Community Based Alternatives for Floride Affected Areas-Jravishanker-2005

8/3/2019 Community Based Alternatives for Floride Affected Areas-Jravishanker-2005

1/16

Small Scale Community Based Safe Drinking Water Alternative forFluoride Affected Areas of Nalgonda district. Andhara Pradesh.

A Pilot Study.2005-06.

Study conducted by Ravi Shanker

Supported by

AWAM &Professional Social Workers Consortium. Hyderabad.

AWAM is a non-profit social organization working for sustainable livelihoods of poor and women in hilly areasand coastal plains.

Professional Social Workers Consortium is an association of professional organsations and individualsengaged in various development activities across the country.

Nalgonda is a district in AP most severely affected by Fluoride problem where the fluoride content exceeds morethan 10 ppm in drinking water.


2/16

Community based safe drinking water schemes in Nalgonda district AP.

AWAM & Professional Social Workers Consortium. AP. Year 2005. 2

Contentw:

What is Flurosis

Common causes of Flurosis

Profile of Nalgonda district

Flurosis in Nalgonda

Impact of fluoride on communities

Existing schemes and programs in the district

Outreach of existing schemes and gaps

Rationale for community based safe drinking water schemes

Technology & approach to community based safe drinking water scheme

Project Area & Communities

Management Practices

Water availability and distribution

Operation & Maintenance

Budget

Capital costRecurring cost


3/16



Project theme:


What is Fluorosis:

Flurosis is dreaded disease caused by consumption of excess fluoride. This is causedchiefly through consumption of water having excess fluoride content. The WHO standardsprescribe 1.5 PPM as maximum level of fluoride in drinking water. However deep bore wellsdo carry excess fluoride causing various bone and physical deformities. This problem issevere in India and need immediate attention of government, donors and philanthropists tosave our people.

While fluorosis is most severe and widespread in the two largest countries - India and China- UNICEF estimates that "fluorosis is endemic in at least 25 countries across the globe. Thetotal number of people affected is not known, but a conservative estimate would number inthe tens of millions."

Common causes of fluorosis: Consumption of fluoride from drinking water and inhalationof fluoride dusts/fumes by workers in industry, use of coal as an indoor fuel source (acommon practice in China) and urbanslums of India. According to scientificsurveys, skeletal fluorosis in India andChina occurs when the fluorideconcentration in water exceeds 1 partper million (ppm), and has been foundto occur in communities with only 0.7part per million1

For instance, in three recent studiesfrom India, China, and Tibet, theaverage daily doses found to causeadvancedskeletal fluorosis ranged from9 mg/day to 12 mg/day2. To put thesefindings in perspective, it is estimatedthat the daily dose of fluoride influoridated communities now rangesfrom 1.6 to 6.6 mg/day i.e., very highlevels of consumption.

It is this fact that makes the proximity indoses causing advancedfluorosis inIndia/China (9-12 mg/day) to the doses ingested in fluoridated communities (1.6-6.6 mg/day)particularly troubling.

While the advancedstages produce extreme, visibly crippling, effects on the skeleton, theearlier stages are less obvious, and extremely difficult to diagnose. Indeed, a commonfinding among researchers investigating fluorosis, is that the early stages are marked by

1Singh 1961; Singh 1963; Jolly 1970; Siddiqui 1970; Susheela 1993; Choubisa 1997; Xu

1997; Bo 2003.

2Teotia 1998; Bo 2003; Cao 2003


4/16



symptoms (stiff and painful joints) which are frequently difficult to differentiate from varioustypes of arthritis. In many parts of urban India where ground water is extracted through deepbore wells for supply is causing this problem. The fluoride levels are shooting up higher andmany communities are unaware about this problem. Especially in economically backwardclass settlements.

The difficulties in diagnosing the early stages of fluorosis stem from the capacity of arthriticsymptoms to occur beforedetectable bone changes are evident. As noted by Singh andcolleagues, the early symptoms are difficulty in diagnosing fluorosis is that even when bonechanges areapparent (e.g. ligament calcification), they can look strikingly similar to otherbone diseases - especially to doctors unfamiliar with fluorosis. Bone diseases which fluorosismay be misdiagnosed as, include: ankylosing spondylitis; renal osteodystrophy;osteopetrosis; and Diffuse Idiopathic Skeletal Hyperostosis. This is further complicating theproblem.

