She should be India’s next national focus

Swachh Bharat Mission to Rashtriya Jal Swasthya Mission

Kalibai with skeletal fluorosis, Jhabua, Madhya Pradesh

Kalibai lives a life with hope now. She no longer lingers with her condition of twisted limbs, due to fluorosis. Living with the disease for 15 years now, she is now used to the adjustments in daily life. For an external viewer though, it is definitely a life of misery, much avoidable and sadness that two back-to-back pregnancies along with high fluoride in water can cause such a lifelong crippled condition.

India has put a national focus on access to improved sanitation for the past four years. The Swachh Bharat Mission (SBM) has firmly put sanitation and toilets on the national map and in the consciousness of the urban Indian. Much good has been achieved, as have been new challenges. True also that the new millions of toilets are also “emitters of concentrated pathogens” into already scarce fresh water. This makes the job of safe drinking water even more tougher now.

a child with skeletal fluorosis

The children of India are already attacked with a host of deadly diseases that cause high mortality till the age of 5. Adding to this are contaminants in drinking water such as fluoride, arsenic, pathogens, and other newly found chemicals, which cause severe burden on them.

Some stark facts:

66 million exposed to high fluoride
39 million exposed to high arsenic
Half of rural India exposed to deadly contaminants

The question clearly is:

Why don’t we have a National mission on Water and Health problems?

The time if ever, is NOW !

Post the SBM, we have a momentum to come together, across our sectors, layers of society and types of conditioning, on one common goal. Save these children from a future condemned to a sad fate, where every moment is an adjustment with life, like Kalibai.

a social worker educating mothers and children in Nalgonda, Telangana

The Rashtriya Jal Swasthya Mission (RJSM) as any new national priority has is own set of challenges. It is built on the premise that the coming together of Water, Public Health, Nutrition and Education sectors can bring miracles of change. It is based on grounded effort in 7 states of India where focussed effort has been ongoing from 2010. The combination of Water and Nutrition for healing people has now been proven and well published.

“District level people-centric Water quality platform” (DWP) is an emerging approach which will serve as building blocks of the RJSM. The DWPs are now being supported by the European Union (EU) in 6 states of India. Eight districts in these states are affected with high fluoride and arsenic problems. Together they are showing a model for their respective states and now for the country, in addressing these threatening problems. INREM Foundation and SaciWATERs are two organizations that lead the fluoride and arsenic streams of work here. Dungarpur (Rajasthan), Chikballapur (Karnataka), Balasore (Odisha) and Nalgonda (Telengana) are the districts where platforms are being built on the fluoride problem. Buxar (Bihar), Bhagalpur (Bihar), Jorhat(Assam) and Nalbari (Assam) are the districts where platforms are being built on the arsenic problem. The action is being supported by the two networks on fluoride and arsenic being coordinated by the two organizations respectively.

Teachers and students making a fluoride map of Remuna block, Balasore

Balasore district in Odisha is one of these 8 pilot districts supported by the EU. The District water quality platform in Balasore has energized the entire Education department on a water testing exercise to produce a detailed map of fluoride in water across a Remuna block. This led to an action plan and now relief to the people exposed to high fluoride here.

The RJSM will build on these individual district experiences of constructing a platform for water quality problems. It will involve:

Ministry of Drinking water and Sanitation
Ministry of Health and Family Welfare
Ministry of Women and Child Development
Ministry of Human Resource Development
Niti Aayog

Apart from these other specific programmes and ministries will also be a part of RJSM going ahead.

The water and health issues span across these ministries in the sense that mid-day meals in schools, daily meals in Anganwadis, hot meals (such as in states such as AP) for pregnant and lactating women, are all prepared today with the same contaminated water.

Nutrition is an important element to be addressed when dealing with these toxins. Lack of basic nutrients in diet such as Calcium, or Vitamin C are causing increasing diseases from water contaminants. Also, there is a problem of “nutrient leakage” from the body due to these toxins. There lies the opportunity for these ministries such as those dealing with schools, Anganwadi programmes, pregnant and lactating women, and also those such as agriculture, to make a dent on Water and health problems.

The imagination is to leverage existing programmes and schemes within the ministries to have a combined impact on women such as Kalibai.

She deserves to be the next national focus.

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