Fatal illness in north central province claims 20,000 in 20 years:

Key to mystery killer disease found

by Manjula FERNANDO

Though just 45 years of age, the man looked ancient and feeble with his ailing body. He looked up at the doctor in attendance at the Padavi Sripura hospital with appealing eyes. Save me was registered in them. He did not want to die. It was not the time.

As a poor farmer and a father of two girls of school-going age, there was so much of unfinished business he could not leave behind. With an uneducated but duty-bound wife, he was the sole bread winner of the family.

In a neighbourhood where all his relatives and friends were farmers he could only wish the two girls will grow up to marry strong men to take over his land and continue the family tradition, paddy farming. He could perhaps make up his mind then, to retire.

But the doctor knew better. By the look of his external and other symptoms, acute asthma, swollen feet, lack of apetite and mostly the dark hard patches on his feet were all but sure evidence that he had caught the killer disease. The mystery kidney disease that had struck the North Central province.

Two months after this encounter with Dr. Chintaka Wijewardena the man passed away. He had been having the disease for a full six months before he sought medical care.

Head of Kelaniya University’s Science Faculty Prof. Nalin de Silva

Head of Kelaniya University’s Chemistry Department Prof. Priyani Paranagama

Even if he visited the hospital before or if he received medical care earlier, the doctors could have only delayed his death. So far no cure has been found for this mystery killer disease.

The chronic kidney disease of unknown aetiology/origin (CKDu), which is responsible for over 20,000 reported deaths in Anuradhapura and Polonnaruwa districts has baffled doctors for the past 20 years.

Despite the fact that it has claimed thousands of lives for two decades, the doctors could not find a cure or find as to what caused the fatal disease. Although there had been many theories along the way, nothing was corroborated by proof, until last week a bombshell was dropped by a research team from the Kelaniya university.

The team which comprised chemists, pharmacologists, botanists, medical doctors, judicial medical officers from Rajarata and Kelaniya Universities finally unearthed the most crucial piece of evidence to link the disease to the agro chemicals used by farmers in the area, in a ground breaking research carried out for the past six months. They have found the mystery disease was directly linked to arsenic poisoning!

Although the people vaguely suspected the agro chemicals having a link to the mystery disease, there was hardly any concrete evidence to pin it down.

The research which is yet to be acknowledged by the perpetrators, established beyond doubt the presence of lethal compounds, arsenic and mercury in disturbing proportions in the agro products, especially the pesticides, manufactured and imported to Sri Lanka by multinational companies, a clear violation of the country’s regulations.

They are at the moment in the process of confirming the link between the disease and the chemicals. The team had not just succeeded in establishing these facts but have come up with a new technique, for which they plan to claim patent rights, to isolate and distinguish arsenic in hard water (Kivul water), which was the key to their findings.

The research team has tested eight different brands of agro chemicals including that of two local products with the same disturbing results.

They proved the agro chemicals contained arsenic in alarming proportions in the pesticides. The ‘hard water’ (kivul) present in the area helped the arsenic to form calcium arsenate Ca3(ASO4)2 an extremely poisonous chemical compound that is water soluble. The people of Rajarata were most susceptible because of this unique quality in their water.

Their research found the well water in the area contained a high level of arsanic and the tank water too contaminated although showed lower contents.

“We are 100 per cent sure that there are alarming proportions of arsenic content in the agro chemicals imported to Sri Lanka. But we need more tests to confirm that this is the cause for CKDu observed in Rajarata,” Prof. Nalin de Silva told Sunday Observer when we confronted him at his office at the Kelaniya University following the revelations of their research.

He said arsenic is a class one poison which had been used from the time of India’s King Asoka and also to kill Napoleon Bonaparte... Arsenic is prohibited from use in pesticides according to Sri Lankan law.

It had been a popular pesticide worldwide during the 1920s.

The head of the Science Faculty of the Kelaniya university and the leader of the research team Prof. De Silva said there were evidence to prove 99% that this was the cause for the mystery disease in Rajarata but the tests were still continuing.

“We don’t have to wait long. The doctors from Rajarata conducting tests on dead bodies of people who died of the disease are already convinced the chemicals had killed these patients.”

Soon after the revelation of arsenic presence came out, the agro companies, the biggest names in the global arena as well as here, challenged the findings. The research team invited them to the Kelaniya university and the tests were repeated in their presence. Representatives of three companies turned up at the Science Faculty to see the tests for themselves.

“It was a unprecedented move to allow them in our labs.

“Outsiders are not allowed under ordinary circumstances. But we did it since lives were at stake. Following the tests they did not challenge our findings.”