Skeletal fluorosis is a bone disease caused by excessive consumption of fluoride. In India,the most common cause of fluorosis is fluoride-laden water derived from bore wells dug

deep into the earth.

Dental Fluorosis damages the cells (ameloblasts) responsible for forming tooth enamel.This raises the question of whether there are other cells in the body (which we can't see)that fluoride may be damaging - particularly in areas like the bone, the pineal gland, and thekidney, where fluoride can accumulate.

Nalgonda District

Brief Statistics of the district.

Area 14,240 Sq.K.MPopulation(2001) 32,38,449

Population rate200( 15 thPlace)

Population ratio 1000:931

Population growthrate

+25.11

Literacy 38%

Scheduled Castes 5,04,206

Scheduled Tribes 2,75,638

Assembly Seats 12

Municipalities 3High Schools 1750

Banks 135

Rain fall 150 m.m

Forests 83,000 hectarsMandals 59

Major Cities 2

Villages 1150

Gram Panchayathies 1013

Voters

Male 16,46,555

Female 15,91,894

Small scale industries 4985

Large & Medium scaleindustries

88

Agricultural Land 6.06 lakhhectars

Hospitals 53

Post Offices 177

Revenue Divisions: There are 3 revenue divisions in this district namely Nalgonda,Miryalaguda, Bhuvanagiri.

Rivers: Krishna, Musi, Aleru, Peddavagu, Dhindi, Paleru.

Major Crops: Paddy, Millet, Pulses, Oilseeds.

Major Minerals: Limestone.


5/16



Major Industries: Silk, Leather, Cotton, Jaggery.

Loksabha Constituencies: 1. Nalgonda 2. Miryalaguda.

Assembly Constituencies:

Nalgonda, Alair, Munugode, Devarakonda,Bhongir,Tungaturthi, Suryapeta, Kodad,Miryalaguda, Chalakurthi, Nakrekal, Ramannapeta.

District Boundaries: North-Medak, South-Mahabubnagar, East-Khammam, West-Rangareddy.

Mandals: The district is divided into 59 mandals. The problem of Flurosis is rampant in mostof the Mandals. However the remotest areas are most affected as development schemes didnot reach these places. They are predominantly tribal and poor communities who can notafford to have their own alternatives for safe drinking water.

1.Yadagirigutta 21.Athmakuru 41.Pedda Ariserlapalli2.Aleru 22.Mothe 42.Chandampeta

3.Rajapeta 23.Chevemula 43.Gundlapalli

4.Turkapalli 24.Nakrekal 44.Nidamanuru

5.Bhongiri 25.Kethepalli 45.Peddapura

6.Bommalaramaram 26.Shaligouraram 46.Haliya

7.Pochampalli 27.Kattamguru 47.Tripuraram

8.Bibinagar 28.Chendur 48.Miryalaguda

9.Ramannapeta 29.Munugodu 49.Damarlacherla

10.Valigonda 30.Narayanapur 50.Vemulapalli

11.Choutuppal 31.Nalgonda 51.Huzoornagar

12.Mothkuru 32.Narkatpalli 52.Neradicherla

13.Athmakuru 33.Kangal 53.Gardepalli

14.Gundala 34.Thipparthi 54.Mattampalli

15.Tungaturthi 35.Chityal 55.Kodad

16.Tirumalagiri 36.Nampally 56.Mellacheruvu

17.Nuthanakallu 37.Chintapalli 57.Chilukuru

18.Arvapalli 38.Gurrampode 58.Nadigudem

19.Suryapet 39.Marriguda 59.Munugala

20.Penpahad 40.Devarakonda

Flurosis in Nalgonda:

In the year 1932, Muller and Gudson revealed to the world the presence of this disease.They started studying the disease and its causes when the same infected their sheep. They

finally concluded that it was due to excess of flourine content in the water. They named thedisease as flourosis. The disease was noticed spreading to many areas of the combined


6/16



madras state in the same year. It was the king's institute of private medicine that confirmedthe disease flourosis.

