In the first stage of the Open IDEO Water and Sanitation Challenge, we

proposed to counter a water-related problem that was large-scale and

cut across geographical and cultural boundaries in India. We zeroed in on

Fluoride contamination in ground-water as the key healthcare concern that

we would attempt to solve.

GUIDE TO

Through substantial on-ground research, we created a rubrics to judge

any solution by, to evaluate its potential effectiveness: a ‘point of use’, i.e.,

domestic level solution that did not call for substantial behavioural changes,

incorporated in design and products that the user was accustomed to, and

was market based, and simple to use and implement would work best, we

realised. The solution also shouldn’t have a complex work- flow, and must

follow the model of a consumer goods business.

Lab tests and secondary research led to the finding of two compounds -

Alum and Alumina - both useful, albeit different methods to reduce Fluoride

contamination in water. Dissatisfied with the efficiency and lack of user-

friendliness of these materials, we conducted further research and zeroed

in on Alum Impregnated Activated Alumina - with maximum efficiency and

versatility of use.

We see the ‘Water Problem’ as being four pronged - Availability, Accessibility,

Quality and (overarching) Efficiency, all affect any population in question.

While we decided to focus on quality, we did not want to solve too narrow

a problem - however scalable the idea might be (due to the geographic

spread of the problem). Hence, apart from defluoridating the water, we went

a step further to disinfect it (using Calcium Hypochlorite powder) and provide

nourishment (through an all natural food supplement: minerals, vitamins etc.)

in powdered form.

We proposed three form-factors:

The Paani Pod (AIAA encapsulated in modular non-toxic, food grade plastic

chambers, that can simply be dropped into water bottles/containers), The

Paani Bottle (non-toxic, food grade PET bottles), and The Paani Ladle (a

traditional ladle to be used for larger quantities of water).

In the Refinement Phase, we focused on the following aspects:

1. Prototyping the form-factors using Human centric design: The (above)

proposed form factors were tested for use, and substantial design input

went into creating the ladle, the bottle and the pod. Primary considerations

were: Cost, Usability, Durability, Form and Function. We took care to put the

user’s experience first, in developing these products, making the process

least disruptive, and making sure that it fit within their existing lifestyles and

practices.

2. Changing the Paani Powder to capsule-form: In our constant obsession

with the least disruptive, most conducive user experience, we scrapped the

Paani Powder sachets, favouring a water-soluble capsule form instead.

3. Channel Partners: Reaching the market at the bottom of the pyramid is

difficult, in India - this is especially true of rural households. Especially for a

product such as this, that requires everyday use to see any tangible results,

constant communication and engagement is key. However, even for a point

of sale system, Fluoride contamination is large-scale issue that required

us to partner with existing organisations with infrastructure in the target

geographies. In finding such an organisation, we looked at organisations

that had: existing infrastructure, a professional management, past traction

in delivering such goods, a goal and vision similar to ours, and a yearning to

go the extra-mile and solve as many problems (peripheral to the core issue

they are countering), as possible. We zeroed in on two organisations for this

purpose.

4. Manufacturers: We contacted and are in talks with PET bottle

manufacturers who buy-in to our vision, to reduce the cost of manufacturing

the form-factors

We hope to evolve further through this journey.

‘Water’ is not one problem, in India - it is a convoluted combination of

complex conundrums, that have significant cultural influences dictating

practices, and creating restrictions. Availability, accessibility, quality,

efficiency - each of these have multiple hues, and vary across geographies,

and cultures. Hence, scalability of a solution becomes extremely challenging.

This complexity forced us to think of a problem that is large-scale and cut

across geographical boundaries, that we could counter. Through substantial

research, we found Fluoride contamination in ground-water to be a key

healthcare concern in India. Hence, the problem we are solving is one of

quality (fluoride and arsenic contamination), when availability and accessibility

are a given.

