Turkana’s Silent Struggle

Battling the Effects of Fluoride

In the heart of Turkana South, in the remote village of Katilu, Kenya, a silent struggle was unfolding, a battle against an invisible enemy that had plagued generations. It was a struggle for clean, safe water, a struggle that left its mark not only on the landscape but on the people themselves. This was the reality a little boy was born into, and early 2000’s marked the onset of a series of events that would reveal the harsh truth of their water crisis.

A Dilemma of Two Waters

Growing up, this little boy called Peter faced daily choices regarding water, the essence of life, with only two options, each laden with peculiar challenges. The first was Turkwel River, a majestic yet treacherous waterway that meandered through their region. It provided sustenance and despair in equal measure, its muddy waters reflecting the pollution contributed by the lands it touched.

To make matter worse, sharing this water with both domestic and wild animals was a common practice. People bathed in it, even though it was far from clean. The belief that the river could silently wash away their waste led to the unsanitary practice of defecating in its murky depths. Upstream, clothes were washed, while downstream, containers were filled with what they believed to be safer water. But was it really safe?

Google Earth map

Clashes over water and livestock

The greatest peril of relying on Turkwel River wasn't just its discoloured waters or the unsanitary habits that tainted it. It was the ever-present threat of insecurity, a danger that loomed large over their lives. In 2004, on a day like many others, little Peter, 8-years old at the time, had taken his father's cows to graze along the river, a routine weekend activity.

On that day, the riverside appeared unusually calm, and he and his friend were tending to their animals, waiting for others to join them. His friend, also 8 years old, had a gun, a startling reality of their upbringing. At a young age, their fathers had trained them in firearm use for self-defence. Fortunately, Peter’s father hadn't given him the gun that day as he was supposed to come later.

Suddenly, the cows exhibited unusual behaviour. They sensed something was wrong and signalled it by not grazing and raising their heads towards home as if ready to flee. 

This was a clear indication of danger, and the boys had to act cautiously. They decided to hide among the cows to observe what was amiss, as this provided a measure of safety.

From that hiding spot, they witnessed their tribe’s enemies, the Pokot community, and they had already laid an ambush. The Pokots had been hiding and watching for some time. They struck from behind armed with guns, first targeting Peter’s friend who had the gun. He was the key to alerting others if he fired the gun. The Pokots disarmed him and bound the boys to a tree, instructing them to remain motionless and silent, with the threat of death hanging over them if they disobeyed.

One Pokot man kept watch while the others herded the cows away at breakneck speed, heading for their own territory. Within moments, all the cows were gone, leaving the boys fatigued and dispirited. The boy's father arrived soon after, though he couldn't immediately locate the cows. He found the tied-up boys while scanning the area and sounded the alarm.

The Pokots hadn't strayed far, and the boy's father engaged them, managing to both divert their attention and rescue some of the cows that hadn't managed to escape. It was a chaotic and perilous ordeal, a race against time. Such encounters had been part of life along this river for decades, and they had exacted a heavy toll. Many had lost their lives, all their animals, or had been forced to migrate to evade the recurring clashes.

The Turkwel River [by Bernard Dupont | https://bit.ly/3IABelN]
The Turkwel River [by Bernard Dupont]

Peter's narrative offered a poignant glimpse into the harsh realities they confronted. 

Fetching water or tending to cattle, simple tasks in other contexts, took on a life-and-death dimension in their world. 

The overarching question remained: how could they break free from this cycle of violence and insecurity that was inextricably linked with their quest for the life-sustaining waters of the Turkwel River?

The Salty Hand Pump

The alternative option was a hand pump, conveniently close to Peter’s homestead. It seemed like a godsend, offering respite from the arduous trek to Turkwel River. However, this well had its own dark secret - the water it yielded was undrinkably salty. Locals, like him, had grown accustomed to the brackish taste, even relying on it for daily hydration.

Remarkably, their school used this salty water for cooking, an ironic twist in their daily routine. This well, though convenient, was slowly becoming the source of a hidden calamity.

