Water pollution

A disease in Dhanbad has left children without smiles

High fluoride content in groundwater is crippling entire generations in several Dhanbad villages, leaving them with weak bones and stained teeth.

Sixty-eight-year-old Himanshu Chakrabarty of Brahman Tola village in Ghadbad panchayat of Dhanbad has only one desire – death. For more than 15 years, he has suffered from weak and deformed bones with almost no flesh on his body, limping around like a living skeleton. A patient of a crippling disease called fluorosis, which caused due to an excess intake of fluoride, Chakrabarty wants an end to his suffering. “I only want death,” he cries out in pain. “How much more do I have to suffer?”

Chakrabarty isn’t the only one suffering in Brahman Tola. “Each of the 68 households in our hamlet has at least one patient suffering from fluorosis,” resident Rajit Thakur told VillageSquare.in. “Almost 60% men and over 75% women of the tola are affected by the disease in some form or the other.”

Fifty-year-old Savitri Mukherjee, a widow, lives alone and cannot walk with her spine straight. “It started with pain in my shoulders, back and knees. But, for the last five years, I am walking with a bent back,” said Savitri. “If I fall on the ground, I cannot get up on my own. I cannot sleep straight on the bed. It’s been five years since I have seen the sky (with back always bent downwards). There are several women like me.”

The common thread tying all the residents of Brahman Tola with a single disease – fluorosis – is their drinking water. “The groundwater of Brahman Tola and its neighboring villages in Ghadbad and Birsinghpur panchayats of Baliapur block is laced with high fluoride. Groundwater is the primary source of drinking water for these villages, which depend on hand pump and dug well to meet their daily water needs,” Eklavya Prasad, managing trustee of Megh Pyne Abhiyan or MPA, a non-profit working on water and sanitation issues, told VillageSquare.in.

High fluoride in groundwater

Chakrabarty used to live in the Purulia district of West Bengal and moved to Brahman Tola in Dhanbad district of Jharkhand about 38 years ago. “Till about 20 years ago, we used to drink water from a dug well near the village school. Then hand pumps were sunk,” reminisced Bani, wife of Chakrabarty. “We were told that hand pump water was clean and pure, but within five years my husband started to complain of pain in the bones and joints.”

“The pain started from my right leg and slowly moved upward in my back. Then, my entire body was affected. Getting up from the bed and moving around has become a challenge,” said Chakrabarty, who has consulted doctors at Dhanbad and Asansol in West Bengal, all of whom have diagnosed him with fluorosis and prescribed painkillers. “Doctors claim that I got this disease from drinking water. So, I have only two choices – die without water, or die drinking poisonous water,” said an exasperated Chakrabarty.

“Fluorosis is a painful and crippling disease,” said Manish Kumar, a radiologist in Dhanbad who often receives fluorosis patients. “High fluoride in the body starts depositing on the bones and as fluoride deposition increases in bones, calcium starts to decrease, making bones brittle.” This is not all. Bones and muscles are joined together through tendon. “Even tendon starts having calcification. Fluoride also deposits on intervertebral disc (which serves as the spine’s shock absorber), because of which patients experience severe back pain and cannot walk straight.”

How much is too much?

Fluoride is a micronutrient and is widely distributed in the earth’s crust, mainly as the minerals fluorspar, fluorapatite and cryolite. According to the World Health Organization, fluoride intake has both beneficial effects in reducing the incidence of dental caries, and negative effects in causing tooth enamel and skeletal fluorosis following prolonged exposure to high concentrations.

The dental effects of fluorosis develop much earlier than the skeletal effects in people exposed to large amounts of fluoride, says WHO. Clinical dental fluorosis is characterized by staining and pitting of the teeth. In more severe cases, all the enamel may be damaged.

The WHO has set the fluoride guideline value of 1.5 milligram per liter for drinking water, beyond which fluoride starts to show adverse human health effects. In India, the BIS drinking water standard for fluoride is divided into two parts – an acceptable limit of 1 mg/l, and a permissible limit of 1.5 mg/l in an absence of an alternate source.

But, the groundwater and drinking water supply in several regions of the country contains high fluoride levels. The Union Ministry of Health and Family Welfare has recently identified at least 132 districts in 19 states severely affected by high fluoride content in drinking water, a leading cause of fluorosis.

“The terms like acceptable and permissible limits do not make sense. It should be toxicity limit and down to 0.5 mg/l because, even at that level, fluoride can affect human health,” Sunderrajan Krishnan, director of Anand-based INREM Foundation, a research institution working on water, public health and agriculture, told VillageSquare.in. Krishnan has done extensive field-based research on impacts of fluoride on human health.

