Yashi Gautam, Assistant Program Lead, S M Sehgal Foundation
It is difficult to gauge how strong people are from the outside. It is commonly believed that physical strength equates to overall strength. However, this realization dawns upon us when we meet someone extraordinary. It’s hard to imagine a disease that prevents you from doing physical activities that most people can easily do and gradually ages you faster than your natural pace of aging. Unfortunately, many suffering people are unaware of the reasons behind their weak or crippled legs and their inability to walk or even to stand straight. Often, they mistake these pains for normal body aches and seek medical attention, which can inadvertently worsen their condition. This unknown threat, known as fluorosis, has had serious health consequences for affected individuals.
Fluorosis is a condition that occurs when an excessive amount of fluoride is ingested into the body. It primarily affects teeth in the form of Dental Fluorosis and bones in the form of Skeletal Fluorosis and other non-skeletal manifestations. Therefore, fluoride is often described as a “double-edged sword” because it has both positive and negative effects, depending on its concentration and how much a person is consuming. The primary source of excessive fluoride intake is through drinking water with high fluoride levels. Other sources include certain foods, beverages, and respiratory exposure.
Many states in India, including Andhra Pradesh, have experienced a significant number of fluorosis cases, and numerous communities have been affected to varying extents. One such worst affected region is the Nalgonda district in Andhra Pradesh, where the groundwater contains a high concentration of fluoride. The impact of fluorosis in this area has reached even the fourth generation, with dental, skeletal, and neurological symptoms observed among children and individuals of various age groups. This highlights the long-lasting and multi-generational effects of fluoride contamination in the region.
Mission Bhagiratha has already succeeded in preventing new cases of fluorosis in the district by supplying fluoride-safe water to every house and eliminating risk from one of the major sources of fluoride. The state Government schemes have brought down the concentration of fluoride to less than the permissible limit which is 1.5mg/L (BIS). A remarkable individual named Mr. Kanchukatla Subhash is a fluorosis victim turned activist who has been awarded the esteemed Seva Ratna Puraskar for his extraordinary contributions.
Mr. Subhash has been a vocal advocate for addressing the issues surrounding fluorosis since 1992. Despite facing numerous challenges, he successfully conveyed his thoughts, aspirations, and opinions to the legislative assembly. As a result of his relentless efforts, approximately 10,000 liters of pure drinking water have been provided to approximately 1,177 villages in and around Nalgonda district. His dream of bringing Krishna water for domestic and irrigation use to the Nalgonda district is now a reality with the government’s support. This accomplishment is seen as the most effective means of eradicating fluorosis from the region once and for all.
S M Sehgal Foundation with the support of Dr. Reddy’s Foundation and Inrem Foundation, conducted a field visit to Nalgonda district, where they had the privilege of meeting the esteemed Mr. K Subhash. Mr. Subhash, who himself has been affected by fluorosis, provided valuable insights and firsthand experiences on the subject of fluoride and fluorosis. He emphasized the critical importance of consuming fluoride-free water, which is being provided to the people of the district.
During the meeting, Mr. Subhash expressed his appreciation for the Government’s efforts in preventing fluorosis in the district. However, he also highlighted a concerning issue: the lack of sensitization and awareness among community members. Additionally, he introduced the team to individuals in the district who were mildly affected by skeletal fluorosis but were still hesitant to use water from the Kaveri River due to the difference in taste, as they were accustomed to using RO water.
During further interactions, it became evident that the community members were unaware of the side effects of using RO water. They had been experiencing complaints related to the shortage of minerals in RO water but continued to rely on it. Unfortunately, the use of RO water may actually worsen the pain associated with skeletal fluorosis. Additionally, the community members are uninformed about the crucial role of nutrition in combating fluorosis.
S M Sehgal Foundation took the opportunity to engage with the community and educate them about the significance of proper nutrition comprising balanced diet in addressing fluorosis. They emphasized on the benefits of consuming nutritious food and its positive impact on mitigating and managing the effects of fluorosis. By increasing the intake of calcium, magnesium, vitamin C, and antioxidants, positive outcomes can be achieved to address fluorosis. One natural remedy that offers numerous benefits in the treatment of fluorosis is the consumption of Moringa leaves or its powder. These leaves are a valuable gift of nature as they contain high levels of vitamin C (seven times that of oranges and four times that of carrots), calcium, and magnesium (four times that of milk), potassium (three times that of bananas), and protein (twice that of curd). Including Moringa leaves (having good amount of antioxidants too) in the diet can be highly beneficial in combating the effects of fluorosis.
By imparting this knowledge, the foundation aimed to empower the community with valuable information that could contribute to their overall well-being and the management of fluorosis. This interaction with Mr. Subhash provided valuable insights into the challenges faced by the community and the need for continued awareness-building efforts to address fluorosis effectively in the district.
| S M Sehgal Foundation, Dr. Reddy’s Foundation and Inrem Foundation with Mr. Subhash (second from the left) |
In the Nalgonda district, the majority of people are compelled to rely on groundwater having high fluoride contamination for their survival. Among the affected individuals is Tirupatamma, who has been battling fluorosis since the age of 12. Tirupatamma not only fights her personal battle but also serves as the convener of the Fluorosis Vimukthi Porata Samithi, a committee dedicated to eradicating fluorosis.
During the meeting, Tirupatamma expressed her gratitude towards Mr. Subhash for his assistance in her fight against fluorosis. She also shared that she had received support from a charitable trust, enabling her to establish a telephone booth and a general store. However, due to advancements in telecommunication sector, she was eventually compelled to close down.
| Tirupatamma (on left) with a staff of S M Sehgal Foundation |
Tirupatamma experienced joint pain while attending school, but it took time for her to realize that her leg pain and subsequent difficulties in walking were actually symptoms of fluorosis. Over the years, the pain in her legs gradually worsened, eventually leading to a crippling effect. As a result, she became dependent on a walking stick to move around. Despite facing numerous challenges in her life, Tirupatamma never lost hope and instead channeled her energy into becoming a proactive advocate for raising awareness about fluorosis within her community. Her primary goal is to ensure that the future generation is saved from the devastating effects of this silent killer. Tirupatamma’s story exemplifies the challenges faced by individuals affected by fluorosis in the region and the efforts undertaken by both individuals like Mr. Subhash and supportive organizations to alleviate the situation. Witnessing the synergistic endeavors of both Mr. Subhash and Tirupatamma, the S M Sehgal Foundation has extended its support to enhance the community’s capacity in the areas affected by fluoride. The foundation is actively involved in sensitizing the communities about the avoidance of RO water and emphasizing the crucial role of nutrition in combating fluorosis. Through these efforts, the foundation aims to empower the community with knowledge and resources to effectively address and prevent the