In the year 1945, it got spread to many areas of Hyderabad district. Fluorine is essential forthe dental and skeletal strength, but it should be less than 1 p.p.m.(Parts per million) in the

drinking water, as per WHO standards. Where as in Nalgonda district the flourine content inthe water is 10 p.pm and more. It is spreading to new mandals. Long awaited Krishna riverwater has not yet reached these habitations. Long delays in project sanctioning andimplementation lead people to consume fluoride water and their precious life crippled withvarious deformities. There is no data available on number of people already affected andnumber of people threatened by the dreaded problem.

Existing Schemes and Programs in the district:

In 1979 under the Netherlands Assistance Project (AP-1) was taken up at a cost of Rs.44.59 lakhs for providing fluoride free water.

In 1989 an integrated water supply and sanitation proposal at a cost of Rs. 277.00 croreswith Nagarjuna Sagar Left Bank Canal as source was mooted for 660 habitations. But itnever materialised. Subsequently, the budget was reduced to 45.00 crores in 1996 withgroundwater based individual schemes in the habitations where fluoride free water isavailable. This means for more than 15 years nothing has done for fluoride affectedvillages.

However, the people of Nalgonda were not in favour of the said scheme. And therefore, itwas not pursued:

De-fluoridation plants and hand pump de-fluoridation plants at a cost of Rs. 1.57 Crores

however were handed over to village panchayats. The Government of India constitutedTechnology Mission during 1996. Sub-mission programmes were identified under the RajivGandhi National Drinking Water Mission for providing safe drinking water to fluoride affectedvillages. The de-fluoridation plants did not run successfully and problem remainunsolved.

As the defluoridation plants did not achieve anticipated results, the Government of Indiaintroduced sub-Mission programmes for control of fluorosis to take up water supply schemeswith sustainable water sources instead of ground water which contents high levels offluoride. The number of fluoride affected villages and population increased in 15years.

In 1991-93 a random survey was conducted, and based on the survey results, out of 1108fluoride affected habitations, 21 habitations were provided with safe drinking watercontaining less levels of fluoride. This means safe drinking water was provided only to1.8% of habitations.

Action plan in respect of 894 villages, covering about 1119 fluoride affected habitations hasbeen prepared at an estimated cost of Rs. 283.16 crores. This does not mean thehabitations now receiving safe drinking water.

1996-97 Netherlands Assistance Project as well as the Sub-Mission Project was withdrawn.Government prepared 8 projects covering 34 Mandals and a population of 9.74 lakhs at an

estimated cost of Rs. 227.30 crores. Out of 8 projects Government of India has clearedone project under Submission programme at an estimated cost of about Rs. 26.77 crores.The Government of Andhra Pradesh cleared another project at an estimated cost of Rs.


7/16



15.00 crores. Six projects were kept in waiting. Have they ever materialised? How manymandals are now getting safe and adequate drinking water?

The Government of India has sanctioned a pilot project to Nalgonda district at a cost of Rs.40.00 crores under Accelerated Rural Water Scheme (ARWS) to cover 248 fluoride affected

habitations in phase I. Has the impact measured? Do the habitations now get adequate safedrinking water on regular basis?

In nutshell government in past 25 years did very little to control the problem. As a result thenumber of villages increased. More young children are affected by fluoride problem. And noconcrete data made available on number of villages equipped with safe drinking water onregular supply basis in adequate quantity (40lts /person/day). Remaining number ofhabitations and time line to cover those habitations. Till that point people suffer withdeformities and sacrifice their lives to state.

Outreach of existing schemes and gaps

Six hundred villages (more than 1100 habitations) in the district are gripped by flourosis. Onehundred and sixty five (165) villages are severely affected. This disease is more prevalent inareas where the underground water resources are tapped and pumped out through pipes.Such water contains fluorine that gets dissolved in it and when people consume such waterthey get flourosis. Though pipelines were laid in many villages water seldom reaches tothese villages. Hundreds of villages are still waiting for water to get collected in the deceptivewater tanks erected on main road.

