Forty nine year old R.L.Prematilleke sits in front his tea kiosk in the village of Kokunnawa in Nochchiyagama in the Anuradhapura district. He is suffering from a kidney disease that has left him debilitated and unable to engage in farming thus depriving his family of their main source of income.
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| A villager in Nochchiyagama looks on at a tube well that was once a lifegiver and now perhaps one of their deadliest enemies. |
Villagers show the damaged
aluminium pots in which they kept water from the tube wells |
Tragically, in this village and in many others in the North Central Province (NCP) this is a common ailment. Kidney disease is striking healthy individuals at an alarming rate and those in the medical profession are still baffled as to what the exact cause is.
The villagers too have no clue as to why so many of their fellow villagers have either died or are dying of kidney-related diseases. The possible causes range from drinking water from tube wells, to exposure to fertilizer used by farmers to eating fish, bred in tanks.
“In other areas of the country, those who suffer from kidney diseases have other concurrent conditions such as hypertension or diabetes which could lead to kidney malfunction. However, in the NCP, Uva and some areas in Kurunegala and Hambantota, we have healthy individuals contracting the disease. This is what is baffling,” Medical Officer of the Nephrology Unit at the Anuradhapura General Hospital, Dr.Dedunu Dias told The Sunday Times.
There are about 4,000 registered kidney patients in Anuradhapua district alone with at least 200 patients dying of the disease each year. Most of the victims are middle aged farmers.
Nimal Rajaratna is a teacher from Nochchiyagama. His father died of kidney failure two months ago and since then he has taken a keen interest in learning about fellow villagers who are afflicted by the same malady and he is encouraging senior students at the Nochchiyagama Vidyadharsha Maha Vidyalaya to do their own research. “Not enough effort has been put into finding out why people in this area are developing kidney disease. It is more than 10 years since the phenomenon was identified but so far the root cause has not been diagnosed and people are continuing to fall sick and die,” he lamented.
A visit to the village of Kokunnawa revealed that households that had installed tube wells about 15 years ago and were using the water for drinking purposes, had family members who are either suffering from kidney disease or have died of it.
They believe it is the water from the tube wells that have caused the disease. To back their theory they say the aluminum pots they used to keep the water in began to develop holes in them.
P.Keerthiratna who lives a few doors away from Prematilleke’s tea kiosk lost his wife recently to kidney disease. “My wife lived for two years after we were told by doctors that her kidneys were damaged. By the time the disease was diagnosed she was too ill to be treated,” he said.
Rukmani Siriyalatha is another villager who lost her husband to the same ailment. “People dying of kidney disease is a common occurrence in this area,” she says. “Most of the villagers have now discarded the aluminum pots and have instead turned to plastic or earthenware,” school teacher Nimal Rajaratna said.
Pipe-borne water too was introduced to the village six months ago and a majority of the villagers have stopped drinking the water from the tube wells. However, for years the tube wells had been a blessing to the peoples of the dry zone districts, where wells and massive tanks run dry during the drought. “We relied on water from the tube wells for drinking, cooking, bathing and washing purposes during the dry spells. We had no idea that we could be falling sick as a result of this water,” he said.
The villagers of Nochchiyagama were informed on September 10, that they should undergo screening for early detection of the kidney disease. The screening is done by taking urine samples that are tested for the presence of albumin in the urine. If there are three positive tests, then further tests are carried out to ascertain the stage of the disease and the necessary treatment is then started.
“Most sufferers of the disease don’t show symptoms until they are in an advanced stage and by that time it is difficult to treat them,” Dr. Dias explained. However, early detection and regular monitoring and necessary treatment, means many could hope to live a relatively full and healthy life, he said.
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| R.L.Prematilleke unable to work as a farmer |
Despite the obvious benefits of early detection, there does not appear to be a concerted effort in screening as well as conducting research into the high incidence of kidney disease in the NCP and other affected areas.
It is only about two months back that the Health Ministry undertook large scale screening of residents in the districts where kidney disease is prevalent with the World Health Organization too stepping in. “We hope to have a better idea of what the causes of the high incidence of the disease are in about a year, by which time the programme should be completed.
What we have had so far has been ad hoc work on the subject which is insufficient,” Dr. (Mrs) Paba Paliyawadana, Deputy Director of the Epidemiological Unit of the Health Department said. It is this Unit that handles the bulk of the work in this connection.
“We have found that one fifth of all kidney patients in the country are in the NCP and the inability to pin point a cause is hampering its prevention,” he said.
Much of the treatment for seriously ill patients is now centered in Kandy but a new Renal Care and Renal Research Centre is nearing completion in Anuradhapura which will enable patients to get treatment closer home. | 
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