By Nabarun Guha/Mongabay
Every day, 21-year-old Amjad Hussain, from Tapatjuri village in the Nagaon district of Assam, walks one kilometre to his neighbour Dilwar Hussain’s house, where he weaves patis (mats) made from the agar tree to earn an income. His family considers this a small miracle considering that a few years ago, Amjad couldn’t even take a step without a walking stick.
“Three of my sons developed bodily deformations, which we later learnt was because of the water we drink,” says Amjad’s mother, Halima Khatun. Her sons were showing symptoms of skeletal fluorosis, which is caused by consuming water with excess fluoride content. Her daughter was spared from this ‘pani wala bemar’ (water-borne disease), she says.
Dharani Saikia, a 62-year-old social worker based in Kampur town in Nagaon district, has been gathering evidence of fluorosis cases in Assam, particularly in Nagaon, Hojai and Karbi Anglong districts for over two decades. He says that as of 2020, 13 districts are affected. In 2022, the Ministry of Jal Shakti confirmed fluoride contamination beyond safe levels in nine districts of Assam. However, no official findings detailing contamination levels of groundwater, number of affected people and symptoms have not been published since nearly a decade ago, when surveys were conducted in 2017-18. Meanwhile, fluorosis continues to grip lives across the state.https://www.youtube.com/embed/dochQYZA-20?si=007O_8lgbhgGnwBI?rel=0
How fluoride enters Assam’s water
Fluoride contamination in the state’s groundwater was first detected in 1999 by A.B. Paul, an engineer in the Public Health Engineering Department (PHED) in Karbi Anglong.
Ph.D. Scholar Nikita Neog, who studies fluoride contamination across the state, says that geogenic factors play a role. “The Assam region is an extension of the Shillong plateau, which has Precambrian rocks rich in minerals like fluorite. These release fluoride into the groundwater. The World Health Organisation (WHO)’s safe limit for fluoride in drinking water is 1.5 mg/l, and anything exceeding that is not safe for consumption,” she says. A study Neog co-authored in 2021 tested groundwater samples from Nagaon, Kamrup Metropolitan and West Karbi Anglong districts detected a maximum of 9 mg/l in a sample from Nagaon.
In Tapatjuri village, more than 1,000 kids have contracted fluorosis, according to Saikia. “In Binakandi, there are 485 villages where most of the population has been affected, making it one of the worst fluoride-affected zones of Assam,” he says.
Tapatjuri falls under the Barhampur legislative constituency. Local legislator Jitu Goswami of the Bharatiya Janata Party says, “Fluoride presence has been detected in many places [in Barhampur] like Doboka and Kathiatoli. I have written to the Water Supply Department to look at the issue. Also, I am trying to raise awareness among people so that they avoid groundwater sources and use water from rivers and springs more.” So far, Goswami’s conversation with the department has not progressed further.
Natural or geogenic fluoride contamination, as in the case of Assam, largely impacts groundwater, leaving surface water resources such as rivers, ponds and springs generally safe.
Impacts of fluorosis on the human body
Saikia has observed that symptoms generally emerge years after consuming fluoride-affected water. He shares that mineral supplements seemed to improve the condition of many children with fluorosis, including his own son, who developed dental fluorosis in 2011.
Dr. Jutika Ojah, Head of Department of Community Medicine, Gauhati Medical College and Hospital, adds that while mineral consumption can help manage fluorosis among children, there is no cure.
At levels of 0.5-1.0 mg/l, fluoride can help prevent tooth decay by strengthening the enamel. Higher doses, however, cause problems. “[Excess] fluoride affects humans in three ways — dental fluorosis, whose symptoms are discolouration, mottling, and pitting [of teeth]; skeletal fluorosis, whose symptoms are joint pain, stiffness, and deformities; and non-skeletal symptoms such as gastrointestinal issues and muscle weakness,” says Dr. Ojah.
“Management focuses on removing exposure and supportive care,” she says. She notes that in high-fluoride areas, around 10-30 cases are reported each month.
Dr. Anuj Kumar Borah, a dental surgeon at the Kathiatoli Block Public Health Centre, says, “I get five to six patients with dental fluorosis symptoms every month. However, the actual number of cases will be much higher.”
While symptoms of fluorosis among children is sometimes manageable, some people live with fluorosis their entire lives.
Fifty-year-old Sadhani Kalita who lives a few kilometres from Amjad Hussain’s residence says, “I face constant pain in my body, and my feet get swollen. I also have fever, high pressure, and diabetes, for which I have to take medicines.”
A pipe dream
PHED launched the Jal Jeevan Mission (JJM) Scheme in 2019 to provide piped water supply in rural areas, sourced from dams, springs and lakes. According to their data, of the 914 schemes handed over in Nagaon — one of the highest in the state — only 510, or roughly 55%, are functional.
The PHED has also set up 83 water-testing labs in rural areas, according to Bhupen Barman, Assistant Engineer, Water Sanitation Support Organisation.
In the most recent tests, no fluoride was detected in water samples from taps installed under the JJM scheme, according to Barman. This indicates water provided by the scheme in the district is safe but fluoride could be present in other groundwater sources, he adds.
Ground realities
According to the PHED, 83% of the state’s rural areas are covered by the JJM scheme. However, regular access to the water is limited because of operational challenges.
Bong Rongpi is employed as a Jal Mitra (workers that are trained in maintaining piped water systems by JJM) in Dhikharumukh village in Nagaon district, which provides piped water to four fluoride-affected villages. “The source of this water is the Udharjuri spring, which is three kilometres away. We draw water from the spring and store it in a 50,000-litre tank,” says Rongpi.
However, the process requires high-voltage power, which is hampered by frequent power outages. “During summer and monsoon, we sometimes don’t have power for a day or two at a stretch. During these times, people in the villages have to go back to groundwater sources,” he says. In these cases, the people are once again vulnerable to fluoride contaminated water.
Experiments with fluoride removal
A research group at Tezpur University led by Robin Kumar Dutta has developed a tool to remove excess fluoride from drinking water through certain chemical treatments, but there have been certain challenges to scale the tool and implement it in Assam. Currently, a pilot of this tool is underway in parts of Yemen with support from Dutch-based nonprofit ZOA.
Dutta, a professor in the Department of Chemical Sciences, has previously developed tools to remove arsenic and iron from water.
This article is republished from Mongabay under a Creative Commons license. Read the original article here.