The team visited one such village where the water tank is empty for past 15 years. Once in awhile a water tanker fills the tank. Rest the village women collect water from pits on riverbed.Two hand pumps were declared not fit for consumption. A fill and filter de-fluoridation plant

was collecting dust as it was not maintained.

Impact of Flurosis on communities3

Nalgonda is a land where excess fluoride has turned theground water into a slow poison, crippling at least 10,000people and leaving hundreds of thousand of others inconstant misery. Nalgonda, one of the poorest and mostdrought-prone districts of Andhra Pradesh in southernIndia.

The seriousness of the problem can be measured by the fact that the groundwater has 10 to

12 parts per million (ppm) of fluoride in contrast to a maximum permitted level of just 1.5ppm.

In the dust-filled hamlets and villages hardly 100 kilometers (60 miles) from the state capitalHyderabad there are many living examples of the havoc caused by fluoride.

People with paralysing bone diseases, stooped backs, crooked hands and legs, deformedteeth, blindness and other handicaps are a common sight. The most shocking and sadimage of this suffering is Ramaswamy. At 18-yeard of age, when other youths are full ofenthusiasm for life, Ramaswamy looks to be hardly five-years-old, with a physiquecompletely devastated by the effects of fluoride. He is so weak that he cannot walk and

3Excerpts from article by Mr. Omar Farukh BBC Correspondent. April 2003.


8/16



weighs barely 15 kilogrammes (less than 34 lbs). He is blind and mentally challenged. Hecannot recognise his own name and he cannot even eat by himself. "We have done all wecould have done," says his father Ramalingaiah,himself a victim of fluoride in Anneparti village.

Saidamma is36, but looks like a 60-year-old with greyhair and a thin body. She is a widow and is sufferingfrom severe chest pains and recurring fever. Her sonis crippled and her grandson was born with defectivelegs.

With extensive suffering, there is growing anger,frustration and disappointment. Sudhakar Reddy is handicapped and uses a hand-driventricycle to move around the village.

"People keep coming to see us as if we are exhibits. They make meaninglesspromises that water will come. But nothing has happened so far," he says angrily.

Venkat Reddy says this is despite a clear ruling that if the government is not able to supplysafe drinking water, it should relocate the villagers. But even if that water comes, it will betoo late for thousands who had already been crippled by an incurable disease.

The skeletal Flourosis is responsible for disorderly development and the twist of skeletalbones. The sysmptoms of this disease are

1.Plain in the joints 2.Abnormal growth of bones at the joints

3.Inactive movements 4.Respiratory problems

Those who get this disease lose appetite and become sluggish. The victims may alsobecome sterille. The disease may lead other diseases like T.b, and pneumonia.

Komati Reddy Venkat Reddy, a member of the Andhra Pradesh legislative assemblyrepresenting Nalgonda district says: Mr Reddy represents the Congress party andsucceeded in raising the profile of the problem when he went on a hunger strike, demandingthe completion of a drinking water project during Telugu Desam rule in year 2003. Althoughhis fast was forcibly broken he succeeded in stirring up public opinion. His party alsomounted pressure on the state's Telugu Desam Government by organising a march offluoride victims to the Governor's House.

Ram Prakash Sisodia head of the administration in Nalgonda however denies the allegationsof inaction. "This problem has been there for ages. The typical underground rock formationwith fluoride is the root cause of the problem. And there is no solution other than bringingwater from other areas through a pipeline," he says. Local

people have been demanding this for 30 years and say they want supply of water from theRiver Krishna, which flows about 100 kilometres (60 miles) south-east of the area.

Community based safe drinking water alternatives:

The key to selecting an appropriate technology is to involve community members in all

stages of the process, from technology selection to operation and maintenance. In this way,a sense of ownership can be generated and an appropriate, sustainable technology could be


9/16



selected. Let water users make their own informed choices, information about a wide rangeof options should be provided to them.

Technology & approach to community based safedrinking water scheme:

What are the technologies and why they failed?

