A short presentation on Agents of Change, a project on awareness workshops on fluoride and water quality, undertaken by Aajwanthi Baradwaj, who was an intern with Biome Environmental Trust

1. Agents of Change
Spreading water literacy
Addressing behavioural change
through community participation
www.whosebehaviour.blogspot.com
An Index Challenge Entry: Open Challenge 2010
(Also adderesses Health and Sanitation through some activities)

2. Agents of Change | SYNOPSIS
Through ‘Agents of Change’, I tried to bring about behavioural
change in children though community participation. The project
aims at spreading water literacy in rural Karnataka (India), where
fluoride is endemic in groundwater and people are not aware of
the problems that are caused due to drinking this water.
The design process involved facilitating a series of participatory
workshops to build awareness around water and sanitation,
focusing on fluoride for high school students in a rural
government school. The children were taken through a series of
workshops, through which performed activities that put abstract
concepts that they have only read about in their textbooks, into
action. The workshops also demonstrated that drinking rainwater
is the only way to prevent fluorosis, an incurable disease caused
due to drinking water with excess fluoride. This was done by
building fun experiences around factual matter.
I translated this journey to produce a toolkit that makes
awareness programmes and learning more hands-on,
interdisciplinary, fun and emotional.
India Karnataka Pavagada Taluk
Top row: Children collecting drinking water from their common village open well followed by A
child affected by dental fluorosis due to drinking water with excess fluoride and is not aware of
what it is and why he has got it.
Bottom row: Pavagaga Taluk in rural India, an affected area where I conducted the workshops
Bibliography
The green school Manual - CSE
Participatory workshops by Robert Chambers
http://www2.unescobkk.org/elib/publications/nonformal/M4.pdf- A handbook on participatory workshops
On Rainwater and harvesting
www.rainwaterharvesting.org
http://en.wikipedia.org/wiki/Rainwater_harvesting
On Fluoride and flurosis
http://www.nofluoride.com/unicef_fluor.htm
http://www.indiawaterportal.org/node/736# - A multimedia kit on fluoride and fluorosis
http://www.indiawaterportal.org/node/1130 - fluoride testing kits
General activities around water and sanitation
http://candleandsoap.about.com/od/soapmakingbasics/ss/howsoapcleans_3.htm

3. Agents of Change | DESIGN
A 60 page illustrated, four colour printed toolkit that contains all
the visual aid needed to facilitate participatory activities to spread
awareness on water and sanitation. The activities themselves
are direct and objective but the toolkit also contains anecdotes
and insights that were drawn from the workshops I conducted
in Rashtrapragathi Higher Public school in rural Karnataka. It
comes with a 9 min 30 sec participatory video that the students
have shot themselves, telling people stories about their problems
around fluoride and what they have learnt and liked about these
activities. This serves as a quick way to imbibe all the content.
As part of the workshops, I build appropriate technology like sand
filters and hand washing devices with the children, to introduce
them to concepts around water and sanitation. A design I came
up with was a low-cost, portable, hand washing bottle. This needs
a plastic bottle (to fill water in), some discarded cycle rubber tube
(to make a water proof pouch for the soap strips), a small piece
of soap or paper soap (to wash hands with) and some thread
(to tie this across ones’ shoulders and to stitch up the pouch). It
costs about Rs.5 a piece and can be made by any student at home
using re-cycled materials. It dispenses minimum water (drop by
drop, due to the cap) and the students can carry it to their loos
(most children walk out of their campus to relieve themselves as
they don’t have washrooms in school) so that they can wash their
hands with soap after they are done. They can also use it to wash
their hands and plates after meals, like the usually do around
campus, using lesser water than taps. The bottle can be re-filled
and used. I made them personalise their bottle so that they feel a
sense of ownership and thus use it more often. It also acts like a
small nudge for them to wash their hands, each time they see it
hanging across their shoulders.
First row: The final toolkit and video and illustrations that were made for the toolkit
Middle row: Two spreads from the toolkit
Bottom row: Chowdamma sporting her bottle across her shoulder, Sushma painting her bottle
and a prototype of the hand washing bottle with paper soap in a rubber pouch

