious and deluding results of ideology, accepted wisdom and the sundry varieties of balmy thought that, occasionally, stagnate into a poisoned well.

An act of charity is a wonderful sensation, and often that gratifying sensation can distract from unsavoury yet important truths. It is not aid, charity, kindness and altruism that he is criticising, in themselves, but the buccaneerism and autobackslappery which accompanies them. And amongst all the high spirited buffeting one can somewhat loose the point.

Posted by: Eric at September 4, 2007 07:38 PM

Although there may be a handful or two of Bangladeshis who would disagree, poisoned wells aren't the main point. The desire to do good, and the heady satiation of that desire at the merest gesture of charity, is often counterproductive.

Again, Dalrymple makes the point that the indulgence in sentimentalism, lack of moral seriousness and active disengagement from unpleasant realities characterises much of our ostensibly noble pursuits. The shallowness of well digging is perhaps the sad irony.

And Dalrymple is clearly not an idealogue. He has been making this point, directly and indirectly, but always lucidly, his whole writing career.

Posted by: Leo Kabon at September 4, 2007 08:28 PM

Doing wicked things with the best intentions is the hallmark of the left. "But I meant well!" won't fly when it comes with a bodycount.

Posted by: S. Weasel at September 4, 2007 08:36 PM

It's amazing how much emotionalism there is in this comment thread concerning foreign aid. I think I'll join the party. Dalrymple is right. There is no peer reviewed study of foreign aid that can demonstrate any statistically significant positive correlation of foreign aid received and economic growth achieved. Why?

1. Foreign aid monies are fungible. For example, the entire "health care system" in Zaire, at least until Mobutu's removal, was administered and funded by missionaries and NGOs. This support premitted Mobutu to redirect national funds that might have been required to finance a minimal amount of health care for political stability into more lucrative ventures such as weapons, military salaries and general corruption. Of course, this is also true of most infrastructure and social welfare spending throughout Africa.

2. Humanitarian programs distort market mechanisms, which, if allowed to play themselves out, would lead to a resolution of the problem through internally generated adjustments. Another bit of useful knowledge is that since WWII no famine has ever developed without the conivance and support of government policy. With the importation and distribution of free "humanitarian" supplies, market prices for domestic food are suppressed and agricultural input supplies, such as seeds, fertilizers and insecticides, are prohibitively expensive or unobtainable. The vicious welfare dependency cycle is thus iniciated and, as malnutrition gets worse, enhanced.

The keys to African growth and development are the liberation of developed country markets for the agricultural products and basic manufactures of the developing world, the promotion of the "Green Revolution" technology in Africa, the conquest of AIDS (cultural adjustments and medicines) and malaria (an ending of the environmentalist genocide of Africans by allowing DDT application in homes, but don't get me started on what should be a mass prosecution of "do-gooders" at the ICC), and, perhaps most importantly, the simultaneous collapse and disappearance of all African "governments," with the exception of Botswana and Namibia. BTW I'm sure you all know that the social welfare indicators in Somalia have improved - yes, improved - since the end of the Siad Barre regime and during the 15 years of "anarchy" in Somalia.

And I probably shouldn't mention that a recent study by two Dartmouth economists compared social welfare and economic growth indicators of never colonized countries to previously colonized countries. And the results showed, counter-intuitively to leftists but what would probably be the most logical result , that the once colonized countries were measurably better off. Oh, and also logically, it was much more advantageous to have been colonized by the British than any other country.

