In addition to having to live with a war raging around them for the past two decades, the people of the North Central Province have had to face another battle. The battle: Chronic Renal Failure. The reason? Unknown. The bottom line however is that thousands are affected by it. In fact, the statistics are frightening.

Around 5-10% of the population in the NCP has some evidence of Chronic Renal Failure. And year after year, the North Central Province records the highest number of deaths due to CRF in the country. At the Anuradhapura Hospital, CRF tops the list of causes of death. The majority of these patients are farmers between the ages of 40 and 60 years, who are the breadwinners of their families. They have had to make a long and difficult journey to the Nephrology and Renal Transplant Unit in Kandy for treatment.
Seeing this desperate situation, two eminent doctors, Dr. A.M.L. Beligaswatte and Dr. Tilak Abeysekera who spearheaded the founding of the National Kidney Foundation, embarked on a project to construct a Renal Care and Renal Research Centre in the North Central Province, to meet the needs of the patients of the area.

Nearing completion: The new hospital

“The province has been in need of a unit such as this for a long time now,” explained Dr. Beligaswatte. “We have found that one in every ten persons in the North Central Province shows evidence of early kidney disease. A significant number of them are young children who remain undetected until the disease is well advanced. The majority of them are from the poor farming community, who cannot even afford to pay for public transport to travel to Kandy or Colombo to seek treatment.”

Apart from providing treatment, the centre will also conduct research and undertake awareness programmes. As of now, the possible causes of the disease that have been identified are: the fluoride content in the water of the province, dehydration, insecticide in the water, and illicit brews such as Kasippu. There is also a suspicion that the fluoride in the water could have an adverse reaction with the aluminium utensils used for boiling water. “This is not a proven cause of the disease,” said Dr. Beligaswatte, “But as a precaution, we have advised people in the area to go back to using earthenware pots for boiling water; we have also been providing fluoride filters for their water and doing screening tests to be able to detect CRF as early as possible.”

Work on the hospital site is almost complete, but for the project to be completed successfully, more funds are urgently required. Inclusive of building costs and the cost of equipping the new Centre, the funds required amount to approximately Rs. 100 million, Rs. 15 million of which is needed urgently.
“Considering the gravity of the problem and the ongoing need for treatment of these patients, we have already begun to recruit staff and doctors, and have started a clinic on the ground floor of the building even though work on the upper floors has not reached completion,” Dr. Beligaswatte said.

In addition to this, Drs. Beligaswatte and Abeysekera hope to open a dialysis section in August to meet yet another urgent need- of the 2000 patients who have registered at the unit so far, 600-800 of them are in need of dialysis.

At present, there are only a few centres both in the government and the private sector equipped to treat patients with CRF. Whilst the minimum number of dialysis machines needed to treat these patients is about 700, there are only 30-40 machines in the whole of Sri Lanka.

What is CRF?

Chronic Renal Failure is a condition in which kidney function gradually declines, until the kidneys are unable to filter wastes from the body, maintain the proper balance of water and chemicals such as sodium and potassium in the bloodstream, or produce urine.

It is usually associated with uncontrolled diabetes, hypertension or kidney stones. However, in the case of the patients from the North Central Province, the reasons for CRF are not these. Research is being conducted to find the causes of the epidemic.

In Sri Lanka, on average, about 2000 patients with CRF are detected annually. The majority of them are young married males in the most productive periods of their lives.

Unfortunately, there are only five nephrologists in Sri Lanka, who are able to provide expert care for this growing number of patients.

An appeal

To accommodate the large number of patients in dire need of help, The Nephrology and Renal Transplant Unit in Kandy was established five years go, with funding from the government, corporate sector and the community at large. “The public response to the project was excellent, and we were able to help many patients,” said Upali Salgado, the Co-ordinator of Fund Raising Activities in the National Kidney Foundation of Sri Lanka.

While many have benefited already, much still remains to be done, and The National Kidney Foundation is urgently appealing for public assistance for the Anuradhapura Renal Care and Renal Research Centre. Cheques could be drawn in favour of the National Kidney Foundation A/C Super Grade Branch, Bank of Ceylon, Kandy, and posted to Upali Salgado, JP, at No. 29, Deal Place (A), Colombo 3. Cash donations could be sent with the donor’s full name and address, and a receipt will be posted back to the donor.