SuSanA - Forum Kunena Site Syndication Sat, 23 Jul 2016 11:10:08 +0000 Kunena 1.6 SuSanA - Forum en-gb Skeletal Fluorosis, What aggravates it and what makes fluoride in the water that you drink to go crazy in your body and lead to bone deformity? - by: VikasR
Questions in your mind, yes?

Ok, lets start things off; The reason for Fluorosis is High levels of fluoride in drinking water supplies and in food grown in endemic areas. the more fluoride there is in the water and food you consume the more severe is your fluorosis, as simple as that.

But interestingly; although there is a standard defined by the World Health Organisation (WHO), which has come up with a universally accepted theory that any fluoride in water upto 1.5 ppm per day per liter is safe to have, The truth is that there cannot be a fixed rule that applies randomly to all. The body mass, the body built, your being a child or adult and other factors have a huge role in determining how much of an effect fluoride can have on you if you happen to be in a endemic area.

Also; in a fluoride affected area, Tropical or extreme hot weather and some hard manual labor can make you feel thirstier, so your body’s water requirement grows and you’d be drinking more water. A lot more fluoride, therefore, which is beyond what’s reasonable; no matter what the limit therefore enters your body.

If your nutrition is poor; which in “fluorosis avoiding terms” essentially means that your food is deficient in reasonable calcium, magnesium and vitamin C which gives you the wherewithal in countering fluorosis by making fluoride flush out; you could end up having really bad skeletal fluorosis, if you keep drinking contaminated water.

Magnesium has a peculiar relationship with fluoride and its optimum intake helps in elimination of fluoride from the body. Vitamin C as well is beneficial in some way in reducing fluoride toxicity.

Fluorosis which earlier used to take much more time to manifest itself in people and very rarely in children, has for the past decade or so started showing up much quicker now. even in small children who are showing symptoms, which was never before the case.

The deterioration in food habits,i.e. foods people that now have being low in nutritional value, is what is leading these things to happen.

A Renal or kidney disease can also aggravate your fluorosis by increased deposition of fluoride in the bones. A diseased kidney cannot handle fluoride excretion from the body, and hence you’d find an increased deposition taking place in bones.

After all; where else can the excess fluoride go if it is unable to find it’s way out of the body?

to sum it up briefly; its about you taking the right kind of food and the capacity it gives you to flush toxins such as fluoride out of your body, along with switching to safe water]]>
Nutrition and WASH (including stunted growth) Sat, 23 Jul 2016 05:49:53 +0000
WASH & stunting: an annotated bibliography - by: campbelldb Sanitation Updates. Please let me know if you know of other recent studies, reports and resources that we should add.

Titles to some of the studies include:

- The NOURISH Evaluation: Can WASH and Nutrition Boost Kids’ Growth? Global Waters, May 2016.

- Can Water, Sanitation and Hygiene Help Eliminate Stunting? Current Evidence and Policy Implications. Maternal & Child Nutrition, May 2016. Authors: Oliver Cumming and Sandy Cairncross.

- Preventing Environmental Enteric Dysfunction through Improved Water, Sanitation and Hygiene: An Opportunity for Stunting Reduction in Developing Countries. Maternal & Child Nutrition, May 2016. Authors: Mduduzi N.N. Mbuya and Jean H. Humphrey]]>
Nutrition and WASH (including stunted growth) Tue, 07 Jun 2016 13:49:10 +0000
WASH & Stunting - open access articles from May 2016 Maternal & Child Nutrition - by: campbelldb
Link to the issue - Maternal & Child Nutrition, May 2016

Stop Stunting in South Asia. Improving Child Feeding, Women's Nutrition and Household Sanitation.

Some of the article titles include:

