Fluoride Action Network

For Telangana and Andhra, endemic diseases remain a challenge

Source: Business Today | July 15th, 2015 | By E Kumar Sharma, Associate Editor
Location: India

A year after the bifurcation of Andhra Pradesh, both Andhra and Telangana are still coping with some region-specific diseases that have troubled them for years. India, like a number of other large countries, has regions where certain diseases are either endemic, or more pronounced than the rest of the country.

For Telangana, the challenge is of tackling fluorosis and Andhra, especially, its two regions of Srikakulam and East Godavari, is still dealing with filariasis. Apart from these, both the states, like any other Indian state, also have to constantly focus on dealing with growing challenges from ailments like dengue, tuberculosis, malaria and seasonal flu other than the usual non-communicable diseases like hypertension, diabetes and cancer.

Telangana has been dealing with the challenge of fluorosis for over 60 years. This is specifically a major problem in Nalgonda. This semi-arid region is known for its groundwater having higher than normal fluoride concentration. Intake of excess fluoride, most commonly through drinking water, can cause Fluorosis. It is a condition that affects teeth and bones.

Moderate amounts lead to dental effects, but long-term intake in large amounts (typically for periods five years and more) can lead to potentially severe skeletal problems. Studies have pointed to some of the remedial measures planned in the region including providing piped water from the Krishna river but providing these to remote affected villages is still a long-term challenge that will need more time and capital. Experts have suggested the need to explore groundwater treatment technologies.

The Telangana government, over the next 18 months or so, intends to deal with this by bringing surface water from the Krishna and Godavari rivers. In fact, K T Rama Rao, the state IT and Panchayat Raj minister, says he is personally looking into this. “Eradicating fluorosis from Telangana is the top most priority of this government through this drinking water project,” says Rao, adding: “the first phase will involve eradicating this from the fluoride affected habitations in Nalgonda in the next one and half years, by the end of 2017.”

This, he says, is part of a major water grid project of the state for which tenders are to be called shortly and work expected to begin in about a month or so from now. If this does happen, it would finally provide some much needed relief to the region.

In Andhra, especially in some of its coastal regions, the challenge is slightly different. It is about eradicating filariasis or lymphatic filariasis, as some would prefer to call it. It is a problem that has tended to be more prevalent in the Srikakulam and East Godavari regions of the state and has been known for several decades now. It is an infection that occurs when filarial parasites are transmitted to human from mosquito bites. These are usually in areas that are waterlogged and where there is stagnation of water.

When these parasites are transmitted to humans and result in swelling (lymphoedema) of legs usually and commonly called  Elephantiasis – a painful, disfiguring swelling of the legs in the late stages of the disease. These regions of Andhra apart from other locations like parts of Kerala, have been coping with this disease for years now in India, which is among the 10 countries globally, which in all, according to the World Health Organisation (WHO), together make up for bulk of people affected by this ailment.

A major part of the solution in creating awareness and as pointed out by global entities like the WHO, elimination of lymphatic filariasis is possible by stopping the spread of the infection. Large-scale treatment involves a single dose of two medicines given annually to an entire at-risk population and includes medicines like albendazole (400 mg) together with ivermectin (150-200 mcg/kg) or with diethylcarbamazine citrate (6 mg/kg).

This treatment is generally referred to as preventive chemotherapy. Incidentally, like it was with polio in 2014, India has set a goal to eradicate filariasis by 2015. However the problem still continues though the officials in Andhra say there is programme to control this by year end.

Other than these region-specific issues, there are other health indicators that need early attention. Consider some statistics available from the government of Telangana. In fact the socio-economic outlook 2015 report brought out by the planning department of the government of Telangana says that  “a number of health indicators in Telangana need to be addressed for improvement.

In six out of ten districts of the state, the infant mortality rate (IMR) is found to be much higher than the national average of 40. The maternal mortality rate (MMR) at 152 is very high in the district of Adilabad as compared with the national average of 167. The percentage of home deliveries at 11.5 percent as per District Level Household Survey (2012-13) – conducted by the International Institute for Population Sciences from Mumbai – is found to be very high in the district of Adilabad.