Nalgonda fluoride mitigation, two years after handover

Nalgonda has some of the highest natural fluoride concentrations in groundwater in India — the Nalgonda technique of defluoridation was named after the district. The fluorosis caseload here is generational, and the cost of treating it is borne by the poorest households.

What the two-year audit shows

• Fluoride levels within BIS acceptable range at 39 of 42 hamlets
• Three exception hamlets traced to specific borewells, retrofitted with point-of-use filters
• User-fee committees self-funding routine media replacement and chemical refills
• Household water-testing protocol still running quarterly across all 42 hamlets

“My grandmother’s knees gave out at fifty. My mother walks with a stick at forty-five. My children drink water that is finally safe.”— B Rajeshwari, ASHA worker — Devarakonda mandal, Nalgonda

The lesson we keep relearning is that infrastructure-without-institutions has a half-life of about a year. The fee committees, not the units, are what kept the supply safe across two monsoons of operating without grant funds.