Controlling dengu and kidney disease: Is the failure due to faulty ideology?


By Chandre Dharmawardana

Kidney disease in the North Central Province (NCP) was unheard of till about the mid 1970s. Dr. Ramachandran identified it in the 1990s and gathered evidence to show that it cannot be due to the usual causes. Hence it has been named "Kidney-disease of unknown aetiology (CKDU)". More recently it has been written as CKDu, but this writer prefers to use the capital "U" to emphasize that its origin is still unknown although theories abound. Since then, the incidence of CKDU has increased rapidly, and today, virtually every family in the affected areas can claim a patient.

CKDU ins a rural phenomenon in the dry-zone of Sri Lanka. Another killer disease that has appeared, especially in the urban regions of Sri Lanka is the Dengu virus. In spite of extensive chemical-fogging of urban areas, painstaking clearance of places of stagnant water (including even bottle caps and flower pots), the incidence of Dengu has risen inexorably. Actually, it is impossible to do this cleaning as even a few drops of water held between bits of moss is enough for the mosquito. Big fines can be imposed if this cleaning is not done, opening up room for corruption as well as creating public antagonism. In spite of all that, everyone knows of someone who was stricken with Dengu and having succumbed to it. Clearly, it would require the constant mobilization of huge numbers of volunteers and health workers in search-and destroy missions, fogging and spraying missions in every urban, suburban, and rural areas throughout the country to effectively control the spread of dengue. And yet, the virus will win.

This writer believes that the solution to both epidemics is simple , inexpensive, and right at hand. But they are not implemented due to misguided ideological concerns.

Eliminating Dengu with certainty.

Let us first take the case of Dengu, which is more straight-forward than CKDU. Currently, cleaning-up breeding places, spraying, creating a dense fog of insecticide etc., are used. DEET, Prallethrin, Allethrin, other compounds, and chemical coils are also used to eliminate the mosquito. However, this needs to be done almost daily in rainy, monsoon-ridden countries like Sri Lanka. A much less dangerous, far less toxic alternative exists, and was used successfully in the 1940s-1950s to successfully eliminate Malaria. The wonder substance is DDT which is cheap and does NOT have any known toxic effects. However, Rachel Carson’s famous polemical work "Silent Spring" became the manifesto of the 1960’s "Green revolution in California". While Carson’s plea had much validity, DDT was wrongly indicted by excessively ideological zealots. The US Environmental Protection Agency (EPA) held two years of hearings, and in 1972 completely absolved it, reporting that "DDT is not carcinogenic, mutagenic or teratogenic to man ¡K uses of DDT do not have a deleterious effect on fish, birds, wildlife, or estuarine organisms"


Nevertheless, Richard Nixon, one of the most corrupt US politicians who ran for office banned it to secure the California "Green" vote. Since then, US agencies and NGOs refuse any money to public-health organizations that attempt to use DDT for pest control. The net effect has been millions of deaths in Africa and in the tropical belt due to Malaria, Dengu, Yellow fever and similar diseases. Many self-styled "ecologists" and "green activists", nurtured on internet myths simply assume that DDT is a deadly substance and have little knowledge of it. Western fascist organizations and NGOs that have called for the culling of populations in the "third-world" from fears of immigration have always espoused the ban on DDT. Very few western countries do research on vaccines against malaria or Dengu. This anti-third-world attitude, as well as the ideology of pseudo-eco-heroism are the Misgotten Ideologies that have prevented the control of mosquito-driven diseases in the tropics.

However, studies at the Institute Pasteur in Paris have confirmed the efficacy and relative non-toxicity of DDT compared to other alternatives for the control of mosquitoes. The WHO in 2006 lifted its ban on the domestic use of DDT, so that it can even be sprayed INSIDE homes. DDT does not kill mosquitoes ¨C but mosquitoes of every variety are strongly repelled by DDT and leave the area.

