By Chandre Dharmawardana

My article entitled Why do ‘Vanniye-Attho’ and NCP Farmers get CKDu while their cows don’t?”
produced several curious responses (Lanka Web, 17-11-2017) which fit in with the well-known way in which proponents of pseudoscience and conspiracy theories extend their claims when faced with the actual facts. Basically, they spin additional explanations that are unsupported by facts, but seemingly  plausible at first sight.
The myth makers introduce these  additional extensions  to cover qualitative but poignant observations (e.g., that Kokku” flocking to eat earthworms is evidence of a healthy soil, or that cows too should be affected by the alleged toxins). They construct denials of established facts – a form of ostrich policy. The more detailed  quantitative facts (e.g., results of chemical analysis) are ignored, i.e., another form of ostrich policy.  Such patently incorrect extensions and denials  need to be rebutted to ensure that they do not take a life of their own.

Some of the responses suggest that cows are unaffected by metal toxins because they have a different digestive system”, while it is claimed that the presence of earth worms is no indication of soil toxicity”.  Another remarkable claim is that Cows with a very short lifespan and a very large body mass cannot be compared to humans”. These contravene the  well known fact that  toxicity tests are routinely effected using creatures with even shorter life spans like amoeba, fruit flies, rabbits, guinea pigs,  and mice.  In fact I referred to the important experiments on CKDu by Dr. Wasana, Dr. Bandarage and their team on mice, published in the world famous journal Nature in 2016.

Heavier humans and heavier animals eat more and accumulate more toxins. So the body mass is not directly a problem in specifying toxicities. The chronic toxicity of a substance is measured or quoted   as a daily intake per kilogram of body weight and usually the extent of the scalability is also established in the experiments used to measure experiments.

It is well documented that arsenic (As), cadmium (Cd), lead (Pb), and mercury (Hg) among many other substances are the most toxic to humans, animals and birds. Even though As is  not ‘heavy’ and not a proper metal, it is put together with  Cd, Pb, and Hg for convenience are called heavy-metal” toxins. Even those who have not studied these materials in college courses (in toxicology or environmental science) can find information on them in the internet.

Of course, a lot of  information on the internet tend to be partially or completely untrue. However,  when it comes to matters of doom and gloom, it does not fail to report them. So, the toxicity of heavy metals to livestock is well recorded, and one may download technically specifications and discussions from the regulatory agencies of the European Union, Canada or Ireland, etc.. They are all very similar, and show that parts per million quantities of heavy-metal toxins can cause chronic diseases in livestock. Livestock include calves much smaller than humans, and they are very vulnerable to toxins. Even fully grown cows are far more sensitive to lead toxicity than are humans.

Within the above picture one may consider the following surprising claims made in response to my article.
(i) the cattle that feed on the grass and straw grown on soil containing toxins need not get sick because they have differences from humans”.
(ii) a first sign of the  toxicity of the soil is the death of earthworms and other soil organisms, and the effect on birds and other  predators who might feed on any remaining soil organisms. And yet, some have come forward to question even this. We will discuss these in greater detail below.

A third uncanny and utterly lame argument is that chronic diseases like CKDu did not exist prior to 1970, and hence it must be caused by the introduction of agrochemicals around 1970 to the Rajarata,causing its residents to get CKDu within a decade.

The latter  question is often asked by those who come discuss CKDu without  (a) realizing the difficulty in detecting and diagnosing CKDu in a patient. (b)  The  Agrochemicals have been introduce to the whole country, and NOT just to the Rajarata. It was the tea plantations and the Nuwara-Eliya vegetable gardens that first began to use agrochemicals. Farmers in low country areas (e.g. Agalawatte or Deniyaya) also have used (and continue to use) agrochemicals in much larger quantities than the paddy farmers in the Rajarata.

Prior to 1970, or even in the 1980s, there were no hospital procedures to detect CKDu in a patient. The modern tests, based on the value of the ratio of two proteins found in the blood (and also in urine) became available only in the 1990s, and that too  in advanced University hospitals. Today it is routinely available. The first reports of CKDu, attributed to Dr. Ramachandran in some publications are tentative and unconfirmed, but more well confirmed  detections were made later, by Nephrologists like Dr. Tilak Abesekera (Consultant Nephrologist, Kandy). The disease may exist in a patient with no outward signs until he is left with only the equivalent of less than half a kidney in good condition. Then various symptoms begin to set in and the patient degrades and dies very soon. Even today villagers only know of the illness when they come to the last stage and attribute it to various other causes like the delayed effect of snake bites, hornet attacks, the attack of an evil spirit like Mahasona”, or the wrath of `Daedimundi’ or `Kadawara’  (regional gods).