- Stop stunting: improving child feeding, women's nutrition and household sanitation in South Asia
- Can water, sanitation and hygiene help eliminate stunting? Current evidence and policy implications
- Preventing environmental enteric dysfunction through improved water, sanitation and hygiene: an opportunity for stunting reduction in developing countries]]>
Nutrition and WASH (including stunted growth) Thu, 19 May 2016 13:15:25 +0000
Concern-Tufts impact evaluation in Chad: hygiene practices and acute malnutrition closely linked - by: kategolden
Concern Worldwide and the Feinstein International Centre at Tufts University implemented the Community Resilience to Acute Malnutrition programme in Chad 2012-2015, which delivered an integrated set of WASH, nutrition, health and livelihoods interventions and incorporated a strong impact evaluation using a randomised control design. Midline results showed a strong link between hygiene - specifically behaviours linked to washing water transport containers and the concentration of livestock at human water sources - to acute malnutrition. The endline results are just in and results should be available soon. A summary of learning from the midline are available here on Concern's website: or hopefully you can access them as attachments below (in English and French)]]>
Nutrition and WASH (including stunted growth) Wed, 20 Apr 2016 06:06:07 +0000
Clean, Fed & Nurtured Community of Practice - by: BijanFHI360 Clean, Fed & Nurtured is a community of practice that brings together practitioners and researchers in the WASH, nutrition, and early childhood development (ECD) sectors. Clean, Fed & Nurtured, which consists of Alive & Thrive, ChildFund, USAID, Save The Children, FHI 360, the Global Public-Private Partnership for Handwashing, and other members, works to share knowledge and proven approaches, and test and improve integration of programming in these areas to promote optimal growth and development for children 0 to 3 years of age. Clean, Fed & Nurtured welcomes those interested in collaborating together to improve integration of efforts. Since 2013, this community of practice has hosted events, published corresponding materials and resources. Clean, Fed & Nurtured continues to actively promote resources, such as webinars; present on the latest evidence at events; and draft technical papers, reports, and reviews of literature.

If you are interested in learning more about Clean, Fed & Nurtured or joining the community of practice, you can learn more here:]]>
Nutrition and WASH (including stunted growth) Mon, 04 Apr 2016 20:21:43 +0000
WASH and Nutrition in West Africa: blog + motion design (materials by Action Against Hunger West Africa Regional Office) - by: ChristelleHure

Contact for more info: This e-mail address is being protected from spambots. You need JavaScript enabled to view it ]]>
Nutrition and WASH (including stunted growth) Thu, 24 Mar 2016 13:57:57 +0000
Re: Introduction to Emergency Nutrition Network (ENN) - by: ENN
Thank you very much fro your very useful feedback. Please see below my comments:

Sticky post with key documents - perhaps you could comment in that thread?
I've done this and will go back as and when I come across other useful resources.

A selection of 20 to 50 important documents that are tagged in the library with the tag for Working Group 12 (WASH and nutrition)- anything missing or superfluous?
I will get back to you on this as there has been several articles in FEX/NEX focusing on Wash & Nutrition and they need to be added to the resources listed there.

Additional documents (beyond the Top-50) could also be uploaded to the library of course again, anything missing? Same as above.

Another thing which I feel quite strongly about and where you could perhaps help me/us, is to get the information on Wikipedia right and up to date.
I'm afraid I need to discuss this in house with ENN technical nutrition team and check their availability, as it's beyond my area of expertise. It might be a while before I can update you on this so please bear with me

Nutrition and WASH (including stunted growth) Wed, 23 Mar 2016 15:00:03 +0000
Re: Key documents for the sub-category on nutrition and WASH - by: ENN


Jaleh Saboktakin
Project Support Officer
Emergency Nutrition Network (ENN)]]>
Nutrition and WASH (including stunted growth) Wed, 23 Mar 2016 14:43:39 +0000
Re: Introduction to Emergency Nutrition Network (ENN) - by: muench
I am happy to see your first forum post, thank you for introducing the Emergency Nutrition Network (ENN) and pointing out the overlaps with the WASH sector. Welcome!

Now that you're here, I am wondering if you could help us with a few things?

One is making available (and easy to browse) the pertinent literature on WASH and nutrition.

We have done that in three ways:

Another thing which I feel quite strongly about and where you could perhaps help me/us, is to get the information on Wikipedia right and up to date.
There is this page on Wikipedia on malnutrition:
And there is this one on malnutrition in children which I started:

Both pages could benefit from making clearer the connection with WASH and also from adding some more good references and images. I think in particular images that show chronic malnutrition are useful (rather than those from emergency situations), because the chronic malnutrition probably gets less attention, it is less "headline grabbing" - so we need to help educate people on that.

Nutrition and WASH (including stunted growth) Tue, 15 Mar 2016 01:56:46 +0000
Stunting in Rural Ecuador - by: F H Mughal Stunting in Rural Ecuador

A very recent paper (published 2 March 2016), published in the International Journal of Epidemiology, as highlighted in the Sanitation Updates, is attention-grabbing, and has a rather novel title: I get height with a little help from my friends: herd protection from sanitation on child growth in rural Ecuador.

