The elixir of life!

Pure water is the solution for CKD says Sisira Amarasekera, expert on water purification:

Although Chronic Kidney Disease (CKD) was initially believed to be confined to the North Central Province (NCP) mainly in two administrative districts of Polonnaruwa and Anuradhapura, it has now been established that prevalence of CKD has spread beyond such boundaries. Over the past 20 years thousands of people have died from CKD. And judging by the present number of patients, it is widely believed CKD has the potential to increase exponentially and explode into epidemic levels in the coming years.

For most of the population living away from urban centres, groundwater is the main resource for drinking water and it is estimated that more than 75% of the drinking water requirements for the rural communities are obtained from shallow and deep wells. Various researchers have been working hard to examine diverse causative factors, by analysing water quality of samples from various sources supplying drinking water in CKD prone areas. It has now been well established that high concentrations of several constituents in drinking water as the cause for Chronic Kidney Disease.

Based on the research findings, number of parameters such as anions, cations, and heavy metals including Glyposates either singularly or in combination has been suggested as causative factors for CKD. High Calcium content in the presence of Fluoride is said to form Calcium Fluoride, which is insoluble in water causing Kidney Tubular Damage influencing CKD. Heavy metal pollution is a recent concern for CKD in Sri Lanka and two such heavy metals, Arsenic and Cadmium, are suspected to be originating from agrochemicals. A relationship between Fluoride and Aluminium utensil usage also has been established where Aluminium and Fluoride in combination could be another contributory factor for CKD.

Although the majority of water quality parameters in surface water in CKD prone areas do not exceed the World Health Organization (WHO) standards for drinking water, which is the basis for regulation and guidelines for drinking water in developing and developed countries, it is essential to look beyond WHO recommended limits to prevent CKD. Unfortunately, none of the traditional water purification methods viz filtering, boiling or chlorination, which works well in urban households, is incapable of addressing the issue of CKD.

It has been proven beyond doubt that Reverse Osmosis (RO), which removes all suspected CKD causative elements such as Cadmium, Arsenic, Calcium, Magnesium, Glyposates, Fluoride and Chloride, is the only definitive answer to prevent CKD.

The government, keen to address the issue has started implementing RO based water treatments plants in severely affected areas.

However, it would be futile to expect the government alone to provide such RO schemes to supply drinking water for all the vulnerable areas.

Having smaller capacity (domestic) Reverse Osmosis systems, which can produce about 100 to 200 litres of purified water, is an option though the cost factor and complexity is of some concern....

However, it should be cautioned that in areas where the hardness of water makes it a high necessity to have pre-treatment systems, such as softening, has almost ruled out the feasibility of individual domestic RO usage. Some opportunistic merchants have resorted to offering machines off the shelf without proper analysis of source water, leading to premature clogging of filers and membranes and then selling all consumables at extremely high prices fleecing the innocent public.

A much better option is for several households to get together and implement small to medium scale RO purification units at central locations such as religious worship places and community centres and share the RO water output among the community.

This creates an opportunity for well intended individuals/groups as well as corporate donors to come forward to financially sponsor implementation and maintenance of such systems.

A new breed of entrepreneurs on their own or in collaboration with social service organizations and groups have sprung in the CKD prone areas to establish small or medium scale RO systems where purified RO water is sold for an affordable price. The government should take note of these developments and take appropriate measures to encourage such small entrepreneurs by offering low cost finance and if necessary establish a regulatory system.

It also has come to light that certain vendors are taking advantage of less educated people by offering cheaper UF filters coupled with Ultra violet filters on their own or in combination with smaller capacity RO filters claiming it is to retain essential minerals in water. One should bear in mind that UF filter has openings of 0, 01 to 0.1 micron whereas RO filters opening is 0.0001 micron (1 micron = 0.001 mm).

Therefore it is obvious that UF filters are incapable of filtering out CKD causing elements such as Cadmium, Arsenic, Calcium, Magnesium, Glyposates, and Fluoride.

RO purified water is generally acidic in nature with pH values in the range 5 to 7 irrespective of whether installed by the Government or the private sector. In this respect it is regrettable to note that certain public health personnel without adequate knowledge on the chemistry of water and its effect on the human body going around trying to propagate the myth that RO water should conform to pH values 6.5 to 9 as set out in the SLS standard 614 for bottled drinking water.

Whilst not a single death has been attributed to low pH values in drinking water, RO water even with a lower pH value shall totally eliminate the dreaded Chronic Kidney Disease.

Last but not least it is very important to remember that purified water should be used not only for drinking purposes but also in water used for consumption in tea, coffee and other foods to avoid harmful elements getting into the body as boiling or cooking will not change the composition of water.

(The writer is a qualified Mechanical Engineer and information Technology Specialist having graduated from the University of Peradeniya and the University of Colombo. He is a member of many international professional bodies and holds vast experience in designing of residential and industrial water purification systems and acts as a consultant to several leading international companies)