In its natural state, water contains a certain amount of fluoride. In low concentrations this protects the teeth against decay. But if it is absorbed in excess, it can lead to the development of a disease known as fluorosis. This attacks the teeth, but also the bones … and with devastating results.

Tibiri, a town situated 10 km from Maradi in the south of Niger has unfortunate first-hand experience of this. The story began in 1985, when a well was sunk to supply the local community with drinking water. Analyses were carried out to determine whether the water was fit for consumption by the local population. But the fluoride content was not investigated.

“Some years later, analyses have shown that the fluoride level was four times higher than the norm”, the local authorities explained to us. And the consequences are very serious, particularly among the children. Over 15 years, more than 5,000 have been affected by fluorosis.

Bone deformation…

The majority of them suffer from “dental fluorosis”, a disabling condition characterised by staining and “pitting” of the teeth. But others are affected by a far more serious form of the disease – it attacks their bones. A gradual accumulation of fluoride in the bony tissue leads to joint stiffness and even bone deformation: this is osteopetrosis.

“With the help of UNICEF we have set up a programme to deal with this”, the village leaders continue. “We have started by isolating the bore hole and the children are gradually being operated on”. Just over sixty in total, being cared for by the Maison de l’Espoir (that is, the House of Hope), a centre that looks after and rehabilitates disabled children and is funded by a Luxembourg NGO. Children and adolescents there are taught to read and write, to count and also trained in occupational skills such as sewing and gardening.

Major and often costly measures (such as tapping in to deep water tables and the building of reservoirs) are needed to eliminate excess fluoride from drinking water. But in a report published at the end of 2006, the WHO proposed more economical remedies such as using crushed terracotta and active aluminium as absorbent filters. Whatever happens, the most appropriate action to be taken must be discussed at local level.