Safe and pure drinking water should be available at thedisposal of communities. They should manage the systemon their own and get assured supply of safe water. Severalexperiments and pilot projects were carried out to ensuresafe drinking water at household level. Most of the projectsfailed for couple of reasons.

1. The technology did not consider sociologicalfactors affecting its usage.

2. Family/Community habits are not considered whiledesigning projects.

3. The systems were provided at 100% subsidizedrates and hence lack sense of accountability andownership.

4. Expensive alternatives like supply through pipelinesfrom distant places are neither assured nor providedesired quality of drinking water.

At present there are empty water tanks in each villagewaiting for piped supply from distant source for yearstogether. As it did not materialize villagers are drinking

fluoride water to crunch their thrust. The villages we visitedas part of initial survey revealed that manual watertreatment units were laying defunct aside hand pumps.Either the technology was not user friendly or no provision made for maintenance.Communities were not equipped to maintain the systems.

Individual water filter units provided under various schemes also failed. Families found it notsuitable to maintain the units. Especially replacement of cylinders (Candles) that filterfluoride was not done. Either the candles were not easily available or they found it expensiveto replace. They are not used as grain storages.

Short-term solution:

It is estimated that the daily consumption of water for all purposes per capita is about135 lpcd in urban areas and about 40 lpcd in rural areas, whereas for drinking andfood preparing purposes it is only 8 lpcd.Keeping in view the cost involved indefluoridating the water it is desirable that the defluoridation of water should berestricted to drinking water only. Hence the only economical and practicable choiceleft is Domestic defluoridation.

It is now desirable to test the various domestic defluoridation processes, especially interms of acceptance by people without the need of any supervising agency, andrecommend suitable alternatives so that effective long-term implementation can be

achieved.

FLUORIDE FACTS

Nalgonda is one of the 23districts of Andhra Pradeshstate

600 villages and 300,000people are affected by excessfluoride in the undergroundwater

10,000 people are totallycrippled

Plans to bring clean water fromthe river Krishna are underway at a cost of 12 billionrupees

Experts say there is no cure forskeletal and dental fluorosis.


10/16



Surprisingly none of the domestic defluoridation processes available today havebeen much successful in the field. Relative merits and demerits of some of theseprocesses are as follows:

1) Nalgonda process:It is a cumbersome technique not suitable for use by

uneducated rural population - the section that needs it the most. Further, it is difficultto control the alum dose because it is different for each source of water. The processcan be used only for water having a fluoride content of less than 10 ppm. If the alumdose is not properly controlled it may result in high residual aluminum content inoutput drinking water. The IS 10500 sets an absolute maximum limit of 0.2 ppm ofAluminum in drinking water. Excess of alum also renders metallic taste to the water.

2) Activated alumina process:It is an expensive process. Reactivation of filtermaterial is cumbersome and it can be done only with the help of trained personsgenerally not available in most of our villages. This process also results in highresidual aluminum in output water ranging from 0.16ppm to 0.45ppm.

Group based Reverse Osmosis Unit.

As a result we thought that Community Based Fluoride Free Safe Drinking Water Systems,could only help communities to save their lives.

In RO system fluoride contaminated water is passed through various filterations and finallythrough high sensitive RO membrane. Here the composit reverse osmosis membraneremoves dissolved chemical impurities, excess minerals. Membrane technology is advancedand physical seperation techniques are most reliable and economical. This could also becombined with ion exchange system.

Reverse osmosis, also known as hyperfiltration, is the finest filtration known. This process

will allow the removal of particles as small as ions from a solution. Reverse osmosis is used

to purify water and remove salts and other impurities in order to improve the color, taste or

properties of the fluid. It can be used to purify fluids such as ethanol and glycol, which will

pass through the reverse osmosis membrane, while rejecting other ions and contaminants

from passing. The most common use for reverse osmosis is in purifying water. It is used to

produce water that meets the most demanding specifications that are currently in place.