It should also be noted that until the coming of the Accelerated Mahaweli Program (AMP) came, people were living in thinly populated settlements where their water supply was the local river,  canal or Wewa. People were not settled far away from agricultural canals and there was NO NEED for private HOUSEHOLD wells. According to the mainstream view (e.g., see  the article by Dr. Tilak Abesekera, kidney specialist, Kandy,   in the Daily News, 9-March-2017),  it is the fluoride-rich hard water from these wells that cause CKDu which is listed among the many possible causes. Such house hold wells became necessary only with influx of more settlers under the AMP.

Chemical analysis of the well water confirm that the well water contains fluoride and hardness. Also, chemical analysis of the Mahaweli water up-stream and down stream (e.g., by Dr. Diyabalanage et al., University of Peradeniya, 2016) , as well as the water in the local irrigation canals and tanks do not show any heavy-metal toxin levels above the WHO specified values. It was such water that was (and is) consumed by the early settlers and those who live close to the irrigation network. It is confirmed that agrochemicals bring in excess phosphates and increase algae growth, but no increased metal toxins have been found by at least five independent research efforts. And yet, the anthropologist Amarasiri de Silva and the swedish student take it for granted that the environment is awash with agrochemical toxins and caused CKDu.

Let us take the responses in detail:

5 Responses to Why do `Vanniye-Attho’ and NCP Farmers get CKDu while their cows don’t?”

Senerath Says:
November 16th, 2017 at 3:21 pm

Digestive system of cows is not the same as humans ( we don’t eat grass, specially dried grass). Cows have a shorter life span. If humans get the decease after 10 years of exposure, by the time cow gets it, it is dead.

If we ate grass, we will be worse off, because leaves of plants like grass or paddy concentrate toxins that they suck up with the water during the lifetime of the plant.  If the soil and water only contained three parts per  billion of lead, or cadmium, the material accumulates in the plant and one may have100  times more amounts of toxin in the leaves. Once the leaves are consumed, and the toxin gets into the body, it finds its way to organs like the liver and ultimately to the kidney in the effort of the animal or human body to excrete it. But the toxin breaks up the epilayers of the kidney glomerulus and tubules, be it they of  human or bovine. This begins to happen in even a few weeks as seen in experiments on mice who live only a few months. Even in a human, CKDu begins as soon as water or food containing toxic agents exceeding the maximum allowed limit given by, e.g., the WHO. So you don’t have to wait 10 years for the onset of CKDu. In 10 years a man, or a cow would have lost most of both kidneys and then the disease becomes manifest. But detecting CKDu earlier to that is difficult without lab facilities.  In the case of cattle, it will be observed  that  calves affected by the diseases will not grow and have to be eliminated as there is no economically useful veterinary intervention available.

aloy Says:
November 17th, 2017 at 3:39 pm

Here is an expert who doesn’t understand the difference of life span between a cow and a human.

You don’t have to wait till the end of a human’s life or animal’s life for it to get CKDu. The cells in humans or mice or cows are very similar, and any given cell (irrespective of the source)  gets affected by toxins at the same rate, right from the first day, gradually. Cows have a life span of about 20 years (i.e., shorter than human life span of about 70-80 years) and hence the effect of CKDu is seen in bovines   sooner than in humans. Mice have an even shorter lifetime and so they are preferred for lab experiments.

There is a saying a that ‘kanna ona unama kabaragoyath thalagoya’. These are serious matters affecting lives of our farmers. They have been doing the farming for thousands of years without any problem. Suddenly CKDu appears.

I believe some people want to eliminate Sinhalas from Rajarata.

Conspiracy theory! A better conspiracy theory could be:
The government, by banning the herbicide known as glyphosate has ensured the death of modern agriculture not only in the Rajarata, but in most parts of the country. Once the farmers are bankrupt, the megalopolis planners and  the multinationals like Dole can just buy up the land at fire-sale prices.

