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What is social condition of affected people?
-Life on pain or painkillers
- Stigma with disease
- Economic loss of wage and others
- Malnourishment makes it worse, so poor affected more
- other related problems such as Kidney, Anemia, Osteoporosis
Who are these Fluorosis affected people ?
Arthritis affects 180 million people in India1
Disability affects 70 million people2
Fluorosis is supposed to affect 65 million people3
A Perspective on the Problem
Fluorosis could be the single biggest source of mis diagnosed Arthritis, Muscolo skeletal disorders and Disability in India 1 arthritis-india.com , 2 un.org , 3 Dr Susheela (1999)
Dental Fluorosis affects only during teeth formation
It cannot affect beyond 12-13 years of age
So DF is effect of Fluoride water exposure below 12 years
Dental Fluorosis as Bio-marker of problem
ICMR Fluorosis Index makes it easy – Mild DF (only white non transparent), Medium DF (horizontal symmetric stains yellow to brownish away from gums, Severe DF (above plus pitted teeth)
How do we give relief to people ?
Can we cure them ?
Can we save children from a life of deformities ?
Or minimize their pain ?
A Mission to help Fluorosis affected people
Can some symptoms reverse ?
How much can we achieve with Safe water, .. Are there other things that could help?
Better nutrition for resistance and ejecting out toxins
Stopping F from water and Food
Ejecting ingested fluoride
Detox of absorbed fluoride
Developing internal capacity
Shifting to safer water
Shifting to safer food
Preventing further F into water and food
Paths to recovery from Fluorosis
Fluorosis condition
Path to recovery
Earlier the detection, better are chances of recovery
Positive hope giving
Threat yes, but selective
Persistence
Solutions which make life easier and have measurable impacts
Learnings from Effective Communication
Emphasis on Possible relief and Benefit to Quality of Life helps with persistence
Safe source – detection, testing – Caddisfly, Marking
Protection of safe sources – Watershed means, sanitary dug wells
Domestic purifiers
Safe Water Choices for Action
Reverse Osmosis , and other treatments
Other safe sources supplied from external places
Enhancing specific nutrients – Calcium (and Magnesium), Vitamin C, Antioxidants
Pharma, and food supplements
Local production, and helping to choose properly
Improving reach and acceptability of govt food progs
Nutrition Choices for Action
Nutrition approach
a) Pharma supplements of Ca, Mg, Vitamin D3 and Zinc
b) Natural food rich In Calcium, Magnesium, Vitamin C: Amla (dried form and tablets), Soya, Til-Chikki, Cassia Tora (Puvadiya, Chakora)
c) Helping access to choosing good food from markets
d) Producing nutritious food with nutrition gardens
Combined approach of:
Sr. No. Parameters Nutrient composition
1 Calcium 4480 mg/100 gm2 Iron 30 mg/100 gm
3 Magnesium 360 mg/100 gm
4 Crude Protein 25 gm/100 gm5 Vitamin C 93.68 mg/100 gm
Cassia tora cold dried leaves powderCassia Tora powderCassia Tora leaves
Nutrition gardens for better food
Help to have green leafy vegetables and other nutritious food which are good to develop resistance
Dhar, Nagaon, Nalgonda, Jhabua, Tumkur, …..
Stories of People fighting and recovering from fluorosis are increasing
Results from Mitigation approaches
Current Programmes of Safe water supply
Community based Water treatment plants
Pipe water schemes
NPPCF Programme
Nutrition programmes
Rehabilitation packages
Efforts from the Government
Towards a holistic
approach
Safe water supply, and sustainability
Disease detection & counselling
Nutrition improvements rehabilitation
Bringing all of it together into one platform by
District Fluoride Monitoring Centre (DFMC) at Nalgonda
Since 2013
Partnership between UNICEF, NIN and District administration
17 line departments involved in Nalgonda
Experience of 1.5 years now
Convergence of Efforts
DFMC approach by govt, and to support it,
Civil society, Academic institutions
Peoples movements , Resource centres
Social businesses
A coalition at district that can address convergence, and deliver to people
What can we do ?