Reverse osmosis uses a membrane that is semi-permeable, allowing the fluid that is being

purified to pass through it, while rejecting the contaminants that remain. Most reverse

osmosis technology uses a process known as crossflow to allow the membrane to

continually clean itself. As some of the fluid passes through the membrane the restcontinues downstream, sweeping the rejected species away from the membrane. The

process of reverse osmosis requires a driving force to push the fluid through the membrane,

and the most common force is pressure from a pump. The higher the pressure, the larger

the driving force. As the concentration of the fluid being rejected increases, the driving force

required to continue concentrating the fluid increases.

Reverse osmosis is capable of rejecting bacteria, salts, sugars, proteins, particles, dyes, and

other constituents that have a molecular weight of greater than 150-250 daltons. The

separation of ions with reverse osmosis is aided by charged particles. This means that

dissolved ions that carry a charge, such as salts, are more likely to be rejected by the

membrane than those that are not charged, such as organics. The larger the charge and thelarger the particle, the more likely it will be rejected.


11/16



o Pre-filter removes sediment and particulate matter from your tap water.o Water is forced through reverse osmosis membrane reducing most dissolved solids,

chemicals and metals.o Water is stored in the expandable storage chamber awaiting your needs. o When water is drawn from the storage chamber it goes through a final polishing filter

to reduce taste and odors, organic chemicals and gasses before flowing through yourfaucet.

Reverse Osmosis (RO) was first introduced to purify seawater to make itpotable. It can remove virtually 90 - 99% of all organic compounds, particlesand ions. In general, reverse osmosis filtration restricts the flow of everythingexcept water through a special type of membrane and allows oxygen to passso product water doesn't taste flat like boiled or distilled water.

The RO filter is called a membrane filter because it works just like a natural

membrane that surrounds a living cell. It is semi-permeable, allowing somemolecules to go through the filter.

HOW THE RO MEMBRANE WORKS

The semi-permeable membrane is wrapped around a hollow cylindrical core.Feed water flows along the surface of the membrane. A flow restrictor limitsthe feed water flow rate creating backpressure that forces some of the waterthrough the semi-permeable membrane.

Once inside the membrane, the filtered product water follows the inside of the

envelope to the core. The water that doesn't pass through sweeps the filtereddirt, particles and debris from the membrane surface and carries the residuedown the drain.

FEED WATER

Feed water is the key to the quality and production of the reverse osmosisfiltration system. The following specifications should always be met:

Feed water: PSI 40 - 125 PSI Feed water Temperature: 40 - 100 (F)

Max. Total Dissolved Solids (TDS): 2000 ppm Max. Hardness: 10 gpg


12/16



pH limits: 4 - 10 Chlorine allowable:2 ppm

PREFILTER

The prefilter is a replaceable activated carbon sediment filter. The filter isnecessary to remove sediment that would otherwise clog the RO membraneand chlorine that would destroy the membrane. After a time, the prefilterbegins to plug and water cannot get through it as fast which eventually slowswater production. The prefilter will remove:

Up to 5 microns of sediment (dirt, sand, silt, etc.) 2 ppm chlorine

Prefilters should generally be changed every 6 months depending on waterusage and the chlorine levels in the water.

POSTFILTER

The activated carbon post filter polishes of the product water. It will removemost unpleasant tastes and odors, sediment and organic chemicals. Thewater passes through this final filtering process immediately before going tothe faucet.

Post filters should generally be changed every 6 months depending on waterusage and the chlorine levels in the water.

AUTOMATIC SHUTOFF

To conserve water, the drinking system has an automatic shutoff thatfunctions by pressure. The automatic shutoff consists of 2 diaphragms and aplunger. The plunger moves up or down in the housing based upondiaphragm pressures.

The lower diaphragm pushes the plunger up allowing feed water to flowthrough the inlet/outlet port until the storage area pressure exceeds one halfthe inlet pressure. At this point, the storage area pressure on the upperdiaphragm is great enough to push the plunger down stopping the flow offeed water. Flow will not start again until the storage area pressure dropsbecause of water withdrawal at the faucet.

