Need to treat and Rehabilitate the people suffering with Fluorosis

Need to treat and Rehabilitate the people suffering with Fluorosis

Mission Bhagiratha is a gift to the people of Telangana, and especially to those of Nalgonda who live in endemic area of fluorosis.

District Nalgonda of Telangana state, once known as the capital of Fluorosis, is now being declared as Fluorosis free district. Fluorosis is caused due to excess fluoride content in the body. In endemic areas of fluorosis, excess amount of fluoride is present in the water. Normal limits of fluoride content are 0.5 to 1.0 ppm for India whereas, WHO recommendations are less than 1.5 ppm. However, in some areas of Nalgonda the fluoride content exceeds 10ppm in the ground/drinking water which is abnormally high. The amount of work to provide fluoride-free water by removing fluoride from water in this district is so great that the process earned it the name, Nalgonda technique. The first cases of Fluorosis were discovered in 1937 in India. From that time onwards, a significantnumber of research studies and various programs were developed to reduce the fluoride content in water but none of them could prove sustainable. But subsequently, Mission Bhagiratha has achieved the goal of providing fluoride-free water. It not only provides Krishna river water but also provides water at the doorstep of every villager. The supply of river water under the Mission for the last 6 years has resulted in no new cases of fluorosis in Nalgonda and that is not only a great success story for Nalgonda but also showed the way forward to the nation to mitigate fluorosis. As a result the present generation may not suffer from severe dental or skeletal fluorosis, but what about those who have already been afflicted by severe skeletal fluorosis leading to disability and crippling? In Nalgonda alone, more than 8,000 people get disability pension which is provided to people who have more than 40% disability. That goes to show the gravity of the problem and the trail of destruction left by the affliction. These people need to be treated, the pain and suffering of these people need to be addressed. Good nutrition, exercise and proper health care will definitely help these people. In a few cases, surgical correction is of great help for people to get back to their feet and lead a normal life and not be bedridden. These are the issues not addressed by Mission Bhagiratha to make Nalgonda free from Fluorosis.

When we look at the endemic area of malaria, to control malaria there are programs to control mosquitos and also to treat the people whohave suffered from the disease. There are clear cut guidelines on medicationas to where to refer, etc. Unfortunately, there are no guidelines or programs that are focused to treat the people who areaffected with fluorosis. In Nalgonda, a special ward was created for fluorosis victims but within no time it has been used for other patients, due to the fact that no cases were diagnosed and referred to the district hospital.

Based on the National Program for the Prevention and Control of Fluorosis (NPPCF), the fluorosis rehabilitation centre was established in a Primary health centre of Marriguda by INREM Foundation with the support of the Governmentof Telangana, Nalgonda. Physiotherapy, nutrition and health services are provided under one roof, at the fluorosis rehabilitation centre. Physiotherapy helps to reduce the pain and also strengthens the muscles. A nutrient-dense formula that is rich in calcium and protein are providedto prevent fluorosis. The PHC doctor after the check-up will provide Calcium supplements or the patient will be referred to Nizam’s Institute of Medical sciences for further treatment. All the PHC doctors are trained to identify and differentiate fluorosis symptoms along with other disease symptoms. There is a huge positive response to fluorosis rehabilitation center as more than 1000 people utilised the Fluorosis rehabilitation centre in a span of one year after the centre was established.

It is true that the treatment is not as simple as malaria, but the same principles of multilevel management can be and should be applied to the approach of endemic Fluorosis.

True to its name, Mission Bhagiratha has been achieved in terms of Fluoride-free water reaching every household in Nalgonda as well as other districts of Telangana. Now there is a need to focus on treating the people who are suffering from Fluorosis. This step would bethe first and one of its kind by Telangana Governament to address Fluorosis in the most comprehensive way that it deserves.

About the Author:
Ms. Suneetha Sapur,
The Author works on nutrition and water linkages, Fluorosis rehabilitation center is one her innovative idea while working as a district coordinator for INREM Foundation.