Head of Chemistry Department Prof. Priyani Paranagama, said they used an internationally recognised method to distinguish arsenic in the Agro chemical samples, water samples, soil, vegetation that included grass and the bodies of the patients who died of the mystery kidney disease.

“The tests on agro chemicals proved that their products contained arsenic levels ranging from 100 to 3000 micro grams per kilogram, which is a highly lethal proportion capable of causing arsenic poisoning among humans,” she said.

The arsenic, a waste product in gold and silver mining as well as glass and computer chip-board production is used as a cheap source for manufacturing pest control, herbicide and germicide intended for countries like Sri Lanka.

However, the law here strictly prohibits the import of arsenic based agro chemicals.

“This way they find a convenient dumping ground for their hazardous waste in Sri Lanka but the irony is that we pay to get their waste dumped here.”

Some argued that the soil in the area could have had arsenic presence naturally. “There are countries like UK and Germany where arsenic is naturally present in the ground soil.

But Sri Lanka is not one of them. Moreover, the arsenic traces were found in the soil from the surface to about eight feet below. If arsenic was present naturally it has to be there deep down as well,” Prof. De Silva explained.

Others argued the kidney disease may have been caused by cadmium in the chemical fertilizers used by farmers or by the high degree of fluoride present in the soil. The research team had ruled out these hypotheses.

Dr. Channa Jayasumana of the Rajarata University’s Medical Faculty who initiated the research as part of his PhD work refuted this theory saying if fluoride was the cause, the people of Hambantota and Ampara should also have been affected by the disease.

Their theory is further supported by the fact that high concentration of arsenic had been found in the extracts of liver, thyroid gland, kidney, spleen and parts of the rectum of the bodies of patients who have died of the disease.

Arsenic poisoning does not show off symptoms until the late stages, thus by the time patients do turn up at the hospitals they are close to death. The disease has no proven cure and this killer disease has claimed many lives below 50, mostly the bread winner in the family, rendering the families destitute.

“We found higher proportions of arsenic content in the body parts, it was over 10-15 per cent higher than the WHO recommended levels,” Dr. Chinthaka Wijewardena of Padavi Sripura Hospital who tested the dead bodies assisted by a Judicial medical officer said.

Many of the patients who were diagnosed with the disease, have died within 1-2 years of its, initial diagnosis.

The other medical complications that can be caused by arsenic poisoning are heart attack, stroke, diabetes and weakened immune system that may be manifested by recurrent attacks of viral flu.

Arsenic and Mercury are Class one carcinogens. Their entry to human body could cause cancer. Further, mercury poisoning can harm the human genetic structure resulting in abnormalies in new born babies in the next generation. Dr. Wijewardena said a shocking 500 people out of the tiny 10,000 population in Padavi Sripura have been diagnosed with this killer disease. He has learnt 40 percent of deaths in this area during the past five years were caused by the CKDu.

According to the Sri Lankan law, which harmonise with the international law, no agro chemical manufactured using arsenic compounds can be imported to Sri Lanka. Calcium arsenate had been a very important agricultural insecticide in 1920s. But now its use is banned in many countries and in some only restricted use is permitted due to adverse implications to humans. Thus the results of their findings have now been referred to the Controller of Pesticides’ for further action.

The research team says the agro companies had violated the law by bringing in arsenic based products to the country. They alleged false declarations have been made via laboratory test reports that were submitted for approval from the Pesticide Controller.

The Controller of pesticides, alerted by the whistle blowing research has referred the samples of Agro chemicals to the state’s accredited laboratory, Industrial Technology Institute (ITI) for a review. The report is expected within two weeks. The Controller of Pesticides can recommend a ban on the products if the ITI tests corroborate the findings of the scientists.

Meanwhile the Bio Diversity Unit of the Customs Department has detained two consignments of the controversial Agro chemicals that was to be cleared from the Harbour for distribution by two companies pending the report of the Controller of Pesticides.

The research team

Prof. Nalin de Silva, Dean Science Faculty, Kelaniya University
Prof. Priyani Paranagama, Head Chemistry Department, Kelaniya University
Prof. Mala Amarasinghe, Head,Department of Botany, Kelaniya University
Dr. Kithsiri Senanayake , Kelaniya University
Dr. Channa Jayasumana, Faculty of Medicine Rajarata University
Dr. K.Dhanayake, Teaching Hospital Karapitiya
Dr. Chinthaka Wijewardena, Padavi Sripura Hospital
Dr. Panduka Mahamitawa, Faculty of Medicine Rajarata University
Dr. Laxita Rajakaruna, Faculty of Medicine Rajarata University
Dr. Dananjaya Samarasinghe, Base Hospital Karawanella