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Counties in drive to monitor fluoride levels in underground water sources

Nakuru, Kericho and Uasin Gishu counties have jointly launched the Rural Evidence and Learning Water Quality Assurance Fund (REAL-water) as a step towards ensuring access to safe and clean water among communities residing in the rural areas of the three counties.

The move comes in the wake of an alleged population explosion in the Counties, which is said to have put a lot of pressure on fresh water sources like rivers and natural springs, with residents said to be increasingly turning to borehole water for their supplies.

The borehole water, in some places, is said to carry excessive and dangerous amounts of fluoride, with the threat being made worse by the fact that, as the rest of the world moves to treated and piped water systems, more than half of Kenyans (56 per cent) still rely on underground water, which the Kenya National Bureau of Statistics (KNBS) defines, among others, as water fetched from wells and boreholes.

Nakuru County Chief Officer for Water and Sanitation, Eng Margaret Kinyanjui, stated that most of Kenya’s underground water contains fluoride levels that are higher than those recommended by the World Health Organization.

He noted that overreliance by residents particularly in rural areas on underground water sources had exposed them to a high risk of suffering from dental fluorosis and crippling skeletal deformities.

Speaking during the inauguration of the fund in Naivasha, Kinyanjui disclosed that Governor Susan Kihika’s administration was committed to increasing the number of alternative fluoride-free water sources in the devolved unit, noting that there were high concentrations of fluoride in the county’s boreholes, sometimes way above the 1.5 milligrams per litre allowed by the World Health Organization (WHO).

The initiative, supported by AQUAYA and USAID East Africa aims to establish laboratories that will monitor and ensure the quality of water in rural areas through the REAL-WATER PROGRAM designed to improve access to water quality testing to guarantee communities have access to safe and clean drinking water.

The programme, besides monitoring fluoride levels in underground water sources in rural areas, Eng. Kinyanjui explained that it will also address contamination from industrial effluents, low water storage per capita, and dilapidated sewer connections, an initiative that aligns with the county’s efforts to comply with Article 43 of the Kenyan constitution.

The chapter on the Bill of Rights in the Kenyan Constitution, 2010 provides for enjoyment of Economic and Social rights under Article 43 1 (a-f) on six sectors which include health, adequate food and of acceptable quality, housing, clean and safe water, social security and education.

Underground water sources in Naivasha, Njoro, Nakuru Town West, Gilgil, Nakuru East and Bahati Sub-Counties have been singled out as having high concentrations of fluoride.

The situation is worse in Naivasha, where boreholes are the main source of water with a recent study done on the area’s boreholes last year indicating that most of the private boreholes in Naivasha have fluoride levels way above the recommended 1.5 mg/litre.

According to a study commissioned by the County Government, fluoride levels range between 2.15mg/Litre to as high as 6.5 mg/Litre in the fifteen boreholes sampled during the analysis carried out at the water quality testing laboratory.

Eng Kinyanjui said that the devolved unit was committed to minimizing the impact of fluoride in all the sub-counties, by ensuring that its Water Service Providers were supplying “blended water” to the residents which is within the recommended levels by WHO.

“We have two river sources, one emanating from Dundori where at the moment we get about four million litres per day and the other water from Malewa. The water from these rivers is channelled into our main treatment works where we do the blending with water from underground sources,” she explained.

Nakuru Water and Sanitation Services Company (Nawassco) sources its water from 25 boreholes; one in Kiondo, eight in Kabatini, three in Nairobi Road, five in Baharini, and eight in Olobanitaa within the county.

According to official statistics the company serves a population of more than one million during the day and approximately 530,000 people during the night.

The Naivasha Water and Sanitation Company Limited (Naivawasco) gets its raw water from 13 boreholes, located in six production sites. It serves a population of about 170, 000 out of the 198,444 people, according to the 2019 census.

The devolved unit has also been supporting initiatives towards developing water distribution networks that includes water kiosks fitted with defluoridation filters using “local bone char technology.”

The bones are put through four steps to transform them into defluoridation material. First, they are burnt, then crushed and sieved before being washed and then dried.

Scientists say millions of Kenyans are at risk of serious bone defects and dental discolouration as a result of high levels of fluoride in their drinking water.

Three years ago, scientists conducted a study on the levels of fluoride in Gilgil and Njoro Sub-counties. The research conducted by Patrick Kirita Gevera and Hassina Mouri both of Department of Geology, University of Johannesburg and Godfrey Maronga from Department of Restorative Dentistry, University of Western Cape sampled dental patients at St. Mary’s Hospital-Gilgil and Egerton University-Njoro Dental Clinic.

The findings were startling with the prevalence of patients with dental fluorosis who visited St. Mary’s Hospital-Gilgil for dental health care hitting 86 per cent, where 54percent of the patients suffered from mild to moderate dental fluorosis.

32 percent had severe dental fluorosis, whereas the prevalence of dental fluorosis in patients below the age of 14 years was higher at 92 percent than in older patients which the study established stood at 85.56 percent. Dental fluorosis mainly affects children with developing teeth, although it affects adults as well.

At Egerton University’s Njoro Dental Clinic, comparative analysis revealed a much higher dental fluorosis prevalence rate of 100 per cent for patients below the age of 14 years relative to the older patients at 79.49 per cent. “While a high number of cases of dental fluorosis from both healthcare facilities were reported in patients residing in Njoro, Nakuru town, Gilgil and Bahati, some cases were reported from Solai and Rongai. The results seem to suggest a much higher occurrence of dental fluorosis within the younger population group.

This implies that rapid population growth and urbanization puts more pressure on public water resources which leads to a strong reliance on fluoride contaminated groundwater and the concomitant increased cases of dental fluorosis.

According to the WHO, ingestion of excess fluoride, most commonly in drinking water, can cause fluorosis which affects the teeth and bones. “Moderate amounts lead to dental effects, but long-term ingestion of large amounts of fluoride can lead to potentially severe skeletal problems,” says the WHO.

The WHO says dental effects of fluorosis develop much earlier than the skeletal effects in people who have been exposed to large amounts of fluoride. “Clinical dental fluorosis is characterized by staining and pitting of the teeth. In more severe cases all the enamel may be damaged,” says the WHO.

The global health body however adds that fluoride may not be the only cause of dental enamel defects. “Enamel opacities similar to dental fluorosis are associated with other conditions, such as malnutrition with deficiency of vitamins D and A or a low protein-energy diet. Ingestion of fluoride after six years of age will not cause dental fluorosis,” states the WHO.

By Esther Mwangi and Merceline Khaemba

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