Fluoride is a vital compound for the growth and development of the human body. Not only does it promote the strengthening of tooth enamel, helping to protect teeth from cavities, but it is also thought to aid in the development of the bones. However, when consumed in any more than minute quantities, the same compound can lead to a myriad of health issues ranging from the browning of the teeth to severe developmental issues leading to the deformation of the skeleton. Fluorosis in India is an issue raising concerns for the health of the country’s people.

India’s Water Supply

These health problems are among those faced by people who rely on India’s heavily fluoridated groundwater, or roughly 80% of the nation’s 1.35 billion people. Water is often sourced directly from the ground by wells, hand pumps or water plants with little to no filtration, leaving dangerous levels of naturally occurring fluoride to be consumed. In fact, fluoride levels have been recorded as high as 15 parts per million, far above the World Health Organization’s maximum recommendation of 1.5 parts per million.

Fluorosis and Other Health Problems

Today, skeletal fluorosis, or the build-up of fluoride in the bones, remains the leading side effect of excessive fluoride consumption and can occur in concentrations as small as 1 part per million. Effects of the disease range from joint pain and stiffness, to the calcification of the ligaments and permanent skeletal deformation. Of India’s 32 states, 17 have been identified as areas of endemic fluorosis, leaving 25 million people impacted and 66 million at risk.

Fluorosis in India is most concerning in children, as excess fluoride can have permanent harmful effects on developing bones, leaving some children bedridden and unable to walk. Additionally, local doctors are often unaware of the disease and do not have the means to treat it, leaving families to spend hundreds of dollars on ‘witch doctors’ offering magical cures.

Organizational Efforts

In response to the prevalence of fluorosis in India, rural villages and urban areas have been the subject of a variety of efforts by local governments and humanitarian organizations alike to purify groundwater and treat those affected.

Since the 1990s, UNICEF, alongside the Satya Sai Organization, has been working to implement defluoridation into the regular process of water collection. The organizations donated a total of 24,000 self-sustaining defluoridation units to five provinces across India and implemented rainwater collection systems in 50 schools throughout the country, providing students with safe drinking water. Likewise, defluoridation units were delivered directly to households, giving families easy access to safe water.

SARITA’s Efforts for Defluoridation

Similarly, the Society Affiliated to Research and Improvement of Tribal Areas (SARITA), has been working since 2005 to provide households with effective defluoridation units in some of the most rural and underserved areas of the country. Alongside community activities to raise awareness about the often unheard of condition, SARITA provided defluoridation filters at little to no cost to villages across 12 states.

The organization was unique in its outreach methods as it deliberately sought to serve the most ostracized members of society, such as the ‘untouchables’ or the lowest and most collectively shamed demographic in India’s social caste system. As SARITA puts it, it is “unusual for government programs to start assistance in isolated hamlets”, meaning the wellbeing of this demographic is rarely of concern in government assistance efforts.

Fluoride Mitigation Support Centre

Doctors and health centers across the nation are also making efforts towards the treatment and cure of fluorosis in India. Although a cure has yet to become widely available, the Fluoride Mitigation Support Centre worked with a group of 20 children in 2013 in an attempt to reverse advanced skeletal fluorosis through calcium, Vitamin C and Vitamin D supplements. Over the course of a year, “dramatic changes were observed in the children”, with one previously bedridden child able to walk again.

The positive effects of widely available defluoridation and fluorosis treatment are quite evident. Increased government support for these existing efforts is needed to put an end to fluorosis in India.

– Jane Dangel
Photo: Flickr