The story of Njeri
Mum, if only you had taken care of my teeth they would not be brown.
These were the words of 12 year old Njeri, a pupil at Milimani Primary School in Naivasha, after she had tried everything she could to get her brown teeth back to their natural white colour. Unknown to her mother, Njeri was suffering from dental fluorosis, a disease caused by ingesting high levels of fluoride.
In Naivasha, boreholes are the main source of water and most of the underground water is characterised by high levels of fluoride. Njeri has been drinking water with fluoride levels as high as 9mg/litre (the World Health Organization recommended level is 1.5mg/l). With no other water source available to her, it was difficult to escape the disease.
There are two types of fluorosis: dental and skeletal. Dental fluorosis manifests itself first and then, over time, the bones yield to skeletal fluorosis. Njeri represents the many girls and boys who suffer from dental fluorosis and, without prevention, are on their way to skeletal fluorosis. A study, conducted in Mirera Primary School in Karagita, confirmed that 90% of the school children are suffering from dental fluorosis.
For Njeri, fluorosis is not just a health issue but a social issue too. She cannot even laugh freely – she feels the need to cover her mouth while laughing to conceal her brown teeth. As a young girl, the social effects of the disease are even more intense as girls are often conscious of the way they look. Njeri’s appearance means that she may have trouble being accepted in some professions and also many men are unwilling to marry ladies with brown teeth.
Njeri recently had to travel outside of Naivasha to areas which are not affected by high levels of fluoride. Her teeth made her stand out and she was stared at by others who condemned her for having dirty teeth and accused her of not taking care of them, unaware that it was beyond her control.
Coming from a low income household, Njeri watched as other children’s parents bought drinking water from the supermarket or purchased household filters to prevent fluorosis, but these were not affordable options for her family.
Njeri has had to come to terms with the fact that, for her, the condition is permanent and irreversible since the cost of curative options like crowns and veneers are too expensive. Dental fluorosis has severely affected Njeri’s confidence and her outlook on the future.
Children showing the effects of dental fluorosis
There have been many myths about the causes of dental fluorosis. Some people thought it was caused by eating hot Irish potatoes, while others believed you could catch it if you were bitten by someone with brown teeth. Many just thought that it was caused by not cleaning your teeth. Through promotional campaigns, WSUP has been raising awareness among school children, families, communities, flower farm workers and health promoters, teaching them about the real causes of fluorosis.
WSUP has partnered with the Catholic Diocese of Nakuru Water Quality Department and Naivasha Water and Sewerage Company to construct 22 water kiosks with deflouridation filters. These filters have reduced fluoride levels from 9mg/l to 0.05mg/l, which is below the WHO recommended level of 1.5mg/l, making treated water accessible and affordable to the urban poor families. A 20 litre jerrican of treated water costs just 2 Kenyan Shillings compared to bottled water from the supermarket which costs 250-500 Kenyan Shillings for a 5 litre jerrican.
Njeri says she has been given a new lease of life. Further damage to her teeth has now been prevented and the possibility of the disease progressing to skeletal fluorosis has been minimised.
The impacts of defluoridation are already being seen in children who have been using defluoridated water since birth.
With the improvement in the levels of fluoride in the drinking water, the percentage of children with dental fluorosis will be reduced. In future, children will not be denied opportunities as a result of flourosis.
Photo: David Schaub-Jones
Njeri shows the irreversable effect fluorosis has had on her teeth
Drinking water containing high levels of fluoride over time leads to skeletal fluorosis