So, the control of Dengu in Sri Lanka is very simple. Spray a tiny amount of DDT inside homes once very six months. All you need are three drops of DDT for every one-hundred million drops of spray. The cost is minimal, the intervention is minimal, the toxicity is non-existent compared to what is being used now. Even more importantly, Dengu will be eradicated with certainty. You only have to look at the track record of the Senanayake era for Malaria.

Eliminating CKDU within a short time.

Since heavy metals like Cd, Pb, and metalloids like Arsenic are known to be toxic to the kidney, it was natural for these to be the prime suspects for causing CKDU. However, detailed analysis of the drinking water and the main food components of Rajarata residents by the WHO-team showed no incriminating amounts of these substances. The studies have been repeated by independent groups of scientists and they too have confirmed this conclusion. These studies have also looked for significant residues of pesticides like Glyphosate ( trade-name "Roundup"), chloro-hydrocarbons (e.g., DDT) etc., and found none. Nevertheless, ideologically and politically driven groups, and some Sri-Lankan NGOs linked to a number of doctors in California, usurping for themselves the mantel of Green activists, have demanded the outright ban of Glyphosate and all agro-chemicals.

A number of Sri Lankan scientists and the present writer have researched, for several years, the nature and origins of CKDU and presented what we believe to be a credible theory of the origin of CKDU in the Rajarata, Sri Lanka


According to this theory, the rise of CKDU is linked to the rise of the free-market which allowed uncontrolled sales of fertilizers to farmers, conjointly with the rise of irrigation works that acted as unwitting sewers that delivered the excess fertilizer (from, for example, the hill country) to the Rajarata area. If the right amount of Fertilizer is used, it remains fixed by the soil and taken up by the plants. If excess is used, it is washed away. This theory remains uninteresting unless there is a mechanism linking the excess fertilizer with disease. This missing link is provided by noting that the total salinity of the water (due to all types of salts from the fertilizer and the ground), known as the ionicity, if sufficiently high, can cause the de-naturing of the protein layers in the kidney and pave the way for full-blown kidney disease. Biochemists know this as the Hofmeister mechanism. Some ions, like phosphates, fluorides, and ammonium ions, are specially active in denaturing proteins. The incidence of CKDU is thus strongly correlated with the total salinity (ionicity) of the water in each locality, and can even vary from village to village in the Rajarata. The effect is unimportant in the frequently rain-soaked soils of the wet zone.

Hence it is clear that the simple and direct solution to curbing CKDU is to strongly restrict the sale of phosphate fertilizers by handing over such control to the agriculture department, and removing all fertilizer subsidies as there is no need to promote the sale of these agrochemicals since the soil in most areas of the country is already saturated with phosphates. This will save much money to the government although the "mudalalis" will loose. Furthermore, there is no need to mine the Eppawala phosphate mines at all.

Once the application of excess fertilizer is eliminated, a few monsoons will wash away the remaining excess residues and bring the soils back to a state where the Rajarata residents will not be at risk.

The middle path.

Thus we see that the dispensation of agro-chemicals is caught between two ideologies. On the one hand there is the free-market ideology which wants to allow free sales of agro-chemicals, with high returns to agri-business and their middlemen (usually henchmen of politicians). The other extreme is the pseudo-ecologists, with their agenda of selling their "organically grown" products, together with the pie-in-the sky claim that traditional agriculture can feed 22 million people as easily as is done today, and within a few years, if they are given the whip-hand to ban all agrochemicals immediately and sell compost instead.

However, (i) the middle-path of restricting agro-chemicals instead of banning them or making them freely available, and (ii) the middle-path of the minimal use of DDT instead of leaving it locked up to satisfy the political ideology of the Greens, are two simple, clear steps. These are needed to beat two huge public health concerns that have reached epidemic proportions in Sri Lanka and in several parts of the world. These are extremely cheap, easily implementable, relatively safe solutions. But they require a political will capable of brushing aside ideological roadblocks of the free-marketeers and the pseudo-Greens.

[The author is a Professor of Chemistry, a Professor of Physics, and has also researched on problems in environment and health. He is currently attached to the University of Montreal and the National Research Council of Canada in Ottawa.]

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