Posted by: boqueronman at September 5, 2007 01:17 AM

" The information on the arsenic poisoning was buried".
Well, of course it was. " Those ****ed peasants can take what we give them, it's better than them drinking excrement from their surface mud toilets !" --- " Don't let a ****ed word of this out, if those people weren't backwards natives centuries behind the world they would have themselves known to test for contaminants"... " Screw them, this is the thanks we get for risking our lives to save theirs?"
Yes, I can certainly imagine the "leadership" of every agenda'd UN agency SQUASHING all the aresenic information and complaints flowing to them for decades after decade. I certainly do not believe noone tested initially either.
To expect them to be any different than "tobacco" companies or "oil companies" executives is indeed to be an insane moron.
What is worse, is there is a possibility that some in power of these leftist organizations are not rushing to "de-implement" "massive reductions of the surface populations" whenever or wherever they happen to pop-up , since they all more or less scream we need a "sustainable world population" that is "reduced from the present 6 billion to a much lower and more reasonable number" that won't be " exploiting and destroying the earth"... or using up the limited fresh water supplies...
Don't think for a second that the "anthropogenic global warming alarmists" aren't brooding inside their own twisted craniums that " if large portions of mankind simply died somehow" that the "in less than ten years" "global warming human extinction event of uncontrolled heat escalation" would never come to pass and would be of course "naturally reversed" by exterminating the "problem" - too many people.
Yeah, it's FREAKY baby..... but those kookballs are up there in overlord land running the whole schmere.

Posted by: Silicon Doc at September 5, 2007 03:27 AM

The road to Bangladesh is paved with good intentions. The UNICEF clowns weren't smart enough to test the water.
Would a mine that accidentally poisened people while providing them jobs to lift themselves out of poverty really be worse than these dummies? It's inconceivable that they wouldn't test the water, arsenic is a common enough problem in well water.

Posted by: Stan at September 6, 2007 04:33 AM

I have an uneasy feeling that my religion is to blame. Christianity has always imagined God as taking good intentions into account when judging human actions however disasterous the results. That is why it is probably fair to regard socialism as the grim and unloveable offspring of Christianity whereas Hitler's cult self-conciously sought inspiration from ancient paganisms which valued success/victory above all (at the same time editing out ancient pieties which placed restraints on human liberty). In recent times, the Catholic and puritan habit of regular spiritual self-interrogation having been largely abandoned by post-Christians and Christians alike, we are not nearly sceptical enough about our own good intentions and are too easily cowed by the confident declaration by others of their own good intentions (what Alain Finkielkraut (I think) called the "fascisme du sympa"). Another religious /post-religious ingredient in the cause of this appalling disaster is the retention of a naïve belief in providence which makes it unnecessary,or even wicked, for the really well-intentioned to entertain rational doubts, talk of relative costs bother with expensive and delaying scientific checks etc etc.

Thank you Eric in the comments for the coinage "autobackslappery" , I hadn't heard/read it before and we have so much of the thing.

Posted by: la marquise at September 6, 2007 11:40 AM

I know that Mr. Dalrymple studiously avoided the specter of intentional malfeasance here, but I cannot. Having read numerous statements from various left-leaning persons to the effect that a good population-reducing problem (such as malaria) would be a good remedy for the world's long-ignored overpopulation crisis, I cannot help but wonder. Are measures being taken to correct the problem? Obviously, the poisoning has been going on long enough for those who created the problem to get wind of it. If not, why not?

Certain subscribers of Jeremy Bentham's catastrophic vision of the future capability of the Earth to sustain its human population have voiced acceptance of the idea of a mass die-off (especially in third-world countries) as the best solution to the crisis, notwithstanding the cost in human lives.

The idea is the result of a dangerous merge of social Darwinism and Benthamite utilitarianism.

Posted by: Old Whig at September 6, 2007 08:50 PM

So let them drink dirty surface water and they can die of cholera, typhus, etc. Life is full of trade offs. Sounds like another cheap right wing hit on the UN, full of fake science and other dodges I guess Theodore is arguing the Scroogian approach to foreign aid, give them nothing!

Posted by: jakealope at September 25, 2007 03:15 AM

Forget making political hay out of this disaster and concentrate on insuring that it or a similar one is avoided in the future. Persons in positions of authority were, to be generous, negligent. It doesn't take a rocket scientist to realize that any new wells should be tested for contamination.

Posted by: William at October 12, 2007 03:16 PM

TO John and JoeCitizen,

you guys made me laugh.

Posted by: simply at June 4, 2008 01:03 PM
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