So why does CKDu appear  ONLY in the Rajarata? Agrochemicals began to be used in the rest of the country even before the Rajarata, and much more intensely. There is no CKDu in Nuwara Eliya although their soils are full of agrochemical residues (phosphates). Same is true for, say, Jaffna peninsular  soils, as shown by a recent study by the International Water Resources Board) . This is a result of   decades of intensive farming (including during some Eelam-war years when smuggled fertilizers were allegedly available in plenty). Any explanation of CKDu must explain its specific geographic distribution.

Dilrook Says:
November 17th, 2017 at 6:11 pm

   A very poor comparison on more than two counts.

    Presence of worms in soil is no indication of lack of toxicity. Cows with a very short lifespan and a very large body mass cannot be compared to humans.

An ex cathedra statement is made that the presence of earthworms  is no indication of lack of toxicity”. On the contrary, it is the accepted scientific position that As, Cd, Pb, Hg etc are deadly to earthworms and the presence of thriving earthworms is a sign of a healthy soil not containing such toxins; the amount of toxins in an earthworm’s body is directly proportional to that in the soil and toxifies the worm. See for instance, the report by Janssen et al.   in the Journal of Environmental Toxicology and Chemistry, 1997, and the 2004 study by Lukkari et al published in Ecotoxicology and Environmental Safety.

As for the body mass, calves  are less heavy than humans and their growth is atrophied if they feed on grass or fodder containing more than a few parts per million of metal toxins. Hence the livestock industry follows the appropriate maximum allowed limits specified by farm-regulatory organizations. Furthermore, such toxins imbibed by cattle can come into the human food cycle via meat and milk. Hence there are strict controls.

Senerath Says:
November 17th, 2017 at 7:02 pm

    I seriously think LTTE and their supportes have poisoned waterways and Wevas of certain areas and are still doing it secretly. This cannot be ruled out.

This can be, and has been totally ruled by the analysis of water. It is also ruled out by the existence of fish and other aquatic life in the water.

But here we have a typical  conspiracy theory. The more common conspiracy theory is that the agrochemical companies have bribed the vast majority of agricultural scientists, kidney specialists,  chemistry professors, government civil servants  etc., and hence they are falsely claiming that the  agrochemicals are safe to use and are not the cause of CKDu. The rare maverick scientist (or sometimes a person with no scientific credentials) who makes statements in agreement with public beliefs becomes and an eco-hero and his message is internationalized through questionable websites like those of Dr.” Mercola.

People who drink water from Wewas (tanks) do NOT get CKDu as has now been established fairly well.  Prof. Kamani Wanigasuriya of the SJP University medical faculty had already conjectured that the use of household wells may be linked to CKDU in an early research paper. The WHO-NSF study of CKDu in the Rajarata (published 2013, 2014)  was the first to show that the irrigation water had no significant amounts of heavy metal toxins or pesticides by studying some 250 water samples.

Senevirath Says:
November 18th, 2017 at 11:36 am

අහෝ,, පනුවෝ සහ හරක් ද නරයන්ට සමානලු බොහෝ දෙනෙක් ලියු හෙයින් මේ ගැන වැඩිදුර නොලියමි
Worms, cattle and humans are all aggregates of cells like those of an amoeba, and hence these cells are extremely similar to each other. The metal toxins also act on cells in worms, mice, rabbits, cows, monkeys or humans by disrupting the epilayers of cells where the toxins accumulate; so they all get sick in the same manner. In addition, there are other pathways for toxification. For example, cadmium can replace the calcium in bones of humans or cows and form human or bovine versions of the itai-itai disease.

On Thursday, November 16, 2017, 3:26:40 PM EST, Chandre dharma-wardana <chandre.dharma@yahoo.ca> wrote:

Regarding Kidney disease among the Vanniye-Aththo.

Unfortunately, this author (Dr Amarasiri De Silva, an anthopologist)  has not checked his facts and instead simply followed what a young Swedish Research student who had come to write a social studies  thesis on Anthopology has said, ignoring the excellent work done by local scientists and medics.

Even for the correct word form for “sinhalese”, this author relies on the Swedish student, as to whether we should write it as “Singhalese”, or “Sinhalese”. English is not a phonetic languages. Even the Sidath Sangara (mdieval sinhalese grammar and literary style book) says that common usage dictates the “right usage”.

Same for  the usage  “Vanniyala-Aththo” where he  follows the swede.

