Fluorosis is a condition caused by consumption of water with high fluoride levels and presents itself in the form of dental, osteo, and mental damage among other effects depending on the dosage of fluoride consumed. Effects of fluorosis during pregnancy begin in the teeth and bone formation stages and, after birth, can affect the child before the age of eight years.
Women are not only the portals that expose their children to fluorosis during pregnancy but they also carry the blame and burden of fluorosis. In fluorosis sensitization conversations, a recurrent theme is that fluorosis-affected teenagers and youth blame their mothers for not having been careful enough to protect them from the irreversible consequences of fluorosis. This makes mothers naturally inclined to want to understand fluoride with every detail. They raise their fluorosis concerns every chance they get around how it challenges their caregiving efforts and impacts their families and express their helplessness.
Even though water supply providers know that they are culpable if they supply consumers with water with fluoride levels above 1.5Mg/L they still supply high-fluoride borehole water because it’s the only readily available source. Protection of residents that have no access to a quality public water supply is left to caregivers who must protect their families in their households.
Access to affordable defluoridation technologies for safe and quality water provision, a health care financing model covering bone and dental health care procedures, and conscious mothering are all greatly needed so that families born and living in fluorosis-affected communities can rise above the fluorosis cycle.
Mothers are normally the primary caregivers and openly share their fears on fluorosis, a condition that is not covered in our basic Kenyan health insurance scheme. They need to have fluorosis conversations with their families, participate in sensitization trainings, and be equipped not just with the right knowledge but also with affordable interventions that will practically assist them in defeating fluorosis, such as subsidized home-based test kits for estimating fluoride levels and the 20L household defluoridation kits.
Information on monitoring the saturation levels of fluoride in household filters to know when to change the filter material as well as ability to estimate the filters’ lifespan and to do regular water quality analysis should be available and considered when mothers are buying appropriate filters for their households. The companies selling the defluoridation filters should collaborate with organizations on the ground carrying out fluorosis sensitization to train caregivers to calculate the level of fluoride that will be removed based on the volume of high-fluoride water the filter can treat. Consequences of negligence of replacement of the filters should also be clearly communicated to them.
In order to transform the old patterns of water, ecosystem, and public health governance, women’s involvement in policy formulation and implementation as well as budgetary allocation towards fluorosis eradication is needed. If fluoride removal is included in the already high water supply tariff, as is normally proposed by water supply providers, the economic burden on fluoride removal will fall on the households and caregivers in fluorosis-affected communities. It is important to ensure that women are present where public policy that affects them is being implemented for effective processes and projects.
The educational system in these communities has been inadequate in providing awareness and incentives for dealing with fluorosis. This is why I am creating a locally available, woman-led community social organization, EmpoVolve, to take action towards fluorosis eradication. The organization’s mission is to bring healing and empowerment to people born and living in fluorosis-affected communities through activities that promote their well-being.
The organization is hosting community sensitization sessions, building wider stakeholder engagement, and aiming to pool funds to finance prevention as well as incentives for managing living with fluorosis. This will empower and evolve the communities towards reaching equitable health care by addressing the systematically marginalized primary health issue of fluorosis.
The organization needs to be equipped with incentives while disseminating knowledge to the communities so that they can make impactful progress in informing people on the available solutions and options. One of the objectives of the organization is to make household filters and the household water quality checking toolkit affordable and easily accessible to caregivers through stewarding partnerships. When we give power to and educate more citizens on the issue of fluorosis—specifically women, mothers, sisters, and daughters—we can truly co-create solutions and change.