SUN-133 THE EFFECTS ON PATIENTS WITH CHRONIC KIDNEY DISEASE OF UNKNOWN ETIOLOGY IN SRI LANKA OF THE USE OF PURIFIED AND REVERSE OSMOSIS WATER FOR DRINKING

Abstract

Many researchers have suggested that environmental toxins in drinking water have played a crucial role in Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka. In response to this, the government has introduced reverse osmosis (RO) water as an alternative form of drinking water in areas where CKDu is endemic. In parallel, the local health department introduced a health behavioral program aimed at CKDu patients and their families. Looking at these developments, and analyzing data on RO plants, statistics relating to CKDu, and the health records of CKDu patients, this article examines a) whether the prevalence of CKDu and the progression of the disease in patients have been reduced as a result and b) how the affected people in the villages perceive the changes brought about by the new source of drinking water. A study was conducted in three Divisional Secretariat divisions in the North Central Province (NCP). Information on people’s perceptions of RO water use was collected in a survey of 200 families in Medirigiriya. Health records of 30 CKDu patients were used to analyze the progression of the disease. RO water use patterns were observed in 48 households. Data on RO plants and the prevalence of CKDu in the NCP were obtained from the National Renal Registry. Research participants gave their verbal consent. The fieldwork in the villages was carried out from January to June 2019. The interviews were conducted in Sinhalese and translated into English. The prevalence of CKDu in the NCP shows an increase with a declining trend from 2014 to 2016 which could be a result of the change in the source of drinking water from dug wells and tube wells to natural spring water, bottled water, and water sold in water shops that commenced around 2008. After 2014, many RO plants and a health behavior program aimed at CKDu patients were introduced, which could be a factor in a decline in the prevalence of the disease after 2016. The change in the source of drinking water and other behavioral changes adopted by the villagers have contributed to a considerable reduction in the prevalence of CKDu. The new programs seem also to have contributed to a diminution of the progression of CKDu in individual patients. However, women now have to spend about 1.5-2 hours each day on RO water collection, carrying heavy containers from a distance, and this has made their role more demanding and arduous.