The attached note (included also as text below) may help in clarifying the issues).

——————————————————————————————————-

Why do `Vanniye-Attho’ and NCP Farmers get CKDu while their cows don’t?

Dr. Amarasiri de Silva (AS), a retired anthropologist, has made a provocative contribution (Island, 15-11-2017) on chronic kidney disease of unknown origin (CKDu)  that goes counter to  main-stream scientific discourse (e.g., by Dr. Tilak Abesekera, Consultant Nephrologist of the Kandy Hospital, see:  Daily News, 9-3-2017), while strongly echoing the  beliefs immensely popular with a section of the wider public.  A young Swedish student named Wiveca Stegeborn (WS)  who prepared a social-anthropology thesis on the  Vanniye-Attho, i.e,  Veddahs”,  is his main source of information.  We are told that the Vanni-Attho contracted CKDu when they joined the Mahaweli settlements, adopted  urban foods,  and became farmers using toxic agrochemicals”.

If AS and WS also imply that DDT and GMO seeds are being used, then we have some truly astounding claims in the article.  AS pushes to extremes the seemingly  credible public view of agrochemicals creating a  toxic environment and causing chronic diseases. Accordingly,  (i) the use of agrochemicals since the 1970s has poisoned the soil, the water and the diet;  (ii) the NCP gets a `double whammy’ because  the  agrochemical runoff from the tea estates gets  to the NCP via the Mahaweli irrigation system. The NCP farmers get chronic kidney disease (CKDu) in due course.

The present author held similar views prior to 2012.  They had to be  drastically modified  during 2012 to 2014 when important field studies appeared. The first was the NSF-funded  WHO  study which medically bench-marked CKDu, and also showed that  toxins in the soil, water and the diet were well below the maximum allowed limits (MALS) for toxicity and hence safe. There was no arsenic or glyphosate, as claimed by the Natha Deviyo” devotees linked to Dr. Jayasumana.

Dr. Sarath Amarasiri, a retired Director General of agriculture points out that when farmers tilled the land, vast flocks of egrets (Kokku”) follow the ploughs to eat the exposed  earthworms and other bugs. If the soil had become toxic, it will not be teeming with organisms, and if they are toxic, the egrets should  also get sick. Clearly, the NCP soil and water are not awash with toxins”.

The present writer used to ask, if the people in some NCP villages get sick, why not the cows? If it is a presence of cadmium and other agrochemicals in the rice, the cows get even more of it from the straw and the grass which also accumulate cadmium and other toxins.  Today many scientists think that they understand these puzzles, and why some Rajarata villagers get CKDu while their cows don’t, while other villagers and their  cows also don’t get CKDu!

Studies  of the blood and urine of the patients showed that 97% of them had no significant traces of glyphosate, the most commonly used herbicide. A mild warning was raised in the WHO-NSF report about possibly elevated levels of cadmium in the diet, but this was also true of the  diet used in the rest of the country that does not have CKDu. The traces of cadmium found in the rice are  amply counteracted by the presence of other substances like zinc and selenium (just as is the case with cadmium-containing shell fish sold in Europe).

The lack of toxic agents in the soil and water were confirmed by independent research including a Japanese-Sri Lankan study led  by Dr Nanayakkara.   A  National Water Board (NWB) study by Dr. Pathmakumara Jayasinghe showed that the canals, rivers and reservoirs in the NCP had clean water, and that expensive Reverse-Osmosis (RO)  machines are cleaning” water which is already clean! The poor farmers, frightened by the threat of CKDU and toxins buy bottled RO water at Rs 2-3 per litre while Colombo gets water for pennies.

Dr AS has ignored the good work of the local medics and scientists. The NSF-WHO study, the Japanese study, the NWB study etc. , have been summarized  in popular articles by Dr. Waidyanatha, Dr.  Tilak Abesekera and others.  The young Swedish student prepared her thesis on the Vanniye-Aettho, but not on the chemistry of the local environment.

Social anthropologists like AS and WS should study the two adjacent villages named Badulupura and Saaragama, both in Girandurukotte, with common life styles, food, and kinship. And yet Badulupura has CKDu, while Saaragama is healthy.  The Badulupura residents who use their private well water get CKDu, while neighbouring Saarapura , being closer to the agricultural land,  gets its water from irrigation canals or private wells connected  to the groundwater of the paddy fields. Research groups like CERTKID of the Kandy Hospital and the University find that  the consumption of water in isolated shallow household wells  may be causing CKDu.