The Legacy of Deformity

It was only later, after years of sipping salty water, that the truth began to dawn upon them. Their community was plagued by an affliction, a legacy shrouded in myth. Their teeth, an astonishing four out of five, bore a deep brown hue. For generations, they were told that this was a familial trait, a genetic quirk passed down from their ancestors. But in reality, it was the insidious work of fluoride, an element seeping into their lives unnoticed. Peter's father embraced polygamy, a common practice in their culture. With five wives, he fathered a total of thirty siblings for Peter. 

Shockingly, 25 of them had brown teeth, including Peter himself. Their parents, like many others in the community, believed it was a genetic inheritance, a quirk that ran in the family. 

Little did they know that their brown teeth were the result of an environmental issue, a hidden consequence of the water they had been consuming for years.

Peter's teeth
Fluoride impacted little Peter's teeth already at young age

An Unaware Community 

In those days, and regrettably even in the present, government and non-governmental organizations would drill wells and provide water sources with well-meaning intentions. However, the community was often left in the dark about the water's quality and whether it was truly safe for consumption or irrigation. Once the wells were drilled, the projects would conclude, and crucial information would disappear with those who initiated them. It was a recurring frustration, a cycle of uncertainty that plagued the community.

More often than not, the focus remained on removing excess chloride, while the issue of fluoride contamination largely went unaddressed. Astonishingly, both government agencies and NGOs were aware of the detrimental impacts, yet the lack of practical alternatives left them with few choices. Alternative solutions, such as desalination plants or defluorination plants, were considered too expensive and challenging to implement at scale.

The consequences of fluoride contamination ran deep, affecting not only their physical health but also their social lives. 

A local joke prevailed, one that highlighted a distinct marker of their identity: aside from the national identity card, you could easily spot a Turkana local by their brown teeth

Those with teeth deeply stained brown were often assumed to hail from regions near Lake Turkana.

However, this supposed marker of identity carried a heavy burden of self-consciousness, especially for the girls. The joke that girls shouldn't smile in front of men due to their brown teeth had far-reaching repercussions. It eroded their self-esteem, impacted their marital prospects, and hindered their social interactions. Many felt compelled to hide their teeth from the world, concealing their smiles and stifling their happiness.

A Hidden Impact on Armed Forces Recruitment

In a surprising twist, the impact of fluoride contamination reached even the doors of armed forces recruitment canters, casting an unexpected shadow over the aspirations of young men and women dreaming of serving their country. It was revealed that in some recruitment centers, not just in Turkana but rift valley region, a staggering 80 percent or more of the hopeful candidates failed their medical evaluations due to fluorosis.

Vice Chief of Defence Forces, Lieutenant General Jonah Mwangi, shed light on this issue during an interview on Kenya Citizen TV in August 2023. His words were clear and unyielding: one could not be accepted into the armed forces if they weren't physically and medically fit. While he acknowledged that recruitment officers sometimes overlooked minor teeth discolouration due to geographical factors, severe discolouration was a disqualifier. 

"From low to medium, that can be looked at by the medic. If you have severe discolouration, it’s an indication that you probably have a problem with the bone structure and you are prone to dental accidents. If you get into a dental accident, that will force them to put you in the hospital instead of training, so it’s a disadvantage to you." - Jonah Mwangi, Lieutenant General - 

In an interview, Esther Mwangi, the CEO of Executive Edge Consulting, further emphasized the impact of dental appearance on job prospects, particularly in disciplined forces like the police and military. She shared the story of a young Kenyan who took to social media to express his frustration after being rejected from military recruitment due to discoloured teeth. His poignant question resonated: 

"What do my teeth have to do with my dedication to serving my country? I am a patriotic Kenyan with a sincere desire to protect our nation. Am I supposed to bite the enemy?" 

Esther added that such bias and discrimination related to teeth were uncommon in government positions, except within the military and the police. 

The issue wasn't limited to military recruitment alone; it extended to various professions where appearance played a crucial role. Jobs like waiting staff or receptionists in hotels, acting, modeling, air stewards, hostesses, and TV anchors, all considered "customer-facing" careers, were equally affected. It was a stark reminder that in some industries, the state of one's teeth could become an unexpected hurdle on the path to pursuing their dreams and livelihoods. The story of fluoride contamination had taken an unforeseen twist, revealing its impact on careers and aspirations beyond health concerns alone.

