Mystery kidney killer spreads fear in Sri Lanka

Mystery kidney killer spreads fear in Sri Lanka

Associated Press: By MARGIE MASON | Associated Press – Mon, Jan 19, 2015

RAJANGANAYA, Sri Lanka (AP) — It’s midmorning and hundreds of people are squeezed under a banyan tree’s shady canopy to have blood drawn by just three nurses, working assembly-line fast. Others wait outside this dusty rural health center to get their vitals taken and give urine samples.

Most of the 1,000 villagers have come here on foot and have stood for hours under the hot sun — not because they feel sick, but out of fear. They want to know if they will be the next victims of a mysterious kidney disease that has killed thousands of farmers in Sri Lanka’s rice basket.

Many have watched neighbors and loved ones — some only in their 30s — quickly succumb to deaths after their kidneys gave out. In the worst-hit villages, it kills as many as 10 people every month. No one knows why.

In this July 16, 2013 photo, Kumaradasa, a Sri Lankan farmer suffering from a chronic kidney disease of unknown etiology, bathes helped by his wife outside their house in Medavachchiya, Sri Lanka. The cause of his disease, which affects anywhere from an estimated 70,000 to 400,000 people in Sri Lanka's rice basket, remains an enigma without a name. Kumaradasa died on June 8, 2014. (AP Photo/Eranga Jayawardena)

In this July 16, 2013 photo, Kumaradasa, a Sri Lankan farmer suffering from a chronic kidney disease of unknown etiology, bathes helped by his wife outside their house in Medavachchiya, Sri Lanka. The cause of his disease, which affects anywhere from an estimated 70,000 to 400,000 people in Sri Lanka’s rice basket, remains an enigma without a name. Kumaradasa died on June 8, 2014. (AP Photo/Eranga Jayawardena)

“In some cases, you only know if a certain person died of kidney disease after the autopsy,” says Kalyani Samarasinghe, 47, standing outside the health center with a handful of medical papers and a cotton ball taped to her arm. “If you get a pain in the stomach or something, then you think: Is it the kidney?”

The disease has killed up to 20,000 people over the past 20 years and sickened another 70,000 to 400,000. It has expanded from two districts to seven in the North Central province’s dry zone, where farming was transformed after the introduction of modern techniques in the 1960s and ’70s. No cases have been detected elsewhere in the country, and research has failed to determine the cause.

Some blame the water, heavy use of pesticides and fertilizer. Others wonder if it’s something in the food, or whether heavy metals or toxic algae could be the source. Villagers have been told to give up lake fish, aluminum cooking utensils and illicit home-brewed alcohol, but no one’s sure if any of it helps.

In this July 23, 2014 photo, V.G. Karunawathie, a patient suffering from chronic kidney disease of unknown etiology, rests in her house with her family member in Konketiyawa village in Padaviya, Sri Lanka. Her kidneys stopped working nearly a year ago, and now she's kept alive by a pump that filters waste from her blood twice a week through a snorkle-like tube implanted into her neck. (AP Photo/Eranga Jayawardena)

In this July 23, 2014 photo, V.G. Karunawathie, a patient suffering from chronic kidney disease of unknown etiology, rests in her house with her family member in Konketiyawa village in Padaviya, Sri Lanka. Her kidneys stopped working nearly a year ago, and now she’s kept alive by a pump that filters waste from her blood twice a week through a snorkle-like tube implanted into her neck. (AP Photo/Eranga Jayawardena)

Dr. Rajeeva Dassanayake, a kidney specialist at the area’s largest hospital in Anuradhapura, has come to the screening to try to calm the crowd.

“You need not fear and flee from this place,” he says. “There are a lot of things being said by many people. Until they have finished fighting each other and come up with an answer, we can say nothing.”

Similar diseases are wiping out thousands of farmers in parts of Central America, India and Egypt. In hard-hit Nicaragua and El Salvador, some believe agrochemicals are the problem, while others think years of prolonged dehydration in the baking heat is shutting workers’ organs down.

In Sri Lanka, a report published by the World Health Organization two years ago found kidney disease in 15 percent of adults across three affected districts. More women were affected overall, but men over 39 years old were more severely sickened. Elevated cadmium and pesticide residues were detected in urine, leading the authors to surmise they may be damaging patients’ kidneys over time, in combination with other factors such as arsenic.

Water — the source widely suspected as the culprit — came up clean. But the WHO study’s Geneva-based author, Shanthi Mendis, says it could still be playing a key role when combined with other elements. She adds that the government’s top two priorities should be supplying safe drinking water to residents and regulating the use of agrochemicals.

The WHO report documented raised levels of cadmium and lead in certain plants and vegetables, such as lotus root and tobacco. Some question whether these heavy metals could be leaching into the soil and groundwater from pesticides and fertilizers, which have been found to have high levels of cadmium in previous studies. The Agriculture Ministry says samples are regularly tested and come back within permitted limits, which are much stricter than those in neighboring countries.

Still, farmers douse their fields with too many chemicals, often using concoctions that include kerosene and multiple poisons. Most do not wear protective gear.

“Without it, it’s difficult to get rid of weeds,” says Ajith Welagedara, a backyard farmer who mixes a stronger-than-recommended amount of glyphosate, the country’s most popular weed killer, and sprays it while walking barefoot without gloves or a mask. “I’m concerned, but there’s no other way.”

The government placed a ban on some agrochemicals since the WHO report came out, but it has not been enforced and the pesticides remain available.

