Arsenic Kills Thousands While Health Ministry Slumbers

Some symptoms of arsenic toxicity

 Sunday, March 17, 2013

Although the Health Ministry denies that the Chronic Kidney Disease (CKD) slowly killing thousands in the North Central, Eastern, Wayamba, Ruhuna and Uva Provinces is due to pesticides and fertilisers containing arsenic being used for agriculture, studies now confirm that the use of fertilizer has contaminated the tanks and ground water in the area with Arsenic and Cadmium.

The study has found that at least two persons die daily due to kidney failure, while over 200,000 patients suffer from CKD, while thousands more are at risk.

Secretary of the Patriotic National Front Dr. Wasantha Bandara accused the registrar of pesticides of defending the pesticide and fertiliser importers and denying that there was any link between CKD, pesticides and fertilisers.

“The registrar in spite of being aware of the high levels of arsenic and cadmium found in samples of fertilizer and pesticides used in the Raja Rata area, which was proved to be the cause of the increasing number of patients with CKD, blatantly denied the report findings. These officials are in the pockets of these multi-national companies that import huge amounts of fertiliser and pesticides to the country,” he said adding that studies carried out in the areas clearly confirms the link between the pesticides and fertilisers and CKD.
However, according to Bandara the fertiliser and pesticides that are imported to the country do not contain high levels of arsenic. “Tests have been conducted on the various types of pesticides and fertilisers that confirm this. However when the samples of the same brand of pesticides and fertilisers that were distributed to various areas were tested individually, it was found that these samples contained arsenic and cadmium in extremely high doses. This proves beyond doubt that these pesticides once brought into the country are adulterated with arsenic to make additional profits. These samples clearly indicated that the amount of arsenic found in the adulterated pesticides and fertilisers were thousand times higher than when it was imported.”

He accused the Government Medical Officers’ Association (GMOA) of maintaining silence in this issue while innocent people are dying of CKD due to arsenic poisoning. “The GMOA who strikes for the most trivial reasons has not spoken a word about the whole issue that is affecting thousands of people’s lives. Most people are afraid to address this issue as these are multinational companies and they all have benefits, or are anticipating benefits. Most of the higher-ups of the health sector are afraid to bring up this issue due to fear of losing their privileges, and are silently ignoring the catastrophe that is slowly killing our farmers,” he said. He pointed out that the authorities are hoodwinking the people by claiming to appoint committees to investigate the issue. “The president appointed a committee to investigate the arsenic issue, who in turn had appointed a subcommittee. However it is ironic that this sub committee comprised representatives of the very companies that import fertilisers and pesticides,” he added.

Even Children As Young As 10 Affected

CKD unidentified which has mainly affected the people of the North Central, Eastern province, Wayamba and Uva province, had been detected in these areas around 20 years ago, but it has spread progressively in the Ruhuna region as well and the situation has reached catastrophic proportions. Today, even children as young as 10 years have been found affected by the disease, while by the age of 40 they reach the critical conditions.

Studies have found that in Anuradhapura, Polonnaruwa and Badulla districts around 15% of the total population (around 200,000) between the ages of 15 to 70 are suffering from CKD, while it is still rapidly spreading.

According to Prof. Priyani Paranagama of the Kelaniya University, extensive research on this issue commenced in mid December 2010. “The danger of arsenic is that it has no smell, taste or colour, making it difficult for people to even know that they are consuming water and other substances contaminated with arsenic.”

She added that she began her research at the Padaviya hospital where over 50% of the patients who had come for treatment had shown symptoms of arsenic poisoning. “The most distinct characteristic of chronic arsenic toxicity is the classical skin lesions including hyper pigmentation and kerotosis in the palms and soles of the patients. Even those who were found healthy in these affected areas were found to have doubled the amount of arsenic and cadmium in their urine samples, in comparison to people outside the affected areas. This increased levels of arsenic and cadmium not only puts them at risk of falling victim to CKD but there is also an increasing prevalence of cancer and diabetes with the biological gradient of arsenic, cadmium, mercury and uranium levels in drinking water,” she said.

The study had also found that the majority of those diagnosed with CKD and are facing imminent death are males between the ages of 40 to 60 and they are the breadwinners of families. She added that in addition a large sum of money has to be spent on medication needed for the treatment of such patients. “Not only in the most vulnerable areas, the entire population of this country is believed to have higher levels of arsenic and cadmium in their bodies. We have also found higher than stipulated levels of arsenic and cadmium in vegetables, lotus yams, fresh water fish and tobacco. In addition vegetables were found to contain dangerous levels of led and mercury as well,” she added.

According to the study it was revealed that the arsenic, cadmium and led levels in phosphate fertilisers for sale in the affected areas were higher than the fertiliser sold in non affected areas. “Therefore it has been clearly established that there is a direct link to the high rate of CKD, cancer, and diabetes with the fertilisers and pesticides being used in the Rajarata area. This is a bigger predicament than the 30 year long war that the people are facing today, as arsenic poisoning is slowly but surely killing our people,” she said.

Urine and hair samples of people in these areas were used for the study, while body parts of those who had died due to CKD were also tested to gather information and confirm the link between fertilisers and pesticides, she said.

The final report by the World Health Organization (WHO) titled Investigation and Evaluation of ‘Chronic Kidney Disease of Unknown Aetiology in Sri Lanka’ prepared for the Ministry of Health, which was released recently highlighted that Chronic Kidney Disease of Unknown Aetiology (CKDU) is being identified as slowly progressive, probably starting in the second decade of life, and asymptomatic until very advanced.

