High amounts of fluoride (>1.5 ppm) in drinking water is a serious issue in many parts of India. Fluorosis has been a serious issue in Andhra Pradesh, as early as 1999 with maximum reported levels at 29 ppm. Evidence indicates that 70-100% of the state is affected. 

Arghyam had taken up the pilot project in partnership with OUTREACH, in Guntavarepalle village in Andhra Pradesh. The study aimed at assessing whether high amount of fluoride (>4.00 ppm) adversely affected the health of the people in the area. For this, indicative tests for assessing fluoride concentration in drinking water were carried out in a total of 60 villages. The field staff of Outreach were trained in testing water quality using ORLAB Test Kit supplied to GPs by the Panchayat Raj and Rural Development Department of the Government of Andhra Pradesh.

The community was involved in the testing of water in all 60 villages. This facilitated increase in awareness on the problem of fluoride contamination, and building local capacity so that routine testing could be carried forward by the community itself using the testing kits available with the Panchayat. All the 60 villages in Chittoor district where indicative tests for fluoride were carried out, indicated the presence of fluoride levels that were much above permissible levels. This data also corresponded with very high levels of fluorosis in the population in these areas.

The study concluded that it was important to focus on interventions that were sustainable both financially and socially. Thus, several options available for providing fluoride-free water were looked into, for Madanapalle region. These included:

• Rooftop rainwater harvesting for meeting the drinking and cooking requirements
• Large number of groundwater recharge structures for diluting the Fluoride levels in aquifers
• Promotion of household-level Activated Alumina filters – It is important to note that the mere distribution of household fluoride filters has failed miserably earlier, mainly because the villagers did not know how to reactivate the alumina filter or who to approach for maintenance. Thus, a strong back up support is essential to make this a successful low cost technology in accessing Fluoride-free drinking water on a sustainable basis, with facilities for reactivating the filter material, for those who have constraints in harvesting rainwater.
• Community-managed defluoridation units with adequate technical support for management
• Creation of awareness on Fluorosis and promotion of calcium-rich diet to reduce the ill-effects of Fluorosis

The report argues that a multi-pronged approach is required for mitigating the fluoride related health issues in many parts of Andhra Pradesh.

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