A Major Irrigation Project (Accelerated Mahaweli Programme) and the Chronic Kidney Disease of Multifactorial Origin in Sri Lanka
Abstract
The Mahaweli River is the longest river in Sri Lanka. In 1978, the government of Sri Lanka launched the Accelerated Mahaweli Development Programme, under the purview of Mahaweli Authority of Sri Lanka, the largest irrigation program in the country. It is a multi-purpose development scheme designed for the generation of hydroelectricity, irrigation, and water for domestic consumption. Since the mid-1990s, a major, non-infectious epidemic of chronic kidney disease of multifactorial origin (CKDmfo) has been reported in Sri Lanka for which no cause has been identified. This disease predominantly affects dry zonal, agricultural regions, particularly the North Central Province (NCP). During the past two decades, thousands of people have died due to this disease. This article assesses whether there is a relationship between this environmental impact from this major irrigation project and the deadly disease of CKDmfo. Water in the Mahaweli River is known to be polluted with various compounds, including phosphates coming from the excessive use of fertiliser in the hill country. However, the levels of phosphate in the Mahaweli River and in the NCP reservoirs are less than 0.15 mg/L. Such levels can cause ecological harm but are not a threat to human health nor causes renal failure. In addition, there are large regions outside the Mahaweli-fed localities where people are affected with CKDmfo. Thus, it is unlikely that water from the Mahaweli River itself is directly related to the occurrence of CKDmfo, but its harmful environmental impact is noticeable. Nevertheless, excess phosphates can cause algae blooms and cyanobacterial growth in water bodies, which harm aquatic lives and the ecology. Thus, governments and society must take responsibility and initiate actions to minimise environmental harm, protect and preserve the watersheds, curb the overuse of agrochemicals, and preserve water quality and the environment for current and future generations.
Keywords
Download Options
Introduction
Water contamination issues are not new to Sri Lanka (Mertens, Fernando et al. 1990, Dharmagunawardhane HA 1993, Guruge and Tanabe 2001), where industrial development and colonization have occurred since the 1950s in areas that previously were forested, particularly in the North Central Province (NCP). This development together with the accelerated Mahaweli project started in the mid-1970s have dramatically altered the ecology of the NCP (Panabokke 2000).
Conserving water is particularly crucial to agriculture because irrigation accounts for more than 70% of freshwater use. Planners need to think of ways to improve crop efficiency with minimal use of water. In the ever-increasing demand for water for irrigation, such efforts are central to meeting future nutrient needs in a sustainable manner. Man-made water conservation structures (known as tanks or reservoirs) traditionally made of earthen dams are a key resource used in agriculture, especially in the dry zonal areas. Both small and large tanks are important not only for agriculture but also for many other human needs in these regions.
Over the past few decades, freshwater resources have been endangered, not only by over-exploitation but also by neglect, poor management, and man-made pollution, including industry effluents; all of this has led to ecological degradation (Burkart 2007). Nevertheless, naturally occurring and man-made contaminations exhibit marked geographical variations (Anonymous 1979), whereas climate changes exacerbate ill health (Mertens, Fernando et al. 1990, Baumgarten, Steinnes et al. 2009). Degradation of watersheds and catchment areas in wooded and hilly country, deforestation, and the consequent soil erosion have led to harmful ecological changes and the need to dredge canals and reservoirs, which contaminates soil (Wimalawansa 2015a)
Conclusion
Since the mid-1990s, a major, non-infectious epidemic of chronic kidney disease of multifactorial origin (CKDmfo) has been reported from a number of provinces in Sri Lanka. The disease predominantly affects agricultural regions in the dry zone. Most of the affected families consume water from shallow wells, tube wells, or streams, which get seepage surface waters from the Mahaweli River, the longest river in the country.
A number of reservoirs supply irrigated water to nearly 365,000 hectares in the dry zone via the Mahaweli Development Programme. Over the past three decades, Mahaweli River water has become polluted with various compounds, including phosphates, which coming from the excessive use of phosphate fertilisers in the hill country (Wimalawansa 2015). It is speculated that drinking water from the Mahaweli River is contaminated with various pollutants, which may contribute to the development of CKDmfo. However, the levels of phosphate (less than 0.15 mg/L) in the Mahaweli River and the reservoirs fed by it can cause ecological imbalance but are not high enough to cause direct harm to human health.
There are large areas in the country affected with CKDmfo outside the Mahaweli water-fed localities, including Polpithigama in Kurunagala district, Mahiyangana in Badulla district, Trincomalee, and Vavuniya. In addition, there is no scientific evidence supporting that consuming Mahaweli River water causes CKDmfo. Thus, despite the high phosphate levels and polluted water, it is unlikely that water from the Mahaweli River itself is directly related to CKDmfo in Sri Lanka.
Nevertheless, excess phosphates in the Mahaweli River may be causing the algae blooms and cyanobacterial growth in NCP reservoirs. Because polluted water causes harm to aquatic lives and the ecology, governments and society must take responsibility and initiate actions to protect and preserve the precious watersheds, curb the overuse of agrochemicals, and preserve water quality and the environment for current and future generations.
CKDmfo is affecting the social and economic life of a large number of people in the country. The families of those who are affected by this disease are in a desperate situation. It is necessary that the basic recommendations indicated here are implemented as early as possible as the first step toward preventing this deadly disease. It is also essential to identify sustainable solutions to the environmental degradation and consequent socio-economic and medical problems in the NCP and entire country.
Conflicts of interest: There is no funding associated with this study, and the authors have no conflicts of interest.