The research scientists headed by Dr. Shanthi Mendis, Senior Advisor and Co-ordinator, Chronic Disease Prevention and Management, WHO in Switzerland and was supported by a group of reputed scientists concluded that there is a CKDU prevalence of 15.3% with a higher prevalence among females (16.8%) than males (13.3%) though more severe condition of CKDU were seen more frequently in males.

The WHO permissible limit of Arsenic for drinking water is 0.01 mg/L and the FAO permissible limit of Arsenic for irrigation water is 0.10 mg/L. However in most of the water samples taken from the affected areas the detected level of arsenic was 20 – 100 μg/L.

North Central Province – ­­High Risk Region

Meanwhile, in addition to the study conducted by the team from the Kelaniya University, a separate study has also been conducted by the Institute of Research of Indigenous Medicine. The research study covered high risk areas of the North Central Province.

Speaking to The Sunday Leader Dr. Parakrama who was part of the team that conducted the research said that the group found most vulnerable to the disease is people who are between 45 to 69 years. He said that they had found that 87.8 % in Anuradhapura and 90% in Polonnaruwa had been those who had consumed water-based plants, freshwater fish and consumed either water from tanks or well water, which had recorded high levels of arsenic and cadmium.

He added that 98.5% of the persons affected were farmers while only 11% of those with CKD were found to be persons not engaged in farming.

He pointed out that due to the adverse effects of arsenic many countries had banned the use of pesticides and fertilisers containing arsenic. However he said that estimates indicated that more than 500,000 MT of arsenic containing pesticides were in stock at the time of it being banned.

A previous study conducted by Dr. Channa Jayasumana revealed that 95% of patients complained of generalised body weakness, 91% headache, 84% burning eyes, 74% anaemia and 76% complained of nausea, while 55% showed mild to moderate hepatomegaly and spleinomegaly (Hepatomegaly is swelling of the liver beyond its normal size, while Splenomegaly is a larger-than-normal spleen.) and 63% had epigastric pain.

According to Dr. Jayasumana’s study rice was found to be more susceptible to arsenic accumulation compared to other cereals. It was discovered that baseline levels of arsenic was 10 folds higher in rice than in other cereals. In a study conducted in 2010 by Tilak Abeysekera it was revealed that 90 – 260 μg/kg of arsenic was found in rice.

Meanwhile Ven. Athuraliye Rathana Thero of the JHU stated during a forum in Colombo recently that the authorities were reluctant to admit that these pesticides and fertilisers were the cause for CKD, due to financial gains.

Highlighting one such incident he said “a container load of fertiliser that was imported was found to be containing high levels of arsenic by the customs. However although the customs seized this container for not conforming to stipulated standards, a directive was issued by the ministry of finance for the release of this container to its importer. The customs officer who made the detection had to leave the country for fear of losing his life,” he added.

Ven. Rathana Thero accused the registrar of pesticides should be removed from his position for failing to implement the stipulated regulations, accusing him of being in the pocket of these pesticide and fertiliser companies. “He had the audacity to even mention in a program on a state radio station that arsenic was vital for the human body, which is such a foolish statement,” he charged.

The Medical Health Officer (MOH) of the Kebithigollewa hospital told The Sunday Leader that they only do the follow-up treatment while the patients suspected of having CKD are sent to Anuradhapura for diagnosis. According to him, 63 patients diagnosed with CKD in the Kebithigollewa area were registered at his hospital while so far this year 21 patients have been diagnosed with CKD.

“In total around 200 patients diagnosed with CKD in the Kebithigollewa area are receiving follow-up treatment. In most instances these patients have lost the function of both kidneys and are sure to die of the disease. Therefore it is pointless to perform transplants, or dialysis, and we generally only provide them follow-up treatment,” he said.

CKD – Mysterious Disease

He further added that having served in the area hospital for the past five years he has seen a rapid rise in the number of patients being diagnosed with CKD. However in spite of the numerous studies that have been conducted in these areas regarding CKD and the direct link to the use of pesticides and fertilisers, the health ministry still claims that there is no link between the two.
Commenting on the issue the health ministry spokesman W.A.D. Wanninayake said that CKD still remains a mysterious disease, where the cause for it is yet unclear.

“Even in Scandinavian countries over the past 15 years many CKD cases had been discovered. Using the information gathered from various areas that the disease is most prevalent, we drew up a map to study the pattern of the spread of the disease. From that information we gathered we found that even in vulnerable provinces, the disease was found only in certain areas,” he said pointing out that this disease could be due to the long term use of medication, consumption of alcohol and various other factors. However CKDU was only prevalent in certain areas.

He said that although fertiliser is being used in many farming areas, the disease has been mostly widespread in just a few areas, adding that if the condition was due to the use of fertiliser, then the disease should have mainly affected areas such as Nuwara Eliya, ‑ an area where the most amount of fertiliser is being used.

He said however that people need to be educated on the proper safety measures to be adhered to when using pesticides.

“In most instances farmers mix two to three different types of pesticides to enable easier spraying. The mixing of these pesticides could create adverse chemical reactions. Another observation was that since the fertiliser is given to the farmers free, they spray these fertilisers on their crops repeatedly with the hope of raking in a bumper harvest,” he pointed out.

However while the health ministry attempts to put the blame on the farmers and safeguard the fertiliser and pesticide importers the WHO report is a clear indication that there is a link between the use of these chemicals and CKD. Hence, the Health Ministry should take up the matter seriously and set proper standards for the pesticides and fertilisers that are brought in to this country, to prevent the entire population of this country from suffering a slow and painful death due to CKD.