Nearly 20 million people in Bangladesh are still drinking water contaminated with arsenic, even though the toxin was discovered in it nearly two decades ago, according to a report.

The Human Rights Watch (HRW) launched a report on Wednesday which revealed that the government failed to take the basic steps needed to tackle the problem which kills an estimated 43,000 Bangladeshis every year.

"Bangladesh isn't taking basic and obvious steps to get arsenic out of the drinking water of millions of its rural poor," HRW researcher Richard Pearshouse told the AFP news agency.

"The reasons why this huge tragedy has remained so pervasive are due to poor governance."

Salma Begum is one of the victims who fell sick and could not work out what was wrong.

"My parents and husband took me to many doctors and all of them said I had a skin condition," Salma told Al Jazeera.

"It wasn't until someone from an arsenic outreach programme came to my village that they figured out what was wrong."

Government assurance

According to the HRW report, thousands like Salma suffer from arsenic-related problems that are not detected.

Chronic exposure to arsenic is linked to cancers of the liver, kidney, bladder, and skin as well as miscarriages, low-birth weights and poor cognitive development in children.

The government says it has installed around 210,000 deep tube wells over the past 12 years to mitigate the crisis and is testing the water from millions of shallow wells for contamination.

Arsenic is a naturally occurring and toxic element found in the soil and groundwater in parts of the world, including vast delta regions such as eastern India and Bangladesh where rivers empty into the Bay of Bengal.

The report warned that millions more Bangladeshis would die unless the government and international donors acted to solve the issue.