Editor's note: Deseret News Staff Writer Tad Walch traveled to India during the summer. This is one in a periodic series of stories chronicling humanitarian aid provided by The Church of Jesus Christ of Latter-day Saints.

MAHAMMADABAD, Telangana, India — A grandmother is up with the early August sun. She expertly wraps a purple-and-white sari around a green shirt and slips outside by 6 a.m. carrying an empty, 5-gallon steel pot.

The humidity never sleeps, but Galamma Janagam, 62, has to work today. She is Mahammadabad's sanitation sweeper. She sweeps dirt in a village with no paved roads. She makes about $3 a day, and she needs the money.

Galamma is barefoot and her back and joints ache. She has known the source of her pain and her son's deformity for 20 years.

"The entire village suffers from this pain," she says. "I suffer, but I still have to sweep every day, because it's a living for me."

Today she has decided to make the four-mile walk past coconut trees and water buffalo to buy clean water and carry it home on her head.

Twice.

The day before the pain and the distance was too much to make both the morning and evening trips. Instead, she and her family drank the local well water, which is free, despite what they know it has done to them.

Her son is bow-legged, like many in the village. She and the rest of her family suffer from joint and back pain, body aches, kidney stones and brittle, discolored teeth. The villagers have begged government leaders to help. One microfilter project in the region is complete, but it supplies clean water once every two weeks to just 25 percent of the villages.

None reaches Galamma. Now she worries for her 9-month-old grandson. Will he suffer muscle weakness and chronic fatigue? Will he develop irreversible bone deformation or osteoporosis? Will he be crippled?

The questions drive her. So she walks the four miles for clean water. Twice. Everyday she can.

Another villager shakes his head.

"From 90 years to nine months, everyone is suffering," Pramuku Reddy says.

Unlikely partners

Miles away on a different day, Elder Barry Hubbard laughs. The 55-year-old American has spent 15 months in India, and he and his wife, Sister Jennifer Hubbard, love sharing it with a visitor. Today they are in a van with one and, serendipitously, it seems like all of India's quirks have converged at a single chokepoint.

Rice paddies line a tiny, countryside intersection. The crossroad is jammed with colors, cars, motorcycles, scooters, a bus, goats and a dog. It's monsoon season, it's humid and overcast, and it's raining. About 30 inches of rain will fall in three months. Water buffalo are visible in the distance. So are palm trees and coconut trees.

Now the visitor laughs, delighted as the drivers add to the scene by honking at each other. Hubbard, who lives in New Delhi with its 21 million people, sees the blaring differently.

"If I never hear another horn again, I'll be happy," he says.

The Hubbards left Sandy, Utah, 15 months ago with an assignment to serve in New Delhi as a senior missionary couple for Public Affairs for The Church of Jesus Christ of Latter-day Saints. On their first day in India, they were drafted to help with the church's humanitarian efforts.

They travel all over the country, networking and negotiating with local political leaders, overseeing new ventures, and auditing completed projects.

They have a secret weapon in the state of Telangana. His name is Sudhakar Yarkala. He grew up in a poor village near Mahammadabad, but now he runs a Honda dealership in the state's capital of Hyderabad, selling the scooters and motorcycles that are ever-present on India's roads.

Yarkala is serious about giving back to the poor villages of his boyhood, where people live on $1 to $3 a day. In 2007, he saw a need for wheelchairs in the area and approached Mormon missionaries helping with a project to ask whether they could help. LDS Charities donated eight wheelchairs to local villagers.

The LDS Church has 13,000 members in India, which with 1.34 billion people is expected to surpass China as the world's largest country by 2020. Eight wheelchairs is a drop in a very large bucket of need. But small, effective singular drops are a start to filling a bucket.

The church and LDS Charities have also provided 150 bore wells to villages in this area. Elsewhere in the country, they have involved in 371 projects, from providing vision care, prosthetics and immunization to teaching self-reliance classes and training in maternal and newborn care.

Yarkala learned the lesson. He began to identify needs. He and the church partnered together to fill them. He regularly consults with Shekar Alamury, a Mormon from the Hyderabad suburb of Madinaguda, who works part-time for LDS Charities.

Earlier this year, Yarkala told Alamury and the Hubbards about Mahammadabad and its water woes.

Fluoride poisoning

"The fluoride here is at toxic levels," Hubbard said. "It makes bones brittle and bend, even in the womb. Their children don't have a chance."

Villagers who drink well water in the village also regularly develop brittle teeth, sore joints and worse. Fluoride poisoning is an epidemic in Mahammadabad and the surrounding areas of this part of southern India.

"This village has the highest fluoride concentration in India," Yarkala says.

It's true. The well water here contains more than four times the permissible limit, according to a report by the Geological Survey of India.

Why?

The reason is right here in the ground. The rocks are rich with fluoride that contaminates the groundwater, according to the International Journal of Research and Development of Health.

The result is skeletal fluorosis, which creates pain in the bones and joints. In later stages it can calcify bones, fuse the spine together and cripple the victim. It also can ossify ligaments and rupture the stomach lining. It is largely irreversible.

Dental fluorosis causes teeth to become pitted and turn yellow, brown and black.

Galamma said other bacteria in the water cause skin diseases and other issues.

Buying clean water isn't only difficult, it's relatively expensive. Galamma spends 5 percent of her daily income on purified water. She pays 10 rupees for 20 liters of water. That's about 15 cents for 5 gallons.

The average American pays less than a penny for 5 gallons of tap water.

"It is a financial hardship," Hubbard said.

About a quarter of the time, the women of Mahammadabad physically or financially can't or simply don't make the walk.

