Nirmala Hanumappa Hosamane, or Nimmi as she is fondly called, is like every other 5-year-old: curious, affectionate, and a love for playing in the outdoors.
When she noticed that I was talking to her mother, Annapurana, she came running and sat swiftly on the latter’s lap.
I’d been talking to Annapurana about how children in the village have been affected by fluorosis.
“Today is one of her good days,” she says, referring to Nimmi. “The bones in her leg ache so much she finds it difficult to walk. Her knees swell at least once a month”, she says.
Nimmi is a very happy child, she says, except for the days when her legs hurt her.
Huligemma (12), Nimmi’s cousin, gets frequent stomach aches in addition to having painful bones and joints. She loves taking part in sports activities, but her condition impedes her. Her teeth are pitted and have taken on a brown streak.
Vinay Kumar Eerappa Uppar (15) has discoloured teeth and suffers from frequent bouts of dry eyes. He, too, has joint pains in the legs. And, he is, understandably, rather reluctant to smile.
A common sight in the village is children with discoloured teeth. There is also a complaint of pus and pain around the teeth.
According to the World Health Organisation (WHO), the most common cause of fluorosis is the “ingestion of excess fluoride” through drinking water. It “affects teeth and bones”.
Dental fluorosis develops much earlier than skeletal fluorosis. WHO also says that moderate amounts can have dental effects, while long-term ingestion can cause “severe” skeletal problems.
Children of Mustikoppa show signs of chronic exposure to fluoride, through drinking water. They complain of stiff joints, knee pain, back pain, and a few of them, bowed legs—signs of skeletal fluorosis. Some even develop rashes on their skin.
Fluorosis is an endemic disease in India, prevalent in 20 states, according to Fluoride and Fluorosis. In Karnataka, 14 districts have been identified as having endemic fluorosis, Gadag being one of them.
Fluoride is present in high quantities in the soil and rocks in this region, which is dependent on groundwater for drinking. Groundwater in this region is, therefore, subject to geogenic contamination that occurs due to natural causes, specifically due to interaction between water and rock. Consuming this water has led to exposure to fluoride.
According to the groundwater studies conducted by the Central Ground Water Board (CGWB), the fluoride content in Mustikoppa’s drinking water ranges from 0.2-3.2 mg/l – very high as per Indian standards, which is 1.0 to 1.5 mg/l. This is not a range—the acceptable limit is 1.0 mg/l, while it is 1.5 mg/l if there is no alternate source of drinking water available.
Mustikoppa does not have a Primary Health Centre (PHC) or even a clinic. To get medical treatment, residents need to visit Kalikeri, a village with the nearest PHC and which is 5 kms away. There is no anganwadi either.
The PHC in Kalikeri, too, is not equipped for child care.
Savitha Beerappa Megeri (24) is a mother of two girls, Yellamma (5) and Ashwini (3). She says both have frequent stomach pain, and develop skin rashes on and off.
“There is no paediatrician who can address the issues. The last time I took them to (the PHC in) Kalikeri, they told me it was due to contaminated water, but not due to fluoride in the water,” she says.
An RO water plant has been installed in the village to enable the villagers to access clean drinking water. They need to pay Re.1 for 10 litres of water. The zilla panchayat has also ensured the installation of a rainwater harvesting system (RWH) in every household. Yet, villagers who live closer to the water pump continue to use it to pump out the contaminated drinking water.
“Water from the pump is sweeter than the RO water”, reasons Rekha Basappa (13). A few of the adults who had gathered chuckled in agreement.
But how about the water harvested through the RWH, I ask.
“We had little rain this time, there wasn’t enough to store”, they say in unison.
Mustikoppa also gets water for domestic purposes from the Tungabhadra every two days, for two hours. The water is not fit for drinking, according to the people of Mustikoppa.
The Karnataka State Pollution Control Board (KSPCB) agrees: it regularly monitors the Tungabhadra river under Global Environment Monitoring System (GEMS) and Monitoring of Indian National Aquatics System (MINARS) programme. According to a KPSCB report, the Tungabhadra water mostly belongs to ‘B’ (outdoor bathing) ‘C’ (drinking water source with conventional treatment followed by disinfection) at different locations and during different months.
The Panchayat Adyaksh, Hanumanthappahalli, was not available for comment.
H B Gadigaravama, an official of the Department of Rural Development and Panchayat Raj, said that Mundargi Taluk has recorded the highest levels of fluorosis in Gadag district.
“We test the water regularly and continuously (sic)”, he said. “We also visit the villages frequently”. He also said that they were adhering to the guidelines and practices prescribed by the National Programme for Prevention and Control of Fluorosis (NPPCF).
Dr. R R Hosamani, District Fluorosis Consultant, said that they were holding awareness programmes in schools in the district regularly, and that currently, they were testing borewell water in Gadag.
While there is no cure for fluorosis according to CGWB, the PHC in Kalikeri hands out medication in the form of tablets to the people of Mustikoppa.
“The tablets keep the pain at bay for maybe two days. After that, we are back to dealing with the tears and aches”, says Savitha, gently carassing Yellamma’s head.
This report is also available as a visual story here.