4. Agents of Change | CONCEPTUAL THINKING AND MOTIVATION
When I visited the village for the first time, I was amazed at
how the government schools were so well maintained with
classrooms, gardens and play areas. Only when it came to
water and sanitation practices, especially since this area had
excess fluoride in groundwater, the knowledge and facilities
were abysmal. The kids thought that the marks on their teeth
(dental fluorosis), was because they did not brush right. The
government has spent lots of funds and provided many schools
with rainwater harvesting tanks (to drink fluoride free water) and
water filters, but they lay unmaintained and un-used because no
one in the community knows what to do and no one wants to take
ownership and help maintain the services that was going to help
them in the future. Instead there was vandalism and theft. This
was happening due to the programme being very impersonal.
The government just builds tanks and goes away, but does not
educate the children and community on how to use or maintain it
and thus, the whole thing just goes for a waste.
The children are the ones who end up maintaining facilities like
the tanks and kitchens in schools and thus this awareness is very
important to make any system work.I also thoroughly enjoyed
working with them. I wanted to use art and design tools to build
experiences around objects and concepts so that the children
take back something, anything related to it. I was hoping that
conducting these participatory workshops through which the
children enjoyed learning, would change the way they looked at
science, arts and learning.
These children are the agents of change. So, through these
activities, I tried to make them proactive agents and spread
knowledge to produce a more aware and interested
larger community.
First row: With the children near their dried tank followed by the kids testing their village water
tanks for the fluoride concentration
Middle row: A rainwater tank built by the government, right in front of the entrance of a class! It
is not being used as the pipes have been stolen and people are not aware of how to maintain it
followed by a water filter that is not connected or being used, due to the same reasons
Bottom row: The new rainwater tank that was built in the school I worked in followed by a student
painting his thoughts on rainwater on his school tank, to personalise it.

5. Agents of Change | POTENTIAL IMPACT- SCALING IT UP
A large population in rural India depend on ground water drawn
through hand-pumps or open wells for consumption. Intake of
untreated groundwater leads to excess fluoride entry into the
body. The urban population too, due to shortage of treated water
are dependent on groundwater to a large extent. India has major
health problems as a result of intake of excess fluoride through
water and food (crops) besides processed food. Throughout
many parts of the world, fluoride occurring naturally have
caused widespread fluorosis, a serious bone disease (dental and
skeletal), among local populations.
The 1984, the WHO guidelines suggested that the optimal fluoride
concentration in drinking water should remain below 1ppm or
part per million. The permissible upper limit was set at 1.5ppm.
Many regions in India still have levels that go up to 5ppm and
more, which is highly dangerous. Fluoride is endemic in parts
of around 17 states in India as seen in the map and around 25
countries across the globe. It is very important for people to be
aware of this and be exposed to fluoride free water for drinking.
The most viable solution of course, is the freely available
rainwater.
I worked only with one class and was happy to see some tangible
results even for that! Within the same school, there were 200
other students and 3-4 such schools in each village and 300
villages just in this one taluk. They are all very enthusiastic but
have no access to material or facilitators. Even the teachers were
not exposed to such methods of teaching and were surprised
to see students running around and having fun while learning.
Through this project, I have tried to add the experiential, human
element and get the students to connect with what they see and
need to learn, thus hoping they will be the agents of change and
spread this much needed knowledge across their community.
First row: Percentage of districts in India affected with fluoride in groundwater
Bottom row: (Right) The map of the taluk (district) with the one village I worked in that is marked.
(Left) 30 villages that a local NGO works with, out of the 300 villages just in that taluk.
Scaling: Even if this NGO takes this programme up, they would have access to about 30 villages
where each village has 3 to 4 schools and each school up to 200 or 250 children, If this whole
district is targeted, around 150,000 children, and through them, many more would be aware and
conscious.
This problem exists in17 states in India and around 25 countries across the globe and thus needs
to be scaled up to address people affected with fluoride in groundwater and fluorosis even if it
means including some activities once a week in their school curriculum.
 Dental Fluorosis
is caused due to excess intake
of fluoride during tooth
development. In its severest
form, when the dental enamel
molts, it is characterised by
black and brown stains, as well
as cracking of the teeth
 Skeletal Fluorosis
is a bone disease caused by
excessive consumption of
fluoride. In advanced cases,
it causes pain and damage to
bones and joints