Water

Sustainable, clean water for all

Substantially debated, researched and marketed, fluoride additives in

drinking water. American Dental Association President Dr. Maxine Feinberg).

However, in India, the high content of fluoride in water does the opposite

- in almost all of the 29 states and 7 union territories, fluoride levels in

drinking water (especially in rural areas) cause, in moderate levels, enamel

corrosion, but in states like Rajasthan, Andhra Pradesh and Gujarat - around

8000 villages, 8 million villagers affected only in these 3 states - that are

severely affected, causes mottled enamel, osteoporosis, and in some cases,

crippling skeletal fluorosis.

203 districts in 20 states in India are affected by groundwater fluoride

contamination. These 67 million people, of which 6 million are children below

the age of 14, complain of fatigue and fragility of the backbone, neck, hand

or leg areas. Sometimes, fluorosis leads to deformity. It becomes difficult

to stand, run, walk or carry a load - substantially affecting their income and

ability to learn, and earn.

FLUORIDE

(Source:Dr. Raja Reddy, 2009)

Andhra Pradesh 17

Rajasthan All districts except 1

Punjab 13

Haryana 12

Maharashtra 10

Bihar 09

Tamil Nadu 08

Uttar Pradesh 07

West Bengal 04

Fluoride contamination levels by state

Gujarat All districts except 1

Imagine this - the U.S. Department of Health and Human Services (HHS)

determines 0.7 milligrams of fluoride per litre of water as optimal for

prevention of tooth decay. in 26 out of 29 states, this fluoride levels are

higher than this recommended level.

In more than 203 districts out of 683 (2014) i.e. 30% of districts, the fluoride

levels affect the population - that is 67 million people, of which 6 million are

children under the age of 14. In these rural areas, the level of fluoride is ≥10

times the optimal fluoride level.

Effects of Fluoride Contamination

Fluoride is the most electronegative element in nature, and causes profound

physiological harm when ingested in excess. Fluorosis primarily causes

harm to the skeleton (skeletal fluorosis) and teeth (Dental fluorosis), mainly

by competing with intrinsic phosphate based crystals in these tissues.

India has more than 66 million people affected by fluorosis predominantly

through excess fluoride consumption via groundwater. This is a geologically

contingent issue because India lies in the fluoride belt between Turkey and

China, with nearly 12 million of the total 85 million tons of global fluoride in

the country.

Fluoride Belt No.3: Turkey, Iraq, Iran, Afghanistan, Pakistan,India, North Thailand, (parts of) China

15%

Dental Fluorosis:

While consumption of fluoride in prescribed levels (Upto 1 mg/L based on

IMA recommendations[S1]) is important in preventing dental caries, higher

fluoride levels can cause teeth to become brittle and easily worn. This begins

primarily through the appearance of darkening, mottled enamel- where

phosphatic crystal structures in teeth are replaced with more stable fluoride

compounds. As concentrations of fluoride increase, teeth can develop deep

‘pits’ and lose enamel easily. Children are particularly sensitive to dental

fluorosis because fluoride easily affects teeth during the early years of

calcification.[S2]

Dental fluorosis has been reported in at least 14 states, with prevalence

going up to 100% for the 12-15 year age group in Karnataka [S3]

Skeletal Fluorosis:

Fluoride interacting with Hydroxyapatite in bone results in a more seriously

crippling disorder. Primarily caused by ingesting significantly high levels of

fluoride in groundwater, skeletal fluorosis can cause abnormal calcification

(primarily by affecting natural remodelling of the bone in response to stress),

fusion of vertebrae, and in serious cases can limit overall mobility. Skeletal

fluorosis can have severe economic and societal consequences in villages

based primarily on agricultural economies. The disorder can have more

serious consequences for at-risk groups, including pregnant women and

children where developmental pathways get affected. [S4]

Severe skeletal fluorosis has been reported in at least seven states, with

nearly 50% of the adults in Jharkhand and 20% of children in the 1-5 age

group in Bihar being affected [S5]

Market ResearchIssues with solutions currently available formed the rubrics to evaluate our

solution to the problem:

Defluoridation through a community-based or top-down approach, despite

widespread positive trials, seems to have not been used effectively.

