Sarath Wijesinghe – former Ambassador to Israel and UAE

Theme of the year Kidney Disease and Obesity

World Kidney Day is celebrating worldwide in order to realise awareness of the amazing Kidney, highlight that diabetics, high blood pressure are key factors on CKD (Chronic Kidney Disease) systems of screening all patients, encourages preventive behaviours, Educating medial and professionals, and activism in these directions with the activists public and media.

Obesity is a growing worldwide epidemic. Obesity is one of the strongest risk factors for new-onset chronic kidney disease, and also for nephrolithiasis and for kidney cancer. This year the World Kidney Day promotes education on the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive behaviours an affordable option.” CKDU is Chronic Kidney Disease spared fast in Sri Lanka and worldwide which is preventable with proper care and precautionary measures.

Kidney is one of the main and most precious organs in the human body, making urine, remove excess water, control body chemicals, toxins, control blood pressure, keep bones healthy, keep make and maintain red blood, controls mineral and potassium, blood acidity and many other matters for a healthy life. This is a complicated vital organ to be maintained carefully for a healthy life of a human being. It is as important as the brain and the heart for the human body to be alive. Kidney diseases were rarely heard in Sri Lanka until the recent past when our community lead a healthy life with nature. Unfortunately now things have changed. We are no longer a healthy nation due to our own mistakes which are out of our control due to changes worldwide on consumption of food, medicine and way of life in the fast developing world. Current catastrophic situation may be due to many reasons which includes intake of adulterated unhealthy water, food, artificial life against nature, excessively intake of chemicals, uneducated and in identified foreign bodies are identified as causes by researchers and scientists worldwide which is a threat to the mankind. Water we drink is polluted, food is adulterated and full of poisonous materials, vegetables and fruits are full of chemicals, drug intake is excessive and out of control, Junk food and unhealthy cola drinks are consumed by adults as well as children, food for sale is full of artificial flavour and chemicals used freely with dry rations adulterated by the unruly traders, food imported with no control and quality is consumed with no control by all age groups, over use of fertilizer with no proper control is rampant, destruction of the environment with de forestation and uncontrolled development schemes in small and large scale is taking

place all over. Citizen lives against the nature due to modern fast life with fast and unhygienic and adulterated food full of foreign and poisonous bodies. It is estimated that by 2035 kidney/diabetic patients will reach 592 million. This indicates that Sri Lanka is a fertile ground to spread Kidney diseases in all parts of the country. Currently it is rampant in villages in suburbs with contaminated water due to over and uncontrolled use of pesticides and fertilizer coupled with the other factors mentioned above.

Cause for the spread of CKD worldwide.

Exact cause of the crisis is exactly not identified but presumed by researchers as one of the abovementioned reasons of living against nature. Diabetes, Hypertension, Kidney disorders, blocking of arteries are near contributory factors of this world tragedy. It is a worldwide scenario in most parts of the world and spreads fast with no boundaries. 1.5 million World citizens die annually and US may need $ 48 billion per year and China $ 558 billion, for future expenses to meet this catastrophic situation indication the gravity of the crisis. 10% of the world population suffers from CKD and two million die allegedly due to CKD related reasons. There is 30% increase of CKD in USA and 7.1% of Indian population lives with this dangerous situation with 17% urban population. Massive Food circulation worldwide with no control and standards has increased the spread of the d consumption of fast and unhygienic food provided by massive multinational companies worldwide and usage of dangerous chemicals for food outlets and domestic consumption. Classis example is the use of a Weed Killer Ajinomoto- Monosodium Glutamate” Essence of Taste – the company with revenue of 1172 billion is used in most restaurants hotels and homes in large quantities for taste. Cola we drink is poisonous and contains 8 to 10 spoons of sugar which strongly catalyzed and promotes CKDu. Citizen should be given pipe born water instead of polluted well and water from tanks with pesticides and agrochemicals as water is identified as one of the main causes of the spread of CKDu.

