Mystery kidney disease spreads in Sri Lanka

Photo: Dilrukshi Handunnetti/IRIN Farmers, mostly over 40, continue dying from a kidney disease of unknown origins

!"# $% P"# & '(L(M)(, * March +0,4 -.#.!/ 0 .ncreasing incidence of a chronic kidney disease of unknown aetiology -'1$u/ is 2uickly turning into Sri Lanka3s latest health crisis, with hospitals in the country3s most affected province linking 40 percent of patients3 deaths to renal failure5 6he disease some refer to as an 7unknown plague8 has triggered internal migration, particularly among youths living in disease0prone areas5 Scientists have failed to identify a cause, thwarting efforts to prevent the disease which leads to renal failure, and at worst, death5 )ased on hospital records, men over 40 seem to 9e most at0risk, which has pushed many households in the island3s north0central region -the most affected nationwide/ to encourage young men to migrate5 Manamendra Padmasena,: 44, a farmer from the capital of !orth 'entral Province -!'P/, nuradhapura, has undergone treatment for '1$u for the

past si; years5 %e takes 44 ta9lets a day, in three doses and re2uires constant hospitali<ation year0round5 %is wife has also 9een diagnosed with the disease5 =e can3t find work 9ecause we are unfit5 (ur two sons do farming work 9ut also work as unskilled la9ourers to support the family,8 Padmasena told .#.!5 Sumana, his wife, is worried a9out her sons3 future and tearfully claimed their marriage prospects were 7<ero8 9ecause of their parents3 ill0 health5 =e are a 9urden to our children5 >illagers don3t want to give their daughters in marriage to children like ours, fearing they too will end up with renal failure58 6heir neigh9our, galawatte Padmasiri3s: three children left the area 0 an increasingly common phenomenon as people flee the disease, say villagers 0 when some of their family mem9ers were diagnosed with the disease5 7.f they stayed, there would have 9een no employment and no marriage,8 Padmasiri told .#.!5 'onfirming the trend, $r sanga #anasinghe, director of the Provincial #enal $isease Prevention "nit of nuradhapura ?eneral %ospital in !'P -the island3s most affected province/, said patients3 families found it difficult to marry their relatives 9ecause prospective partners often feared higher suscepti9ility to renal failure5 People suffer from a fear psychosis and lack awareness5 6here is a 9elief that '1$u is communica9le and even genetic5 .f family mem9ers are diagnosed with '1$u, others will have reduced chances in marriage5 6his health stigma is driving youth away from homes,8 said %emantha >ithanage, e;ecutive director of local !?( 'entre for @nvironmental Austice, which has helped conduct disease research5 +0,000 patients in one province 6he =orld %ealth (rgani<ation -=%(/ estimates there are appro;imately +0,000 '1$u patients undergoing care in !'P, with the most densely populated district, nuradhapura, where the disease was first reported in +000, recording the highest num9er of patients5 #anasinghe said the province3s monthly death rate average as of the end of +0,B due to renal failure was ,C, the island3s highest5 Some +,000 cases were reported countrywide in +0,B with the electoral

divisions of Medawachchiya and nuradhapura -where there were nearly ,,*00 reported deaths linked to '1$u from +00+0+0,0/ in !'P reporting the most5 ccording to #anasinghe, the annual increase in kidney patients in nuradhapura is appro;imately ,,4D0, and 4D0 in the provincial district of Polonnaruwa5 %ealth officials 9anned the import of three pesticides -chlopyrifos, propanil and va9arly/ last pril after local researchers linked agrochemicals to the disease5 griculture Minister Mahinda Eapa 9eywardena told .#.!: 76hese pesticides are e;tremely harmful to human health5 @ven if there is no direct link, this is preventive action58 6he %ealth Ministry spends some "SFB million annually to treat persons diagnosed with '1$u5 6he government provides kidney patients receiving regular treatment with a monthly stipend of a9out near F4 and those on dialysis, F,,5 $ata pro9lem 6hough hospitals maintain registers of '1$u patients, data is still spotty, said #anasinghe5 7(ut of ,0 hospital deaths in the !'P, eight are linked to renal failure58 %e added that many sick patients go undetected in the villages5 6wo research reports pu9lished in +0,+ on '1$u3s causes disagreed over statistics and pro9a9le causes5 (ne report 9y =%( estimated ,D percent of the population in !'P and "va Province -working out to 9e some *0,000 people/ had '1$u, and that ++,000 had died in the past +0 years in nuradhapura alone from it5 6here is evidence, according to =%( research, that the disease is spreading to the Southern, "va and @astern Provinces5 Meanwhile, the !ew $elhi09ased 'entre for Science and @nvironment -'S@/ in a parallel survey placed the figures at over ,D,000 people in !'P, indicating water contamination as a possi9le source5 6his only highlights the need for relia9le scientific research, (liver .lleperuma, head of the chemistry department at Peradeniya "niversity in Sri Lanka3s 'entral Province, told .#.!: 76here are multiple causes identified through different research attempts5 .t is important to treat this as a growing health crisis and increase preventive programmes58 :!ames changed to protect privacy dh&pt&c9

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