Continued fluoride contamination of groundwater is a glaring public health issue in central India

  • Across villages in central India, people are developing discoloration of teeth, a main symptom of dental fluorosis caused by excessive ingestion of fluoride. People in their 30s and 40s are experiencing bone deformities that is claimed to be due to long exposure to contaminated water.
  • In many of the tribal villages in Jharkhand, Chhattisgarh and Odisha, contaminated groundwater is not only a health problem but also has social impacts.
  • Experts claim that slow progress on solutions by the government, a lack of technological interventions, and no monitoring of newly contaminated villages is making the problem of fluorosis contamination worse..

Tulsa Bai is a 60-year-old woman from the Dumerpani village in the Kanker district of Chhattisgarh. She uses a stick to move from one place to another. It’s not just her age that makes her dependent on the stick. Many others in the village of 400-odd households in north Bastar, some in their late 30s and 40s, also need a stick to move around. “Many, including children, suffer from bone-related disease,” Bai told Mongabay-India.

The people in the village attributed their poor health to the contaminated groundwater that has a high amount of fluoride – a problem that is prevalent here for decades. “You can see the visible impacts of dental fluorosis in most of the children here. They have brown and yellow patches on their teeth. When we consulted doctors they said that it was because of the contaminated water we consume,” Gobardhan Padopi told Mongabay-India while showing the borewells of the village which the people use to get water for drinking and other purposes.

Right next to one of the village borewells is an open, single room with a defunct water filtration plant. This was set up three years ago but does not work. People continue using water from contaminated sources.

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Health is just one of the areas that is impacted by the contaminated water. There is a social impact being witnessed too. Dental fluorosis, which causes discoloration or physical damage in teeth due to ingestion of excessive fluoride, is now a barrier for some of the adults in the village looking to get married to people from outside the region.

“We have seen daughter-in-laws who came from other areas and are in good health and have good dental health too. But soon their teeth start getting discoloured,” Kamal Dev Mishra, another villager from Dumerpani told Mongabay-India. He added that it is also hard to find a match for marriage for the girls and boys in the village. Many of them have trouble finding a partner outside the area, from unaffected villages, because of the visible signs of fluoride that impacts their physical appearance.

Mishra and others, when asked about the response of the government towards such problems said that many times, officials come, take their pictures, take some samples of the contaminated water too but nothing has changed on the ground so far.

Dr. Bijaya Biswal, a public health expert told Mongabay-India, “The most perceivable symptoms of fluorosis is dental fluorosis or brown stains on teeth due to damaged enamel. Skeletal fluorosis isn’t as easy to detect unless substantial deformation occurs and normally needs radiographic examination so it might not be as apparent as dental fluorosis. Controlling fluoride intake in the initial stages of skeletal fluorosis can reverse it but the disease becomes untreatable after a certain point as bones lose their elasticity, become rigid and prone to fractures. Ingestion of more than 4mg/l of fluoride on a daily basis can be hazardous and lead to more chronic diseases: miscarriages, renal injury, arteriosclerosis and myocardial damage, thyroid insufficiencies, anemia, hypertension among others. There is also some evidence of it affecting neurodevelopment in children and also causing bladder and lung cancer but it’s not established as well.”

The government sponsored fluoride filtration plant at Dumerpani. The people in the village claim that it is not operational since its installation three years ago. Photo by Manish Kumar/Mongabay.

Around 50 kilometers away from Dumerpani, is Icchapur village, a primarily tribal village in Chattisgarh. One of the residents, Narsingh Teta, told Mongabay-India that there are several cases of dental fluorosis and bone-related disorders in the village. In Icchapur, the government has been providing solar energy-based piped water supply. There are allegations by the villagers that these pipelines draw water from the borewells which in turn pull up the contaminated groundwater.

According to government data, as of September 2020, Chhattisgarh has 154 habitations with a total estimated population of around 54,828 which are affected by fluoride contamination in water. Kanker – where Tulsa Bai, Gobardhan Padopi, Kamal Dev Mishra and Narsingh Teta live – along with other districts Rajnandangaon and Dhamtari, are among those affected.

A 2016 study in Dongargaon Block in Rajnandangaon district in Chattisgarh had examined urine samples and other symptoms of the local people as well as that of cows, goats and other cattle to document health impacts of fluoride contamination of groundwater in humans and animals in the Block which has a human population of around 100,000 people.

Khageshwar Singh Patel, one of the authors of the study from Raipur in Chattisgarh told Mongabay-India, “Fluoride pollution is more serious than arsenic contamination as basic rocks are contaminated with fluoride minerals. At least two third of the bed rocks of the country are composed of alkaline rocks. Overuse of groundwater, for especially agriculture crops and enormous coal burning for energy production, tend to cause fluoride contamination of the groundwater  in several parts of the country,”

In Jharkhand, some solutions are explored but not enough

Fluoride contamination in water is also prevalent in Chattisgarh’s neighbouring state, Jharkhand. There are 81 habitations in Jharkhand where the government has admitted  to the existence of the fluoride problem and is running programmes to tackle the issue. However, the solutions are restricted to certain areas for now and there are other pockets where people’s health is suffering due to fluoride contamination in the water.

Mongabay-India visited the Sadar Hospital in Jharkand’s Latehar district, adjacent to Palamu district which had been in news for fluoride contamination causing physical disabilities.

The doctors and other senior officials here denied fluoride contamination as a problem in the district. But about 15 kms from the hospital and district headquarters, in a tribal hamlet, most of the children have dark yellow pigmentation of their teeth – a common visible sign of excessive ingestion of fluoride.

