A joke that does the rounds in Nakuru district is that besides the national identity card, you can easily identify a local by their brown teeth, the result of very high concentration of fluoride in the water.
Doctors are now raising the alarm over the fluoride levels. On Monday last week, the Kenya Dentists Association (KDA) criticised the Water ministry’s newly published National Water Services Strategy Draft for its silence on excess fluoride in water.
“When I worked at Kenyatta National Hospital the first question a dentist would ask a new patient with discoloured teeth would be, “do you come from the Rift Valley?’” recalls a Nakuru based dentist, Dr Chauhan Kaur.
KDA has now entered the fray. In a letter to the Director of Water Services — obtained by Business Daily — KDA national secretary Dr Melvin D’lima noted that the problem of “unacceptably high levels of fluoride” in water for consumption has been well documented as a national issue and is prevalent in segments of the rural population including South Nyanza, Nakuru, Baringo, Makueni and Kiambu districts and wondered how it could have escaped the attention of the Ministry’s policy mandarins.
Last year, a study by the Kenya Society for Fluoride Research (KSFR) indicated that 19 million Kenyans suffer from fluorosis. It says the worst hit community is the smallest tribe in the world — the El-Molo — living near Lake Turkana, where 80 per cent of the 186 members suffer from the condition.
“In some (Armed Forces) recruitment centres in Central Province, more than 80 per cent of the attendees fail the test because of fluorosis,” the KSFR chairman, Mr Mwangi Chomba, says in the report.
This observation agrees with an earlier national study on the prevalence of fluoride, carried out almost two decades ago, which showed fluorosis affected 56 per cent of the Central Kenya population, followed by Eastern and Rift Valley provinces.
The lowest levels were reported in Western Kenya, at 11.7 per cent of the population. In fact, excess fluoride in water is an international issue.
According to a World health Organisation (WHO) statement released last year, excessive amounts of fluoride in drinking water is exposing millions around the world to risks ranging from crippling skeletal conditions to milder dental conditions.
The report, issued in Geneva, says the widespread effects of fluoride in drinking water, though preventable, remains largely unrecognised and neglected. The report identifies the belt that stretches from Syria, through Jordan, Egypt, Libya, Algeria, Sudan, and Kenya as one of the main fluoride belts.
According to the KDA South Rift branch chairman, Dr Silvanos Barasa, the Rift Valley region has very high fluoride content due to its volcanic soils, a view corroborated by the KSFR report, which adds that 90 per cent of the children residing in Naivasha suffer from fluorosis.
Both WHO and the Kenya Bureau of Standards recommend a maximum of 1.5 milligrams of fluoride per litre of water for human consumption. “A third of boreholes drilled in this region contain three times the WHO permissible levels of fluoride”, observes Ms Gertrude Salama, a Catholic Diocese of Nakuru (CDN) water project officer. Ms Salama finds it baffling that residents have taken fluorosis casually.
The CDN programme, which was started in 1985, sells defluoridation filters and is already celebrating a breakthrough.
Dr Barasa describes the CDN project as the first real attempt to address the issue of fluorosis, adding that he refers his patients to have their water samples tested at the Catholic water programme and to buy the CDN filters.
“Nothing pains me more than the fact that my two children, born in Nakuru, have brown teeth. It is a tragedy to have girls who cannot smile before people”, says a pastor who sought anonymity.
Dentists say fluorosis, which develops slowly, is an irreversible lifelong disease with no real cure and must thus be prevented.
Apart from browning and chipping off teeth, it leads to distorted growth of the skeleton resulting in deformities.
Ms Salama says the CDN programme uses burnt animal bones (bonechar), which they package in different sizes to suit different usages, to deal with the problem.
The bones, bought at Sh6 per kilogramme from butcher shops in Nakuru town, are carefully chosen to avoid those from animals which may offend certain cultures or religions.
“Currently, we use mainly bones of cattle, sheep, goats and camels,” she said of their defluoridation project.
The fresh bones are put in a furnace and burned at temperatures of 500 degrees Celcius for 10 to 14 days before they are crushed to various sizes — coarse, medium, fine or dust. The latter is sold as bone meal, a livestock feed. The bones are then put through a cleaning process.
The project’s sales and marketing officer, Ms Esther Wanja, says the main challenge facing the project is the communities’ attitude towards fluorosis, a condition that creates a sense of belonging among residents.
But with intensified campaigns, Ms Wanja says the number of residents taking water samples for testing at the CDN laboratory has increased. From the test results, residents are then advised whether water is good for irrigation or human consumption.
Ms Wanja observes that the water filtration process using the bonechar is based on the simple chemistry that calcium which is a major component of burnt bones is rich in calcium whose ions absorb excess fluorides in the water.
She says the sale of defluoridation filters to communities, especially living in Molo, Nakuru, Baringo and Naivasha, has increased in recent years due to their cheap prices.
Over 1,000 filters have been sold to households. One that can filter between 30 and 40 litres of water a day goes for between Sh1,800 and Sh2,200. Combined household filters (that remove both bacteria and fluoride from water) go for between Sh2,750 to Sh3,200.
CDN also makes institution and community filters. Institution filters, which can serve between 100 and 500 people with 1000 to 2400 litres of filtered water per day, are sold at Sh60,000 to Sh150,000.
Ms Wanja said community filters can serve over 1,000 people and cost between Sh450, 000 and Sh3 million. Baringo residents, she added, prefer community filters.
While we could not vouch on efficacy, Dr D’lima suggested in his letter that the government should adopt private — public partnerships in the installation of cost effective fluoride filtration systems that will reduce the fluoride content in water.
KDA has also offered to provide technical assistance to the Water ministry to standardise the quality of drinking water across the country.
In the draft Water Services Strategy 2007, the Director of Water Services, Mr R N Gakubia, says sustainable access to safe water is around 60 per cent in the urban setting and drops to as low as 20 per cent in settlements of the urban poor.
WHO admits that removing excessive fluoride from water can be very difficult and expensive to communities and recommends low cost options such as the use of absorptive filters, bone charcoal and crushed clay pots.
Print 
PDF