Many trials of large defluoridation plants that use different techniques like

adsorption, ion exchange, precipitation, Donnan dialysis and electrodialysis,

have been conducted; among these methods, adsorption is the most widely

used method for the removal of fluoride from water. However, because

of their capital intensive nature, and the need for supervision and skilled

labour they have not been scalable. While the quality of treated water from

such facilities is assured, the immediate feasibility of such measures are

questionable, especially in developing countries, specifically, in rural areas.

Bulusu et al. in 1979 developed a fluoride removal technique in which

treatment with alkali, chlorine and aluminium sulphate or aluminium chloride

or both reduces fluoride content by 98%. Though this has been extensively

trialled in India, the prohibitively high cost, alkaline pH content, and large

dosage required makes it not viable for scalability. Reardon and Wang’s

fluoride-precipitation technique using a limestone reactor is also not suitable

to make water drinkable, as it removes fluoride only up to 2 mg/l (higher

levels of fluoride content in India).

Others have tried using different materials for defluoridation using the

adsorption-precipitation technique, such as activated alumina, amorphous

alumina, activated carbon, low-cost adsorbents such as calcite, clay charcoal,

tree bark, saw dust, rice husk, groundnut husk and rare earth oxides, to

varying degrees of success. One major impediment to large scale adoption

of some of these techniques is that the lowest limit for fluoride reduction

by most of the adsorbents is greater than 2 mg/l, making them unsuitable

for the drinking water treatment.

Add to this, the fact that they work only at extreme pH values (activated

carbon, for instance, is only effective for fluoride removal at pH less than 3.0),

and this makes it difficult to implement at scale. Cultural issues also play into

this complex environment - bone char carbon, which is proven to be useful

(and cheap) in defluoridation cannot be adopted in India because it is taken

from the bones of cows - considered holy in the region.

An analysis of measures such as the above mentioned, seem to consider

a top down, community-based approach. These solutions do not consider

one key factor, the psychology of the user. Take the Nalgonda technique

(adding powdered Alum to water to flocculate, sediment and eventually

filter out fluoride) for instance - adding a white, powdery chemical to

clear water (fluoride contamination does not discolor the water), and

removing flocculated sediments, and drinking the remainder is not only

a cumbersome, time consuming process, but plays straight into inbuilt

psychological barriers, in communities where ‘clear’ is equated with ‘pure’.

Another issue is the existing cultural and practical norm - for instance,

while ‘fetching’ water might be a community endeavour, ‘consuming’

water/’purifying’ water (by boiling, for example) is a personal/family level

endeavour. To expect substantial changes in these existing workflows

is not viable. All existing solutions fall into two categories - treatment

at a community level, i.e. treatment systems attached with hand-pump

installations, or through a top-down approach i.e. large scale treatment

systems.

Community based efforts don’t seem to work at scale - scalability issues due

to cultural differences

Top-Down approaches don’t seem to work at scale - scalability issues due to

capital constraints, geographic differences

Expectations of substantial change in work-flow/ practices are unreasonable

Non-Market-based solutions are not sustainable when scaled

Scientific Impediments: water pH values

Hence, we came up with a solution that could be implemented at the ‘point

of use’, i.e., domestic level, did not call for substantial changes in practices

that the user was accustomed to, and was market based, and simple to

implement. The solution also doesn’t have a complex work-flow, and followed

the model of a consumer goods business.