Initially, I got a bit struck up with the term “herd protection,” – I thought it has something to do with animal herding. However, reading the paper made it clear.

This is the key message from the paper (abstract): “improved sanitation in one household may provide community-wide benefits if it reduces contamination in the shared environment. Sanitation at the household level is an important predictor of child growth, but less is known about the effect of sanitation coverage in the community.”

If there is improvement in sanitation in a house, people have tendency to link the benefits of improved sanitation within that particular household – benefits include stunting benefits. Generally, people do not vision benefits in the wider community.

The researchers took repeated anthropometric measurements on 1314 children under 5 years of age in 24 rural Ecuadorian villages, during the period 2008-2013. They investigated the association between sanitation coverage in surrounding households and child growth.

The researchers - from the Department of Epidemiology, University of Michigan; Center for Human Growth and Development, University of Michigan; Centro de Biomedicina-Carrera de Medicina, Universidad Central del Ecuador; and Department of Anthropology, Trinity College, Hartford, USA – found that the sanitation coverage in the surrounding households was strongly associated with child height, as those with 100% coverage in their surroundings had a 67% lower prevalence of stunting compared with those with 0% coverage.

Children from households with improved sanitation had a lower prevalence of stunting. When analyzing height as a continuous outcome, the protective effect of sanitation coverage is manifested primarily among girls during the second year of life, the time at which growth faltering is most likely to occur.

The study has important implications that received less attention in the past. The conclusions says it all:

“Study highlights that a household’s sanitation practices can provide herd protection to the overall community. Studies which fail to account for the positive externalities that sanitation provides will underestimate the overall protective effect.”

The paper is available at:

F H Mughal]]>
Nutrition and WASH (including stunted growth) Sat, 12 Mar 2016 13:00:25 +0000
Introduction to Emergency Nutrition Network (ENN) - by: ENN
As my first contribution to the forum, please allow me to introduce you to ENN.

ENN enables nutrition networking and learning to build the evidence base for nutrition programming. Our focus is communities in crisis, typically humanitarian emergencies, and where undernutrition is a significant chronic problem.

We consider both nutrition-specific programming, such as management of acute malnutrition, and nutrition sensitive programming, that involve sectors such as social protection, agriculture, health, and water, sanitation and hygiene (WASH).

We have two major publications:

Field Exchange (FEX)
Field Exchange is an established online and print technical publication on nutrition and food security in emergencies and high burden contexts. Fifty issues have been produced to date.

Field Exchange enables fast track publication of programming experiences of relevance to nutrition in emergencies and high burden contexts. We welcome suggestions for articles to feature in Field Exchange at any time. We can support you to write about your experiences.

Whilst Field Exchange is not a peer reviewed publication, where topics are contentious, particularly challenging to the norm or critical of another agency, we invite a postscript from relevant stakeholders that are published alongside the article.

Field Exchange is produced three times per year in English. All editions are available online and in print.

Here are examples of some articles under the theme of WASH & Nutrition:

Call to Action on improving Water, Sanitation, and Hygiene for Maternal and Newborn Health
WASHplus in Mali: integrating WASH and nutrition for healthy communities

Evaluation of an integrated health-nutrition-WASH project to reduce malnutrition prevalence in children under two in Bangladesh

Nutrition Exchange (NEX)
Nutrition Exchange is an ENN publication that contains short, easy-to-read articles on nutrition programme experiences and learning, from countries with a high burden of malnutrition and those that are prone to crisis. It also summarises research and provides information on guidance, tools and upcoming trainings in nutrition and related sectors. Each issue contains original articles from national level readers and summarised information from ENN's flagship publication Field Exchange.

Nutrition Exchange is for all those working to reduce levels of malnutrition at the national, district and community level. This includes Government, Civil Society, International and National Agency sta? working in nutrition, including agriculture, health, education, water and sanitation and the social protection sectors. Nutrition Exchange is available in English, French and Arabic.

Examples of articles in NEX:

The power of WASH: why sanitation matters for nutrition

Water, sanitation, and hygiene (WASH), environmental enteropathy, nutrition, and early child development: making the links

Subscription is free and you will receive copies of either or both publications delivered to your door or to your inbox.

