For the past year, residents of villages in northeast Tharparkar, Pakistan, have thought evil spirits were cursing them. It was the only way they could explain why so many children within their community were disabled, with bones bowed severely out of shape, leaving them unable to walk, eat, or leave their homes without assistance.
In 2006 the Food and Agriculture Organization (FAO) identified Tharparkar as a highly affected area. Diseases have afflicted all 15 villages of Islamkot, Tharparkar, since the late 1995 when cases were first recorded in hospitals. For my Masters degree research surveys were carried out in all 15 villages of Islamkot, and water samples from all these localities were collected.
During my research visit I had a lot of interaction with the local community. I concluded that three types of labourers were affected by drought. Livestock breeders (pastoralists) lost up to two-thirds of their livestock and hence earnings. Agricultural labourers, the majority of whom are women, suffered due to declining labour opportunities and sharecroppers were forced to seek alternative livelihoods.
The main problem the community faces is with their drinking water, i.e. groundwater which is polluted with naturally occurring fluoride. Most people in the villages of Thar, like millions across Pakistan, drink water drawn from underground wells, which has absorbed hazardous levels of fluoride from surrounding rocks.
The fluoride in the water causes skeletal fluorosis, a major public health problem in more than 25 countries, with Pakistan, China and India being the worst affected, and millions suffering from bent bones, non-skeletal fluorosis, or less severe dental problems.
In the UK the chemical is associated with strong teeth and is even added to drinking water by some local councils. However, when it aggregates in the body at higher levels, it starts to mottle teeth and calcify joints.
The World Health Organisation recommends limits of 1.5 parts per million (ppm) of fluoride in potable water. In villages of Islamkot, people have been drinking water from dug wells containing up to 15 ppm.
A global campaign to dig wells in developing countries was funded by the United Nations in the 1980s.
“The UN campaign helped decrease cases of diseases like dysentery, caused by bacteria found in surface water. However, neither the government nor UN agencies made sure that the groundwater was free from chemical contaminants,” said Chris Neurath, a public health researcher from Yale University.
Building officials know that the problem with fluoride has been a painfully slow process. Studies show that fluoride is a vital micronutrient used to strengthen the apatite matrix of skeletal tissues and teeth. I debated with the Health Department in Mithi, Tharparkar and tried to convince them that fluorosis is harmful, but a representative said that many medical professionals, unimpressed at being lectured to by an engineer, insisted the villagers were suffering from diseases such as polio or rickets, with symptoms similar to skeletal flourosis.
The water I collected was finally tested in 2016, where two of the dozen wells were found to be contaminated with fluoride above WHO limits.
Like with many families, the frustration of Akbar, a local villager, and his wife is understandable. Three of their sons are disabled and the couple themselves are suffering from a painful condition that makes their joints and bones ache.
A literature review revealed that 79 per cent of water in Tharparkar desert is brackish and high in total dissolved solids (TDS), and only 21 per cent of Thar's desert groundwater is suitable for human consumption. But even then, accessing groundwater is not easily. It requires large amounts of funds and manpower, which is rare in this marginalized community.
Thar also receives water through a pipeline that runs from Naukot to Mithi and then goes from Mithi to Islamkot, carrying canal water to these villages once a month.
The government must consider more activities for villagers. It should pursue treatment plans, keeping in mind the requirments of villages and the size of the population. Many villagers are unable to bear the cost of transport and hospital charges, to spare the lives of their loved ones who fall sick because of this waterborne fluoride.
The current situation in Thar is alarming and requires the government to promptly take remedial measures, including better water collection, advancement of access to freshwater, and the establishment of de-fluoridation and desalination plants.