To add real value to the end user, we wanted the solution:

Consumer goodTo be available for direct consumption and require minimal/no further processing (not cumbersome to use)

Long shelf life To have a considerably long life-cycle (recurring replacement costs will be eliminat-

ed), with clear representation of expiry/damage (risk of use is reduced)

AffordableTo be a fraction of the price of available alternatives, yet make a margin per unit sales (low-cost, yet sustainable, so we can target the population at the bottom of the pyramid). Be easy to purchase with minimum shopping effort - not many choices, widely marketed and distributed

Use and throw To require no after sale service

Durable To be easy to use, reuse, store, transport and flexible for use between different peo-ple (nonlinear - it could be used as one per household or one per member of house-

hold)

QualityTo render homogeneous and consistent outcomes - output quality/product value does not differ from user to user, does not depend on who uses it.

Flexible, Scalable To be flexible across geographic, linguistic, cultural, and economic differenc-es between communities (ensures scalability)

The extra mileTo not just sterilize water, but go the ‘extra-mile’ and add nourishment to clean water

Rubrics for any solution

Activated alumina efficacy: Activated alumina has a greater capacity for fluoride adsorption at scale,

which is dependent upon the crystalline form, the activation process and

the solution pH and alkalinity [20]. The most important factors influencing

adsorption are pH of water and the crystalline form of the adsorbent. It has

been reported that, in case of activated alumina, the optimum pH for

maximum adsorption is between 5 and 7 (the average pH of groundwater

in India is 6.0-8.0). The relationship between pH of water and the

defluoridation efficacy of AA is a U-curve (figure below) that coincides with

the groundwater pH levels in India. It has been proven experimentally that

the adsorption of fluoride by AIAA increases with increased pH, and reaches

a maximum of 96% at 6.5-7.5 pH, and with further increase, the adsorption

levels decrease. Hence, the optimum pH values to attain maximum

adsorption of fluoride from water coincides with the levels found in India.

Alum Impregnated Activated Alumina:The activated alumina was impregnated [24] with alum by adding 200 ml

of 5% NaHCO3 and 200 ml of 1 M Al2(SO4)3· 16H2O solution to 100 gm of

activated alumina. pH of the solution was maintained 3.4–3.5 by addition of

0.1N HCl. The alum solution remained in the contact with activated alumina

until equilibrium was reached. Preliminary runs showed that 3 h were enough

for loading. Then the alum-loaded activated alumina was washed thoroughly

with double-distilled water until the runoff was clear and dried for 4–5

days at ambient temperature, stored in a reagent bottle. Activated alumina

prepared in this way is referred as alum-impregnated activated alumina

(AIAA).

The Science

Efficacy of AIAA:When a porous substance is coated with particles, logically the surface area

of substance must decrease because the particles would have diffused into

the pores of the adsorbent. However, the surface area of AIAA increases

after impregnation process - this is attributed to the uniform coating of an

amorphous precipitate of (Al(OH)3) of alum on the surface of the activated

alumina increasing the pore volumes.

ACTIVATED ALUMINA

Hence, the efficacy of the (already efficient) Activated Alumina, on being

impregnated with Alum increases due to two reasons - the affinity of the

alum to fluoride, and the increase in the surface area of the porous AIAA

(adsorption is a surface phenomenon).

CHOICE CHOICE CHOICE

ALUM

Powdery material

Flocculant with

Fluoride affinity

Flocculates

Difficult to use

ALUMINA

Crystalline substance

Adsorbent with high

Fluoride affinity

Extreme pH required

Increased surface area

Adsorbent with high

Fluoride affinity

Requires extreme pH

If we could combing the properties of these materials, it would increase efficiency

ALUM IMPREGNATED ACTIVATED ALUMINA

Adsorbent with high

Fluoride affinity

The hunt for AIAA

Works well with

Moderate pH

Reusable

Efficient

A simple non-toxic plastic casing holds the material (AIAA) that absorbs

fluoride from the water very efficiently. Add the water soluble tablets to it (by

clicking the dispenser - detailed below under “Form Factors”), and you get

water free of Fluoride, bacteria, viruses and full of essential nutrients.

