Esther Ewoi crawls to the shade of a tree where dozens of rocks and gravel lie in wait for her hands and mallet. Years after her body suddenly became weak, her hands are the only strong parts of her body, so she has learnt to crush the rocks into ballast, which she sells to feed her children.
When she gets to the rocks, she shakes her head, picks a mallet and hits a rock as hard as possible, just as she has done for years, after developing weakness in other parts of the body, from a disease suspected to be skeletal fluorosis, which has wreaked havoc in an entire village near Lake Baringo.
Ms Ewoi is joined by five women whose lives have also been confined to crushing rock for survival. They are in different stages of disease. Some can still walk with the aid of sticks, while some like Ms Ewoi have to crawl to the shade that has become their working space. They converge to crush rock ordered from a nearby quarry, chat about life and kill the despondency brought about by an unlikely sisterhood.
Ms Ewoi’s legs first became weak 30 years ago. The 50-year-old mother of six who was born and bred in Kampi ya Samaki Village in Baringo led a relatively normal and healthy life before she started developing stiffness and pain in her neck and back, as well as joint pain. The pain and weakness worsened, rendering her immobile over time. At the Kampi ya Samaki dispensary, health workers told her that her bones had been weakened by drinking water with high fluoride content from Lake Baringo. Seeing as she could not afford to seek specialised treatment, she resigned to her fate.
“Life is hard. I can’t walk and I can only use my hands to crawl because my legs are paralysed,” a distraught Ms Ewoi told Healthy Nation, adding that her option was to either go to the streets to beg or to crush stones, which was the only thing she could do while seated.
HIGH FLOURIDE CONTENT
She chose the latter, but demand for ballast, which goes for Sh50 per debe, is low and the middle-aged woman says she can go for more than seven months without a client. Moreover, the amount of money the women make from selling the crushed stones is too little to cater for their needs, and many are the nights they go hungry.
“I sit under this tree all day waiting for my luck … my children had to drop out of school after I got sick due to lack of money,” Ms Ewoi told Healthy Nation.
This is the story of dozens of residents of Kampi ya Samaki. Many, like Ms Ewoi were relegated to a life of crawling, while the few lucky ones have wheelchairs. And even though the lake is the source of their woes, they continue to rely on it as their only source of water for drinking and domestic use.
“Doctors say that my problem was caused by water from the lake, but we have no option but to use it. It is our only source of water,” said Ms Ewoi.
“When people take water with excess fluoride content over time, it affects the bones which makes them weak and brittle due to lack of calcium. This makes people prone to upper and lower limb fractures and back and neck pain,” said Gideon Toromo, a medical doctor who used to work at the Baringo County Referral Hospital, and now serves as the county’s chief officer for health. He added that children between one and eight years are most at risk for dental fluorosis as their teeth are still developing.
“Severe cases affect the spinal cord, causing permanent paralysis, so the victims have to walk with the aid of a stick or crawl. The solution to the problem is the provision of piped water,” he added.
Fluoride has a high affinity for calcium ions in teeth and bones. It accumulates in the bones progressively over many years, with early symptoms being stiffness and joint pain. In severe cases, bone structure may change, and ligaments may calcify causing muscle impairment and pain.
CONFINED TO WHEELCHAIR
According to the World Health Organisation, control of drinking water quality is critical in preventing fluorosis. People who consume water with moderate amounts of excess fluoride (more than 1.5 milligrammes per litre) develop dental fluorosis characterised by brown teeth (usually before six years of age), while long-term exposure can lead to potentially severe skeletal problems.
A few metres from Ms Ewoi’s home, we meet John Lomtomo, who was confined to a wheelchair three years ago after falling while taking a bath at the lake. Doctors at the Nakuru General Hospital and the Moi Teaching and Referral Hospital in Eldoret, where he sought treatment, told him that his bones had weakened over the years from consuming water with high fluoride content. As a result, the fall had an impact on his spine, rendering him immobile.
“I used to work as a mason around Kampi ya Samaki and in the nearby Marigat Town. Now I am forced to sit in a wheelchair all day, Mr Lomtomo told Healthy Nation, adding that after he depleted his (and his wife's) money while seeking treatment, his children had to drop out of school. His wife, who used to work as a fishmonger at the local shopping centre now spends her days looking after her husband.
“I am now the breadwinner but it’s hard to balance fending for the family and taking care of my ailing husband,” said Linah Lomtomo, who relies on odd jobs.
For Sote Cherutich, 70, when she started having sharp neck pain and stiffness and weak legs 10 years ago, doctors at a health facility in Gilgil thought it was due to old age. She and Ms Ewoi are part of a 10-women group suffering from skeletal fluorosis, and despite their disabling condition, locals say they have not benefitted from cash transfers given by the government to the disabled.
According to Willy Limo, a deputy warden and curator at Lake Baringo, more than 4,000 locals have been affected by high levels of fluoride in drinking water, with several children developing deformities and bow legs.
“The problem has not only affected older people, but also newborns and babies who have brittle bones. Others have brown teeth which indicates dental fluorosis, while others have bent backs and have to walk with the aid of sticks. Some locals have also suffered paralysis,” said Mr Limo, adding that three in 10 residents have fluorosis, with the most affected villages being Kampi Samaki, Ng’enyin, Forest, Noosukro, Ng’ambo, Loruk, Ruko, Kiserian, Kokwo Island and Kapkirwok.
Residents say that if they had an alternative source of drinking water, they wouldn’t have to rely on the lake, and their health problems would dissipate.
“The government has failed to provide us with clean water, forcing us to draw water from the lake. Most people have been affected by fluorosis, which has rendered them paupers, but without an alternative source of water, we are forced to take the same water that causes us problems,” said Charles Muchinga, a resident.
“This is a hazard that should be addressed with immediate effect.
While the World Health Organisation recommends fluoride levels of 1.5 milligrammes per litre depending on the climate and the local environment, Lake Baringo warden Jackson Komen says that the lake’s water has more than double the recommended maximum.
In hot areas, the WHO recommends a lower limit because people drink more water.