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On the fluoride and arsenic problem in India

Fluoride and Arsenic have become a recurring theme in discussing water issues and particularly water quality issues in India. The areas affected seem to be increasing over time. There are several different aspects to the problem some of which are mentioned below:

  • Technical solutions to the problem like defluoridation kits and plants
  • Socio-economic aspects. Many interventions have failed due to the lack of maintainance of the technical solutions implemented
  • Understanding the mechanism of mobilization of arsenic or flouride into groundwater 

We would like to start a user discussion on these critical topics! - India Water Portal team

Resources on India Water Portal

/search/node/fluorosis pulls up most of the resources on India Water Portal on Fluoride.  Some notable content:


The Sachetana project is Karnataka is a successful government intervention to combat fluoride. Among the measures adopted is intensive household level rainwater harvesting for drinking water, where the attempt is to get all the households in the village to adopt rwh.

A downloadable multimedia training course on Flouride in English, Kannada and Telugu

A good introductory presentation: http://indiawaterportal.org/node/897

A map of high endemic flouride areas

For arsenic, the following links are usefuL

Field testing kits for water quality

Tags:

4. Bangalore water summit

Having read through your discussion, I'm really impressed by your thoughts and views, I think you will agree with me when I say that India needs some drastic changes when it comes to the way we treat our water.

http://www.bangalorewatersummit.com/

I work for the summit management team incharge of the above project. And I think that it will be great to have you on the panel to discuss these topics.

My name is Sean, please contact me on info@bangalorewatersummit.com.

Looking forward to hearing from you...

3. Prevention and cure for fluorosis

Fluorosis can be prevented by consuming low-fluoride foods and drinking water. Cure of fluorosis is a medical problem. I am not a physician to cure fluorosis.

R. Jagadiswara Rao

rjagadiswara@gmail.com

Dr. R. Jagadiswara Rao, Professor of Geology Retired, Sri Venkateswara University, Tirupati, AP 517502, India rjagadiswara@gmail.com

2. what about the people who are suffering with fluorosis?

Prevention is better than cure..but what about the lakhs of people who are suffering with fluorosis? You ended your article with Byrraju Foundation..what about the real victims?

1. Flurosis in North Andhra districts

 

