Mystery Kidney Disease Killing Sri Lankan Farmers
Karunawathie isn't hungry for breakfast. She rarely is these days, but she forces herself to choke down a few bites of rice, dried fish and a simple coconut mix. The doctors say it's better to have something in her stomach before the four-hour dialysis treatments.
She's going for her second session of the week, dressed all in pink, right down to her flip-flops. Her fingers and toes are fat with fluid, and her spongy arms feel like soft water balloons. Since she can no longer pass liquids on her own, doctors have told her to drink only 500 milliliters a day — equal to less than a can and a half of soda.
As she walks unsteadily to the door, her two youngest children, 16 and 11, kneel before her and place their heads at her feet in a traditional show of respect.
V.G. Karunawathie is only 40 years old, but she is dying, and no one knows why. Her kidneys have stopped working, and now she's kept alive by a pump that filters waste from her blood twice a week through a snorkel-like tube implanted into her neck.
The cause of her disease, which affects an estimated 70,000 to 400,000 people in Sri Lanka's rice basket, has baffled doctors and researchers for two decades. Even the World Health Organization hasn't been able to pinpoint what's killing as many as 10 people a month in Karunawathie's village — ravaging one house while sparing the next — as it creeps farther and farther into neighboring areas.
The disease mirrors equally confounding conditions plaguing thousands of farmworkers in parts of India, Egypt and Central America. Suspected causes include chronic dehydration and the heavy use and misuse of agrochemicals. In Sri Lanka, fertilizer use is among the heaviest in the world.
No one cause has been identified, but theories abound. Many believe a combination of factors could be at play — from toxic algae and hard ground water to heavy metal exposure and high fluoride in drinking water.
But to Karunawathie, there is no mystery at all. She understands more about this so-called chronic kidney disease of unknown etiology than anyone should.
It killed her father, mother and five brothers. Three other siblings have been sickened.
As the youngest of a dozen children, Karunawathie was diagnosed with the disease 12 years ago in her impoverished farming village. Since then, she's been told to stop eating fish and lotus root and to abandon her aluminum pots and pans for clay cooking utensils.
She's heard arsenic is to blame along with cadmium, lead and even home-brewed alcohol. Like most, she believes there's something in the water. But she has long given up trying to determine the source of her family's killer. Instead, she lives day to day at the mercy of a machine. And even that's not a sure thing.
Dialysis is supposed to be given three times a week, but most Sri Lankan patients get it only twice since just 183 machines exist nationwide — even though 2,000 new patients are in need annually. Critics say it's just one area where the government is failing the sick. Clean drinking water still isn't available in all affected areas, only a handful of kidney specialists practice in public hospitals and there's no national donor transplant program.
With few options, many desperate patients are forced to burn through their meager savings, traveling hours every week by bus for treatment only to be too exhausted afterward to return home. Instead, they sprawl out on hospital grounds or in hallways for the night. Or they simply stay home and wait to die.
Karunawathie is fortunate to live only 10 kilometers (6 miles) from basic care. But the ride on the back of her son's motorbike is a torturous trip across scabbed pavement framed by a tangle of trees alive with monkeys and peacocks.
When she reaches the hospital on this day, there's bad news: All the dialysis units are being used.
Karunawathie is told to come back later. But with each step, her strength is dying.
Source: Associated Press
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