RO MEMBRANE CARTRIDGE

The RO cartridge is a tightly wound semi-permeable membrane. When wateris forced through the membrane, it flows only one way down into thecartridge. This high quality product water is directed into the storage area orout to the faucet. The membrane has 2 O-rings on one end that fits into thecheck valve. Rejected water flushes the membrane surface and carries thedissolved solids and organic matter to the drain.

Each group (Sangham) consists of 20 members (maximum). Based on the size of groupand drinking water need proportionate unit will be set up at group level. Group will managethe unit. Each member would contribute to run the unit. This contribution will help inmaintaining the system.


13/16



To prevent a fluorosis disaster, it is imperative that safe water supply is made available, withmore emphasis on surface water sources, as they are generally free from fluoridecontamination.

Long term solutions:

Some of the major strategies being worked out for fluoride mitigation, including

Identifying surface sources and drawing water from them,

Providing de-fluoridation units at habitation level,

De-silting existing tanks

Recharging ground water to dilute fluoride levels in the aquifer.

Provide medical aid to affected people

Roof Rain Water Harvesting and storage for drinking at household level.

Roof Rain Water Harvesting:

Fluoride not only affects the people but it also affects the animals. Therefore it is desirablethat the animals should also be provided with fluoride free water for maintaining theirlongevity. Defluoridation of drinking water for animals will be too costly and not feasible, andtherefore the only solution of this problem is water harvesting. The water harvestingtechnologies should be aimed not only to provide fluoride free water to human beings butalso to animals. Rainwater storage can be a major source of fluoride free drinking water for

the animals.

Rainwater harvesting is potentially an effective method of collecting and storing cleandrinking water. Rainwater is the primary source for all water and is one of the purest forms ofwater, without any groundwater contaminants. Harvesting rainwater and using it for drinkingand cooking would ensure clean potable fluoride-free water for consumption.

Harvesting of rainwater simply involves collection of water from surfaces on which rain fallsand subsequently storing this water for later use. Normally, water is collected from the roofsof buildings and stored in rainwater tanks. A 10,000 lts., unit costs approximately Rs.20,000.

The process of rooftop rainwater harvesting would mean keeping the roof clean, collectingthe water through gutters or pipes, filtering the water to remove silt and other sediments andstoring the water for later use. Except for thatched roofs, all other roofs, such as countrytiles, RCC, asbestos and corrugated iron sheet roofs, are ideal for collection. After twostages of filtration, the clear water is stored in a closed container. Water free of organiccontaminants, if kept away from air and sunlight, can be stored for a long time without itgetting polluted. This is popular in western part of the country.

Medical solutions:Executive director of Fluorosis Research and Rural Development Foundation, A K Susheelasaid a large number of patients are directed to the foundation since tests for fluoride werenot part of the routine blood and urine tests conducted at government hospitals. Meanwhile,

the non-skeletal fluorosis affects the soft tissues in the body and one may develop healthproblems in a very short interval.


14/16



Local PHCs are giving tablets to communities to prevent any form of fluoride affect onpeople. However it is to be further executed effectively through community education, propermonitoring of medication and use. Many households said that they are not regular at takingmedication.

Changing the dietary habits

Defluoridation of drinking water alone shall not bring the fluoride level to a safe limit.It would be necessary to overcome the toxic effects of the remaining fluoride ingestedthrough other source. This can be done by effecting minor changes in the diet anddietary habits of the population compatible with their social system and availableresources. The main aim should be to

Restrict use of fluoride rich food and fluoride rich water Avoiding use of fluoride rich cosmetics Use of food rich in calcium, vitamin C and proteins

Health Education

Creating awareness about the disease: The main area of interest will be

1. Creating disease awarenessCreating awareness about the disease should be in form of graphic presentation ofthe final consequences of the disease to the extent possible. If required livepresentation of the patients, who are suffering from the severe form of the disease, inareas where the gravity of problem has not reached to that extent. It may be of use,to demonstrate the most severe extent of the disease and to motivate them to use

the preventive or therapeutic measures.2. Creating awareness about the sources of the fluorideThe creation of awareness will help in implementing the need based preventive measuresin the affected community.

