The Lifesaving Benefits of Convenient Infrastructure: Quantifying the Mortality Impact of Abandoning Shallow Tubewells Contaminated by Arsenic in Bangladesh

By: Nina Buchmann, Erica Field, Rachel Glennerster and Reshmaan Hussam

Format:Print
| Language:English

Abstract

We document the consequences of a public health campaign which led to the sudden abandonment of local water infrastructure by one-fifth of Bangladesh’s population. Households who experienced quasi-randomly distributed arsenic contamination, and thus were likely to abandon their shallow tubewells, saw 28% greater child and 47% greater elderly mortality post-campaign than those who were not motivated to shift. Sudden mortality increases are driven by diarrheal disease, with no change in arsenic-related deaths. Mortality changes depend on the distance to alternative clean water infrastructure: those with an (arsenic and pathogen-free) deep tubewell within 300m of their home experience no increase in mortality, but mortality rises as households are forced to walk further for safe water access. Our results quantify the mortality benefits of water infrastructure and underscore the importance of physical proximity to, rather than just access to, pathogen-free water sources.