Budhram Bhuyian, a labourer from Sukalkatta village under the Bendi panchayat in the district told Mongabay-India, “Around 60-70 percent of the kids here have developed yellow patches on their teeth. However, we do not know the exact reason. We consume water from the borewell as well as from the rivulet nearby.” School teachers from the Sukalkatta Primary School, a local government school, verify his claim of children getting discolouration on their teeth.

In Jharkhand, the districts of Palamu, Garwa, Dhanbad, Ranchi and other districts in the state have been identified as contaminated zones where the government is working to ensure safe drinking water.

A child shows his teeth with yellow and brown stains, one of the primary symptoms of dental fluorosis. Photo by Manish Kumar/Mongabay.

The government schemes, Jal Shakti Mission and Swachh Bharat Mission (Rural) are also working in rural areas across the country to provide piped water supply to the rural habitations. But in the case of villages like Sukalkatta in Jharkhand the water supply through tanks is confined to its anganwadis (rural child care centres).

Contaminated groundwater also a problem in Odisha villages

Going further south, Nuapada district in Odisha lies close to the Odisha-Chhattisgarh border. It has been known for decades for fluoride contamination in water. According to the official data from the Nuapada District Water Testing Laboratory, as assessed by Mongabay-India, there are 903 habitations in the Nuapada district which are affected by fluoride contamination. Komna Block of this district has 254 affected habitations, the highest number in the district.

Divakar Majhi is a resident of Dharamsagar village in the Pendravan panchayat of Nuapada. He is in his late 30s but uses the support of a stick to move around. He told Mongabay-India that he was healthy and without any bone disease till his late 20s. “Earlier, I was perfectly alright but now I am bound to use a stick as I have severe pain in my back and my bones have become stiff. You just venture in my village and you will see many such cases of people, young and old, with severe bone related problems which make it tough to work and earn a livelihood or move to other places for work,” Majhi told Mongabay-India from his courtyard where another person in his 50s showed his bent hand and described restrictions in movement of his limbs.

In Jhingidongri, a neighbouring village of the same panchayat, Basu Majhi complains about severe pain in his back and his lower limbs which does not allow him to move even a few steps without support. He said that doctors told him that it was because of the contaminated water he has been been consuming from the borewells.

Discoloured feet, weak physique, swollen legs along with inability to move without support are some other symptoms that people in the village display. The older people in the village are worse off and there are some who are bed-ridden as well.

The district administration told Mongabay-India that fluoride contamination impacting the health of the people there has been an ongoing problem. But the government has been contributing to make things better. “The situation is improving in the district. As contaminated groundwater is the reason behind fluoride-triggered health ailments, we are trying to promote more surface water. There are five mega drinking water projects going on in the district where 85 percent of the work has been done. We are aiming to filter the water and distribute it via pipes,” said Nuapada Collector, Swadha Dev Singh.

She also added that a total of 1,101 de-fluoridation plants have been installed in the district which filters the excess fluoride in the water to make it safe for human consumption.

A study earlier conducted by Regional Centre for Development Cooperation (RCDC) showed that not only health hazards but there had been incidences of displacement of villages in states like Odisha due to chronic fluoride presence in the local areas like in the case of Balsingh and Singhpur in Khurda district of the state. The district administration had planned moving these residents to safer places several times but due to some practical issues the resettlement did not happen fully.

Read more: Time-bound plan needed to address contaminated water

Better policies, technological interventions needed urgently

Experts working in the field meanwhile claimed that there are several issues related to fluoride contamination which need to be addressed.

Anurag Gupta, State Programme Director, WaterAid (Odisha) who has worked in fluoride affected regions of Chattisgarh and Odisha told Mongabay-India, “There are several policy-related issues that need to be addressed. There are fluoride containment programmes in identified locations in the country but what about those areas where the problems started late and due to lack of testing and awareness, people are slowly becoming sick and there is no intervention? There are also several cases of exclusion of affected villages in the programmes which even the drinking water projects cannot address. There is also lack of certification of the patients who got disabled due to fluorosis as it was not developed since birth.”

Divakar Majhi (left) in his late 30s needs a stick to move around because of bone issues that are suspected to be caused by fluoride-contaminated water that he drinks. Another person (right) from the same village is also suffering from bone disorder. Photo by Manish Kumar/Mongabay.

Gupta also added that the government should promote household level filtration methods which are cheaper and affordable so that people have a solution that’s under their control instead of depending only on contractors and the government to do the filtration work in a centralised manner which the community does not have control over.

He cited some of the solutions in fluoride mitigation by research institutes such as NEERI in Nagpur and Tejpur University in Assam which have come out with cheap and affordable in use techniques to filter water which he said should be roped in for better prevention measures.

Tapan Padhi from Regional Centre for Development Cooperation (RCDC), Bhubaneswar told Mongabay-India that fluoride contamination has several consequences which need timely attention of the government. “Fluoride contamination is a major health hazard which often misses government attention. If it goes unnoticed, the contamination goes into the food chain and the farm produce prepared from such fluoride rich areas can even make people ill in urban areas who were never exposed to it and using RO filter water,” Padhi said.

He also added, “Another issue is with the disposal of the filtered items. If processed water and filtered materials containing fluoride are dumped into the nearby ground or farmlands it could enter into the local area and water body too. So unscientific handling of such parts could create other problems too for the local communities.” Padhi also said that as ingestion of contaminated water often leads to bone deformities at the earning age, several families and their prime bread earners who can longer work, move into poverty, triggered by a public health issue which could have been prevented but has been ongoing over several generations.

Read more: Madhya Pradesh’s ‘fluoride warriors’ unleash citizen science to empower community

Banner image: A woman walks along Jhingidongri village in Nuapada. Many people in the village, across age groups, have health issues that are claimed to be linked to the fluoride-contaminated water they consume. Photo by Manish Kumar/Mongabay.

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