After 20 years of hard work, Rotary and its partners are on the brink of eradicating this tenacious disease, but a strong push is needed now to root it out once and for all. It is a window of opportunity of historic proportions.

Your contribution will help Rotary raise $200 million to match $355 million in challenge grants received from the Bill & Melinda Gates Foundation. The resulting $555 million will directly support immunization campaigns in developing countries, where polio continues to infect and paralyze children, robbing them of their futures and compounding the hardships faced by their families.

As long as polio threatens even one child anywhere in the world, children everywhere remain at risk. The stakes are that high.

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"If we all have the fortitude to see this effort through to the end, then we will eradicate polio."

- Bill Gates

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Hand pumps, such as the one above, are the water source for most villagers. Photo by Allison Kwesell

A s your dentist knows, some fluoride is a good thing. Too much, however, can be devastating. The residents of Patari, a village in Uttar Pradesh, are among the millions of people in India who suffer the consequences of fluorosis, an irreversible condition caused by elevated levels of fluoride in drinking water.

Amit Mishra, of the Rotary Club of Unnao, hands a fluoride filtration kit to Mangal Prasad. Photo by Allison Kwesell

The dental symptoms of fluorosis include mottling and erosion of tooth enamel, and its painful effects on bones can result in deformities, calcification of ligaments and tendons, and osteosclerosis.

“The fluoride, because of its strength, rots teeth and destroys bones,” says Maurice Halliday, past governor of District 1020 (Scotland), which worked with District 3110 (India) to provide fluoride filters to 60 families in Patari through a Rotary Foundation Global Grant project. “Many people are bent and bowlegged, if not totally disabled. Farm animals are also affected.”

In a 2001 study of Patari and three nearby villages, researchers measured fluoride content in drinking water. The World Health Organization has set 1.5 milligrams of fluoride per liter of water as the safe upper limit; in Patari, drinking water measured up to 3.45 milligrams per liter. The body absorbs as much as 90 percent of the fluoride in drinking water, and the risks increase for people who perform manual labor in hot climates such as Patari’s, because they drink more water than average.

Fluoride occurs naturally in water throughout the world, with several belts of high groundwater concentrations. One stretches from Eritrea to Malawi, and another from Turkey through Iraq, Iran, Afghanistan, India, northern Thailand, and China. In China, fluorosis is endemic in every province, autonomous region, and municipality except Shanghai. In India, it affects about 25 million  people.

According to a WHO report, “fluorosis might be one of the most widespread of endemic health problems associated with natural geochemistry.”

Earlier this year, photographer Allison Kwesell traveled to Patari and several other villages to document the children – in whom the irreversible effects of too much fluoride are only beginning to surface – and their parents and grandparents, hunched over canes, legs bowed.

She also photographed the Indian Rotarians who delivered the specially designed filters. The US$40,000 global grant project also provided toilet blocks, safe drinking water, and hygiene training to eight schools serving about 2,300 students in Uttar Pradesh. The effort addressed two areas of focus under the Foundation’s Future Vision Plan: disease prevention and treatment, and water and sanitation.

WHO estimates that almost one-tenth of the global disease burden could be prevented by improving water supply, sanitation, hygiene, and management of water resources. As the Indian villages demonstrate, the solution requires a targeted approach, including assessments of each community’s needs.

From India, Kwesell traveled home to Tennessee, USA. In August, she headed to Tokyo to begin studies as a Rotary Peace Fellow.

Meanwhile, District 1020 is researching another fluoride filter project, Halliday says, that would provide filters to another 400 households in the region.

W ith just one case of polio reported in the last 10 months, India is more determined than ever to ensure eradication of the disease.

As part of that effort, Rotarians helped administer bivalent oral polio vaccine to more than 35 million children during a Subnational Immunization Day on 13 November. The vaccine is effective against the two remaining types of the virus.

Sporting their signature yellow vests and caps, the Rotarians also helped organize free health camps and polio awareness rallies, as well as distribute banners, caps, face masks, comic books, and other items to the children.

On 20 November, a team of Rotarians from District 3700 (Korea) served in a health camp in Meerut, Uttar Pradesh, which included immunization of children against polio. The camp was organized by Indian Rotarians in cooperation with local health officials and UNICEF.

The following day, the team took part in a door-to-door mop-up campaign, administering vaccine to children who otherwise would have missed receiving it. A TV news crew from Korea accompanied the Rotarians throughout their visit, taking the End Polio Now message back to their country.

And in Mumbai, Rotary leaders John Germ, chair of Rotary's US$200 Million Challenge Committee; Rotary Foundation Trustee Ashok Mahajan; and RI General Secretary John Hewko joined Indian Rotarians in immunizing children.

“This year, there have been just over 500 cases worldwide. The fact that only one of those cases is in India is a tremendous achievement that reflects the determination of the nation's leaders and its citizens to finally rid their country -- and the world -- of this terrible scourge,” Hewko wrote in an article published earlier this month in the Hindu Business Line.

India’s next National Immunization Days are scheduled for January and February, and a series of supplementary activities are planned through June. At the same time, intensive surveillance for the wild poliovirus is continuing throughout the country.

“Rotary has invested heavily in surveillance in India over the last 12 months,” said Bruce Aylward, the World Health Organization’s assistant director-general for polio eradication and related areas, at a September meeting of Rotary’s International PolioPlus Committee. “That’s the reason we can say with confidence that we think we’re getting close to zero [cases] in India.”

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