catchment management1Symptoms of skeletal fluorosisof <strong>water</strong>-harvest<strong>in</strong>g structures) andreduced ground<strong>water</strong> extraction near tothese critical sources (e.g. by zon<strong>in</strong>g).Case studyOne example of how local solutionscan sometimes work is the village ofBattuvani Palli <strong>in</strong> <strong>Andhra</strong> <strong>Pradesh</strong>.Here, Acción Fraterna undertook participatory<strong>fluoride</strong> surveys (Box 1)as part of a <strong>water</strong>shed developmentprogramme. Watershed developmentprogrammes <strong>in</strong> the area typicallyhad previously focused on activitieslike promot<strong>in</strong>g tree-crops to enablefarmers to diversify from groundnutmonoculture, and construct<strong>in</strong>g checkdamsand other <strong>water</strong>-harvest<strong>in</strong>gstructures to catch more <strong>water</strong> forirrigation. Generally such programmesignore domestic <strong>water</strong>-supply issues,even though domestic <strong>water</strong>-supplyproblems are often related to patternsof ‘<strong>water</strong>shed management’: especiallyground<strong>water</strong> development. However,Acción Fraterna were motivated to<strong>in</strong>vestigate more <strong>in</strong>tegrated options todevelopment, and had noticed theprevalence of health problems thatmight be l<strong>in</strong>ked to <strong>fluoride</strong> <strong>in</strong> dr<strong>in</strong>k<strong>in</strong>g<strong>water</strong>.The results of <strong>fluoride</strong> surveys <strong>in</strong>Battuvani Palli us<strong>in</strong>g portable field kitswere of huge <strong>in</strong>terest to villagers, manyof whom suffered from symptoms offluorosis. The day after the surveys werecompleted, people were busily exchang<strong>in</strong>gresults and had memorized most ofthem. They wanted <strong>in</strong>formation tounderstand why they were suffer<strong>in</strong>ghealth problems and, more importantly,to start discuss<strong>in</strong>g solutions. Thevillagers’ <strong>in</strong>terest <strong>in</strong> and acceptanceof results contrasted starkly with thereaction from district-level authoritieswho stuck firmly to the official l<strong>in</strong>e thatthere was not a <strong>fluoride</strong> problem <strong>in</strong> thevillage. It was only after approximately12 months of <strong>in</strong>teractions that these11Box 1. A methodology for participatory <strong>fluoride</strong> surveysMeasurement techniquesMethodologies available to monitor <strong>fluoride</strong> <strong>in</strong> <strong>water</strong> samples<strong>in</strong>clude:● Laboratory analysis: reliable, but usually slow, whichleads to long delays <strong>in</strong> giv<strong>in</strong>g feedback on results tocommunitie.● Portable field kits: these can be reliable if the kits (basedupon colorimeters or ion-selective electrodes) are usedproperly, and make it possible to feedback results.quickly, as well as sampl<strong>in</strong>g a large number of sourcesacross areas quickly. In this study, a HACH portablecolorimeter was used (HACH pocket colorimeter Type I,Hach Company, Loveland, Colorado).● Indicator test strips: these can make analysis veryparticipatory and are useful for rais<strong>in</strong>g awareness on<strong>fluoride</strong> problems, but are not sufficiently reliable forpotential life-and-death decision-mak<strong>in</strong>g.Sampl<strong>in</strong>gIn the vic<strong>in</strong>ity of the study villages, <strong>water</strong> samples werecollected from each well with<strong>in</strong> approximately 2 km of thevillage centre. This <strong>in</strong>cluded the ma<strong>in</strong> domestic <strong>water</strong>-supplysources for the villages, but also other sources like irrigationwells <strong>in</strong> order to provide <strong>in</strong>formation on the (large) variations<strong>in</strong> <strong>fluoride</strong> levels around the villages where better quality<strong>water</strong> might be available. Information on the type and usemade of each well was also collected, and us<strong>in</strong>g a GPSsystem, the exact location was also logged. Occasionalmeasurements were also made of surface <strong>water</strong> <strong>in</strong> tanksand check dams that are used to recharge ground<strong>water</strong>.Given the high levels of temporal variation, importantsources were monitored regularly (monthly).Tra<strong>in</strong><strong>in</strong>g and test<strong>in</strong>gSamples were analysed us<strong>in</strong>g the manufacturer’s prescribed‘pipette’ method. This requires use of standard <strong>fluoride</strong> solutionsto calibrate the meter, and add<strong>in</strong>g reagents to <strong>water</strong>samples, so users must be experienced and careful.Tra<strong>in</strong><strong>in</strong>g should be given to check that the procedure recommendedby the manufacturer is carried out, and to checkresults for consistency (by repeat<strong>in</strong>g tests) and reliability (bycomparison with results from laboratories). Our test<strong>in</strong>gperiod showed that we would also need to dilute sampleswith distilled <strong>water</strong> by a ratio of 2:1 <strong>in</strong> order to rema<strong>in</strong> with<strong>in</strong>the measurement limits of the equipment.Analysis proceduresSamples were analysed us<strong>in</strong>g the colorimeter <strong>in</strong> a temporarylaboratory – a clean room with space to layout the samplesand equipment – usually on the same day as sample collection,either with<strong>in</strong> the village or nearby. After solv<strong>in</strong>g problemsrevealed by the <strong>in</strong>itial cross-checks (poor results dueto procedure, dilution etc) it was possible to complete10–15 tests <strong>in</strong> an hour.Calibrations of the portable meter were