How people are fighting fluorosis?

Lessons from movements across India

Bantu Singh of Dhar for Hope from fluorosis in Dhar (MP), 2015

Nilesh recovering in Jhabua, 2015

Furhan recovering in Nagaon district of Assam , 2015

What is social condition of affected people?

-Life on pain or painkillers

- Stigma with disease

- Economic loss of wage and others

- Malnourishment makes it worse, so poor affected more

- other related problems such as Kidney, Anemia, Osteoporosis

Who are these Fluorosis affected people ?

Arthritis affects 180 million people in India1

Disability affects 70 million people2

Fluorosis is supposed to affect 65 million people3

A Perspective on the Problem

Fluorosis could be the single biggest source of mis diagnosed Arthritis, Muscolo skeletal disorders and Disability in India 1 arthritis-india.com , 2 un.org , 3 Dr Susheela (1999)

Dental Fluorosis affects only during teeth formation

It cannot affect beyond 12-13 years of age

So DF is effect of Fluoride water exposure below 12 years

Dental Fluorosis as Bio-marker of problem

ICMR Fluorosis Index makes it easy – Mild DF (only white non transparent), Medium DF (horizontal symmetric stains yellow to brownish away from gums, Severe DF (above plus pitted teeth)

How do we give relief to people ?

Can we cure them ?

Can we save children from a life of deformities ?

Or minimize their pain ?

A Mission to help Fluorosis affected people

Can some symptoms reverse ?

How much can we achieve with Safe water, .. Are there other things that could help?

Better nutrition for resistance and ejecting out toxins

Stopping F from water and Food

Ejecting ingested fluoride

Detox of absorbed fluoride

Developing internal capacity

Shifting to safer water

Shifting to safer food

Preventing further F into water and food

Paths to recovery from Fluorosis

Fluorosis condition

Path to recovery

Earlier the detection, better are chances of recovery

Positive hope giving

Threat yes, but selective

Persistence

Solutions which make life easier and have measurable impacts

Learnings from Effective Communication

Emphasis on Possible relief and Benefit to Quality of Life helps with persistence

Safe source – detection, testing – Caddisfly, Marking

Protection of safe sources – Watershed means, sanitary dug wells

Domestic purifiers

Safe Water Choices for Action

Reverse Osmosis , and other treatments

Other safe sources supplied from external places

Safe sources

Domestic purifier

Capturing rainwater

Water treatment servicesExternal water supply

Enhancing specific nutrients – Calcium (and Magnesium), Vitamin C, Antioxidants

Pharma, and food supplements

Local production, and helping to choose properly

Improving reach and acceptability of govt food progs

Nutrition Choices for Action

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

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

Dhar, Nagaon, Nalgonda, Jhabua, Tumkur, …..

Stories of People fighting and recovering from fluorosis are increasing

Results from Mitigation approaches

Aarambh – a beginning …

Current Programmes of Safe water supply

Community based Water treatment plants

Pipe water schemes

NPPCF Programme

Nutrition programmes

Rehabilitation packages

Efforts from the Government

Towards a holistic

approach

Safe water supply, and sustainability

Disease detection & counselling

Nutrition improvements rehabilitation

Bringing all of it together into one platform by

District Fluoride Monitoring Centre (DFMC) at Nalgonda

Since 2013

Partnership between UNICEF, NIN and District administration

17 line departments involved in Nalgonda

Experience of 1.5 years now

Convergence of Efforts

DFMC approach by govt, and to support it,

Civil society, Academic institutions

Peoples movements , Resource centres

Social businesses

A coalition at district that can address convergence, and deliver to people

What can we do ?