This concept paper published by MDPI, 2019
Fluorosis has been prevalent in the great East African Rift Valley (EARV) since before this
region was given a name. In the Tanganyika days, Germans reported elevated fluoride concentrations
in natural waters. In the 1930s, the clear relationship between high fluoride level and mottling of
teeth was established. Since then, the global research community has engaged in the battle to provide
fluoride-free drinking water, and the battle is not yet won for low-income communities. An applicable
concept for fluoride-free drinking water in the EARV was recently presented, using the Kilimanjaro
as a rainwater harvesting park. The Kilimanjaro concept implies that rainwater is harvested, stored
on the Kilimanjaro mountains, gravity-transported to the point of use, eventually blended with
natural water and treated for distribution. This article provides a roadmap for the implementation
of the Kilimanjaro concept in Tanzania. Specifically, the current paper addresses the following:
(i) presents updated nationwide information on fluoride contaminated areas, (ii) discusses the quality
and quantity of rainwater, and current rainwater harvesting practices in Tanzania, (iii) highlights
how low-cost water filters based on Fe0/biochar can be integrating into rainwater harvesting (RWH)
systems to provide clean drinking water, and (iv) discusses the need for strict regulation of RWH
practices to optimize water collection and storage, while simplifying the water treatment chain, and
recommends strict analytical monitoring of water quality and public education to sustain public
health in the EARV. In summary, it is demonstrated that, by combining rainwater harvesting and
low-cots water treatment methods, the Kilimanjaro concept has the potential to provide clean drinking
water, and overcome fluorosis on a long-term basis. However, a detailed design process is required
to determine: (i) institutional roles, and community contributions and participation, (ii) optimal
location and sizing of conveyance and storage facilities to avoid excessive pumping costs, and (iii)
project funding mechanisms, including prospects for government subsidy. By drawing attention
to the Kilimanjaro concept, the article calls for African engineers and scientists to take the lead in
translating this concept into reality for the benefit of public health, while simultaneously increasing
their self-confidence to address other developmental challenges pervasive in Africa.