regularly checkedaga<strong>in</strong>st standard <strong>fluoride</strong> solutions, and samples sent toother laboratories for cross-comparison. Regular check<strong>in</strong>gof different batches of samples over time, tests by differentoperators, and with different laboratories are important toreveal possible errors. It is useful to plot the field and laboratoryresults together <strong>in</strong> a scatter graph and to look fordifferences and patterns. In order to triangulate the f<strong>in</strong>d<strong>in</strong>gsof the surveys, results were compared with results from arapid assessment where <strong>water</strong> users had been asked toassess the quality of <strong>water</strong> from domestic sources on thebasis of taste and whether they felt the <strong>water</strong> conta<strong>in</strong>ed<strong>fluoride</strong>.Feedback of resultsParticipation of the community <strong>in</strong> collect<strong>in</strong>g <strong>water</strong> sampleswas encouraged, so that people understood the objectivesof the survey and felt some level of ownership of thef<strong>in</strong>d<strong>in</strong>gs. Equally important, results were then rapidlyreported back to the community and well owners. Wellswhere <strong>fluoride</strong> levels exceeded the safe limit of 1.5 mg/lwere marked with a red cross to <strong>in</strong>dicate that the <strong>water</strong> wasconsidered unsafe for dr<strong>in</strong>k<strong>in</strong>g.Vol. 24 No. 1 July 2005 25
catchment management1●that was drilled <strong>in</strong> the tank bed andclose to some low <strong>fluoride</strong> sourcesturned out to be unsafe.Recharge of the exist<strong>in</strong>g source andmanagement: It was thought thatenhanced recharge <strong>in</strong> the zone closeto the exist<strong>in</strong>g well and managementof <strong>water</strong> levels <strong>in</strong> the area (e.g. byrestrict<strong>in</strong>g pump<strong>in</strong>g from adjacentirrigation sources) might <strong>in</strong>fluence<strong>fluoride</strong> levels.1111Undertak<strong>in</strong>g <strong>fluoride</strong> measurements locallyauthorities started to accept the f<strong>in</strong>d<strong>in</strong>gsof the prelim<strong>in</strong>ary surveys and to recognizethat people <strong>in</strong> these villages havebeen suffer<strong>in</strong>g because of the <strong>water</strong>quality of their dr<strong>in</strong>k<strong>in</strong>g-<strong>water</strong> supply.Health problems are not rout<strong>in</strong>ely l<strong>in</strong>kedto the monitor<strong>in</strong>g of the performance of<strong>water</strong>-supply systems.As part of a participatory plann<strong>in</strong>gprocess, ideas for solutions were developedthat <strong>in</strong>cluded:●Treatment: Given the exist<strong>in</strong>g plentiful<strong>water</strong> supply, despite very high<strong>fluoride</strong> levels, household- or community-leveltreatment of <strong>water</strong> was●an option. Filters and lower-costtreatment methods were both tried,but neither was considered to be anadequate solution due to high cost orlimited effectiveness.An alternative source for dr<strong>in</strong>k<strong>in</strong>g:eight out of a total of 65 irrigationwells sampled <strong>in</strong> the vic<strong>in</strong>ity ofBattuvani Palli recorded <strong>fluoride</strong>levels below the safe limit of 1.5mg/l (<strong>in</strong> the range 1.04–1.46 mg/l).There was a cluster of wells about2 km south of the village (see Map)where a new source could be sited,however this area was disputed witha neighbour<strong>in</strong>g village. A borewellEventually, an irrigation well withsafe <strong>fluoride</strong> levels (1.5 mg/l <strong>in</strong> early2004 compared to the 3.8 mg/l of theexist<strong>in</strong>g source at this time) was usedto develop a new dr<strong>in</strong>k<strong>in</strong>g-<strong>water</strong> supplyfor the village (see map). This providesa limited quantity of relatively low<strong>fluoride</strong><strong>water</strong> to supplement the exist<strong>in</strong>gdomestic supply. The farmer whoprovided this well was compensated,and a new short pipel<strong>in</strong>e was laid totake safe <strong>water</strong> to the village. Rapidhealth improvements were reported.However, the quality of this <strong>water</strong> willneed to be monitored regularly and thesource protected.By March 2005, after a prolongeddry period, <strong>fluoride</strong> levels had risen toan unsafe, although still improved,1.7 mg/l. While new borewells with<strong>in</strong>300 metres have been prevented, 30 newborewells were drilled <strong>in</strong> the village <strong>in</strong>the previous year and recharge has beenlow. The community are now consider<strong>in</strong>gconstruction of a check dam toenhance recharge of the source, andthe village <strong>water</strong> committee has alreadyhad to reduce daily <strong>water</strong> collectionfrom the low-<strong>fluoride</strong> source to 50 litresper household and only 25 litres dur<strong>in</strong>gsummer.Conclusions andrecommendations11Figure 1The location of some key monitor<strong>in</strong>g wells <strong>in</strong> Battuvani PalliParticipatory <strong>fluoride</strong> surveys l<strong>in</strong>ked toimproved <strong>water</strong>shed management couldbr<strong>in</strong>g relief to some of the hundreds ofthousands of people who are currentlysuffer<strong>in</strong>g from <strong>fluoride</strong> poison<strong>in</strong>gthroughout <strong>India</strong>. The need for muchbetter monitor<strong>in</strong>g and mitigation measures,both areas where rural communitiesare clearly able to play a vital role,should build upon the rout<strong>in</strong>e use ofparticipatory surveys by governmentl<strong>in</strong>e departments and a broader26Vol. 24 No. 1 July 2005