The poisoned waters of Palamu

Priyanka Kumari is a fast runner, and her father Lal Deo Oraon speaks of his 18-year-old daughter’s speed with pride. “Bahut tej daudti thi bachpan se [She used to run very fast since childhood],” he says.

The eldest of four children of the daily wage labourer, Priyanka has been preparing for SSC GD — the common entrance test for paramilitary forces.

“Hamko wardi pahanna hai [I want to wear the uniform],” she says, shyly.

Priyanka trains every day – for an exam she might not be eligible for anymore. The paramilitary medical examination checks for fluorosis, and the spots on her teeth and pain in her joints – both signs of the disease – can be grounds for disqualification.

Last November, she began practising in the open fields near her village. The target was 1,600 metres in 8.5 minutes. “Pahala din ham 7 minute me hi daur gaye [The first day I ran it in 7 minutes],” says Priyanka, with quiet pride.

But after that first run, the pain came, beginning with the knees. Her father suggested a painkiller; she refused. “If I take it once, it will become a habit.” Around her, every adult reaches for a painkiller when the pain gets unbearable. She has seen this all her life here in Palamu district of Jharkhand.

The people of Chukru, mostly from the Scheduled Tribe community, are victims of fluorosis, an irreversible condition caused by excess fluoride in drinking water. Fluoride is found naturally in rocks, soil, and groundwater. Gneiss and granite, which make up much of the bedrock in Palamu, are rich in fluoride-bearing minerals. As water runs through them, the fluoride leaches into it.

According to the Bureau of Indian Standards, the permissible limit for fluoride is 1 to 1.5 milligrams per litre. The average in Chukru is nearly three times that (4 to 4.5), a water department engineer said on condition of anonymity.

Handpumps in the area are marked with a red cross to indicate that the fluoride content is dangerously high. According to an August 2025 state health department report seen by PARI, all 20 handpumps in Chukru had fluoride contamination.

Despite the markings, the villagers have no option but to use the contaminated water source. The options of buying water are too expensive, and the state is turning a blind eye.

“People in the village know which water is unsafe and which sources are better… some handpumps are safe,” says Jason Huruh, the executive engineer of the drinking water and sanitation department. But Huruh was unable to point to them, or share any evidence of fluorosis awareness programmes.

Excess fluoride slowly poisons the body. Children develop dental fluorosis first, their teeth get spotted and discoloured. It progresses to skeletal fluorosis – joints stiffen, bones weaken and become deformed.

“Fluoride replaces calcium; in the teeth, in the bones, wherever calcium is present,” explains Dr. Anil Kumar Shrivastav, the civil surgeon and chief medical officer (CMO) of Palamu.

Eight out of every 10 children examined in Chukru village in 2008 had dental fluorosis, and skeletal fluorosis was found in almost half the adult population surveyed, a report in the journal Fluoride had pointed out.

In 2016, Anupriya Patel, then Union minister of state for health and family welfare, had told Parliament that about 2.46 lakh people across the country are suspected to be affected by fluorosis. However, Indian scientists writing in this report said the number was 26 times higher at 66 million. The report also said that India is the worst groundwater fluoride and arsenic-affected country in the world.

India has a National Programme for Prevention and Control of Fluorosis. Twelve of the 24 districts in Jharkhand have been flagged for fluoride contamination by the Central Ground Water Board. Palamu is among them.

Yet, when PARI visited multiple government offices – the Palamu deputy commissioner, Dilip Pratap Singh Shekhawat, the executive engineer of the drinking water and sanitation department, and the civil surgeon and chief medical officer (CMO) – we were told there is no record of the number of people affected by fluorosis in the district.

Both Priyanka’s grandparents were crippled by the disease. Lal Deo's mother Sukhani Devi was confined to the bed in 2017. A year later, his father Budha Oraon followed. The couple died in 2021, a month apart.

In front of the family’s three-room mud house stands a handpump, marked with a red cross. Priyanka is filling water from it.

“What can we do?” Lal Deo asks. “We cannot afford to buy water.”

The few who can, drive 10 kilometres to Daltonganj to buy filtered water at Rs. 30 for 20-litres.

Priyanka goes to the fields every day. But she runs slower now, carefully, her knees deciding how far she can push. She does not run at full speed anymore. She is saving that for the exam day; one last push when it matters.

But once she clears the test, another awaits her – the medical exam for her dream job.

Nandu Singh would carry 50 kilos of paddy on his head. Now he lies all day on a charpoy (string cot). “My whole body aches constantly, it feels like I am getting electric shocks,” he says.

The 56-year-old’s legs are swollen, the bones twisted. He has skeletal fluorosis. “Go to any house in the village, you’ll find fluoride there,” he adds. ‘Fluoride’ is how the villagers refer to fluorosis.

He recalls how he farmed his five acres – paddy and maize in the Kharif season and wheat and mustard in Rabi. During the off season, he migrated to work as a daily wage labourer. “I used to earn two lakh rupees a year, I worked very hard.”

