Helping Severely Fluorosis affected people

Safe Water and Better Nutrition

Can we help people at the critical stage ?

What does research say ?Dr Susheela: Vitamin C and Antioxidants help in resistance. Iron absorption can be increased by safe water -- Amla

Dr Chakma: Calcium and Vitamin D improvement can help in recovery of malnourished children --- Cassia Tora

Dr Khandare: Tamarind helps in detoxification

Dr Teotia: Fluorosis and Calcium deficiancy causes Ricket like condition which can be treated with safe water and better calcium -- Calcium supplementation

Dr Reddy: Calcium, Magnesium and Vitamin C help in better resistance --- Til Chikki, Pharma supplements

• Minimize intake of fluoride through water and food

• Increase intake of Calcium and ways of absorbing Calcium

• Reduce Fluoride impact within body through better nutrition of Vitamin C, Magnesium, and other nutrients

INREM works with fluorosis affected communities and tries to bring in people an understanding of their disease. We have a strong emphasis on proper detection of the disease and then developing technologies which can help people to alter their current behaviour.

Detect with visual symptoms and blood, urine fluoride and x-rays

5 years of experience in Jhabua, MP2010 till 2015

Within the geographical situation that people live in Jhabua and given problems of electricity and roads, we need to think of technologies which can be easily maintained and used. Also, those which can easily connect with people’s culture

With these in mind, INREM has developed a earthen pot filter which uses Activated Alumina (AA) for fluoride removal

People also adapted to using dug wells which have relatively lesser fluoride

Safe Water Options

Nutrition approach

a) Pharma supplements of Ca, Mg, Vitamin D3 and Zinc

b) Natural food rich In Calcium, Magnesium, Vitamin C: Amla (dried form and tablets), Soya, Til-Chikki, Cassia Tora (Puvadiya, Chakora)

c) Helping access to choosing good food from markets

d) Producing nutritious food with nutrition gardens

Combined approach of:

Amla tabletsCalcium, Magnesium supplements

Dried AmlaTil Chikki

Nutrition enhancement

Sr. No. Parameters Nutrient composition

1 Calcium 4480 mg/100 gm2 Iron 30 mg/100 gm

3 Magnesium 360 mg/100 gm

4 Crude Protein 25 gm/100 gm5 Vitamin C 93.68 mg/100 gm

Cassia tora cold dried leaves powderCassia Tora powderCassia Tora leaves

Nutrition gardens for better food

We help to have green leafy vegetables and other nutritious food which are good to develop resistance

Impact on children

2010 2014

Apart from this, several reported changes by several other children and adults in Fluorosis symptoms such as pain, gastric problems and weakness related to Fluorosis

Similar work through Fluoride network

Assam(WQ Resource centre)

Chittoor(OUTREACH programme)

Nalgonda & Prakasam(DFMC, UNICEF, NIN)

Hubli(FRRC)

Other initiatives in Raichur, Tumkur, Dhar, Sonbhadra, Gadchiroli, Singrauli, Nanded, ….

Jhabua, Dhar(INREM, PSI, VVS)

Other key activities through Fluoride network

A Public health manual for Fluorosis

A fluoride detection kit using mobile phone

An open data and knowledge platform on Fluoride and Fluorosisfor better learning

A communication material package for fluorosis

An active social media forum to exchange information

State policy briefs

and many other initiatives …

What can NPPCF do ?

Choose 30-40 highly affected districts

Choose 100 highly affected patients in each district

Start

A - nutrition supplement programmeB - Safe water information awareness

How

Get officers trained using knowledge resource of ICMR Fluorosis task force and use local resources which are available from Fluoride network

How will this help?

Reduction in pain

Reduction in painkillers like Aceclofenac

Reduction in gastric problems

Improvement in Blood hemoglobin

Other benefits

Communicate positive improvement of 100 patients to entire district and scale up

Framework

NPPCF officers coordinating at district level

ICMR task force, NIN giving knowledge guidance and training

INREM and Fluoride network giving support locally and in local solutions