Will Uma Oya bring Kidney Disease to Uva-Wellassa and Ruhuna?

Already the death sentence has been passed against thousands of innocent people living in the North Central Province (NCP). That is by way of a ‘mysterious’ kidney disease that has been sweeping across the region. Since early 2000, a hitherto unknown kidney disease has started eating into the lives of people in various parts of the NCP. So far, hundreds have died and thousands are confined to the sick bed with routine haemo-dialysis being the only hope of day to day survival, but with imminent death lingering over them. The magnitude of this public health catastrophe has been large enough for the government to seek the assistance of the World Health Organization (WHO), which already has sent five experts to investigate into the mystery behind this calamity.

According to Dr. Thilak Abeysekera, a consultant physician who has immense experience treating the people affected with this unknown kidney disease since early 2000, there are over 6,000 patients diagnosed, since then.

Greater availability of facilities for early diagnosis, together with an effective public education campaign about the disease throughout the province and the neighbouring areas has prompted people to come for early detection and early treatment. This has helped check the progress of the disease to some extent. However, chronic renal failure remains the eventuality. While haemo-dialysis is costly (but borne by the government - thanks to our ‘free health’ service), the facility is available much less than the requirement demands.

As Dr. Sarath Weerabandara, the director of the Teaching Hospital Anuradhapura states, at present only four haemo-dialysis units are available in his hospital, which hardly serves the demand of the growing number of patients who are in requirement of this modality of treatment (‘The Island’, 28.02.2008).

Many areas in the NCP and the immediate outskirts such as Padaviya, Siripura, Medawachchiya, Kebithigollawe, Mahawillachchiya, Thanthirimale, Eppawela, Medirigirya, Welikanda, Aralaganwila, Welioya, Girandurukotte have been the worst affected, with 8-10% of the adult population in some of these areas afflicted by the disease, according to Dr. Abeysekera. These figures in no uncertain terms speak volumes for the public health debacle which has come to stay (or has been created) in these areas. (For a detailed account of the problem in the NCP – refer ‘Chronic Kidney Disease in NCP: A Post-Mahaweli Predicament?’, ‘The Island’, 28.02.2008, http://www.island.lk/2008/02/28/features5.html).

Although ‘causality list’ of this disease that has taken its toll in the NCP is not yet established (and international expertise has been sought), many clues are being unearthed and made public by our local scientists which could definitely be an asset to international experts looking into the issue. In this regard, the research done by Prof. Sarath Bandara of the University of Peradeniya, who analysed the water and soil quality with regard to the heavy metals, W. Perera and W. D. N. Wickremarachchi who studied the water pollution by agro-chemicals, and the hypothesis put forward by the renowned environmentalist Udula Bandara Ausadahami et al, on the water use and management pattern in the NCP since the accelerated Mahaweli project are ground-breaking.

Through his research, Prof. Bandara has shown that cadmium, (iron and lead) are present (some in very) high concentrations in the water sources, soil and even in the ‘nelum’ (lotus) rhizomes and ‘Thilapia’ fish in the affected areas. Similarly, research by Perera and Wickremarachchi have shown the weedicide propanil and the insecticide chlorpyriphos in excess amounts in water. In addition, most parts of the NCP also have high concentrations of fluoride in the ground water, which has attributed to a condition known as dental fluorosis that causes discolouration of teeth, a condition that has affected the people of these areas for generations (though not lethal).

Ausadahami believes that disruption of water retaining and management system following the ‘bringing-of’ the Mahaweli waters to the (NCP) region - changing from ‘regional’ to ‘imported’ water use - is one reason for the current tragedy in the NCP. This has resulted in ‘importation’ of loads of silt from the central hills, together with heavy metals and agro-chemicals which are seriously detrimental to the human health and environment.

While all these facts and theories loom large over the current public health catastrophe created by the kidney disease in the NCP, (and awaiting some positive revelations to come about as a result of the international intervention in the due course), the possible incriminatory effect of the diversion of Mahaweli waters (that is contaminated with toxic heavy metals and agro-chemicals) to the Raja Rata cannot be belittled or ignored. In this backdrop, another (trans-basin) diversion of the Mahaweli river is now going to take place with the Uma Oya project. Will this mean a repetition of the scenario (of the NCP) in the Uva-wellassa and Ruhuna in the years to come – perhaps in another couple of decades?

