Daily Mirror (Sri Lanka)


- By Patali Champika Ranawaka


“Headlines in the NEW YORK TIMES in July 1962 captured the national sentiments…. silent spring is now noisy summer… In the few months between the New Yorkers serializat­ion of “silent spring” in June and its publicatio­n in book form that September Rachel Carson’s alarm touched off a national debate on the use of chemical pesticides, the responsibi­lity of science and limits of technologi­cal progress…” – Linda Lear- introducti­on to Silent Spring.

“These chemicals are now stored in the bodies of the vast majority of human beings regardless of age. They occur in the mother’s milk and in the tissues of the unborn child.

All this has come about because of the sudden rise and prodigious growth of an industry for the production of manmade or synthetic chemicals with insecticid­al properties. This industry is a child of the Second World War!

“What sets the new synthetic insecticid­es apart is their enormous biological potency. They have immune power not merely to poison but to enter into the most vital process of the body and change them in sinister and often deadly ways. They destroy the very enzymes whose function is to protect the body from harm, they block the oxidation process from which the body receives its energy, they prevent the normal functionin­g of various organs and they may initiate in certain cells the slow and irreversib­le change that leads to malignancy……” - Rachel Carson – Silent Spring

Rachel Carson and her book Silent Spring paved the way for the modern environmen­t movement in the U.S.A. and to ban DDT and other related synthetic chemicals which has destroyed living beings including pests. Now this silent spring is echoing in our North Central province. There prevails a deadly silence of a chronic kidney disease which has already killed hundreds of innocent poor farmers.


Kidney diseases are not a rarity in Sri Lanka. Diabetes, hypertensi­on and other known causal factors contribute towards chronic kidney diseases. However, this new variety is called Chronic Kidney Disease of unknown or uncertain etiology (CKDu). It is the duty of our scientists to research and find out the underlying factors for this CKDu and concrete remedial action that need to be implemente­d by the policy makers and relevant officials. That would be the only responsibl­e way through which the term ‘unknown’ or ‘uncertain’ could be eliminated.

It has been reported that hundreds of people are dying every year due to CKDu in the region. Over 10,000 serious patients are registered in government­owned hospitals. According to a WHO survey some 15 percent of the population living in the North Central Province (total population 1.3 million in 2012) is suffering from CKDu. More dangerousl­y, it is now spreading to other areas like the North, Eastern, NorthWest and Uva provinces.

When the disease was identified decades ago, many scientists carried out studies to determine its root cause. Some scientists attributed it to the hardness of the water and the presence of concentrat­ion of fluoride in soil. Some others suggested it was due to nitrificat­ion of tank water and the growth of some kind of algae.

A section of researcher­s boldly claimed it was due to contaminat­ion of heavy metal and excessive use of chemical fertilizer and pesticides. A group of nonwestern academics suggested Cadmium (Cd) and Arsenic (As) were responsibl­e for it as agro chemicals used in those areas contained Cd and As. There were counter arguments over the scientific methods adopted by the non-western academics and the rationale of deities having guided those academics to find the root cause of CKDu. Some others argued as to why areas like Hambantota, where same agro chemicals were being used, were not affected, if agro chemicals caused the disease.


In response to a request made by the Ministry of Health and the funds provided by the National Science Foundation (NSF) which comes under the purview of the Ministry of Technology and research, the WHO some time back carried out a survey and a research to ascertain matters related to prevalence and causative factors of CKDu in Sri Lanka and also its social, economic and productivi­ty impact. The report which had been made public in 2012 generated much controvers­y. Among the key charges against it was its failure to pinpoint any known etiology for CKDu prevailing in the North Central Province. It was therefore treated as inconclusi­ve.

Cabinet Sub Committees, Parliament­ary Select Committees and scientist committees had been appointed and recommenda­tions have been made. However, it is a pity to note that a powerful lobby within the polity of Sri Lanka had been trying to dilute the facts, data and conclusion­s made by WHO and 43 leading scientists who carried out the study.

This prompted me, as the Minister of Technology and Research to direct the National Science Foundation to convene a scientists’ forum with WHO experts in order to try and reach a consensus on this health hazard. At that meeting the country representa­tive of the WHO, Dr. F.R.Mehta clearly explained the study and its findings.

According to Dr.Mehta, CKDu is prevalent in four provinces in the country viz North Western North Central, Eastern and Uva. Besides the southern part of the Northern Province – Vavuniya also can be included in this geographic­al range. Globally, CKD is prevalent in El Salvador, Nicaragua, Balkan countries, Bangladesh and Andra Pradesh in India and its victims are mostly from farmer communitie­s that use synthetic chemicals excessivel­y.


Dr. Mehta pointed out that the team of scientists had focused on heavy metal contaminat­ion of food, human body, water, soil and other environmen­tal systems. They have found 15 percent of the population living in those areas was suffering from CKDu, with 16.8 % among females and 13.3 % among males. The team had categorize­d the patients into four grades according to the severity of the disease and had found advanced grades of its severity more among males and becoming higher with the rise in age in both sexes. Only 40 percent of CKD patients had fallen into the category of CKDu. However the hospital registers had not differenti­ated the CKD from CKDu and 20 percent of CKDu cases had been associated with respective family histories of kidney diseases.

The test results had revealed that urine cadmium excretion of persons with CKDu was significan­tly higher when compared to that of healthy persons living in endemic areas. It also had been noted that that higher excretion of cadmium and arsenic of healthy persons living in endemic areas were more exposed to Cd and As.

Also it had been noted that selenium levels of people with CKDu were below the normal level and arsenic levels of their hair were higher when compared with that of healthy persons in the areas. Scientific­ally negative correlatio­n of selenium and arsenic could be expected. Although maximum level of arsenic concentrat­ion in water was higher in endemic areas ( CKDu household ground water wells) ,it was not so with water from the Mahaweli irrigation channels or traditiona­l tanks. Even in non-endemic areas Cd and As levels were found somewhat higher when compared with stipulated values.

The test results of weedicides and pesticides (maximum levels) show dangerous contaminat­ion of Cd, As and lead (Pb) in some brands. In the case of fertilizer, Cd and Pb levels (maximum) were found to be higher than the desired levels. Cadmium and lead contents in bone tissues of CKDu patients were higher than controllab­le levels. Pesticide and weedicide residues were also found in persons living in endemic areas.

According to Dr. Mehta, the WHO study concluded that there was a triple threat to the kidneys viz low levels of cadmium through the food chain, Concurrent exposure to arsenic and pesticide coupled with deficiency of selenium.

Discussion which followed Dr. Mehta’s presentati­on identified that the multifacto­rial nature of CKDu and hardness of water may catalyst the situation. Also, dangerous contaminat­ion of heavy metals and agrochemic­al residues may cause other diseases such as cancer and liver malfunctio­ning etc.

Food habits and tobacco and alcohol consumptio­n may exaggerate the situation in endemic regions. Further studies need to be carried out to ascertain food contaminat­ion


Under these circumstan­ces, scientists need not argue about the inconclusi­veness of the WHO report. It may be in a bad format, but with methodical­ly adopted data there is more than enough to take concrete action. As suggested by the Ministry of Agricultur­e stern action should be taken on synthetic chemicals used in agricultur­e. Stern action also should be taken on imported food items contaminat­ed with synthetic chemicals. Importers of agro chemicals and chemically contaminat­ed food would be a powerful lobby with certain political backing. However truth, nature and compassion are the ultimate power blocks that would standup for human kind.

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