The Core Product

Disinfection // Calcium Hypoclorite

Nutrition // Micronutrients

Kills bacteria and viruses

Adds Nourishment

Defluoridation //AIAA

Depending on use case scenarios we have adapted this core product to

various form-factors.

The Paani Bottle: These non-toxic, food grade PET bottles will be targeted

at children between the ages of 8 and 18, and will be marketed through

schools, and community centres. At this age, habits form easily, and they can

be conditioned to drink only out of these bottles.

Form Factors and User Experience

Components

AIAA- Fluoride Adsorbent

Bottle mouth

Plastic casing for filter

Plastic Bottle

Tablet dispenser lid

Micronutrient tablets

Tablet dispenser

Strap

Carabiner

The Paani Ladle: The clean water ladle is a traditional ladle that is made of

food grade plastic to the bottom of which up to 10 of the modular Bullets can

be attached. This is used for larger quantities of water, where the handle is

used to provide tension.

Tablet dispenser

Plastic casing

The Paani Pod: This is AIAA encapsulated in modular non-toxic, food grade

plastic chambers that can simply be dropped into water bottles/containers.

Each of these bullets can be used for 1L water and if they need to be used

for 2, 5, 15, 25 L bottles, the modules can simply be attached together and

detached after use.

Paani Tablet: Each Pod/Bottle/Ladle comes with 6 month’s supply of

tablets- that contain water soluble vitamins, minerals, salts etc. and

Calcium Hypochlorite - a disinfectant.

The Paani Powder is an all natural supplement: mineral enhanced

yeast providing: iron, selenium, zinc, copper, gtf chromium, boron,

iodine, molybdenum and manganese;

Vitamin C incorporated in citrus pulp;

Beta carotene incorporated in carrot concentrate;

Vitamin E combined in vegetable oil;

Yeast concentrate providing; niacin, pantothenic acid, riboflavin, vitamin

B6, thiamin, vitamin B12 and vitamin D;

Biotin, inositol and choline incorporated in corn meal;

Folic acid and vitamin K incorporated in alfalfa concentrate.

To this we add powdered Tulsi/Holy Basil - known to be medicinal

properties and substantial cultural connotation. Verification may be

necessary but known positive effects, and cultural connotation.

The Paani Powder can be targeted at specific deficiencies in specific

geographies such as scurvy, maternal health etc.

Calcium

Defluoridation and disinfecting agent

Vitamin A

Vitamin E

Powdered Tulsi

/Holy Basil

Vitamin B

Iron

Alum Impregnation

Activated Alumina

Cost of nourishing pure water is .18944 Rs/ 0.003$ per liter

Calcium Hypochlorite Disinfectant

Bottle Manufacturing

Labor, Others

Multivitamins,Minerals

Product Cost Breakdown

Plastic Casing

COST OF

0.06

0.010.0089

0.000530.00001

0.01

0.1

CHANNEL

Sakhi Unique Rural Enterprise (SURE) Private Limited was founded in

2009 as Sakhi Retail Private Limited. The organisation specialises in creating

rural retail women entrepreneur-networks focussed on reaching out clean

and green energy product solutions to those at the Base of the Pyramid.

SURE also runs a Micro-Business Incubator - encouraging rural women to

undertake socially conscious micro-businesses by providing them access to

technology, finance and markets.

SURE has built long standing strategic partnerships with leading companies

in the sector for prototyping and producing clean and green products for the

rural BOP markets, supporting such companies in cutting down distribution

costs and reaching the BOP market in an effective manner.

We plan to propose a partnership with SURE to encourage women

entrepreneurs to become local ‘Paani Champions’ - entrepreneurs who act

as distributors and marketers in local communities, encouraging adoption,

delivering training, and ensuring effective use.

Distribution Strategies

Note: While Janalakshmi is a Financial organization (micro-finance institution),

and we are unaware of any partnership between them and water.org, we

explored a non-financial aspect of Janalakshmi’s business model as the basis

of our choice of channel partnership. The access that Janalakshmi has, to the

markets at the Base of the Pyramid, that we are trying to target, is substantial.