Ausadahami strongly believes it is so. "This is essentially similar to what was done before with the diversion of Mahaweli (river) to the NCP. That resulted in large loads of silt and heavy metals and other toxic compounds in the agro-chemicals used in the hills to be transported to the NCP. With this diversion this scenario will be repeated. Now all these ‘toxins’ will be taken to the Uva-wellassa and Ruhuna," commented Ausadahami.

Ausadahami believes that many of the ground conditions remain the same in the Uva-wellassa and Ruhuna, as in the case of the NCP. "Climatic conditions are very similar. High fluoride content is there in the ground water. Traditional irrigation patterns were also very similar. Already the Lunugamwehera project has done a lot of harm to some of these areas by destroying the small tanks and going into a large reservoir. This has resulted in acute water shortage to people in some parts of the Ruhuna. On top of that, this is going to be another situation where water with many toxic contaminants being brought to an area that is alien to this kind of water management," opined Ausadahami.


Post 1959 Irrigation Projects

The ambitious Uma Oya project is a ‘multi-purpose project’ where generation of electricity (estimated at 100 KW) and supply of water for irrigation, industrial and drinking purposes for parts in Uva-Wellassa and Ruhuna are the main objectives. One may argue that the country needs such projects, especially in the wake of the present development drives that target the hitherto ‘underdeveloped’ and poverty stricken areas. At the same time, we need to learn lessons from our past mistakes. In this regard, all possible mitigatory measures will have to be adopted, dealing with river diversion projects of this nature.

According to D. L. O. Mendis, the eminent irrigation engineer with vast experience working in many irrigation projects in the country, "most of the major reservoir projects in the country are flawed as they emanate from the Water Resource Development Plan of 1959. Water Resource Development Plan 1959, is defective, as it had been formulated on the premise of the 4 stage hypothesis (of R. L. Brohier)." As Mendis points out, these irrigation projects are wrongly located and would have done at alternative sites (example, Uda-walawe best done fifteen miles upstream of the present location, Lunugamwehera in Hurathgamuwa). The devastating effects (both socially and health-wise) that we see in the aftermath of the big (post 1959) irrigation projects such as Mahaweli, Lunugamwehera and Uda-walawe, perhaps would speak best for what Mendis says about the Water Resource Development Plan of 1959.

Chemical input intensive agriculture and its health impacts

‘Importation’ of toxic substances used in agriculture downstream has become one of the main health (and environmental) concerns today. The NCP experience has shown that cadmium, (iron and lead) among the heavy metals and some other toxic chemicals (from these agricultural inputs) to be present in high concentrations in the ground water of NCP and some of these have been possibly incriminated in the kidney disease causation as well. A scrupulous inquiry into this aspect needs to be done by those concerned without delay and definitive evidence as to their possible role needs to be established soon. If they are found incriminatory then corrective measures in this regard ranging from abandoning their use to adoption of ‘healthier’ farming practices need to be espoused, both for the good of public health of the populace and the economy of the country – for the colossal amounts of foreign exchange these ‘inputs’ consume out of the public coffers.

Today, destruction of forest cover (for agriculture), that also serves as the watershed for the main rivers and streams takes place in a big way in the central hills. Some of these agricultural ‘enterprises’ operate well organised, with extensive ‘mechanical’ and ‘chemical’ inputs going into these. To prevent a serious ecological calamity from occurring in the future, this needs to be taken up as an issue of national importance of dire urgency and national policies in relation to land use and agricultural practices needs to be arrived at. In this regard, the elevations and gradients of the ‘marginal lands’ in the central hills needs a special attention. Reforestation of the watershed areas is another issue that needs to be taken up as a priority area. Also considering the harmful effects (both to the environment and human health), by using chemical inputs to the agriculture in the central hills, promotion of measures such as non-chemical agriculture and ‘Kandyan forest gardens’ needs to be given due attention and prominence where human habitation and cultivation are possible.

We have learnt many lessons from the Accelerated Mahaweli and similar irrigation projects of the past. Now the time has come for us to look closely at our past mistakes, and take all the possible precautions under the sun, to prevent another huge public health and ecological calamity from occurring in the years to come. This would also be the best justification that we could do to our friendly nations who help us with generous funding for these projects, especially in our hour of need.

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