Lake Turkana, an Oasis or a Mirage

Turkana Lake [credit: Rita Willaert | https://bit.ly/4cbjZ8d]
Turkana Lake [by Rita Willaert]

In the vast expanse of Turkana, nestled in the northern part of the region, lies Lake Turkana - a magnificent body of water, renowned as the world's largest permanent desert lake and the largest alkaline lake on Earth. One would think that such a colossal water source would be a blessing for the community, a lifeline in the arid desert. However, the reality was a bitter paradox.

For Peter and the other people of Turkana, the quest for access to safe drinking water has been an enduring, elusive dream. Lake Turkana, with its seemingly boundless and abundant waters, harbors a dark secret within its depths. These waters are treacherous, tainted by high levels of fluoride and an alarming alkalinity that has inflicted severe deformities, especially to the bones. Moreover, this contamination renders the water utterly unsuitable for human consumption. The very source of life had become a silent threat.

Yet, in the absence of viable alternatives, the resilient residents of Turkana had little choice but to rely on this perilous water source for their survival. 

It was a cruel dilemma, a choice between dehydration and the insidious effects of fluoride. 

As they drank from the lake's unforgiving waters, they unknowingly subjected themselves to a slow, silent battle against an invisible enemy.

The consequences of this desperate choice were evident in the deformities that afflicted their limbs. High salinity and fluoride levels in the water wreaked havoc on their bodies, causing limbs to contort and twist in unnatural ways. The anguish of deformity was a heavy burden carried by many; a visible reminder of the price paid for quenching their thirst.

Lake Turkana
Life at Lake Turkana, bathing (left), fetching drinking water (second/third) and washing clothes (right) [by Milton Ng'ibeyo]

A Desperate Need for Change

Nevertheless, in the face of such adversity, even today Peter’s community display remarkable resilience. They grasp the urgent need for change, the imperativeness of breaking free from the clutches of fluoride-laden waters and the scourge of cholera. The pivotal question looms large: How can they usher in a transformation, secure a sustainable source of clean water, and shield their children from the relentless grip of disease?

In the short term, they have begun to explore innovative solutions. Sand rivers, abundant in this region, have become a lifeline, offering a means to supply water for their daily needs and enhance economic activities through farming. 

Solar-powered water pumps are used to treat this water before distribution, ensuring its safety for consumption. Practical Action has initiated projects in select areas, but there is a pressing need to expand these efforts to reach more people.

To combat fluoride contamination, organizations like UNICEF have trained individuals in the use of defluoridation filters. However, this requires concerted efforts from county governments, the National Government, and NGOs to ensure that such filtration plants are accessible throughout Turkana, making safe drinking water a reality.

Additionally, Turkana could adopt a technique practiced by the Nakuru Catholic Diocese in Nakuru County, Kenya. By utilizing bones from animals such as goats, sheep, camels, and cows, which are readily available in this pastoralist community, they can treat fluoride in water effectively. This method involves the use of bonechar, derived from charred bones. Bonechar is processed under specific conditions, and when incorporated into filters, it attracts fluoride, leaving the water fluoride-free and safe for consumption. It's an affordable and locally available solution that holds great promise for Turkana and other regions across Kenya.

Looking to the long term, collaborative efforts must be undertaken to harness Turkana's groundwater resources. Extensive aquifers have been discovered, with the potential to serve the entire country for over seven decades. However, research has identified this groundwater as saline. To address both the salinity in the lake and groundwater, the implementation of a desalination plant emerges as a viable solution. Such an initiative would transform Turkana's water landscape, making water scarcity a thing of the past.

The little boy who became a Groundwater Correspondent

The boy in this story is me, Etukutan Peter. When I was young, I didn't know much about the water we drank. It wasn’t until I turned 20 years in my second year in the university in Kenya, where a teacher named Dr. Moses Mwangi explained something important to me during groundwater pollution module. 

He said the strange colour of my teeth was because of something called fluoride in our water. This revelation inspired me to educate others about the occurrence and risks of groundwater contamination and led me to undergo postgraduate studies on groundwater and global change and to become a Groundwater Correspondent representing Kenya.

Peter Etukutan