Test result: Fail

According to the residents of Brahman Tola, a couple of years ago, the Public Health Engineering Department or PHED tested water quality of hand pumps in their village.

“The PHED officials painted some hand pumps red and told us not to drink water from them, as they contained high levels of fluoride. But, the government has not provided any alternate source of water. Hence, we drink contaminated water knowingly,” lamented Ashish Sarkhel, another resident suffering from skeletal fluorosis. “Initially, I had only back pain, but in the last seven years, my condition has worsened. I used to work in a factory, but had to give up my job.”

Last December, MPA carried out a survey of high-fluoride affected villages in Ghadbad, Birsinghpur and Machiyara panchayats of Baliapur administrative block in Dhanbad district. Water sources of Brahman Tola were tested as well. Children were screened for dental fluorosis at local schools.

“Using field-kits, we tested water quality of 11 villages and hamlets in the three panchayats. A total of 45 dug well samples and 78 hand pump samples were tested. Of these, only six samples of dug wells and three samples of hand pumps were found safe for drinking. The rest had fluoride levels above the permissible limit,” said Pradeep Poddar, program officer at MPA.

Entire generation affected

The situation is so grim in Brahman Tola that its children refuse to smile. They fear their smile will expose their stained teeth (dental fluorosis) to visitors. “More than 90% of the children in the tola have stained teeth. No child above the age of six or seven years has clean white teeth,” said Thakur. “Our entire younger generation has been blotted.”

“I used to have clean, white teeth. But, for the last three-four years, my teeth have developed brown stains. Elders tell me that it is due to the water I drink. My friends also have stained teeth,” said Debu Sarkhel, a nine-year-old who studies in the 6th standard of the local middle school.

All the children in the middle school – Utkramit Madhya Vidyalaya, Ghadbad – which is till the 8th standard, drink water supplied from a 400-feet deep tube well within the school premises. “Earlier, the school hand pump was only 150 ft deep. Last year, as part of a drinking water scheme for the school, the hand pump was dug deeper to 400 ft,” Thakur said. “We fear that even at 400 ft depth, fluoride is present in the groundwater.”

Private gains

While fluorosis has become a public health issue in the affected villages, private companies selling bottled water are making private gains. Almost daily, vans supplying bottled water visit the affected villages.

“I cannot bear to see my husband suffer every minute. So, I buy 20-liter bottled water for Rs 20. Both my husband and my son drink that water. I continue to drink the hand pump water,” said Bani, wife of Chakrabarty.

It is hard to find a child above 6-7 years age in Brahman Tola who does not have strained teeth due to dental fluorosis. Most children cannot touch their toes, which is a sign of early stage of skeletal fluorosis. Photo credit: Eklavya Prasad
It is hard to find a child above 6-7 years age in Brahman Tola who does not have strained teeth due to dental fluorosis. Most children cannot touch their toes, which is a sign of early stage of skeletal fluorosis. Photo credit: Eklavya Prasad

The condition of 60-year-old Gita Chatterjee, a widow, is worse. She lives alone and can barely walk a few steps. “I have to beg and request village youth to fetch me some drinking water,” said a hapless Gita. According to Thakur, only 10-12 families in Brahman Tola have the money to buy 20-litre jar of drinking water. “Fluorosis has crippled us and we cannot earn a living. Buying bottled water is an additional cost,” he lamented.

Drinking water scheme in limbo

The state government and the district administration are aware of the sufferings of people in the fluoride-affected panchayats. Three years ago, Rs 7 million worth of drinking water treatment and supply scheme for the affected villages, including Brahman Tola, received technical sanction from the state government.

As per the scheme, water of Damodar River is to be treated and supplied to the villages through piped water supply. Villagers have to pay a user fee to the village water sanitation committee. But, the scheme hasn’t made much progress.

“The work is already underway. It was expected to be completed by November, but there has been some delay. The scheme should be functional by March next year,” said Kuldeep Chaudhary, deputy development commissioner of Dhanbad.

According to him, the Dhanbad Mineral Fund Trust, which is based on royalty received from mining companies in the district, is highest in the country, somewhere between Rs 50-60 million. “Sanitation, water and environment are the priority areas where we want to spend the trust fund. We can use money from this fund to support the villagers suffering from fluorosis,” added Chaudhary.

The people of Brahman Tola and the surrounding villages have suffered enough in the past few decades. An entire young generation is at the risk of being crippled for life. The government must act on a war footing and supply safe drinking water to the people.

Nidhi Jamwal is a journalist based in Mumbai.

This article first appeared on Village Square.

