In the Mayo Tsanaga River Basin area in Cameroon’s Far North region, teeth-whitening agents are often in high demand to mitigate the impacts of dental fluorosis. More than 500,000 people there are exposed to this disorder, which can cause irreversible damage to teeth — ranging from permanent discoloration to skeletal deformation.
Climate change is making dental fluorosis more common. Rising atmospheric temperatures are making water scarcer, increasing both water mineral concentration and the community’s reliance on run-down groundwater systems.
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In the Far North region, the main sources of potable water are wells and boreholes supplied by groundwater aquifers — bodies of rock or sediment that hold groundwater — with high concentrations of fluoride. Some local communes have fluoride concentrations above 4 or even 6 milligrams per liter, well exceeding the World Health Organization safety standard of 1.5 milligrams per liter.
Not only does dental fluorosis damage teeth, but it also has a profound impact on society. Women play a central role in the collection, management, and supply of water in the area, and they are more severely impacted by the societal effects of this disorder than men. Women and girls with dental fluorosis are often discriminated against, less likely to find long-term partners, and considered “dirty” by some men, according to Global Water Partnership Cameroon.
Launched in Cameroon in February, the Water Climate Development Program-Gender, or WACDEP-G, is looking to combat this issue.
Murielle Elouga, head of WACDEP-G in Cameroon, said that she wants to promote gender-transformative planning through new laws and policies and that she also intends to push institutions to make climate-resilient water investments. Her program, made up of a nearly all-female team, seeks to improve knowledge and attitudes around gender issues related to water security in Cameroon and to build climate resilience both locally and nationally.
“Some young affected girls found it hard to get married. Others struggle with low self-esteem and, in a bid to attract men, used bleaching products as teeth-whitening agents.”— Murielle Elouga, head of WACDEP-G in Cameroon
Elouga told Devex that women in Cameroon spend more than a third of their time collecting water and are directly affected by droughts and erosion polluting main water sources, limiting access to clean water for their domestic needs.
“Women in the country are more vulnerable to climate change and water-related challenges,” she said. “Female farmers are more vulnerable to climate change than their male counterparts. In addition to that, they have difficulties adapting to climate change because they lack knowledge and access to climate-related information.”
In 2009, scientists discovered that the groundwater in the Mayo Tsanaga River Basin was fluoride-rich and leading to dental fluorosis. But officials didn’t understand that misconceptions about the cause of fluorosis were motivating stigmatization until nine years later. Women and girls bear the brunt of this stigma and are often accused of witchcraft, poor dental hygiene, and carrying bad genes, Elouga said.
“This [set of misconceptions] influenced social relations between affected and unaffected persons, and especially negatively impacted the social integration of affected women,” Elouga said. “Some young affected girls found it hard to get married. Others struggle with low self-esteem and, in a bid to attract men, used bleaching products as teeth-whitening agents.”
In 2019, an awareness campaign was carried out on the origin of fluorosis to change public attitudes toward it. After being approved by the community, messages about the disorder were developed, translated into two local languages — Fufuldé and Mofou — and distributed through flyers and posters in community health centers, schools, public offices, and markets, with the support of local authorities.
Elouga said that since the campaign was organized, women with dental fluorosis have regained confidence and some have been able to lead community church sermons and Bible readings in front of large crowds without feeling anxious about their teeth. Also, the local community is now more aware of the cause of the disorder, and people are collecting far less water with high concentrations of fluoride as the population becomes more educated on what sources to avoid and how to filter the water.
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WACDEP-G plans to develop a network to promote a gender-transformative approach in the water and climate sectors, bringing together government, universities, NGOs, and other partners to share knowledge. The program is also working on a filter prototype using charred bones to purify fluoride-rich water.
Started in April 2020, the wider WACDEP-G initiative now covers five African countries — Benin, Cameroon, Tunisia, Uganda, and Zambia — each with a basin vulnerable to climate change. Lessons drawn from these pilot countries will help expand the program to another 13 African nations. Global Water Partnership launched the scheme together with the African Union, African Ministers’ Council on Water, New Partnership for Africa’s Development, African Development Bank, and African Water Facility.
Continentwide, the program has a €25.6 million budget over a six-year period and is expected to influence some $1 billion in gender-equal and climate-resilient investments, according to the AIP, or Continental Africa Water Investment Programme, website.
The Austrian Development Agency, Britain’s Foreign, Commonwealth & Development Office, and the Danish Ministry of Foreign Affairs — via Danida — are the program’s main donors. Additional funding is provided by the Global Water Partnership’s core donors, including the European Commission, France, Germany, the Netherlands, Norway, Spain, Sweden, and Switzerland.
This focus area, supported by the U.N. Development Programme, explores how climate change and other planetary imbalances impact the rising trend of human inequality and vice versa. Visit the Focus on: People and the Planet page for more.