Indo-Sri Lanka kidney fiasco

The amazing kidney is a precious organ in the human body

The kidney is one of the main precious organs in the human body – making urine, removing excess water, controlling body chemicals/toxins, controlling blood pressure, keeping bones healthy, helping make red blood, controlling mineral potassium, blood acidity and many other factors for a healthy life. 

For a long and healthy life the kidney is as important as the heart that pumps blood for the body to function. Many external and internal factors are responsible for the damages caused to the kidney leading to kidney failure which was somewhat rare in the past. Today it has become dangerously high due to imbalanced food/water, artificial life against nature, excessive intake of chemicals and other undetected and unidentified causes researched worldwide due to the threat to the human kind. 

It is the duty of the human being to take precautions for the maintenance and safety of the precious kidney pressured due to excessive use of chemicals, external articles and many other factors causing short and long term damages to this vital organ. Sri Lanka is the most recent victim of this disastrous epidemic.

Kidney diseases in the world and in Sri Lanka

Due to the rapidity of the increase of kidney diseases, government and non-governmental organisations have set up foundations, advisory centres and worldwide networks on educating the citizens on safety and preventive measures. Medical researchers have found the main causes of kidney diseases to be due to diabetes, blood pressure, hypotension, chemicals, food pattern and many connected factors. Diabetes is spreading fast worldwide including Sri Lanka with the increase of kidney patients. 

About 10% of the world population is affected by Chronic Kidney Diseases (CKD) with 6% Asian diabetic patients and death of 1.5 million citizens per year worldwide. There are 400,000 sickened kidney patients and 4 million diabetic patients in Sri Lanka out of 21 million. 382 million diabetic patients in the world will rise to 592 million in 2035 which is a frightening health risk for the future population.

Kidney diseases were presumed to be prevalent among farmers and Chena cultivators initially which is now spreading length and breadth of the country including NE, North Central North and urban areas. The affected people were 15% of the population rapidly increasing now at an alarming rate. There are 22,000 CKD patients and 300 deaths ever increasing with 1,100 patients every month. 

It is suspected that the cause of this is due to water contamination, excessive unregulated fertiliser, wrong food patterns and contaminated food/water with excessive chemicals, potassium and cadmium in the water polluted with fertiliser, and many undetected reasons. Ministry of Health, UN, and many NGOs and professionals have researched this disaster to which no proper and longstanding solution is forthcoming.

Kidney transplant and dialysis

When the most precious kidney is not functioning, the only alternative is dialysis and transplant which is costly, complicated and cumbersome. Due to recent developments and advancement of science and technology transplant and dialysis has become accessible with a price. Dialysis is used for actuate disturbance of kidney function or worsening kidney function. It is a holding measure until a kidney transplant is performed. Transplant is an operation in which person with kidney failure receives new kidney taking over the work of clearing blood. There are related non related living and non-living donors.

Kidney transplant and dialysis in Sri Lanka and India

Kidney and diabetic patients are rampant in India. It is a hidden epidemic and the rate is alarmingly high as 17.4% with 7.1% diabetic population which is the main cause of CKD. Recently India brought legislation to prevent organ sale allowing only the family to donate organs to the relations. In Sri Lanka donations of blood, eyes and parts of body are liberal due to the willingness of Buddhists to donate parts of the body to the needy which is not an offence under the Penal code unless it comes under cheating or sale of organs of the body. 

On the other hand, Sri Lanka has a proud history in this area maintaining highest standards for the doctors and the hospitals private and state. The late Lakshman Kadirgamar the former Minister of Foreign Affairs lived with a kidney donated by a Buddhist Monk. Sri Lankan private hospitals and able doctors have performed successful operations to Indian nationals visiting Sri Lanka with kidney donors. It is not illegal in Sri Lanka. 

Medical tourism is in promotion of our medical system to foreigners. Other modes of tourist attractions such as cricket tourism, tea tourism and cultural tourism too are to be promoted with the influx of tourists due to various factors including the environment and beauty of this boatful tourist paradise. Therefore, kidney transplants in Sri Lanka are to be promoted and encouraged with a regulatory procedure.

Alleged kidney scam by Indian nationals  with agents

Publicity is given in India, Sri Lanka and international media about exploitation of the patients eager to save their lives and their agents misusing the facilities goodwill and the excellent services offered by the Sri Lankan doctors and the private hospitals to visiting patients and relations. India enacted legislation to prevent organ sale and trafficking and misuse of the transplant process. 

On the other hand, what is the alternative for the dying patient without proper medical care? Sri Lankan legal basis is more liberal and patient friendly. Relations in Sri Lanka are allowed to donate organs and sometimes it extends to others with the permission of the Ministry of Health. Historically Buddhist monks offered organs for which the Ministry readily granted permission. Indians managed to undergo kidney transplants of the donors until the scam revealed that the agents and the middlemen were exploiting large sums getting the services of Sri Lankan doctors by paying the nominal amounts when the middlemen and agents were exploiting the patients.

It is informed that 60 such transplants have been performed so far and it is advisable to regularise as in blood and eye donations. Sri Lankan side are only facilitators and providers of services with no involvement in the procedure except the services of hospitals and doctor’s professional duties. Many are of the view that the needy patients should be given the option and facility for treatment to save the life and to benefit from the advancements of the medical field.

Way forward and Kidney Day on 10 March 

It is time that the State, NGOs local and international and professionals launch short and long term concerted plan of action to educate the citizen and bring about a solution to this disaster by educating the people and the victims to eradicate the man made menace engulfing the entire nation. Threat is imminent and all over the country with contaminated water and poisonous dry and cooked food in the market. 15 districts out of 25 have no tap water which is supposed to be safe as ground water which was the safest to drink is now polluted. 

Vegetables and fruits are poisonous and contaminated with excessive use of chemicals as preservatives and used as fertiliser. Cooked food is unreliable with the use of foreign bodies used and the use of contaminated dry food vegetables and fruits. Ministry of Health, Consumer Affairs Authority, Local Authorities, Standards Bureau and Public Health Inspectors are to be mobilised by the State to clamp down the imminent danger increasing day by day.

‘Samastha Lanka Kidney Patients Association’ backed by Professor Rezvi Sheriff and Dr. Sanjeeva Heiyanthuduwa is doing a yeoman service in educating patients and would-be victims for prevention and assistance in dialysis and transplants through the Association. It is informed that we need at least 1,000 dialysis centres to cater the current needs. We are planning to arrange a few centres with the assistance of the Israel entrepreneurs who are world leaders on water agriculture and technology. 

The Association will be organising an event on World Kidney Day in the morning and Sri Lanka 2050 is organising a seminar/workshop at the Auditorium of the Organisation of Professionals on 10 March with the assistance of Israel enterprisers addressed by Professor Rezvi Sheriff and a group of speakers backed by the kidney related organisations, ministries and the State in the joint operation in assisting eradication of the imminent threat to the dangerous epidemics of kidney diseases on the doorstep.

(The writer is former Ambassador to UAE and Israel. He can be reached via [email protected]).