KAPIL MUNI PANDEY held out his palms. The skin on his hands was coarse, and his nails were brittle. His arms had signs of pigmentation. His eyes were dry, and his face was swollen. Kapil, who was in his early thirties, was weak and had difficulty walking. He told me he was suffering from arsenic poisoning. He thought that I was a doctor.
I met Kapil in Tiwaritola, a village of fewer than five hundred people, in the Ballia district of eastern Uttar Pradesh, one morning in March 2019. Around thirty people had gathered to attend a meeting, called by a local activist, on arsenic contamination in the region’s groundwater. Some had medical prescriptions as proof of their ailments. Others, who could not afford a doctor visit, only had symptoms to show. Lesions, rain-drop pigmentation and signs of keratosis—crusty, hard growths on the skin—were visible on their bodies. While they spoke about their own conditions, they were all concerned about Kapil and worried that he would not live long.
The meeting was held in a lawn outside the house of Tarkeshwar Tiwari, a local convenor of the ruling Bharatiya Janata Party. Tiwari seemed healthy. He told me he wanted to solve the problem of arsenic exposure common in the region. About twenty of the people gathered posed for a group photo. Some held up their hands to show their skin conditions.
Arsenic is a highly toxic element—an odourless, colourless and tasteless metalloid, widely distributed in the earth’s crust—that can lead to the contamination of groundwater. It ranks number one on a 2001 priority list of hazardous substances and disease registry defined by the World Health Organization. “The greatest threat to public health from arsenic originates from contaminated groundwater,” the WHO has stated. Arsenic contamination in drinking water can also cause a disease called arsenicosis, symptoms of which are primarily manifested as different types of skin disorders, such as lesions, keratosis and melanosis. The WHO defines arsenicosis as “a chronic health condition arising from prolonged ingestion of arsenic above the safe dose for at least six months,” which can occur “with or without the involvement of internal organs.” The WHO also notes that, in extreme cases, “acute” arsenic poisoning can lead to death.