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We do not know why? Ignorance is not bliss!


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A recent news item mentions that there is an unknown disease affecting bees in Sri Lanka which has led to the disappearance of several of their colonies. Peradeniya University’s Faculty of Veterinary Science is studying the issue but they are yet to identify a cause. Is this significant and should we be concerned?  3

Pollination is a service we receive from bees and today such services do receive the attention of economists who have realised the critical importance of ecosystem service valuations. World Bank calculations have listed $ 153 billion as the value of pollination services. Humble bees may demand incentive payments if they decipher the WB publications. Thus the disappearance of bees is a serious issue.  

Our agriculture does depend on these worker bees. Indeed, Sri Lankan bees may have been responsible for the growth of our economy. Perhaps the last word came from Albert Einstein, who understood relativity quite well and aptly sums up the value of bees. If the bee disappeared off the surface of the globe then man would only have four years of life left, he stated. 

In his words: no more bees, no more pollination, no more plants, no more animals and no more man. His comment that if bees disappeared then humanity would be gone quite quickly sums up an intricate connection. I must admit that there is some controversy over whether this statement can be attributed to Einstein. 

This measure of understanding is missing within the general public. The disappearance of colonies is not a local issue as this had been identified globally too with some attributing the proliferating mobile towers to the problem.  

Our attention is usually grabbed by simple events and information and most of the time we do not use our analytical faculties. At this stage we are not aware of the reason and the sooner we understand the issue the better the situation will then be for us.  I hope the University of Peradeniya receives support to resolve this matter quickly.

This whole issue of unravelling the unknown has been a key feature of our human progress.  We have faced many an issue and have come out triumphantly. We have termed the process ‘Progress’.  Each our advances has come through being quite creative or finding answers to problems or then turning solutions to advances that are at times spectacular.  

 

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Chronic Kidney Disease

We searched for speed and today escape velocities are a routine operation. Beating the speed of sound is not an issue anymore and benefitting from the speed of light is also not an issue though beating that speed still remains an elusive goal.   

Our human imagination of course may be showing speeds exceeding the speed of light.  Challenging the unknown has been a hallmark of human beings. Yet in some quarters we have allowed ignorance to be sustained for far too long.

Like with bees, we ourselves are facing a mystery illness within our shores. When you move up to the North Central Province we witness many a family in distress. This situation has been worsening since making an appearance in the early 1980s. The issue has been ravaging the region and spreading its effects beyond the province in recent times.  

This mystery kidney disease has been termed CKDu - Chronic Kidney Disease of unknown etiology and is today receiving the attention from the very top. As such the graveness of the situation is evident. Chronic Kidney Disease as a non-communicable disease is identified across the island and the root causes for such is known to be diabetes and high blood pressure. There the reasons for the issue are well-established.  

CKDu strikes the kidney differently and usually the patients have no history of diabetes or high blood pressure. It is also known that when the disease is identified the patients are actually at an advanced state.   

Examinations have also yielded information to the effect that the parts of the kidney affected by CKDu are different from that of the CKD. What is worrying is when the disease is detected it is almost too late. Reversing the disease at that stage is considered not possible. CKDu has been studied by many, including members of a WHO program funded by Sri Lanka.   

Many a hypothesis exists and some even have been deemed to be acceptable and have been followed up with regulations. Yet the overall consensus still is that the cause is not known. Not an enviable position considering that we have been facing the situation for the past 30 years.  There is the need to focus on the issue and direct resources to eliminate the ‘u’ from the ‘CKDu’.   This is a problem demanding national attention and not something to be relegated to be solved through corporate social responsibility. 

The community under threat is our farmer community and again the linkage to the national economy should be well understood. While the area under this disease burden was once the cradle of hydraulic civilisation, today we speak of difficulties in laying a pipe network to distribute good quality water which, whether it solves the issue or not, is a basic human right.  The use of simple cost calculations over what we should be attending to with all our strength signals a lack of courage and determination that prevail within 21st Century Sri Lanka.

The world has witnessed many such situations.  The most famous from the past is the singular contribution of John Snow, who studied the Asiatic cholera episode which gripped London in 1831. He tracked the origin to a water pump debunking the prevailing ‘miasma theory’.  Not much was known about germs but the causative agent was tracked and he broke the pump handle to inactivate the pump thereby providing a now famous solution. His notes of the day state the story of his effort very well.  He had only access to pencil and paper and a desire to seek the truth.  His diagrams made during the study are well known and his methodology gave way to a new medical science termed as Public Health.  He is considered the forefather of epidemiology. 

 



Minamata disease

In place of the pencil and paper which he used to map and track the disease, today we have satellite information, GPS technology and immense computing power even within our phones. Yet we are faltering in finding the way forward.

From the recent past the Japanese Minamata disease was another classic situation.  When the first patients appeared in May 1956, the Japanese authorities really had no clue even with respect to the non-communicable nature of the disease.     65

It has been stated that the initial evidence of an emerging issue was quite alarming – cats going mad, running around and jumping into the sea.  Crows and birds living along the shore of the sea had fallen to die. Thereafter the human victims appeared. Thereafter the human victims appeared. Death was inevitable with a patient succumbing to the disease within one month of its onset.  

The story of the Minamata disease is perhaps the story of Japanese environmental awakening.  This included the founding of the Japanese Environmental Authority.  The reason for the death and disabilities were systematically studied – the Government set up the Strange Disease Countermeasures Committee to investigate - and finally mercury was found to be the culprit and the cause was tracked to a chemical factory.  

It is interesting to note that the crusade against mercury has been continuing and today there is a global convention known as the Minamata convention. Sri Lanka became a signatory to the convention last year. Today in Japan there is a National Institute for Minamata Disease as well as a museum telling every visitor the modern yet unsavory story of the disease done with the hope of avoiding a repetition of a tragedy yet again somewhere.

Considering all that we have, to have an unknown disease in our midst affecting many is simply not acceptable.  The disease is eroding the confidence of a community, reducing them to a difficult state of existence. 

Unlike in Japan and the UK today the existing body of knowledge is significant. The mechanisms and tools for generating understanding abound and exist well within our shores. It is time that Sri Lanka adds itself to the map of progress by understanding and eradicating this mystery kidney disease. Ignorance is not bliss as misery and death is the direct product of inaction.  Again there is awareness of what we are not doing and that too is an indictment of the system.



(The writer is Professor of Chemical and Process Engineering at the University of Moratuwa, Sri Lanka. With an initial BSc Chemical engineering Honours degree from Moratuwa, he proceeded to the University of Cambridge for his PhD. He is the Project Director of COSTI (Coordinating Secretariat for Science, Technology and Innovation), which is a newly-established State entity with the mandate of coordinating and monitoring scientific affairs. He can be reached via email on ajith@cheng.mrt.ac.lk.)

 


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