Their families then play fluoride roulette.

Water celebration

"The only way to get heavy metals like fluoride out of the water is to filter it," Hubbard said.

Galamma has longed for a solution to protect her family, especially her grandson, but she has had no way to fashion one herself. She is nowhere near alone.

Over half the groundwater in India has fluoride above recommended levels, according to a study published in Neurology India. The same report estimated that fluoride poisoning has disabled an estimated 6 million Indians and that another 60 million are at risk.

LDS Charities began to address the problem a decade ago. Since then, it has donated reverse osmosis water filtration systems to 145 villages like Galamma's. Each system costs $3,250. The project is accelerating. Half of the systems, helping 72 villages, have been installed in the past three years.

LDS Charities has approved systems for an additional 48 villages.

Finally, on Aug. 17, it is Mahammadabad's turn.

Galamma's excitement is palpable. Most of the village's men are working in the fields, but she and about 40 other women are waiting when Yarkala, Alamury and the Hubbards arrive for what LDS Charities calls a water celebration.

A state legislator is late, but the women turn the delay into an opportunity. Laughing, they spirit away Sister Hubbard, whom they've never met, into a neighboring building. They can barely communicate because Hubbard doesn't speak Telugu and the villagers speak very little English.

It doesn't matter. Love is enough.

They all emerge 20 minutes later smiling broadly. For the first time during her mission, Sister Hubbard is wearing a colorful sari wrapped over her blouse and skirt, with new dangling earrings and beaded necklaces and bangles on her wrists. She has a red dot, the traditional Hindu bindi, on the center of her forehead.

Now Galamma and the rest of Mahammadabad are ready for fresh water.

'Skin in the game'

Before filtered, fluoride-free water flows in a village, the church requires that villagers agree to take over the system.

"This is the model LDS people want," says Manohar Tirumala, owner and director of Liquid Services, which contracts with LDS Charities to install the water systems. "The local political leaders are not accustomed to that."

First, each village forms a water committee, which hires a water master, who will oversee the line and keep records.

"The water committee members are so proud to be involved with something that does so much for their village," Elder Hubbard said. "It gives them some 'skin in the game.' If the villagers have a part in building it and managing the water, they take responsibility for the entire operation."

Each community commits to build a building for the unit, typically cinder block but sometimes bamboo, with a concrete floor. The villagers also commit to supply the raw water and electricity to the building.

The villagers also will pay for the water, 5 rupees for 20 liters, or half what Galamma had been paying two miles away. There are good reasons for charging for the water.

"We need to charge them," says Alamury, the LDS Charities employee. "Otherwise, they start washing their clothes with it, too. This water is only for drinking."

The money pays for the electricity that pumps raw water from a bore well into the building and powers the filtration system. It pays the water master's salary. It pays to replace filters. Finally, the water master will save money from the payments to finance a replacement system. The Hubbards conduct audits, checking to see how much is being saved.

"It's about self-sustainability," Elder Hubbard says. "We buy the reverse osmosis plant, but then the community charges for the clean water. That cash flow buys the filters and maintenance to keep the machines running for years."

The machine should last eight years. The systems are simple, but sometimes villagers make mistakes and damage occurs. About 80 percent of the units supplied here by the church over the past decade are still running.

First in line

Raw water pumps into a 3,000-liter tank, then goes through a five-stage water purification process. A sand filter removes bits of mud and dirt. An activated carbon filter removes odors and gasses. Next, a micron filter removes micron particles. Then, fluoride and other metals are cleared out by a semipermeable membrane called a reverse osmosis filter — "the heart of the plant," Tirumala says. Finally, UV light kills all the bacteria in the water for 72 hours.

Purified water gathers in a 2,000-liter tank. A short pipe leads through a pink wall to a spigot outside.

The state legislator has arrived and suddenly more than 150 people are crowding around the new building. Hubbard's face transforms into a mixture of dread and determination. At every water celebration, she is asked to join politicians in christening the new system by smashing a coconut on the doorstep of the building. She hasn't mastered the trick, and her wrist is still sore from the last attempt.

This one goes no better, but everyone laughs with her. Tirumala turns on the reverse osmosis unit, then steps in the coconut milk on the floor to go outside and turn on the spigot.

Galamma is delighted to be first in line. It's 11:51 a.m. For the first time, Mahammadabad has fresh, running drinking water, and her steel pot swallows the first drop.

"I'm very happy," she says, mentioning her 9-month-old grandson. "He's going to be healthier. I feel good because it will take care of the people."

Sister Hubbard exchanges hugs with her new friends.

"It's what every mother wants, is to have healthy children," she says. "This encompassed everything in the Relief Society song, 'Because I have been given much... .'"

'We will remember'

Sister Hubbard is crying as her car pulls away from Mahammadabad. The Hubbards have been at water celebrations that lasted 10 minutes. This time, they were on site for nearly two hours.

"This was much more personal," she says. "This one we got to spend time. I felt a connection. They were my sisters. I felt included. For the first time in India, I felt like I was one of them. It's just the same with women all over the world. They just want to include you."

Mahammadabad is a small village, with 500 people. Alamury says the biggest village in the LDS Charities water project has over 5,000 people. The Hubbards are negotiating with at least one large city, but government officials there have not been able to agree to the church's self-reliance model.

Maybe the Hubbards should bring Galamma to the negotiating table.

"I'm very happy that the church is doing this," she says. "We will remember forever what the church has done here. Every time we drink a glass of water, we will think of you."

To donate to the LDS Church's humanitarian fund and help provide reverse osmosis systems in India and elsewhere, visit ldsphilanthropies.org.