C K D (Chronic Kidney Disease} in Sri Lanka

Four million out of 23 million of the population suffers from diabetic related ailments, which has a direct impact on the future generation which is a dangerously high proportion. It is estimated that there are one hundred thousand kidney diabetic related patients at hospitals and it is now known the unknown potential suffers growing at the rate of 5000 per year. The cure is expensive and complicated. The potential patients are to be dialysed or kidneys are to be transplanted which are expensive in any standard and not provided by Government hospitals. Country needs 1000 dialysis centers, but hospitals have facilities for only 178 to be used by patients in dire need in last stages. If you are not dialysed at least thrice a week death is the next option. There are around 20,000 patients on CKDu needing dialysis thrice a week which will cost around 10,000 per session which will take around five hours available in private hospitals in urban areas with other facilities as backup medical

staffs is required during the process of dialysis. Vat has become the additional monster adding 15% to dialysis, drugs and consultants. 50% of the population is on Samurai Benefits” and the average salary of the average common man is around 700 rupees per day. If 20,000 families in one province have five members 20, 0000 citizens suffer with which is ever growing. By 2035 it estimated kidney/diabetic patients will reach 592 million and it is estimated there are over one hundred thousand CKD patients growing annually fast in all the districts at 5000 new patients per year. Therefore it is not the time for the politicians to give concessions and benefits on to themselves on Car permits, Tax, Rent and other allowances with further expansion of the Political Portfolios and Parliamentary Committees with facilities and perks at the cost of the tax payer already in trouble. They have no mandate to exploit the citizen lead extra superior lives at the expense of the tax payer who had trust on the politicians who has been given the country as trustees on trust. In the UK and other countries dialysis and transplant is free to the citizen. It is nothing but fair to extend the facility to the dying brothers and families in Sri Lanka to save their lives making and creating strategic innovative mechanisms.

International and Local mechanisms to prevent and cure CKDu

National Kidney Foundation based in the USA is active in organizing awareness and educational programs with directions to find funds to needy. Kidney education foundation and Kidney Foundation in India encourages donation of Kidneys and assistance to the needy. World Kidney day and many programs are organized by the National Kidney Foundation with the network with 150 countries. National Kidney foundation was incorporated on 26thSept 2006, but the progress of the Foundation not known and published. National Kidney fund was set up to assist needy with the help of Holsim” with the Presidents blessing’s and the Presidential Task Force established appear to work hard more on publicity which requires more professionalism and strategy not giving prominence and working arrangements to publicity alone. National Kidney Foundation attempted to set up a database on Dona supply programs under the auspices of the President and the Minister of Healthy with is still in the formative stages with National donor Supply program. Cricketer Dilshan and Wetthamony were appointed by the President as Brand Ambassadors on the CKDu crisis to promote programs under the tasks force with lot of publicity and funfair with excellent concepts and future plans with results unknown to the citizen yet. Samastha Lanka Kidney Patients Association backed by Professor Razvie Sheriff and Dr Sanjeva Heiyantuduwa is doing a yeoman service on educating patients and would be victims to prevention and assistance in dialysis and transplants through the Association.

Way forward and a case for a Kidney Bank in line with Eye Bank and the Blood Bank, A Tissue Bank, Blood Bank and Eye Bank is performing reasonably well in Sri Lanka with State Patronage which is an essential factor under any regime as it is a matter of a service to the citizen and the mankind in need. Pioneer of the Eye Bank Dr Hadson Silva is ever remembered by Sri Lankans as the originator of the society

now spread worldwide giving free service in providing super quality cornea tissues free for transplant. It is a joint venter with Singapore government managed by a Committee consisting of the Health Minister, Director of Health services and representatives from Singapore sited at the Eye hospital in Colombo. First blood donation took place in 1921 and the current blood bank provides 350000 volumes of blood per year free collected by voluntary donors. Blood donor day is on 14th June and the blood is offered by the public voluntary with no hesitation. There is a tissue bank in Sri Lanka and organ banks in the UK and USA. There were media publicity on Kidney Rackets and transplantations performed illegally in Sri Lanka. But it was revealed that 107 operations performed in three years are for Indian patients with Indian donors using the expert performances of Sri Lankan and Indian Doctors in Sri Lanka. This should be encouraged and promoted to encourage medical tourism and to raise the standard of Sri Lankan Doctors and the medical system to the international standards.

Sri Lanka Kidney Association is celebrating the Kidney Day in Sri Lanka in the New Town Hall Colombo with Hon the speaker Karu Jayasuriya as the Chief Guest organized led by Dr Sanjaya Heiyantuduwa with invitees including Professor Risvy Shereff, Professor Mendika Wijerathne, Ravindra Randeniya Sathishchandra Edirisinghe and invitees where invitation is open to the public. It is advisable for the CKD patients and potential patients in vulnerable situations to be aware of the realities, facts with precautionary measures in order to aspire to be in a world free from Kidney Diseases. Sarath Wijesinghe could be contacted on sarath7@hotmail.co.uk and the views expressed are that of the author.