A large population, especially children, in 27 of the 50 Madhya Pradesh districts are threatened by the fluorosis menace as people in these districts are being forced to drink water with excessive fluoride, much beyond the permissible limit. According to the latest information available from the state public health engineering department, the fluoride content in water is much beyond the prescribed norms of 1.5 mg per litre or 1.5 part per million (ppm) in 11,460 drinking water sources (mainly handpumps) in 6,746 habitats spread across 27 districts. The problem is particularly glaring in districts like Dhar and Jhabua in western Madhya Pradesh.

The department has also claimed that alternative arrangements were being made for providing drinking water in areas affected by excess fluoride in water. The main problem districts with distribution of flouride in ground water above permissible limit are Bhind, Chhatarpur, Chhindwara, Datia, Dewas, Dhar, Guna, Gwalior, Shivpuri, Harda, Jabalpur, Jhabua, Khargone, Mandsaur, Rajgarh, Satna, Seoni, Shajapur, Sheopur, and Sidhi.

Inquiries have revealed there are villages in Rama block of Jhabua district and Tirla block of Dhar districts where children, over the last several years, have suffered severe bone deformities — mainly crippling of their lower limbs — as they have been drinking water with excessive fluoride over a long period.

The villagers in these blocks have been informed through the intervention of Unicef and some NGOs about the danger of drinking water drawn from hand-pumps and the relative safety of water collected from dug-wells. They have also been told about the advantage of diluting water drawn from hand-pumps with rain water collected in specially built tanks through water harvesting. Experts point out that children in the affected areas should supplement their diet with milk products and foods rich in calcium but these lessons more or less remain localised and people on a large-scale have not adopted these practices.