Peradeniya Chemists like Prof. Illeperuma,  and Geologists like Professors Dissanayake, Chandrjith and others had noted that the endemic areas have hard water and a geology rich in fluoride.  The present author  and several colleagues argued (in a research paper) that Panabokke’s redox mechanism worked in the stagnant wells to progressively leach out fluorides and other mineral salts (known as Hofmeister-active salts) into the  well water.

Hard water has dissolved magensium and calcium. If hard water containing fluorides were the cause of CKDu, one can immediately explain why the people in Badulupura got CKDu, and why those in Saaragama are healthy. We also understand why the cows don’t get CKDu. The cows do not drink water from wells, but drink surface water in canals and fields connected to the agricultural system.  AS and SW claim agricultural water to be contaminated, where as it is not.

A milestone  in CKDu research was the work of Dr. Wasana, Dr. Bandarage et al. of the IFS, Kandy. They fed HARD water containing fluoride to laboratory rats, and established a dose dependent causal relationship between damaged kidneys in the rats, the fluoride, and hard water. If the water was free of fluoride, or if the water was soft, no kidney damage!  Both hardness and fluoride were simultaneously necessary. The present write provided evidence that the magnesium in hard water joined itself to the fluoride forming a pair. Magenisum is not toxic; but it synergistically augments the toxicity of fluoride. Independent  experiments by Dr. Tammityagoda et al. (veterinary science) used water from endemic village wells and showed that mice fed on such water contracted CKDu, while mice given normal water remained healthy. These experiments, the geology of the endemic villages and the chemistry of the well water  led most scientists  to  conclude that CKDu in the NCP  is caused by consuming hard water  containing fluoride. Professor Gamini Rajapaksa’s Moneragala studies confirmed these conclusions.  Provision of cheap clean water by harvesting rain water has been launched.

Scientists have shown that farmers are using agrochemicals in excess, especially with the free market in 1977 cutting out the agriculture department’s control on agrochemicals.  Such excessive use leads to algae blooms and environmental problems. The agriculture department has issued 25 booklets for the 25 districts, indicating where fertilizers are NOT needed, or how much is needed.  Agrochemicals are used thorough out the country, and especially in the hill plantations. But no CKDu and other diseases attributed to agrochemicals have been detected. We now understand why some villagers get CKDu while their cows stay healthy, or why other villagers escape the  illness. Fluoride and hard water are not found together in the hill country, or in Jaffna where there is heavy agrochemical usage, and so there is no CKDu in those areas.

Finally, let us look at the Swedish student’s views on the rural food culture, since they apply equally well to most of the country without CKDu.
(quote)… with time diabetes started to spread. It came with junk food, and with Cokes, Seven-Ups and Fantas … welfare coupons for sugar and white flour… The tea was no longer taken with honey or hackuru [Kithul jaggery], it was with refined sugar. …This is a common ailment among indigenous people introduced to a ‘western’ excessive food culture (end quote).

Honey and jaggery are nearly as bad as refined sugar. Sugar is 50% fructose and 50% glucose, while honey (i.e., bee’s vomit) contains 40% fructose, 30% glucose while the remaining 30% is water, pollen and bio-matter from the bee. Honey has  some 31% more calories than sugar. The pollen can cause botulism especially in children younger than 12. Honey has similar effects as sugar on blood glucose levels, causing problem for diabetics, whether they are Vanniye-Attheo or not. The digestive tract absorbs fructose poorly, and the fructose end up in the liver, leading to metabolic problems including type-II diabetes. The American Diabetes Association regards  palm sugars (e.g, Jaggery) to be no better than pure sugar.

The embrace of western food culture”, or the equally unhealthy Kalu dodol, Kaevum, athiraha, kiri-paeni, ala dosi” or baedum, ghee rice” etc by the Vanni-Aetto or anybody else reflects the lack of nutritional education in Sri Lanka. There were no courses on food science, environmental science etc., in any Sri Lankan university until the mid 1970s.  The present writer, as a Professor of Chemistry and as a  Vice Chancellor of the Vidyodaya (SJP) University  worked to introduce them to the university curriculum.   Course units in nutrition, health and environmental science  are badly needed even in our schools.

Chandre Dharmawardana.