We welcome your comments at letters@scroll.in.
Sponsored Content BY 

“My body instantly craves chai and samosa”

German expats talk about adapting to India, and the surprising similarities between the two cultures.

The cultural similarities between Germany and India are well known, especially with regards to the language. Linguists believe that Sanskrit and German share the same Indo-Germanic heritage of languages. A quick comparison indeed holds up theory - ratha in Sanskrit (chariot) is rad in German, aksha (axle) in Sanskrit is achse in German and so on. Germans have long held a fascination for Indology and Sanskrit. While Max Müller is still admired for his translation of ancient Indian scriptures, other German intellectuals such as Goethe, Herder and Schlegel were deeply influenced by Kalidasa. His poetry is said to have informed Goethe’s plays, and inspired Schlegel to eventually introduce formal Indology in Germany. Beyond the arts and academia, Indian influences even found their way into German fast food! Indians would recognise the famous German curry powder as a modification of the Indian masala mix. It’s most popular application is the currywurst - fried sausage covered in curried ketchup.

It is no wonder then that German travellers in India find a quite a lot in common between the two cultures, even today. Some, especially those who’ve settled here, even confess to Indian culture growing on them with time. Isabelle, like most travellers, first came to India to explore the country’s rich heritage. She returned the following year as an exchange student, and a couple of years later found herself working for an Indian consultancy firm. When asked what prompted her to stay on, Isabelle said, “I love the market dynamics here, working here is so much fun. Anywhere else would seem boring compared to India.” Having cofounded a company, she eventually realised her entrepreneurial dream here and now resides in Goa with her husband.

Isabelle says there are several aspects of life in India that remind her of home. “How we interact with our everyday life is similar in both Germany and India. Separate house slippers to wear at home, the celebration of food and festivals, the importance of friendship…” She feels Germany and India share the same spirit especially in terms of festivities. “We love food and we love celebrating food. There is an entire countdown to Christmas. Every day there is some dinner or get-together,” much like how Indians excitedly countdown to Navratri or Diwali. Franziska, who was born in India to German parents, adds that both the countries exhibit the same kind of passion for their favourite sport. “In India, they support cricket like anything while in Germany it would be football.”

Having lived in India for almost a decade, Isabelle has also noticed some broad similarities in the way children are brought up in the two countries. “We have a saying in South Germany ‘Schaffe Schaffe Hausle baue’ that loosely translates to ‘work, work, work and build a house’. I found that parents here have a similar outlook…to teach their children to work hard. They feel that they’ve fulfilled their duty only once the children have moved out or gotten married. Also, my mother never let me leave the house without a big breakfast. It’s the same here.” The importance given to the care of the family is one similarity that came up again and again in conversations with all German expats.

While most people wouldn’t draw parallels between German and Indian discipline (or lack thereof), Germans married to Indians have found a way to bridge the gap. Take for example, Ilka, who thinks that the famed differences of discipline between the two cultures actually works to her marital advantage. She sees the difference as Germans being highly planning-oriented; while Indians are more flexible in their approach. Ilka and her husband balance each other out in several ways. She says, like most Germans, she too tends to get stressed when her plans don’t work out, but her husband calms her down.

Consequently, Ilka feels India is “so full of life. The social life here is more happening; people smile at you, bond over food and are much more relaxed.” Isabelle, too, can attest to Indians’ friendliness. When asked about an Indian characteristic that makes her feel most at home, she quickly answers “humour.” “Whether it’s a taxi driver or someone I’m meeting professionally, I’ve learnt that it’s easy to lighten the mood here by just cracking a few jokes. Indians love to laugh,” she adds.

Indeed, these Germans-who-never-left as just diehard Indophiles are more Indian than you’d guess at first, having even developed some classic Indian skills with time. Ilka assures us that her husband can’t bargain as well as she does, and that she can even drape a saree on her own.

Isabelle, meanwhile, feels some amount of Indianness has seeped into her because “whenever its raining, my body instantly craves chai and samosa”.

Like the long-settled German expats in India, the German airline, Lufthansa, too has incorporated some quintessential aspects of Indian culture in its service. Recognising the centuries-old cultural affinity between the two countries, Lufthansa now provides a rich experience of Indian hospitality to all flyers on board its flights to and from India. You can expect a greeting of Namaste by an all-Indian crew, Indian food, and popular Indian in-flight entertainment options. And as the video shows, India’s culture and hospitality have been internalized by Lufthansa to the extent that they are More Indian Than You Think. To experience Lufthansa’s hospitality on your next trip abroad, click here.

Play

This article was produced by the Scroll marketing team on behalf of Lufthansa as part of their More Indian Than You Think initiative and not by the Scroll editorial team.