Fluorosis in Nalgonda District.

About Fluorosis:

Fluorosis is a disease caused due to ingestion of excess fluoride, most commonly in drinking-water, which affects the teeth and bones. Moderate amounts lead to dental effects, but long-term ingestion of large amounts can lead to potentially severe skeletal problems. Paradoxically, low levels of fluoride intake help to prevent dental caries. The control of drinking-water quality is therefore critical in preventing fluorosis. The condition and its effect on people Fluorosis is caused by excessive intake of fluoride. The dental effects of fluorosis develop much earlier than the skeletal effects in people exposed to large amounts of fluoride. Clinical dental fluorosis is characterized by staining and pitting of the teeth. In more severe cases all the enamel may be damaged.

Fluorosis in Nalgonda:

There are three kinds of water sources available namely rainwater, surface water and ground water. Rainwater is clean and ideal for drinking and cooking. Since rainfall is uneven storage becomes a major problem. Large storage reservoirs are needed which are very expensive to build and maintain. Rainwater harvesting in bunds and tanks will help in keeping ground water levels higher. Surface water sources are tanks, dams, canals and rivers. The fluoride content of Nagarjunasagar reservoir and its canals is low and suitable for drinking and cooking since the fluoride content ranges between 0.4-0.5 PPM. Tank waters are usually contaminated with biological and chemical pollutants. Such water should not be used without treatment and disinfection. Fluoride content of tank water is higher than rainwater and is in the range of 1.4 PPM. Rivers are not perennial and their fluoride content varies from 1.0 PPM in Alair vagu to 7 PPM in stream near Sivannagudem. It is surprising that fluoride content river waters in Nalgonda like Peda Vagu, Chandur Vagu, Chinnakaparthi stream, Kodabakshupalli vagu etc are higher and are not suitable for drinking.
Ground water sources are wells and boreholes. Fluoride content of well water can vary greatly depending on the geological structure of the aquifer and the depth at which water is drawn. The fluoride content is unevenly distributed in ground water both vertically and horizontally and hence every sample has to be tested before use. The fluoride content of granite rocks in Nalgonda varies between 325 to 3200 PPM with a mean of 1440 PPM. The fluoride content of soils in this district varies between 28 to1780 PPM. The fluoride content of ground waters in Nalgonda ranges between 0.4 to 20 PPM. The reasons adduced for this high level of fluoride in ground waters of this district are the low calcium content of rocks and soils and the presence of high levels of bicarbonate in soils and waters. Borehole content of fluoride is even higher and they may have abnormal concentrations of trace elements and hence may not be suitable for drinking. If all the sources of waters in the region are not suitable for use one has to consider defluoridation of waters to reduce its fluoride content. The experience with the use of defluoridation plants was not satisfactory in the past. Part of the problem may be poor maintenance due to lack of skilled help and also the cost. The majority of these plants clogs up after sometime and become ineffective in lowering the fluoride content of the water in the long run. Adding alum as done in Nalgonda technique may not be ideal because aluminum is being incriminated in the causation of Alzeimers disease in the west.
Among the three sources of water best is rainwater followed by Nagarjunasagar water supply through canals. Majority of ground waters in this endemic regions are not suitable for human consumption.

Preventing fluorosis:

*Supply clean and floride-free water from canalas/rivers like, Nagarjunasagar.
*Install deflorination water treatment plants in all villages, schools/colleges, public/private offices, and so on.
*Thorough medical checkup.
*Keep environment clean.
*DO NOT let the ground water polluted from external checmicals.

Fight against Fluorosis in Nalgonda:

Though many regional socail welfare organizations and other organizations from round the world are fighting to educate governments and the local people about FLUOROSIS, the damage rate is still raising.

High Court ordered to supply clean and floride-free drinking water to the high-hit areas like Nalgonda in 2001. A division bench of the AP High Court comprising chief justice SB Sinha and justice VVS Rao on 24 Aug 2001 directed supply of drinking water in water tankers to fluorosis-affected parts of Nalgonda district. In a 20-page order, the bench disposed of a writ petition filed by PR Subash Chander. The petitioner complained of failure on the part of the government in providing proper drinking water for the residents of Nalgonda district. Senior counsel s Ramachandra Rao pointed out that the permissible percentage of fluorine in water was between 0.5 to 0.8% but water in Nalgonda had a high percentage of fluorine ranging from 10 to 13%. He successfully argued before the bench that any further delay in arresting the consumption of such water would be a serious violation of the right to life guaranteed under the constitution. “The role of the state to provide every citizen with adequate, clean drinking water and to protect water from getting polluted is not only a fundamental directive principle in the governance of the state but is also a right under article 21 of the constitution of india,” the bench said. The directions issued by the court include consideration by the government of the feasibility of concentrating on mandals where the problem is more acute; free special medical care to all those afflicted with fluorosis free of cost; involving non-governmental organisations like society for integrated development in urban and rural areas and sri satya sai institute of higher learning; educating people about use of ground water and if necessary, taking steps to close down borewells where the problem of fluorosis is endemic and consider feasibility of evacuating the people from affected villages to safer places.

A.B.N.Rao and A.H.Siddiqui, have posted articles on fluorosis to influence government and welfare organizations.

Govt aids to fluorosis victims in Nalgonda:

On 10 Sept 2004, the Chief Minister of Andhra Pradesh, Dr.YS Rajashekhar Reddy gave an assurance to the fluorosis-affected people of Nalgonda district that the Government would tap all sources to mobilise Rs. 600 crores required for providing fluoride-free drinking water for them. He also announced a pension scheme for those crippled by the disease.

Past state and central governments assured to adopt the floride-effected Nalgonda district, and relieve the people from fluorosis. Not all kept their words.

Important links:

http://www.pubmedcentral.nih.gov/pagerender.fcgi?artid=1981710&pageindex=1

http://fluorosisinandhra.org/faqs_page.htm