The last time he went out for work was in 2015.

As Nandu speaks, his daughter-in-law Saro Devi walks in, carrying water from the nearby handpump marked with a red cross.

Saro, barely 30, has pain in her joints, back and head. “It feels like an electric current,” she says.

Calcium is needed for the electric signals that travel through the nerves, CMO Shrivastav says, adding, “when it is absent, you will feel a shock.”

No one wants to marry their daughters into this village any more for fear they will become disabled, says Nandu. “Look at our daughter-in-law,” he says, “See how thin she has become.”

Inside the house, water is boiling on the makeshift stove. “Some say boiling helps,” says Saro. So she boils the water to protect her two daughters and two sons. “This is what the children drink,” she adds.

What Saro doesn’t know is that boiling increases the concentration of fluoride in water.

As we speak, the children gather, laughing and posing for the camera. Their teeth are spotted, discoloured, the first mark the water leaves before it moves deeper into the body.

“Such young children say, ‘Mummy, my body is hurting, my head is hurting’,” says Saro. The eldest of the four is 10 years old, and the youngest is 2. “What can we do, when the pain doesn't stop and they cry too much, we give them the same painkiller, they take it and sleep.”

Fluorosis is preventable. All that is needed is the supply of safe drinking water.

“Take surface water, whether from a river or a pond, filter it, and give it to the people. This is the best solution,” says the chief medical officer.

In 2017, more than 1,000 people from fluoride-affected villages marched to demand clean water. That led to teams from Ranchi and Delhi who visited and, “they tested every handpump in the village and marked them red, saying they were unfit to drink,” says Nandu.

Around the same time, the state government laid a pipeline to supply drinking water. “It ran for a year,” he adds. A filtration system was installed on some of the handpumps, “but once it broke down it was never repaired”.

“The ‘saheb’ [officials] who come here bring their own water, they don’t drink ours,” says Nandu.

The Jal Jeevan Mission was launched to provide clean piped water to every rural household by 2024, prioritising areas with contaminants such as fluoride, but its deadline has been pushed back to December 2028. “Central funding has been stopped for the last 2.5 years, though the state has started releasing some funds in parts now,” says Huruh.

It might be too late for many in Chukru.

Villagers say at least 20 to 30 people suffering from severe fluorosis have died over the past decade. Lal Deo begins counting names. “Two from Satarua's household are gone, Nanhu, then Naveen Pal and Jadhav Pal, both brothers….”

“Life expectancy is reducing, and people are becoming disabled, ageing prematurely and dying,” he says. “As long as a man is walking, he is walking. Once he takes to the cot, his story is over.”

Upender Kumar Singh was 10 years old when he started getting a disability pension of Rs. 600. He is now 19. His legs had started to bend in the summer of 2012, when he was just five years old. “The left leg bent and the right one flattened,” his mother Savita Devi recalls.

For the next several years the family went to doctors in Daltonganj, Ranchi, even Rajasthan. By 2022, they stopped trying. “A full box of medical papers had accumulated,” says Savita. And a debt of Rs. 10 lakh. “One day, I got angry, gathered all the papers and burned them,” she says.

More than 100 people out of Chukru’s present population of about 1,200 receive disability pension, says Ravindra Singh, the husband of the mukhiya (head) Anjana Singh. At 8.3 per cent, this is almost four times India’s average disability rate of 2.21 per cent.

Upender can walk short distances without the help of a stick, “but if I walk 10 minutes, it starts hurting,” he says. He has dropped out of school.

Whenever a government team visits Chukru to document the impact of fluoride contamination, they call Upender. “They take a photo of the leg, a photo of the teeth, and leave,” he says. “Sometimes I feel very angry.” He looks up. “At least you are talking to us; they don't ask anything. They just take photos and leave.”

Hiramati Devi, 70, doesn’t want to talk. She lives in a one-room mud house with her husband Ganesh Ram, 80. In one corner of the dark room is a chulha and in the other, Ganesh Ram lies on a cot under a mosquito net, staring at the ceiling.

Hiramati moves across the room with great difficulty. She places both her palms flat on the floor first, then pulls her body up inch by inch. Her spine is fully curved. Her fingers, hands and feet are twisted. She holds them out. “It hurts everywhere, look how everything has bent,” she says. But she keeps moving.

“You sit, I will give him food and come,” she says.

She pushes herself slowly towards the chulha, takes out boiled rice from a pot, adds a leafy vegetable, then stretches her hand to move the plate a little closer to him.

“For three days the old man has eaten nothing, I force-feed him, if he does not eat he will not live,” she says.

The couple used to plough 10 acres. Hiramati gestures towards the empty fields visible from the door. “All this empty land you see, we used to plough all of it.” Then, slowly, fluorosis took them.

“So many have already died, and now you have come,” she says. She looks towards the door. “Jayiye, jo jinda hai usko dekhiye, hamlog ka to din ab pur gaya [Go, meet those who are still living. Our days are over now].”