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Accident – Death – Obituary News : : 1. Kidney disease Sri Lanka
2. Farming community health Sri Lanka
In the peaceful village of Ambagaswewa in Polonnaruwa, Sri Lanka, 63-year-old rice farmer TMH Gamini Sunil Thennakoon is facing unexplained kidney problems, a common issue in the region. Along with his neighbor U Subasinha, who also suffers from kidney disease, they struggle with the financial burden of treatment. This chronic kidney disease of unknown cause (CKDu) is a growing concern in rural Sri Lanka, affecting farming communities disproportionately. Researchers have linked the disease to agricultural irrigation water sources. Early detection is challenging as symptoms are often asymptomatic until the disease progresses. Access to affordable treatment remains a major issue for those affected. Mujahith highlights a geographical link to the prevalence of Chronic Kidney Disease of unknown etiology (CKDu) in Sri Lanka, particularly in eastern and north-central provinces. A WHO study in the 2010s failed to identify the exact causes, but Mujahith suggests a connection to toxic agrochemical exposure among agricultural workers. As the nation faces its worst economic crisis, access to treatment is limited, especially in remote areas like Ambagaswewa. Researchers like Jayasundara and Gunasekara emphasize the importance of education in reducing agrochemical use and promoting hydration. The economic crisis exacerbates the situation, leading to chronic dehydration among fishing communities like those in Batticaloa. The causes of Chronic Kidney Disease of Unknown Origin (CKDu) in Sri Lanka are multifaceted, including hereditary issues, contaminated water sources, pollution, toxins in agrochemicals, improper pesticide disposal, and unhealthy lifestyle choices. Fishermen, who are exposed to arrack to combat seasickness, face additional stress on their kidneys. The lack of formal fishing collectives hinders understanding of the impact of ocean resource depletion on their health. Food scarcity, exacerbated by economic crises, further complicates the situation. Geological shifts due to climate change and rising sea levels pose additional risks. Crippling debt from medical expenses adds to the burden, highlighting the urgent need for intervention in addressing CKDu in Sri Lanka. our latest product launch. Our newest product is a revolutionary solution that will transform the way you work. With its cutting-edge technology and innovative features, this product is designed to streamline your workflow and increase productivity. Whether you are a small business owner or a large corporation, this product is perfect for any organization looking to stay ahead of the competition. With its user-friendly interface and customizable options, this product is sure to meet all of your needs. Don’t miss out on this game-changing product – order yours today and experience the difference for yourself.
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Since then, efforts have been made to understand the root causes of the disease and find solutions. Dr. Mujahith explains that the lack of early symptoms makes it difficult to diagnose CKDu in its early stages when treatment could be more effective.
The exact cause of CKDu is still unknown, but researchers have pointed to various factors that could be contributing to the high prevalence of the disease in certain regions of Sri Lanka. One theory is that the use of agrochemicals in farming practices could be contaminating the water sources in these areas, leading to kidney damage in residents who consume this water.
Another possible factor is the high prevalence of heat stress and dehydration among farmers, which could be putting additional strain on their kidneys. Additionally, poor access to healthcare and lack of awareness about kidney disease in rural communities could be delaying diagnosis and treatment for affected individuals.
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In response to the rising cases of CKDu in Sri Lanka, the government has implemented various programs to provide screening and treatment for affected individuals. However, more research is needed to fully understand the causes of the disease and develop effective prevention strategies.
For individuals like Thennakoon and Subasinha, living with CKDu means facing daily challenges and uncertainties about their future. As they continue to cope with the symptoms of the disease and navigate the complexities of accessing healthcare, they remain hopeful for a better tomorrow.
As the sun sets over the rice paddies of Ambagaswewa, the peaceful village is a stark contrast to the silent struggle faced by its residents. With continued efforts to research and address the root causes of CKDu, there is hope that one day, the villagers of Polonnaruwa and other affected regions in Sri Lanka will no longer have to live in fear of this debilitating disease. There’s a geographical link, says Mujahith – some parts of the eastern and north-central provinces seemed especially hard hit. Many, like himself, wanted to investigate further and identify the causes. A World Health Organisation (WHO) team even came to investigate the causes of CKDu in the 2010s, but ultimately the study was inconclusive.
Mujahith likes to use the term “chronic interstitial nephritis in agricultural communities” (CINAC) since the disease is rather specific to the nation’s agricultural workers. It affects mainly men – most patients live and work in poor agricultural communities and may be exposed to toxic agrochemicals through work, inhalation, and ingesting contaminated water and food, explains Mujahith.
Sri Lanka, a small tropical nation with a population of about 22 million people, is undergoing the fifth year of the worst economic crisis in its history. The result has been limited access to medicine and food which hinders treatment and management of the disease, particularly in remote and under-served places such as Ambagaswewa.
‘Education is key’
Jayasundara, who grew up in a farming village in southern Sri Lanka, is currently working to isolate the factors of CKDu in his research, which examines phenomena such as how agrochemical concentration increases during drought (due to evaporation), or how the economic decline has affected the rest of the country. Chronic disease in one specific organ of the body – in this case, the kidneys – can be a telltale sign of environmental harm, he says. “Sri Lanka serves as a clear example of how environmental change leads to so many downstream effects that affect people’s lives.”