As one who intermittently worked on the fluorosis problem in parts of south India since 1965, I welcome the interest evinced by IWP to work on the problem in Nalgonda district of Andhra Pradesh. My views on the eradication of skeletal fluorosis are summarised at http://www.indiawaterportal.org/node/897.
I could know the severity of the problem of skeletal fluorosis in Nalgonda district way back in October 1974 when some physicians of Osmania Medical College arranged a parade of some adult victims of severe skeletal fluorosis from the district to dramatise their presentation at the Symposium of Fluorosis organised by the Geological Survey of India at Hyderabad. Apart from a number of NGOs including Fluorosis Vimukti Porata Samtihi and Sri Ram Charitable Trust, the websites `maintained by http://nalgonda.org/ and Knight Center for International Media of the University of Miami School of Communication in USA
illustrate the pathetic condition of the fluorosis victims in the district.
Although it is estimated that there are over eight lakh fluorosis victims in the district, the webpage at http://nalgonda.org/fluorosis/flouridelevels.htm  created in 2005-06 reported 61,625 victims suffering from severe fluorosis in 164 habitations with fluoride content of local groundwater ranging from 3.0 to 13 mg/L with a mean of 4.3 mg/L and a median of 4.0 mg/L.
Although the problem could have been solved long ago by sustainable supply of low-fluoride drinking water and nutritious food with antioxidants to all the victims and to those in the process of becoming victims, the problem continues to be as bad as it was some 4 decades ago. Researchers have designed several defluoridation plants using different methods including the famous Nalgonda method with funds made available by several agencies including Netherlands Government. All these worked as long as they were maintained by the researchers, but stopped working soon after handing over to the local panchayats and individual households. Other methods of obtaining low-fluoride water through rainwater harvesting and reclamation of groundwater to reduce its fluoride content through aquifer storage and recovery (ASR) have limited success.
The approach of the State Government was to formulate a large number of piped water supply schemes with funds made available by NABARD and special schemes formulated by the Central Government from time to time with the source of water supply being local groundwater, local minor irrigation reservoirs, and summer storage reservoirs filled with Krishna river, Nagarjunasagar left bank canal constructed for irrigation, World Bank assisted pipeline laid from the Nagarjunasagar reservoir to Hyderabad city, and Srisailam left bank canal involving high lift constructed for irrigation. All these methods have never worked and will also never work to provide sustainable low-fluoride water for the fluorosis victims.
Another problem relates to inclusion of several diseases other than dental and skeletal fluorosis such as malnutrition, dwarfism, genu valgum, rickets and osteoporosis prevalent in the fluorosis endemic areas are erroneously included under fluorosis. According to the National Institution of Nutrition, genu valgum develops in children without regard to the fluoride content of groundwater while skeletal fluorosis is found only in adults due to cumulative accumulation of fluoride in bones and joints over a period of several years. When fluorosis was first reported from India in 1937, no case of genu valgum was reported. It developed only after several years because of environmental degradation. Although surplus or deficiency of several elements including fluoride is the cause for the various health disorders, the tendency is to simply blame high-fluoride drinking water without bothering to take up any scientific studies.
Take for example the case of the 27-year old Amsala Swamy (Attachment 1), a victim of genu valgum and dwarfism looking like a 10-year old boy with short twisted legs and rubbery arms. He was used by several NGOs as spokesman to represent the case with five Prime Ministers, three Presidents and several other leaders that matter.
The strategy presently advocated by the NGOs to eradicate fluorosis is to fight for early completion of head regulator and two 9-m diameter bored tunnels with an aggregate length of 51 km with a balancing reservoir in between at an estimated cost of Rs. 1,925 crore to convey water by gravity for both irrigation and drinking. Although the work was commenced in 2004, only 5-km long tunnel could be so far completed. The cost of the project is going to increase several times with revision of standard schedule of rates year after year. The progress of work is so poor that it takes several decades before water could possibly made available to the fluorosis victims.
As the approach of the Government is to make available piped water of good quality for all uses, there is difficulty to supply such huge quantities of water for the targeted population on sustainable basis.
It would be worthwhile to adopt the traditional wisdom of India, as per which water for drinking and cooking is segregated from that used for other purposes. Although the methods of defluoridation used in the past never worked properly on a continuing basis, the reverse osmosis has been used successfully to obtain high-quality water, which is also free of fluoride. The methodology evolved by the nine-year old Byrraju Foundation has allowed for sustainable supply of high-quality drinking water for over 9 lakh people living in 180 villages in other parts of Andhra Pradesh through use of 60 drinking water plants (http://www.byrrajufoundation.org/html/deliverymodulae.php?cat=d16).
This methodology has been emulated by some NGOs with equal success. It is high time this methodology is adopted in the fluorosis areas of Nalgonda district to make available fluoride-water drinking water to the victims in the quickest-possible time.

As one who intermittently worked on the fluorosis problem in parts of south India since 1965, I welcome the interest evinced by IWP to work on the problem in Nalgonda district of Andhra Pradesh. My views on the eradication of skeletal fluorosis are summarised at http://www.indiawaterportal.org/node/897.

I could know the severity of the problem of skeletal fluorosis in Nalgonda district way back in October 1974 when some physicians of Osmania Medical College arranged a parade of some adult victims of severe skeletal fluorosis from the district to dramatise their presentation at the Symposium of Fluorosis organised by the Geological Survey of India at Hyderabad. Apart from a number of NGOs including Fluorosis Vimukti Porata Samtihi and Sri Ram Charitable Trust, the websites `maintained by http://nalgonda.org/ and Knight Center for International Media of the University of Miami School of Communication in USA

(http://www.1h2o.org/index.php/dev_site/featured_story/india1/)

illustrate the pathetic condition of the fluorosis victims in the district.

