It is still early in the summer but the scorching heat makes it nearly unbearable to walk outside in the mid-morning sun. The temperature has already touched 37 degrees.

Pavagada is one of the taluks in the state that receives the least rainfall. With no river in the vicinity, people are forced to depend on borewell water. With a depleting source that it is, residents have to drill to several hundred feet to be able to reach water. The result – high chloride and fluoride content in the water.

Water samples analysed by the Central Ground Water Board from five taluks (Sira, Gubbi, Madhugiri, Koratagere and Pavagada) in Tumakuru district were found to have higher than normal content of fluoride.

Skeletal fluorosis

At the entrance of one of the houses in Thirumani is a cot. A heap of bedsheets and pillows lay scattered on top. One might almost miss the child fast asleep nestled in the sheets. There are no adults in sight. The door to the house remained locked.

“See this child’s legs,” Venkatesh, a local social worker, says as he carefully lifts a part of the bedspread, mindful not to wake the boy up.

Skeletal fluorosis is a risk that people at Pavagada are exposed to. It is a condition caused by the consumption of water laden with excessive fluoride. Brittle bones, weakness of muscles and immobility are just a few of the symptoms.

In a short while, the parents return home. “He has been like this since birth,” his mother Gangamma says as she picks up 8-year-old Arun to cuddle him. As the boy gives his mother a warm smile, she picks up the end of her sari and wipes the beads of sweat off his face.

“The doctors told us that this could be due to the water we consume. I see all other children his age walk. Only my son has not been able to,” she says as tears begin to trickle down her cheek. Unable to walk, Arun has always been confined to a bed.

“He does not have the energy needed to walk. Doctors initially said he would take some time but would walk eventually. Till date he has not. We were referred to Nimhans. The doctors did not prescribe any medication,” she says.

In a span of four hours, TNM saw three cases of children with similar complaints.

Seven-year-old Anusha sits on the porch of her house with her father’s help, where she spends the rest of her day gazing at visitors who pass by.

Her parents tried helping the girl walk when she was two. Just as she would take a few steps, the little girl would fall, unable to balance herself on her feet. Her family explains that the doctors in their village told them that some children take longer than usual to walk. It was only after years passed that they were told by specialists in Bengaluru that her inability to walk was probably a side-effect of the water she consumed.

Dental fluorosis

Venkatesh, who also lives in Pavagada, points out another thing in common among the residents. A brownish deposit on the teeth that could be easily mistaken to be an ill-effect of consuming excess tobacco or areca nut. Children as young as 10 also have a similar discolouration of teeth.

“This is another side-effect of the kind of water we consume. When we are referred to any hospital in Bengaluru, we do not have to tell the doctors where we hail from. ‘Pavagada na?’ (You are from Pavagada, right?) is the first question we get asked,” he says, explaining how rampant the condition is.

Weakness and joints pain

Speak to senior citizens and joint pain is a common complaint. 74-year-old Akkalappa, who runs a restaurant in the area, says, “I have a constant pain in my joints. There are days when I am nearly immobile. I have had this since a young age. Doctors told me that the water was a cause for this. Until about a year ago, I had no choice but to consume the same,” he explains.

The state’s health department acknowledges the issue. Dr Venkatesha Murthy, Pavagada taluk health officer, tells TNM that awareness camps are being conducted to educate the locals on the need to consume only filtered water.

“We conducted a camp recently which saw patients referred from a few Primary Health Centres. Skeletal and dental fluorosis are the most common health issues here. Out of the 130 who were screened, 80 members have been x-rayed and will be given mobility aids,” he says.

Another doctor in Pavagada, who did not wish to be named, said that the situation was alarming and needed more attention. “This is something like slow poison. People only notice the complications after having consumed the water for decades. Unfortunately, it is too late by then. It cannot be treated easily,” he adds.

“Only water with fluoride content less than 1 ppm is fit for human consumption, but over 60% of the water samples tested here have fluoride above the permissible limits,” he says.

Installed water filters hardly help

According to a study conducted by NITTE University in 2016, the geographical location and the rocky terrain is what is to be blamed for the presence of excess fluoride content.

“The rocks in southern India are rich in fluoride, which forms the major reason for fluoride contamination in groundwater, and the granites in the district of Nalgonda, Andhra Pradesh contain much higher fluoride than the world average fluoride concentration of 810 mg/kg. Moreover geology, hydrogeology, geochemistry and climate of the area apart from saturating water properties were found to be the associated factors,” reads a report.

The locals say the taluk has over 100 water filters installed at various residential localities. Acting on the PIL filed by D A Amarnath, a divisional bench of the Karnataka High Court headed by Justice Subhro Kamal Mukherjee had issued directions to ensure that Pavagada residents were provided portable water free of fluoride.

The NITTE report states that Pavagada has a population of approximately 50,000. Males constitute 51% of the population and females 49% with an average literacy rate of 67%.

Even as water filters have been installed, residents speak of the innumerable challenges they face to fetch water.

For some like Muthyalamma*, the concern is distance. With no one at home to help, many feel drinking the fluoride-rich water is an easier option.

“Firstly, I have to walk 10 minutes from my house to get to the water filter unit. Also, it is open only for a few hours in the day. I have to carry the water all the way back. I have undergone a uterus removal surgery recently and have been asked not to lift anything heavy. I would rather choose to drink the bore water at home,” she says.

For others, it is a financial issue. “We have to pay Rs 5 per can of water. I require at least two cans daily for my kitchen needs. That comes up to about Rs 300 a month. I cannot afford it,” says 82-year-old Gowramma as she sieves rice in her house.

Unaware of the risk they are putting themselves at, some residents also believe that the water from the filters does not taste good.

“We are used to consuming borewell water. I have lived on it for over 50 years now,” says Ramanjanappa, another local.