Treatment of the disease

Vitamins C and D, and, salts of Calcium, Magnesium or Aluminum were prescribed in anattempt to reverse these effects. Published results were, however, inconclusive and largelynegative. Recent studies conducted in Rajasthan under Rajasthan DST sponsored studiesindicated that Fluorosis could be reversed, at least in children by a therapeutic regimen(Calcium, Vitamin C and Vitamin D) which is cheap and easily available.

The choice of the reported therapy was logical. The presence of calcium in gut directlyaffects the absorption of fluoride ions and will also improve serum calcium levels. Vitamin Din low doses enhances calcium absorption and retention without causing hypercalcemia andthus directly affects the absorption of fluoride ions. It also inhibits the excessive release ofparathyroid hormone thereby preventing excessive activation of osteoblasts thus preventinghyperosteoidosis and osteopenia. Ascorbic acid controls collagen formation, maintains theteeth structure and also enhances normal bone formation. These structures are adverselyaffected by higher fluoride intake.

Project Area & communities:

1 village Korra Tanda is remotely located tribal hamlet of Chillakuru Village. The communityis predominantly tribal. Currently they are collecting water from existing bore well where the


15/16



fluoride content is around 6 ppm. There is no pipeline or other scheme that could assuresafe and pure drinking water to this hamlet.

In the entire district tribal population is spread across various mandals and they aremarginalized. The project operations would be focused in Narayanpur and Marriguda

mandals of the district. The focus will be chiefly to support tribal communities.

Project ManagementThe project in Nalgonda will be managed through Professional Social Workers Consortium,operating from Hyderabad. Member organizations are actively working in the district. It isenvisaged that PSWC is a professionalbody that could pursue the problem offlurosis on continuous basis. Itsmember organizations largely located inTelangana region where fluorideproblem is severe.

The project will be monitored andexecuted with local staff on pilot basis.Later on expansion it will rope in otherorganizations to execute variousactivities. There will be a technician andcommunity organizer who chieflyensures the success of the pilot project.Upon completion of one year the projectwill be handed over to communities.Maintenance charges will be collectedfrom communities to make it self-sustainable. A community management

practice will be established with in thehamlet where groups will be trained inwater distribution, collection of chargesand attending to technical issues in running the unit.

Water availability and distribution

Each family (of 5 members) will get 20lts of drinking water from the plant on regular basis.They could also collect more water as per the family requirement. However the usage normswill be worked out in dialogue with communities. Each family will pay water charges onweekly basis. The charges collected will be deposited in local bank. This sum will be usedfor maintenance of the system. At no point of time any member of the community will bedenied water. Detailed norms will be drafted by the group that manage the system.

Operation & Maintenance

O&M at initial stages will be monitored by PSWC. However the group that is entrusted for itsmanagement will carry O&M responsibilities. The on job training will be provided bytechnician and community organizer in water distribution practices, conflict resolution,collection of water charges and attending to small technical issues. Any major technicalissue will be referred to the company that installed the unit. Annual maintence contract willbe signed to avoid major breakdown.

Nalgonda district AP


16/16



BudgetsAny local alternative should not cost more than Rs.200000.00 (Rupees Two lakhs) pervillage having population of 500 inhabitants. At this rate the water could be made availableat the rate of Rs.0.35 per day per person at. This amounts to less than Rs.0.70 per 10 litersof safe drinking water for any person. This cost is much cheaper when compared to anycentrally managed drinking water schemes in the sector. This is possible by optimizing thetechnologies earlier mentioned in this report.

To provide assured, safe and self-managed drinking water for fluoride affected populationsshould not be constraint to any donor irrespective of whose responsibility it is. We are nottalking about able bodied persons having access to drinking water. We are consideringcomplete region that is under threat. We have seen many promises broken by politicalbosses. We have seen the struggle of poor for drop of safe water. We have also seen greatreservoir adjacent to this region and yet people are poisoned every day.

We take this opportunity to request donors to support this cause and help us.

Date post:	07-Apr-2018
Category:	Documents
Upload:	j-ravi-shanker
View:	219 times
Download:	0 times

Community Based Alternatives for Floride Affected Areas-Jravishanker-2005

Documents