Clean Water

Providing access to clean cooking and drinking water avoids a broad range of short- and long-term health problems.

According to the World Water Development Report, problems of poverty are, for the most part, inextricably linked with those of water; its availability, its proximity, its quantity, and its quality. Worldwide, over 1 billion people lack access to a reliable supply of clean water. The problem is especially acute in the developing world, with waterborne ailments accounting for 80% of disease and deaths and an estimated 2% drag on developing countries’ GDP. Improving access for the poor to safe water has the potential to make a major contribution toward alleviating many key problems associated with poverty.

The rural population of India comprises more than 700 million people residing in about 1.42 million habitations spread over 15 diverse ecological regions. Providing drinking water to such a large population is an enormous challenge. India suffers a particularly large health burden due to poor water quality. The WHO's Safe Water, Better Health report (2008) suggested that 780,000 deaths in India are a direct result of poor water and sanitation. Diarrhoea alone causes more than 1,600 deaths each day – and the deaths of 1.5 million children annually – more than any other disease. It is estimated that 37.7 million Indians are affected annually by waterborne diseases, and 73 million working days are lost due to waterborne disease each year. WaterAid estimates that the economic burden from lack of access to safe water in India is $600 million a year.


A recent survey of national opinion revealed that when asked what would make respondents proud of India, a staggering 73% said that availability of safe drinking water to all our people would truly make them proud of being an Indian...

— Indian Prime Minister Dr. Manmohan Sing

Groundwater is the major source of water in India, with 85% of the population dependent on it. Drinking water comprises less than 1% of total water demand, and is the top priority among all uses of water. Indian women and girls spend hours fetching water – time that often eliminates opportunities for education and self-development. Providing water distribution infrastructure and services, and, where appropriate, installing water purification plants are vital to improving health conditions and the quality of life of rural villagers, and reducing incidence of disease and premature death. Removing fluoride from water used for drinking and cooking is critical for preventing Dental and Skeletal Fluorosis. Fluorosis is a disease affecting the teeth and bones, caused by ingesting excessive quantities of fluoride, commonly from groundwater.



Dental fluorosis is a health condition caused by a disruption in enamel formation, which occurs during tooth development in early childhood. Enamel formation of permanent teeth, other than third molars (wisdom teeth), occurs from about the time of birth until approximately five years of age. The severity of dental fluorosis depends on the amount of fluoride exposure, the age of the child, individual response, as well as other factors including nutrition. In its mild form, which is the most common, fluorosis appears as tiny white streaks or specks that are often unnoticeable. Severe cases can be caused by exposure to water that is naturally fluoridated to levels well above the recommended level. In this form – also called mottling of dental enamel – it is characterized by black and brown stains, as well as cracking and pitting of the teeth.

Long-term ingestion of excessive quantities of fluoride also leads to potentially-severe skeletal problems. Skeletal Fluorosis is endemic in India. With skeletal fluorosis, caused by a high Fluorine concentration in the body, the bone is hardened and thus less elastic, resulting in an increased frequency of fractures. Other symptoms include thickening of the bone structure and accumulation of bone tissue, which both contribute to impaired joint mobility. Most patients suffering from skeletal fluorosis show side effects from the high Fluorine dose such as ruptures of the stomach lining and nausea.

Twenty Indian states have been identified as endemic areas effected by the presence of excess fluoride in groundwater. An estimated 60 million people are exposed and 6 million people disabled; about 600,000 are at risk of developing a neurological disorder as a consequence. The sight of crippled limbs in both middle-aged persons and elders suffering from crippling Skeletal Fluorosis is commonplace. Despite continuous efforts by the State government, external support agencies, NGOs and private enterprises, the problem remains unsolved.