In North central province of Sri Lanka, an alarming increase in chronic kidney decease of an unknown origin (CKDu) has been reported during the last decade. Karuna Trust is exploring avenues to provide safe drinking water to a selected village in the affected  area as a pilot project. We are seeking your kind assistance for this worthy effort

Executive Summary

For over a decade, Karuna Trust has been engaged in grass-root level community development programs in Medavachchiya area, in north central province of Sri Lanka. During a recent visit to the area, we learnt that the villagers were extremely concerned and helpless about the rapid increase in kidney deceases in their community. Since then, Karuna Trust has collected background information and research data about this emerging health crisis impacting the north central and north western provinces of Sri Lanka. Government of Sri Lanka has established a national steering committee with collaboration of WHO to define and implement necessary steps to arrive at the root cause and prevention of chronic kidney decease of unknown origin (CKDu) in the affected areas. Even though, aeitology of the decease remains a mystery to date, it is widely believed that drinking water is an influencing factor.

Upon reviewing the data, and considering severity of this issue and its socio-economic impact, Karuna Trust would like to seek your kind support to provide safe drinking water to communities in the affected areas, using a pragmatic and promising scheme pioneered by National Water Supply and Drainage Board. 

Problem

A new form of chronic kidney disease of an unknown origin (CKDu) has been reported in several areas of Sri Lanka. This is also referred to as Chronic Renal Failure (CRF) in some literature on this topic. The disease is characterized by a slow, progressive, asymptomatic development, frequently starting at a younger age group. It is more prevalent among men, typically around the age of 40-60 years, engaged in agriculture. The patients affected by CKDu appear to be more in North Central, part of North Western and Uva provinces. The total number of affected individuals is unknown, but it is thought that around 10,000 people are currently undergoing treatment for this disease. In 2005, Anuradhapura Teaching Hospital alone recorded 742 live discharges and 140 deaths due to CKDu. The Health Ministry has established two separate units one in Kandy and the other in Anuradhapura to treat those patients affected by CKDu, but it is necessary that appropriate actions are taken to prevent the incidence of CKDu.

Summary of statistics

• Approximately 300-600 deaths occur in hospitals due to CKDu Annually
• Mortality rate could be higher because home deaths are not included in death registries.
• Estimated 1400 deaths occur nation-wide annually.
• Approximately 2000 new patients nation-wide with CKDu annually.

Proposal

Our objective is to minimize the long term risk posed by CKDu to this under-privileged farming community. Apart from “clear and present danger” suggested by the increasing CKDu death rates at hospitals, it has far reaching socio-economic consequences as well, due to reduction of active workforce in these farming communities and the burden of long term health care cost of those who survive . The overall impact of our action may be minute considering the totality of the problem, and we are hopeful that Government steering committee with help from WHO will arrive at a broad solution to this issue soon.  However, in the meantime we strongly believe that engaging at community level to provide “best known” solutions would go a long way towards helping the situation and uplifting the spirit of the poor farmers of these villages.

National Water Supply and Drainage Board (NWSDB) has recently taken the initiative to try out a solution based on existing data on this issue. Data is showing that CKDu cases from Anuradhapura and suburbs are very rare when compared to surrounding rural communities.

Anuradhapura and suburbs get their drinking water from a central treatment plant fed by large irrigation tanks in the area while the surrounding rural areas depend on ground water sources such as dug well. Water board (NWSDB) has started to supply treated water from their main treatment plant in Anuradhapura, to surrounding rural areas using bowsers. Water is filled to 1000 liter plastic tanks placed close to the houses.  So far this scheme has been implemented as pilot projects in several villages in Anuradhapura district. Billewa was one of the very first villages selected for this scheme, in mid-2011. Already there is some evidence to show stabilization of the CKD conditions in this village.

During a recent visit to the area, we were able to get some first-hand information from the villager and it was very encouraging. They were saying that CKDu related deaths have stopped in their village. Only issue they raised was that they sometimes run out of treated water. This is mainly because the water tanks are shared by several homes.

A tank of 1000 liter capacity helps to provide water supply for 3 families for 2 weeks under this scheme. Household tanks are filled twice a month by NWSDB. However in some localities more families share the water from the same tank due to lack of tanks. Therefore sometimes they run out of treated water. Up to now, majority of the tanks have been donated by charity organizations while the water distribution is done by NWSDB.  Each family is charged Rs 300 /month which is sufficient to cover the full cost born by NWSDB for this scheme. The major cost component is the transportation cost. 

Considering all the available solutions and the currently available data on the issue Karuna Trust has decided to extend the above described scheme to one new village in the same area.  Since we sought support for this issue back in July 2012, we have been able to raise LKR 292,875 for this project with kind donations from our supporters. This would be sufficient to provide about 25 tanks which will serve a community of ~ 75 families. We have had several discussions with NWSDB and communicated our intentions to them and together we are committed to move forward with this project.

 How You Can Help

If you wish to support this worthy cause please do contact us at: helplanka@karunalanka.org or by phone. As a first step, we would like to get a preliminary assessment of the funds that can be committed for the project. Subsequent contributions can be routed to Karuna trust by using the instructions below. Please include the reference “Safe Drinking Water Project” along with your donation.