Please let me know if you have any questions. Also feel free to browse our Resources page and let us know if you have any suggestions for other interesting materials to be added to the library (you can find most of the WASH-related ones under the tag of Health).

Thank you and best regards,
Nutrition and WASH (including stunted growth) Thu, 10 Mar 2016 14:02:19 +0000
Re: Key documents for the sub-category on nutrition and WASH - by: F H Mughal
Though I'm a bit familiar with EHP, you have given a good background information.
Thanks for digging out all that information. I'm sure, that would be quite an information for other forum users, as well.

F H Mughal]]>
Nutrition and WASH (including stunted growth) Thu, 18 Feb 2016 16:01:32 +0000
Re: Key documents for the sub-category on nutrition and WASH - by: muench
I took a look at the journal's website. Here is the overview for that issue in question (i.e. volume 122 | number 11 | November 2014 • Environmental Health Perspectives):

It does not include other articles on the topic of sanitation and children.

This journal has a great archive page, by the way:

And, amazingly, all articles are open access and free (see here:

Published since 1972, EHP has been online-only since January 2013. EHP is open access, and all content is available for free online.

Permissions and Copyright: EHP is a publication of the U.S. Federal Government, and its content lies in the public domain. No permission is required to reuse EHP content. However, use of materials published in EHP should be acknowledged (for example, “Reproduced from Environmental Health Perspectives”) and a link provided to the article from which the material was reproduced.

And more information from their website (perhaps more people should publish articles on WASH and health topics there!):

Environmental Health Perspectives (ISSN-L 0091-6765) is a monthly peer-reviewed journal of research and news published with support from the National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health, U.S. Department of Health and Human Services.

The mission of EHP is to serve as a forum for the discussion of the interrelationships between the environment and human health by publishing high-quality research and news of the field. With an impact factor of 7.98, EHP is ranked 2nd of 87 journals in Toxicology, 3rd of 162 journals in Public, Environmental and Occupational Health, and 4th of 221 journals in Environmental Sciences.

The environmental health sciences include many fields of study and increasingly comprise a multidisciplinary research area. EHP publishes articles from a wide range of scientific disciplines encompassing basic research; epidemiologic studies; risk assessment; relevant ethical, legal, social, environmental justice, and policy topics; longitudinal human studies; and in vitro and in vivo animal research with a clear relationship to human health. Because children are uniquely sensitive to their environments, EHP devotes a research section specifically to issues surrounding children’s environmental health.
Nutrition and WASH (including stunted growth) Thu, 18 Feb 2016 13:31:16 +0000
Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: CaitlinMcC
Nutrition and WASH (including stunted growth) Mon, 15 Feb 2016 15:45:26 +0000
Re: WATSAN-AGRICULTURE: Improving on the Nexus among Water Quality and Quantity, Sanitation, Hygiene, and Agriculture - by: mhasan
Thank you for your questions. I Do apologize for my late reply. Regarding you question number one, I would say, yes. The project includes the discussion with the policy makers of agriculture and sanitation. Cross-sectoral policies are important as WATSAN-agriculture are inter-related. But we have more focus in the system analysis in the project where we try to identify how agri-ecological system such as different types of irrigation, land holding, livestock management affect the health outcome of households. The impact of government policies on WATSAN-Ag is still not dominant in our research. May be our colleagues from the project might have intention to do that research.

I know some government organization in Bangladesh are already working on providing irrigation water as well as drinking water to the rural households. To some extent they are more serious to provide potable water so that households do not need to take canal water or pond water to drink. Department of Public Health and the Agriculture ministry do have some compliance to promote water and sanitation services in Bangladesh. It is very difficult to say how receptive they are to new collaboration. But I must say government of Bangladesh has taken water and sanitation seriously and as a result we have almost stopped open defecation and we have potable water more than 90 percent.

Regarding you second question, as you said this is another link between agriculture and sanitation, this approach is compatible with watsan approach. Sanitation organic waste requires processing and rural households are incapable of doing that. A processing industry is required who can do that commercially so that the fertilizer can be used in the agricultural field. This approach is innovative and it needs proper methods of collecting faecal materials from households time to time from proper sanitation infrastructure with good incentives. I think this is a promising sector for public private partnership in the community level.

Nutrition and WASH (including stunted growth) Mon, 15 Feb 2016 12:50:01 +0000