The confounding cause of CKDu means it’s difficult to prescribe solutions for villagers, although those with the means are switching from drinking groundwater to filtered water. Filtered water is not an option for many, however. “If you’re choosing between food and sending your kids to school, you’re not going to be spending money on filtered drinking water,” says Sumuthuni Sivanandarajah, a marine biologist working at Blue Resources Trust, a marine research and consultancy organisation based in Sri Lanka. Her work focuses on the self-employed fishing communities along the coasts of Sri Lanka, among whom kidney disease is also on the rise.
Sameera Gunasekara is a research scientist at Theme Institute in Sri Lanka exploring how climate change and diverse environmental exposures affect public health – specifically kidney diseases. He agrees that the economic crisis has made it harder for people in remote farming and fishing communities to buy water filters. “People know, are conscious that clean water helps,” he explains. “But there’s some misunderstanding. [People] think that chlorinated water, or boiling, will help. That does with bacteria, but not the removal of hazardous materials.” The need for more education in these underserved regions is key, says Gunasekara.
Across the afflicted north-central farming provinces, Gunasekara is working to help educate the local population on reducing agrochemical usage, not staying in the sun for a long time, and preventing dehydration. “Farming and fishing people have a stereotype, they are hard groups to convince,” the researcher continues. To begin with, biomarkers for the initial stages of the disease – back pain and leg swelling – are very subtle; not everyone experiences them. But even those who do experience them may not pay them heed. “They just take a painkiller and get back to the field – they tend to suffer for a long time without doing proper [kidney] screening.” For many of these households, says Gunasekara, since the father is the only person earning money, the whole family collapses when he falls ill.
An economic crisis and chronic dehydration
Batticaloa on Sri Lanka’s east coast, known for both its aquaculture and agricultural activities, in the form of shrimp farms and rice and fish processing facilities, was the site of a brutal massacre during the nation’s relatively recent, longrunning civil war between the Sinhalese and Tamils. It is also one of the hotspots identified for the prevalence of CKDu, he says. The civil war was an ethnic conflict that lasted for 26 years, ending in 2009 after killing more than 100,000 civilians and 50,000 soldiers from both the Tamil and Sinhalese sides.
Christy PL Navil, 58, has been working as a fisherman here for 12 years – before that, he worked as a helper on the boats. Along Pasikuda beach near Batticaloa, a landing site where 106 fishermen work each day, Navil fishes for calamari from 5am, not returning until the afternoon. “Sometimes it’s many fish, sometimes it’s no fish,” he says. On the boat, they bring very little water considering the conditions – just 5 litres for two people to last for more than nine hours in the tropical heat. “The sun is hot, but we are just used to it. Sometimes fishing is busy, we aren’t drinking water or eating,” the fisherman admits. “We want to catch the fish.”
With the economic crisis, many fishermen also have to cut back on food, only taking one meal a day. The resulting chronic dehydration is a major problem, says Sivanandarajah.
Exploring the Causes of Chronic Kidney Disease in Sri Lanka
Sri Lanka has been grappling with a silent epidemic of Chronic Kidney Disease of unknown origin (CKDu), particularly affecting rural communities in the country. This mysterious disease has been a cause of concern for researchers and healthcare professionals, who are working tirelessly to uncover the factors contributing to its prevalence.
One leading researcher, Dr. Sivanandarajah, points to a combination of hereditary issues, water sources and pollution, toxins in agrochemicals, anthropogenic factors such as improper pesticide container disposal, and lifestyle choices as potential causes of CKDu. The complex interplay of these factors makes it challenging to pinpoint a single root cause of the disease.
Moreover, the lack of formal fishing collectives or societies in Sri Lanka has left self-employed fishermen vulnerable to the impacts of ocean resource depletion. These communities, reliant on the sea for their livelihoods, face health ramifications that are not fully understood due to the absence of comprehensive data collection and analysis.
One concerning trend highlighted by Dr. Sivanandarajah is the reliance on local “arrack” – a form of liquor – by some fishermen to manage seasickness. This practice, combined with rising temperatures, can exert additional stress on the kidneys, potentially exacerbating the risk of CKDu in these communities.
The Impact of Environmental Factors on CKDu
Geological shifts linked to climate change can also play a role in increasing the risk of CKDu in Sri Lanka. The use of tube wells, which extract hard water from deep below the surface, has become popular in response to natural disasters like tsunamis and monsoons. However, this water extraction method can lead to the ingestion of minerals that are harmful to the kidneys.
Furthermore, the rising sea levels associated with climate change pose a threat to coastal communities, inundating them with brackish water that can further exacerbate the water quality issues in these regions. These environmental factors, combined with anthropogenic influences, create a complex web of challenges for researchers seeking to understand and address CKDu.
The Human Cost of CKDu in Sri Lanka
Individuals like Nadaraja Pereatambi, a fisherman from Pasikuda beach, have experienced the devastating impact of CKDu firsthand. After undergoing emergency treatment for acute kidney pain, Pereatambi was left with crippling debt due to the exorbitant hospital bills. Many fishermen in his community also suffer from kidney issues, highlighting the widespread nature of the disease in Sri Lanka.
Similarly, individuals like W Sirani Silva in Negombo face daily struggles with CKDu, relying on dialysis treatments and awaiting a kidney transplant. The financial burden and emotional toll of managing this chronic illness are immense, affecting not only the patients themselves but also their families and support systems.
As the search for answers to the CKDu epidemic in Sri Lanka continues, it is clear that a multifaceted approach is needed to address the complex interplay of genetic, environmental, and lifestyle factors contributing to the disease. By raising awareness, conducting further research, and implementing targeted interventions, there is hope for mitigating the impact of CKDu on the affected communities in Sri Lanka.
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