Dusk is already beginning to settle on the small village of Saibandathanda in the district of Nalgonda in central India, but it does not bother Suvarna Ramavath.

Undeterred by the fading light, she makes deft strokes onto a page adorned with intricate sketches of peacock feathers. Behind her pictures of women in lavish pink saris dance across the walls.

But the scene, which could be straight out of one of the 23-year-old’s favourite Bollywood movies, is a far cry from the day-to-day reality of her life. Suvarna is crippled by the debilitating bone disease fluorosis and she has not left the bed where she is now sitting for seven years.

Drawing, she explains, is her escape. “If I use my imagination, I can draw whatever I like.”

Prevalent across rural India, fluorosis is caused by excessive consumption of the mineral fluoride, usually through drinking contaminated groundwater. As fluoride builds up in the body it leads to skeletal deformities.