Although it is estimated that there are over eight lakh fluorosis victims in the district, the webpage at http://nalgonda.org/fluorosis/flouridelevels.htm  created in 2005-06 reported 61,625 victims suffering from severe fluorosis in 164 habitations with fluoride content of local groundwater ranging from 3.0 to 13 mg/L with a mean of 4.3 mg/L and a median of 4.0 mg/L.

Although the problem could have been solved long ago by sustainable supply of low-fluoride drinking water and nutritious food with antioxidants to all the victims and to those in the process of becoming victims, the problem continues to be as bad as it was some 4 decades ago. Researchers have designed several defluoridation plants using different methods including the famous Nalgonda method with funds made available by several agencies including Netherlands Government. All these worked as long as they were maintained by the researchers, but stopped working soon after handing over to the local panchayats and individual households. Other methods of obtaining low-fluoride water through rainwater harvesting and reclamation of groundwater to reduce its fluoride content through aquifer storage and recovery (ASR) have limited success.

 

The approach of the State Government was to formulate a large number of piped water supply schemes with funds made available by NABARD and special schemes formulated by the Central Government from time to time with the source of water supply being local groundwater, local minor irrigation reservoirs, and summer storage reservoirs filled with Krishna river, Nagarjunasagar left bank canal constructed for irrigation, World Bank assisted pipeline laid from the Nagarjunasagar reservoir to Hyderabad city, and Srisailam left bank canal involving high lift constructed for irrigation. All these methods have never worked and will also never work to provide sustainable low-fluoride water for the fluorosis victims.

 

Another problem relates to inclusion of several diseases other than dental and skeletal fluorosis such as malnutrition, dwarfism, genu valgum, rickets and osteoporosis prevalent in the fluorosis endemic areas are erroneously included under fluorosis. According to the National Institution of Nutrition, genu valgum develops in children without regard to the fluoride content of groundwater while skeletal fluorosis is found only in adults due to cumulative accumulation of fluoride in bones and joints over a period of several years. When fluorosis was first reported from India in 1937, no case of genu valgum was reported. It developed only after several years because of environmental degradation. Although surplus or deficiency of several elements including fluoride is the cause for the various health disorders, the tendency is to simply blame high-fluoride drinking water without bothering to take up any scientific studies.

 

Take for example the case of the 27-year old Amsala Swamy http://www.flickr.com/photos/indiawaterportal/4606099994/, a victim of genu valgum and dwarfism looking like a 10-year old boy with short twisted legs and rubbery arms. He was used by several NGOs as spokesman to represent the case with five Prime Ministers, three Presidents and several other leaders that matter.

 

The strategy presently advocated by the NGOs to eradicate fluorosis is to fight for early completion of head regulator and two 9-m diameter bored tunnels with an aggregate length of 51 km with a balancing reservoir in between at an estimated cost of Rs. 1,925 crore to convey water by gravity for both irrigation and drinking. Although the work was commenced in 2004, only 5-km long tunnel could be so far completed. The cost of the project is going to increase several times with revision of standard schedule of rates year after year. The progress of work is so poor that it takes several decades before water could possibly made available to the fluorosis victims.

 

As the approach of the Government is to make available piped water of good quality for all uses, there is difficulty to supply such huge quantities of water for the targeted population on sustainable basis.

It would be worthwhile to adopt the traditional wisdom of India, as per which water for drinking and cooking is segregated from that used for other purposes. Although the methods of defluoridation used in the past never worked properly on a continuing basis, the reverse osmosis has been used successfully to obtain high-quality water, which is also free of fluoride. The methodology evolved by the nine-year old Byrraju Foundation has allowed for sustainable supply of high-quality drinking water for over 9 lakh people living in 180 villages in other parts of Andhra Pradesh through use of 60 drinking water plants (http://www.byrrajufoundation.org/html/deliverymodulae.php?cat=d16).

This methodology has been emulated by some NGOs with equal success. It is high time this methodology is adopted in the fluorosis areas of Nalgonda district to make available fluoride-water drinking water to the victims in the quickest-possible time.

Dr. R. Jagadiswara Rao, Professor of Geology Retired, Sri Venkateswara University, Tirupati, AP 517502, India rjagadiswara@gmail.com

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