In this July 24, 2014, photo, V.G. Karunawathie, left, a patient suffering from a chronic kidney disease of unknown etiology, leans on her son as she rides home from a hospital after a dialysis session in Konketiyawa village in Padaviya, Sri Lanka. She received treatment on her second visit the same day to the tiny nearby hospital as there were not enough dialysis units to go around. (AP Photo/Eranga Jayawardena)

In this July 24, 2014, photo, V.G. Karunawathie, left, a patient suffering from a chronic kidney disease of unknown etiology, leans on her son as she rides home from a hospital after a dialysis session in Konketiyawa village in Padaviya, Sri Lanka. She received treatment on her second visit the same day to the tiny nearby hospital as there were not enough dialysis units to go around. (AP Photo/Eranga Jayawardena)

For those already sickened, care is often inadequate. The country of 20 million, which emerged from a quarter-century of civil war in 2009, has just 183 dialysis machines, forcing most villagers to receive less than the three recommended weekly treatments. Since no national cadaver transplant program exists, many patients post desperate newspaper ads with their photos and blood types pleading for kidney donors.

The Health Ministry is trying to screen the area to determine how many people are sick with the so-called chronic kidney disease of unknown etiology, which often strikes several members of one family.

Fear is breeding stigma, but it is also driving many villagers to be screened. They hope early detection can help slow the disease, which typically does not produce symptoms until late. But their biggest worries extend much further.

“The major fear is about the children,” says Samarasinghe, the villager at the community screening. “We have lived our lives to a certain extent, but it’s the children we’re worried about.”

___

This Dec. 9, 2013, photo shows the swollen feet of Seneviratnalage Jayatillake, a Sri Lankan farmer suffering from a chronic kidney disease of unknown etiology, as he rests in his house in Padaviya, Sri Lanka. The cause of his disease, which affects anywhere from an estimated 70,000 to 400,000 people in Sri Lanka's rice basket, remains an enigma without a name. Jayatillake died in February 2014 after a prolonged illness. (AP Photo/Eranga Jayawardena)

This Dec. 9, 2013, photo shows the swollen feet of Seneviratnalage Jayatillake, a Sri Lankan farmer suffering from a chronic kidney disease of unknown etiology, as he rests in his house in Padaviya, Sri Lanka. The cause of his disease, which affects anywhere from an estimated 70,000 to 400,000 people in Sri Lanka’s rice basket, remains an enigma without a name. Jayatillake died in February 2014 after a prolonged illness. (AP Photo/Eranga Jayawardena)

In this Feb. 5, 2014, photo, family members weep around the body of Seneviratnalage Jayatillake, a Sri Lankan farmer who suffered from a chronic kidney disease of unknown etiology, during his funeral in Padaviya, Sri Lanka. The cause of his disease, which affects anywhere from an estimated 70,000 to 400,000 people in Sri Lanka's rice basket, remains an enigma without a name. It mirrors an equally confounding condition plaguing thousands of farmworkers in parts of India, Egypt and Central America, where chronic dehydration is one suspected cause. (AP Photo/Eranga Jayawardena)

In this Feb. 5, 2014, photo, family members weep around the body of Seneviratnalage Jayatillake, a Sri Lankan farmer who suffered from a chronic kidney disease of unknown etiology, during his funeral in Padaviya, Sri Lanka. The cause of his disease, which affects anywhere from an estimated 70,000 to 400,000 people in Sri Lanka’s rice basket, remains an enigma without a name. It mirrors an equally confounding condition plaguing thousands of farmworkers in parts of India, Egypt and Central America, where chronic dehydration is one suspected cause. (AP Photo/Eranga Jayawardena)

In this July 24, 2014, photo, a Sri Lankan farmer walks past an advertisement promoting agrochemicals in Padaviya, Sri Lanka. A chronic kidney disease that has already killed up to 20,000 people over the past two decades and affects anywhere from 70,000 to 400,000 more in the country's North Central rice basket, remains an enigma without a name. Many in Sri Lanka, including the World Health Organization, have pointed to heavy use and misuse of agrochemicals as a possible culprit in a country that's among the world's top fertilizer users. (AP Photo/Eranga Jayawardena)

In this July 24, 2014, photo, a Sri Lankan farmer walks past an advertisement promoting agrochemicals in Padaviya, Sri Lanka. A chronic kidney disease that has already killed up to 20,000 people over the past two decades and affects anywhere from 70,000 to 400,000 more in the country’s North Central rice basket, remains an enigma without a name. Many in Sri Lanka, including the World Health Organization, have pointed to heavy use and misuse of agrochemicals as a possible culprit in a country that’s among the world’s top fertilizer users. (AP Photo/Eranga Jayawardena)

In this July 24, 2014, photo, a Sri Lankan agrochemical vendor gives instructions on how to use Glyphosate, the country's most popular weed killer, at a chemical sales point in Padaviya, Sri Lanka. A chronic kidney disease that has already killed up to 20,000 people over the past two decades and affects anywhere from 70,000 to 400,000 more in the country's North Central rice basket, remains an enigma without a name. Many in Sri Lanka, including the World Health Organization, have pointed to heavy use and misuse of agrochemicals as a possible culprit in a country that's among the world's top fertilizer users. (AP Photo/Eranga Jayawardena)

In this July 24, 2014, photo, a Sri Lankan agrochemical vendor gives instructions on how to use Glyphosate, the country’s most popular weed killer, at a chemical sales point in Padaviya, Sri Lanka. A chronic kidney disease that has already killed up to 20,000 people over the past two decades and affects anywhere from 70,000 to 400,000 more in the country’s North Central rice basket, remains an enigma without a name. Many in Sri Lanka, including the World Health Organization, have pointed to heavy use and misuse of agrochemicals as a possible culprit in a country that’s among the world’s top fertilizer users. (AP Photo/Eranga Jayawardena)

Related Post


What are your thoughts?