It is already leveraging these relationships by partnering with product-based

companies to provide market access to them. This non-financial aspect of

Janalakshmi (although founded on its financial infrastructure) is the value it

holds for Paani Project.

Janalakshmi Financial Services, Established in 2006, is India’s largest micro-

finance organization. It is present in over 170 cities across 19 states, and

focuses on urban and rural poor, with outstanding loans and advances of

almost Rs.6,000 Crore as of September 2015. They services over 1 Cr + urban

and rural poor through their tailored products.

While the bank’s core product is Small Batch loans, Apart from core banking

functions, However, the company also provides individual loans to those who

have demonstrated a successful credit track record as well as loans to micro

and small and medium enterprises (MSMEs). Janalakshmi also distributes

micro pensions and savings accounts on behalf of other financial institutions.

But perhaps the most innovative of their offerings is a debit card -

Janalakshmi lends its SB loans using debit cards (not cash) - a portion of the

lent amount is then directed towards essential products (health beneficial,

basic necessities etc) that are sold to the borrowers through Janalakshmi

itself (the bank becomes a supplier of the goods to its customers, acting as a

channel partner for other companies.

It is this feature that we want to use, to distribute the Paani Pods and the

Paani Bottle to fluoride affected rural and urban areas in India.

Supply Chain Logistics

Project Paani sells product at a margin to Janalakshmi

Janalakshmi makes it available through its Jana Centres and other means

Marketing and awareness is taken care of by Project Paani

Janalakshmi acts as point of sale channel partner and distributes the product

to the target customer

From the Janalakshmi database, we are also able to find out specific user

data and draw analyse these to further iterate the product and understand

the user base.

The Paani Powder seems to offer a log1 reduction in pathogens. However,

most water treatment options offer a greater efficiency. Have you

considered something with a log2-3 reduction? Are there any limitations

to the bacterial kill and virus disablement of the powder? In other words,

if bacterial levels are extreme is there a threshold that the contents of the

sachets cannot cope beyond and/or are there any bacteria (specifically

E.coli and cryptosporidium) that it cannot handle?

The core value proposition of this product is de-fluoridation: which is

the problem in the target market. Both disinfection and nourishment are

peripheral value-adds. For the urban and rural poor in the affected regions,

availability and access to potable water is a relatively less important issue,

compared to the fluoride contamination of such water. The disinfectant,

mixed with the nourishing powder, provides basic Log1 reduction. That said,

we are exploring more efficient options for disinfectants that can be used in

powdered/capsule form, that are water soluble - all suggestions are welcome!

Have you tried any field tests to see what people think of the products?

While no direct field tests have been conducted, we have designed the

products after observing the target group, with minimal disruption to existing

habits. The two products - the Paani Bottle, and the Paani Ladle - both fit

within existing habits of school-going children and housewives (who use pots

or ‘chombus’. We have planned field tests in the coming month.

Given that the Paani Powder is a micro-nutrient, is there any kind of

government safety or approval process required? Has there been a health

impact assessment conducted with the products yet?

Yes, government safety approval processes have to be followed and obtained.

But the micronutrients are standard issue - lab tested for impact, and having

consulted with experts, we don’t expect any hassles in the approval process.

The approval is not just mandatory, but will help gain traction with channel

partners.

Exploring FormsThe Leaf Pod was a primary iteration in our form factor explorations. The idea

was to maximize surface area for increased contact with the AIAA and also

allow the user to take advantage of the modularity of the pods to fit different

containers and scenarios.

Components

Bottle cap.

Allows any strap to be

attached

Plastic casing for filter

Plastic Bottle

Pod Rack

OTHER FORM FACTORS EXPLORED

Pods can be detached from

the pod rack and used in other

containers

A ‘chombu’ is a traditional container

that people in India store their water

in and also drink out of. The leaf pod

can be detached and clipped onto

the rim of the container.