Water, environment and sanitation

Mitigating Fluorosis Scourge in Madhya Pradesh

© UNICEF/India/2006/Ruhani Kaur

Fluorosis, caused by ingestion of excess fluoride, most commonly through drinking-water and food crops irrigated with fluoride contaminated water, affects the teeth and bones.

By L. Shastri

JHABUA, 22 March: Three tribal children, Mukesh  Mesu,  10,  Mukesh Munsingh, 12 and Lalita, 11, all from Bochka village of Rama block (Jhabua district) in the state of Madhya Pradesh are severely affected by skeletal fluorosis. Their problem began about five years ago and gradually led to complete bone deformity, crippling their lower limbs, ankle and feet. Mukesh Munsingh, painfully struggling to walk, says:  “I can only watch the other kids play.” He was sad that he would not be able to dance and join the annual Bhagoria festivities, which coincide with Holi--the popular north Indian festival of colours.
Moderate amounts lead to dental effects, but long-term ingestion of large amounts of fluoride can lead to potentially severe skeletal problems.

Fluorosis, caused by ingestion of excess fluoride, most commonly through drinking-water and food crops irrigated with fluoride contaminated water, affects the teeth and bones, as well as many organs in the human body and some of the body's critical biological functions. Moderate amounts lead to dental effects, but long-term ingestion of large amounts of fluoride can lead to potentially severe skeletal problems. The control of drinking-water quality is therefore critical in preventing fluorosis.

In Chapri village, also in Rama block of Jhabua district, most children have stained teeth. But the residents of the village are now attentive to the problem of fluorosis as a result of the awareness generated by the intervention of UNICEF and allied NGOs. They are aware of the excess fluoride content in water drawn from hand-pumps and the relative safety of water from dug-wells.
A hand-pump has now been capped by the authorities in Khadaubujurg village of Dhar district, as it contained fluoride in excess of permissible limits. Here too children suffer from fluorosis. Santosh, 11, walks with great difficulty. Rangita, a little girl has her legs and arms badly bent and affected.  Madan, who is slightly older, is already suffering from advanced stage of fluorosis.

© UNICEF/India/2006/Ruhani Kaur

Long-term ingestion of large amounts of fluoride can lead to potentially severe skeletal problems.

In the intervention villages, the villagers, who now appear to be aware of the need to supplement their diet, have started growing vegetables and their eating habits have changed considerably. It has also come to light that the tender leaves of “Puadia” (cassia tora), a wild shrub that grows locally during the rainy season, is rich in calcium and can be eaten cooked. The Paudia leaves can be collected, dried and stored for round the year consumption.
The control of drinking-water quality is critical in preventing fluorosis.

Awareness Campaign
An awareness campaign has already been completed in Jhabua district through the intervention of UNICEF and support  of  NGOs  like  the  National  Centre  for  Human  Settlements and Environment (NCHSE),  Adivasi Chetna Shakti Sansthan (ACSS) and Maitri. A similar campaign has also been carried out in Dhar district by three separate NGOs - Vasudha Vikas Sansthan, Gram Bharti Mahila Mandal and VASPS.

Fighting the Scourge

An integrated water and food safety programme is now being advocated and implemented by UNICEF in Madhya Pradesh in a few selected Ashrams (hostels for school-going children) in the Rama Block of Jhabua district. The children run the Water Safety Plan by diluting the water drawn from the tube-well with rain water collected in specially built underground tanks. The children are also aware of the need to supplement their diet with milk products and foods rich in calcium.