The past week, I travelled with my team to Chikkaballapur district for the inauguration of Swasti’s three new water plants. While there, we happened to visit a primary health centre (PHC) at Beechaganahalli. Much to my surprise, I came across Dr.Mahima, who willingly travelled 60-65 kms each day, worked in a health centre with limited resources and was happy to be serving the communities in the villages. Taking time out of her busy schedule, she said, "The district has 56 villages and a population of 27,000, and I’m the only doctor here. Nobody wants to work here; I’m doing it because I feel happy and satisfied when I serve these people.

" Chikkaballapur has excessive amounts of fluoride and arsenic in groundwater leading to multiple health problems. Excessive intake of fluoride causes skeletal fluorosis characterised by stiffness and pain in joints. It eventually leads to osteosclerosis, bone deformities and calcification of tendons; and during tooth formation causes dental fluorosis characterised by yellow-brown stains on the teeth. The doctor informed fluorosis to be a major health concern for the residents. Many of them are also diagnosed with Anaemia (indicated by constantly low levels of haemoglobin), and suffer from mental health problems (depression and suicidal tendencies) and vector borne diseases (dengue and chikungunya).

People come to the PHC constantly complaining of "not being able to work" as a result of body/joint pain. Many of them who depend on daily labour in the agricultural fields lose their wages as a result. Dr.Mahima said, "All they come for is pain relief which will get them working for a couple of days without pain – which again is temporary and as the effect of the analgesic wears off, they come back to the PHC to get another shot." She is particularly concerned about children who visit her with yellow-brown stained teeth, complaining about body and muscle pain, I"m so worried about the children showing symptoms of skeletal fluorosis. If they already have bone problems at this age, what will their condition be in the future?” The situation is dire and exact large costs - financial, health and wellbeing - from individuals and their communities.

In Tirumani, another village in the district, episodes of Dengue and Chikungunya are common. There are no pipelines and access to water is poor. As a result, community residents store water in the house, which then become a breeding spot for mosquitoes and increases the risk of waterborne diseases.

Swasti has been working in Chikkaballapur for the last 10 years, setting up 11 water plants in 11 different villages. The work focuses on improving access to safe drinking water. The team creates awareness and disseminates knowledge on the importance of safe water, effects of excessive fluoride on health and appropriate methods to store safe water. The programme equips people to make right choices and informed decisions, thus influencing behaviour change. When asked about what more can Swasti do better for the health of the residents, Dr. Mahima said, "The thing that needs to be top priority is health education. Sometimes the community does not even understand the importance of simple things like covering stored water to avoid mosquito breeding."

Just that moment, an old hunched-over woman, barely able to walk or stand, came in. I knew that instant that her patients needed her more than I did.

As I left, it was evident that setting up water plants and creating awareness is of utmost importance to improve the health of the residents. The water plants give the communities a safe and easy to get to water supply, free up the time of women and girls from the labour of collecting, carrying and cleaning water, and gives everyone a chance of good health and improves their wellbeing.

Please email queries, and inputs to: hello@swasti.org.