Globally, around 844 million people are struggling to access life’s most essential requirement – water. Although access to water is still a hard reality for millions in the country, the quality of water accessed is a greater issue for some of the poorest and marginalised people in India.
Presence of high fluoride levels in drinking water is gradually becoming a critical health hazard for habitations in Kanker, a district located in the southernmost region of Chhattisgarh. As per the National Rural Drinking Water Programme, around 400 habitations or 1.25 people are affected by fluoride contamination in rural Chhattisgarh.
Fluoride can occur in drinking water naturally as a result of the geological composition of soils and bedrock.
Another reason for fluoride getting into drinking water is because of anthropogenic factors such as industrialisation, urbanisation and improper utilisation of water resources.
Though fluoride in permissible limits is an essential component of bones and dental enamel, its excessive intake can cause fluorosis, a disease, which affects the teeth and bones.
Various researches conducted over the past few years have shown that fluoride concentration is higher than the permissible limits in the district because of the nature of rocks. Rampant mining activities in the area simply add on to the district’s ordeal. Unfortunately, the removal of excessive fluoride from drinking water is a difficult and expensive process.
A class VI student suffers from dental fluorosis as the water she drinks at school as well as at home has a high concentration of fluoride.
Children at a very young age develop yellowing of teeth, later leading to dark brown patches and ultimately tooth decay. Women of Dumarpani village in Kanker district shared an interesting fact. “Men and women from this village can be identified with the colour of their teeth… the women who come from other villages and are married here have almost perfect coloured teeth.” The situation is getting even worse now, as women from other villages refuse to marry men from our village, as they have decayed teeth and other associated problems.
What comes as another major concern is the effect of fluorosis on the bone structure of children, men and women. At the onset, stiffness and pain in the joints are the common symptoms. Over the years as the severity of the disease increases, the bone structure changes, along with impacting the ligaments and ultimately resulting in impairment of muscles.
After understanding the water quality problem that people were facing in their everyday life, WaterAid India, a not-for-profit organisation working to ensure access to clean water, decent toilets and good hygiene, intervened into the community and undertook testing of all water sources across the district.
As several water sources were found to be contaminated, WaterAid India along with its local partner Samarthan developed an integrated approach for fluoride mitigation in the district.
A group of 40 volunteers from 20 gram panchayats in the district were trained on conducting regular water testing procedures.
The Public Health Engineering Department (PHED) provided field testing kits (FTKs) to every gram panchayat. Water sources, such as handpumps, are tested twice a year (pre and post monsoons), and the reports are submitted to PHED.
The water sources in the village as well as near each school and Anganwadi were also tested. The ones that were safe to use, were marked in green, while the others were marked red or black.
The principal of the Government Primary School in Chotepara village revealed, “the water quality has been poor. If we fill water in a bucket and keep it aside for a few hours, the colour of the water would change.” The teachers, Anganwadi workers as well as the children were then informed about the fluoride content in water and the repercussions of consuming it.
In order to deal with the common problem faced in the entire district, water filters have now been set up. With the consolidated efforts of WaterAid India, Samarthan as well as the government authorities, these filters are placed at schools and hospitals that are centrally located.
And the result was amazing. The water that is now dispensed from the filtration plant is within the permissible limits of fluoride. Long-Term consumption of clean water along with some dietary changes, such as the inclusion of green leafy vegetables in the food, will help in ensuring the good health of children.
With various filtration techniques and plants installed across the gram panchayats, the children are now able to access clean water.
One of the tests at a school shows a clear result. The water orange in colour [left] has a large amount of fluoride, while the water after filtration turns pink during the test [right] which shows it is within the permissible limits
However, the villages at large still experience water contamination and its after-effects. Thus, doctors at the district hospital in Kanker are working towards addressing the issue. They hold medical camps from time to time and examine the patients.
As a next step, various patients are now provided with walking support, such as crutches, walking sticks and so on. Also, various awareness generation tools are used to inform the villagers about the causes and effects of fluorosis.
The villagers shared how this awareness is helping them in being more alert about the disease. As a mandate, the mid-day meal at schools is also prepared keeping in view the dietary needs of the children. However, there is a long way to go.
For each household to be able to access clean water, large scale and long term solutions need to be considered. Although gradual efforts are being made in this regard, accessible clean drinking water for each and every household is still a dream for many.
All Photos: WaterAid/ Prashanth Vishwanathan