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Life for Gita Deb (44) of village Tekelangjun in the Karbi
Anglong district of Assam is an endless odyssey of pain. For
the last seven years she has been bedridden, suffering from
perennial body pain. She is also without medical care, even
medicine. Her husband looks after the family and also takes
care of the wife's needs. As they cannot afford a bedpan,
he uses a plastic sheet, convenient for repeat use.
Gita suffers from skeletal fluorosis, a water borne disease,
caused by excess fluoride in drinking water. Her son, a fourth
standard student of Tekelangjun High School, is also showing
signs of dental fluorosis. The two elder daughters, married
and staying in distant villages, are also now complaining
of tiredness and severe pain, sure signs of skeletal flourosis.
One can find many Gitas in the area, showcasing an impending
tragedy. Around 100,000 people in the state, at least half
of them women, are in the grip of hydrofluorosis. Hundreds
of villages in Karbi Anglong and few areas in neighbouring
district of Nagaon, are reported to be prone to excess fluoride.
Severe anemia, stiff joints, painful and restricted movement,
mottled teeth, loose muscles, kidney failure, premature death
and physical disability are manifestations of the disease.
Women and children are more prone to the disease as they remain
at home and thus are in contact with the contaminated water
for a longer period. Moreover, malnutrition during childhood
makes the women more vulnerable to fluorosis. According to
statistics, more than six million children (all together 62
million people in India are suffering from fluorosis) are
presently in the grip of fluorosis. Of them, at least 20,
000 are in Assam.
Well known for its scenic beauty and thick rainforest, Karbi
Anglong district has recently been included in the fluoride
affected map of India. Of the 700,000 habitants, one tenth
are suffering either from dental fluorosis or skeletal fluorosis,
The first fluorosis case in the state was discovered in the
middle of 1999 in the Tekelangjun area where fluoride levels
were found to be as high as 5-23 mg per litre, whereas the
permissible limit is only 1 mg per litre (according to World
Health Organisation guideline). The tragedy, first of its
kind in the North-East, was revealed following a study by
the state Public Health Engineering (PHE) department.
"In the affected villages of the district, it was found
that one in every four persons was suspected to be with Fluoride
related disease ," informs Amalendu Bikash Paul, additional
chief engineer (PHE), at capital Diphu. Later independent
studies conducted by various organisations including Central
Ground Water Board, All India Institute of Hygiene and Public
Health (Kolkata), School of Environmental Studies ( Jadavpur
University) also confirmed the findings. It may be worth mentioning
that geological and health scientists of the country had declared
North Eastern region as safe from fluoride contamination till
1998.
Unfortunately, fluorosis has no cure. However, it can be
prevented from deterioration if diagnosed at an early stage.
The fluoride replaces hydroxide in bones and this is deposited
in bones and causes chronic skeletal fluorosis. It affects
both young and the old.
Fluoride can enter the human body through food, toothpaste,
mouth rinses, other eatable products and of course, more swiftly
through drinking water. A colourless and odourless natural
pollutant, Fluoride comes to contact with the groundwater
from its original source of rock minerals. Another important
aspect is that most of the fluoride compounds in the earth's
upper crust are soluble in water. When fluoride containing
minerals come in to contact with ground water, they release
fluoride into water by the process of hydrolysis.
Geologically, the area around Karbi Anglong and adjoining
Nagaon district is full of joints, fractures and faults. Besides
ancient and younger sedimentary rocks and unconsolidated materials
like gravel, sand, clay with intrusive granite, quartz shale,
which are known as high fluoride content, are abundant in
the area.
At least 20 states in India including newly created Uttranchal,
Jharkhand and Chattisgarh are endemic to fluorosis. States
like Andhra Pradesh ( first ever case of fluorosis in India
was detected here in early 1930), Gujarat, Rajasthan (where
70-100% districts are affected), Bihar, Punjab, Haryana, Karnataka,
Maharashtra, Madhya Pradesh, Tamil Nad,u Uttar Pradesh, some
parts of Delhi (40-70% districts affected ), Assam, Kerala,
Orissa, West Bengal, Jammu & Kashmir (10-40% districts
affected ) can be identified as significantly affected. India
thus has been facing another water-related public health problem
after arsenic. But statistics reveal that fluoride poisoning
is more wide spread than arsenic in the country.
There is a distinct relation between poverty and fluorosis.
Almost 70 percent of the affected population in Assam are
very poor. Healthcare awareness is certainly the need of the
hour. But to create awareness the people have to be economically
self- dependent. Besides, malnutrition adds to the aggravation
of the disease.
There are other socio-economic implications. Girls from endemic
villages with their mottled teeth due to dental fluorosis
find it tough to get married, or abandoned after marriage.
The skeletal fluorosis, which can cripple a working individual,
directly affects the earning of the family.
The UNICEF and few local Non Governmental Organisations (NGO)
have been involved in health awareness drive in the affected
areas of the district. Jirsong Asong, an NGO and the official
organ of the Catholic Diocese of Diphu, has so far conducted
several preliminary investigations in the affected villages.
Father Paul of the Diocese says that alongwith, providing
safe drinking water from alternative sources and medication
for the victims deserve urgent attention. Since last year,
the organisation has been encouraging economic development
among the poor villagers with formation of self help groups
in the affected areas.
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